Effectiveness of Health and Safety at Work Services (PSAL) in reducing occupational injuries in Lombardy Region

Introduction: In recent years, Italy has seen a reduction in workplace accidents due to several factors, including the controls carried out by the Health and Safety at Work Services (PSAL) of the Local Health Units (ATS). Objective: To verify the contribution of PSAL Services to injury reduction. In particular, to identify the existence of a difference between incidence rates of accidents in companies before and after inspections and possible variations in rates between inspected and non-inspected companies. Methods: We analyzed data of the activities carried out by the PSAL Services of the Lombardy Region in the system I.M.Pre.S@ (Computerization and Health Prevention Monitoring) in the period 2010-2015, together with data from the Regional Accident Database of the National Institute for Insurance against Accidents at Work (INAIL). The "difference in difference" (DID) method was used to evaluate the different effect on inspected and non-inspected industries. Results: Between the pre-and post-vigilance periods, inspected companies showed a greater reduction either of total injury rates (DID=-2.7 per 1000 worker-years; 90% confidence interval (CI): -4.1; -1.3) or of severe injury rates (DID=-1.1; 90% CI: -1.7; -0.5). These effects were visible in the majority of ATS and occupational sectors. Conclusions: This study, made possible by a valid and efficient regional data tracking system, has shown the positive effect of the PSAL prevention actions on the frequency of both total and severe injuries.