Impact of organization on occupational injury risk: Evidence from high-speed railway construction.

Background The construction industry is at the top of the list of priorities for surveillance and research, although it is often difficult to perform detailed analysis of the risk factors. In mid-2002, construction work started on the Torino to Novara high-speed railway line. A Regional Epidemiological Observatory developed a standardized data collection system that provided a rare opportunity for researchers in Italy to analyze risk factors for occupational injury in a large cohort of workers involved in a single major construction project. The aim of this study is to describe the characteristics of a cohort of workers employed at construction sites of the high-speed Torino to Novara railway between 2003 and 2005, analyze the main determinants of occupational injury risk and estimate incidence rates. Methods Frequency rates of occupational injury were calculated by characteristics of workers and firms and relative risks were estimated using a Poisson model. Results Annual injury incidence decreased over the period and was higher than the Italian construction industry rate. The risk was highest among workers performing the least skilled jobs and with the shortest contracts. Moreover the risk was higher in large enterprises. Conclusions Although calculated within a specific context, the results provide information applicable to all construction sites. The high risk of occupational injury associated with short-term contracts suggests, at such large and long-term construction sites, to engage workers on a permanent basis for the duration of the construction project. [ABSTRACT FROM AUTHOR]