ORIGINAL ARTICLE

Prevention of work related eye injuries: long term assessment of the effectiveness of a multicomponent intervention among metal workers

G Mancini¹, A Baldasseroni², G Laffi³, S Curti⁴, S Mattioli⁵ and F S Violante⁶

¹ Occupational Health Service, Azienda USL di Ravenna, Ravenna, Italy (formerly at Occupational Health Service, Azienda USL di Imola, Imola)
² Epidemiology Unit, Azienda USL di Firenze, Florence, Italy
³ Occupational Health Service, Azienda USL di Imola, Imola, Italy
⁴ Laboratory of Epidemiology, Occupational Medicine Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy
⁵ Alma Mater Studiorum–University of Bologna, Laboratory of Epidemiology, Occupational Medicine Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy
⁶ Alma Mater Studiorum–University of Bologna, Occupational Medicine Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy

Correspondence to:
Correspondence to:
Dr S Mattioli
Laboratorio di Epidemiologia, Unità Operativa di Medicina del Lavoro, Policlinico Sant’Orsola Malpighi, via Pelagio Palagi n.9, I-40138 Bologna, Italy; smattioli{at}aosp.bo.it

Background: Systematic assessments of the effectiveness of interventions to prevent work related eye injuries are needed.

Aim: To investigate the long term effectiveness of a multicomponent prevention campaign.

Methods: The campaign (conducted in collaboration with the local Employers’ Association and Trade Unions) targeted all 237 metal-ware factories in the district of Imola, Italy. Based on preliminary inspections, the main intervention included distribution to all factories of specific educational brochures and broadcasting/publication of television/radio programmes and local newspaper articles containing expert advice on the subject. This was followed by a four year "post-intervention reinforcement" period of unannounced official inspections. Main outcome measures analysed were eye injury rates (versus non-eye injury rates) among metal workers during "pre-intervention" (1988–90), "peri-intervention" (1991–92), "post-intervention reinforcement" (1993–96), "late post-intervention" (1997–2000), and "very late post-intervention" (2001–03) periods with respect to two comparison sectors (construction and wood/ceramics).

Results: A Poisson regression in which the eye injury rates were modelled for each sector, period, and interaction, adjusting for non-eye injury rates, was chosen. The periods did not by themselves determine an overall reduction in eye injuries. The period/sector interaction terms were related to significant reductions for the metal sector when crossed with the "post-intervention reinforcement" (IRR = 0.77, 95% CI 0.61 to 0.97; % decline = 23.4), the "late post-intervention" (IRR = 0.63, 95% CI 0.50 to 0.79; % decline = 37.4), and the "very late post-intervention" (IRR = 0.58, 95% CI 0.43 to 0.77; % decline = 42.4) periods, suggesting a sustained reduction in eye injury risk following the main intervention.

Conclusion: Results suggest that a carefully coordinated, extensive, multicomponent intervention can lead to lasting reductions in the burden of eye injuries.

Keywords: eye injuries; prevention; effectiveness

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