Trends in Occupational Diseases in Italian Industry and Services From 2006 To 2019

Our plain-English summary of Trends in Occupational Diseases in Italian Industry and Services From 2006 To 2019, by F. Larese Filon, O. Spadola, C. Colosio, et al (La Medicina del Lavoro, 2023).

The study

• Authors: F. Larese Filon, O. Spadola, C. Colosio, H. Van Der Molen
• Journal: La Medicina del Lavoro
• Published: 2023;114(4):e2023035
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: There is a paucity of data on occupational disease incidence in Italy, and we analyzed the trend on time as an incidence rate ratio (IRR).

Methods: Occupational diseases reported to the Italian National Insurance for Occupational Diseases (INAIL) in industrial and services sectors from 2006 to 2019 were considered and analyzed. Annual case counts were analyzed using a Poisson regression model to estimate incidence trends.

Results: The incidence of occupational diseases in the industrial and services sectors in 2019 was 261 cases for 100,000 workers, with musculoskeletal disorders (MSDs) representing 65% of the total cases, their incidence being 169.5 cases per 100,000 workers. The incidence of ear diseases (ED) decreased to 20.8 cases for 100,000 workers. The annual change in incidence (IRR) was 1.08 (CI 95% 1.07-1.11) for MSDs, 1.08 (CI 95% 1.06-1.10) for cancers, and 1.04 (CI 95% 1.03-1.06) for respiratory diseases. The trend was significantly negative for ear diseases, 0.96 (CI 95% 0.96-0.97), and skin diseases 0.93 (CI 95% 0.92-0.93). No changes were found for asbestos and mental diseases.

Conclusions: During the study period, occupational diseases increased in Italy, mainly for MSDs, due to a changeover in eligibility criteria from 2008. However, the overall incidence was lower than in other EU Countries. More efforts are needed to harmonize the legislation for joint action in the prevention and recognition of occupational diseases.

In plain English

This short communication analysed occupational diseases reported to INAIL, Italy's workers' insurance body, in the industrial and services sectors from 2006 to 2019. The authors divided yearly case counts by the number of workers employed in those sectors (18,073,000 in 2006 and 18,863,438 in 2019). In total, 544,924 occupational diseases were notified over the 14 years. In 2019, 49,271 cases were reported, or 261.2 per 100,000 workers, and musculoskeletal disorders made up 65% of them. The yearly incidence rate ratio was 1.08 (95% CI 1.07-1.11) for musculoskeletal disorders, 1.08 (1.06-1.10) for cancers and 1.04 (1.03-1.06) for respiratory diseases, while ear and skin diseases declined. For the category labelled asbestos diseases, 30,558 cases were reported over the period and 2,234 in 2019, with no change over time (rate ratio 1.00, 95% CI 0.99 to 1.01). The authors linked this to Italian law making the exposure relationship clear and stable. The article does not name fiber types or specific asbestos diseases. The authors concluded that the trends seemed mainly due to legislation and insurance criteria, not an actual increase in disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Short communication analysing national insurance records of reported occupational diseases over time (time-trend analysis using Poisson regression)
• Who was studied: Occupational diseases notified to INAIL in Italy's industrial and services sectors, 2006 to 2019. The denominator was the number of workers employed in these sectors each year: 18,073,000 in 2006 and 18,863,438 in 2019.
• Exposure: Work in the Italian industrial and services sectors. No specific exposures were measured. Asbestos diseases appear as a reporting category, with no fiber types, products or individual diseases described.
• Main results:
  • Over the 14 years, 544,924 occupational diseases were notified among workers in the industrial and services sectors
  • In 2019, 49,271 occupational diseases were reported, an incidence of 261.2 per 100,000 workers. Musculoskeletal disorders were 65% of cases (n=31,973), or 169.5 per 100,000 workers.
  • The annual change in incidence (IRR) was 1.08 (95% CI 1.07-1.11) for musculoskeletal disorders, 1.08 (95% CI 1.06-1.10) for cancers and 1.04 (95% CI 1.03-1.06) for respiratory diseases
  • Reported cancers rose from 5.8 to 13.1 cases per 100,000 workers between 2006 and 2019
  • The trend was significantly downward for ear diseases (IRR 0.96, 95% CI 0.96-0.97) and skin diseases (IRR 0.93, 95% CI 0.92-0.93)
  • Asbestos diseases: 2,234 reported in 2019 and 30,558 over 2006 to 2019, with no change in trend (IRR 1.00, 95% CI 0.99 to 1.01)
  • The authors attributed the stable asbestos trend to Italian law making the relationship with exposure clear and stable over time
• The authors' conclusion: The authors concluded that the trends in reported occupational diseases in Italy seemed mainly due to legislation and insurance criteria rather than to an actual increase in disease, and called for common EU legislation on recognising occupational diseases
• Limitations the authors state:
  • The authors stated that the incidence of reported occupational diseases is biased by the criteria used for compensation
  • The authors stated that comparing incidence between countries is problematic because surveillance systems differ
  • The authors stated that skin diseases are under-reported in Italy
  • The authors noted that mental disorders are not on Italy's official list of occupational diseases

Topics

Medical terms in this study, explained in our Lexicon: Occupational Disease, Incidence.

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• Italian National Register of Occupational Cancers: data system and findings — A. Scarselli, S. Massari, et al. (2010)
• A labor-management occupational health service in a construction industry — I.R. Tabershaw, W.C. Cooper, et al. (1970)
• The silence: the asbestos industry and early occupational cancer research--a case study — D.E. Lilienfeld (1991)
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