Air temperatures and occupational injuries in the agricultural settings: a report from Northern Italy (Po River Valley, 2013-2017) Air temperatures and occupational injuries in agricultural industries

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Matteo Riccò
Luigi Vezzosi
Federica Balzarini
Giovanni Gualerzi
Marina Valente
Nicola Luigi Bragazzi


agricultural workers, climate change, heat exposure, occupational injuries, hot weather, heat wave


Introduction. High environmental temperatures are associated with an increased risk for occupational injuries (OIs), particularly where environmental exposure and heat sources in the workplace, are associated with internal heat generation by strenuous muscular work. As a consequence, Agricultural Workers (AWs) are among the most heavily affected occupational groups.

Methods and Aims. The aim of this study was to assess the relationship between environmental temperatures and OIs in AWs from the Po River Valley in the Northern Italy (27,736,158 total inhabitants; mean agricultural workforce of 312,195.6 individuals). Data about OIs from 2013 to 2017, and daily weather for the administrative unit of occurrence were retrieved. Days were classified by a) mininum (Tmin) / maximum (Tmax) air temperatures; b) average day temperature (Tday); c) daily temperature variation (TV), d) relative humidity. Risk for daily OIs was calculated as correspondent Odds Ratios (OR) through a Poisson regression model.

Results. Estimated incidence for OIs was 66.3/1,000 workers-year. In regression analysis, for every Tday percentile increase equal to 2.5, an OR 1.007 (95% CI, 1.003 to 1.010) was reported. More precisely, higher risk for OIs was associated to Tmax > 25°C (OR 1.143, 95%CI 1.125-1.160) and to Tmax > 25°C + Tmin > 20°C (OR 1.158, 95%CI 1.138-1.179), Tmin < 0°C were associated with a significantly reduced risk (OR 0.879, 95%CI 0.850-0.910), with the notable exception of older age groups (OR 1.348, 95%CI 1.254; 1.449). During timeframes characterized by Tmax > 35°C (i.e. HW time period), the risk was higher during the first day (OR 1.266; 95%CI 1.206-1.330), and again from the fourth day onwards (OR 1.090; 95%CI 1.048 – 1.133). Analysis of TV identified an increased risk for occupational injuries in days characterized by higher variability, and particularly for TV ranging 4.0 – 4.9 (OR 1.042, 95%CI 1.017 – 1.068), and equals to 5.0 or greater (OR 1.143, 95%CI 1.118 – 1.167). Also increased relative humidity was associated with higher risk for OIs (OR 1.096, 95%CI 1.081-1.126, and OR 1.154, 95%CI 1.135-1.173 for relative humidity 70 – 89%, and ≥ 90%).

Conclusions. Our findings recommend policymakers to develop appropriate procedures and guidelines, in particular for the HW time periods.


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1. Messeri A, Morabito M, Bonafede M, et al. Heat Stress Perception among Native and Migrant Workers in Italian Industries—Case Studies from the Construction and Agricultural Sectors. Int J Environ Res Public Health 2019;16(7): pii: E1090. doi: 10.3390/ijerph16071090
2. Bonafede M, Marinaccio A, Asta F, et al. The association between extreme weather conditions and work-related injuries and diseases. A systematic review of epidemiological studies. Ann Ist Super Sanità. 2016;52(3):357–67. doi: 10.4415/ANN_16_03_07.
3. Xiang J, Bi P, Pisaniello D, et al. Health Impacts of Workplace Heat Exposure: An Epidemiological Review. Ind Health. 2014;52:91–101. doi: 10.2486/indhealth.2012-0145
4. Mcinnes JA, Akram M, Macfarlane EM, et al. Association between high ambient temperature and acute work-related injury: a case-crossover analysis using workers’ compensation claims data. Scand J Work Env Heal. 2017;43(1):86–95. doi: 10.5271/sjweh.3602
5. Intergovernmental Panel on Climate Change (IPCC). Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Stocker TF, Qin D, Plattner GK, Tignor M, SK Allen, Boschung J, Nauels A, Xia Y, Bex V MP, editor. Cambridge, United Kingdom and New York, NY, USA: Cambridge University Press; 2013.
6. Riccò M, Garbarino S, Bragazzi NL. Migrant Workers from the Eastern-Mediterranean Region and Occupational Injuries : A Retrospective Database-Based Analysis from North-Eastern Italy. Int J Env Res Public Heal. 2019;16(4): pii: E673. doi: 10.3390/ijerph16040673..
7. Riccò M. Air temperature exposure and agricultural occupational injuries in the autonomous province of Trento (2000-2013, North-Eastern Italy). Int J Occup Med Environ Health. 2018;31(3):317-331. doi: 10.13075/ijomeh.1896.01114
8. Lucas RAI, Epstein Y, Kjellstrom T. Excessive occupational heat exposure : a significant ergonomic challenge and health risk for current and future workers. Extrem Physiol Med. 2014;3:14. doi: 10.1186/2046-7648-3-14
9. Crowe J, Nilsson M, Kjellstrom T, et al. Heat-Related Symptoms in Sugarcane Harvesters. Am J. Ind. Med 2015;58(5):541-548. doi: 10.1002/ajim.22450
10. Kjellstrom T, Holmer I, Lemke B. Workplace heat stress, health and productivity-an increasing challenge for low and middle-income countries during climate change. Glob Health Action. 2009;2: 10.3402/gha.v2i0.2047 doi: 10.3402/gha.v2i0.2047
11. Singh S, Hanna EG, Kjellstrom T. Working in Australia’s heat: Health promotion concerns for health and productivity. Health Promot Int. 2015;30(2):239-50. doi: 10.1093/heapro/dat027
12. Xiang J, Bi P, Pisaniello D, et al. The impact of heatwaves on workers’ health and safety in Adelaide, South Australia. Environ Res 2014;133:90–95. doi: 10.1016/j.envres.2014.04.042
13. Xiang J, Hansen A, Pisaniello D, et al. Extreme heat and occupational heat illnesses in South Australia, 2001-2010. Occup Environ Med. 2015;72(8):580–586. doi: 10.1136/oemed-2014-102706
14. Varghese BM, Hansen A, Bi P, et al. Are workers at risk of occupational injuries due to heat exposure? A comprehensive literature review. Saf Sci 2018;110(Part A):380–392. doi: 10.1016/j.ssci.2018.04.027
15. Messeri A, Binazzi A, Morabito M, et al. Evaluation of the impact of heat stress on the occurrence of occupational injuries: Meta-analysis of observational studies. Am J Ind Med. 2019;62(3):233-243. doi: 10.1002/ajim.22946
16. Riccò M, Vezzosi L, Gualerzi G. Health and Safety of Pesticide Applicators in a high income agricultural setting: a knowledge, attitude, practice, and toxicity study from North-Eastern Italy. J Prev Med Hyg. 2018;59(3):E200-E211. doi: 10.15167/2421-4248/jpmh2018.59.3.934
17. Riccò M, Vezzosi L, Bragazzi NL, et al. Heat-Related Illnesses among Pesticide Applicators in North-Eastern Italy (2017). J Agromedicine. 2020; 25(1):52-64. doi: 10.1080/1059924X.2019.1606745
18. Riccò M, Razio B, Poletti L, et al. Knowledge, attitudes, and sun-safety practices among agricultural workers in the Autonomous Province of Trento, North-Eastern Italy (2016). G Ital Dermatol Venereol 2017; Epub ahead of print. doi: 10.23736/S0392-0488.17.05672-3:
19. Guo Y, Gasparrini A, Armstrong BG, et al. Temperature variability and mortality: A multi-country study. Environ Health Perspect. 2016;124(10):1554–1559. doi: 10.1289/EHP149
20. Riccò M, Vezzosi L, Balzarini F, et al. Air temperatures and occupational injuries in the construction industries: a report from Northern Italy (2000-2013). Ind Health. 2020; 58(2):182-192. doi: 10.2486/indhealth.2018-0268
21. Morabito M, Cecchi L, Crisci A, et al. Relationship between work-related accidents and hot weather conditions in Tuscany (central Italy). Ind Health. 2006;44(3):458–464. doi: 10.2486/indhealth.44.458
22. Morabito M, Iannuccilli M, Crisci A, et al. Air temperature exposure and outdoor occupational injuries: A significant cold effect in Central Italy. Occup Environ Med. 2014;71(10):713–716. doi: 713-6. doi: 10.1136/oemed-2014-102204
23. Marinaccio A, Scortichini M, Gariazzo C, et al. Nationwide analysis on the effect of outdoor temperature on occupational injuries in Italy. Environ Int 2019;133(PtA):105176. doi: 10.1016/j.envint.2019.105176. 24.
24. Campbell S, Remenyi TA, White CJ et al. Heatwave and health impact research: a global view. Health and Places 2018;53:210-218. doi: 10.1016/j.healthplace.2018.08.017
25. Riccò M, Razio B, Panato C, et al. Knowledge, Attitudes and Practices of Agricultural Workers towards Tetanus Vaccine: a Field Report. Ann Ig 2017;29(4):239-255. doi: 10.7416/ai.2017.2156
26. Bozzola M, Massetti E, Mendelsohn R, et al. A Ricardian analysis of the impact of climate change on Italian agriculture. Eur Rev Agric Econ. 2018;45(1):57-79. doi: 10.1093/erae/jbx023
27. Mirabelli MC, Quandt SA, Crain R, et al. Symptoms of heat illness among Latino farm workers in North Carolina. Am J Prev Med. 2010;39(5):468–71. doi: 10.1016/j.amepre.2010.07.008
28. Ghafari M, Cheraghi Z, Doosti-Irani A. Occupational risk factors among Iranian farmworkers: a review of the available evidence. Epidemiol Health 2017; 39:e2017027. doi: 10.4178/epih.e2017027
29. Gatto M, Cabella R, Gherardi M. Climate change: the potential impact on occupational exposure to pesticides. Ann Ist Super Sanità. 2016;52(3):374–385. doi: 10.4415/ANN_16_03_09
30. Martínez-Solanas È, Basagaña X. Temporal changes in temperature-related mortality in Spain and effect of the implementation of a Heat Health Prevention Plan. Environ Res 2019;169:102-113. doi: 10.1016/j.envres.2018.11.006
31. Martinez-Solanas E, Basagana X. Temporal changes in the effects of ambient temperatures on hospital admissions in Spain. PLoS One. 2019;14(6):e0218262. doi: 10.1371/journal.pone.0218262
32. Casanueva A, Burgstall A, Kotlarski S, et al. Overview of Existing Heat-Health Warning Systems in Europe. Int J Environ Res Public Health. 2019;16(15). pii: E2657. doi: 10.3390/ijerph16152657.
33. Morabito M, Messeri A, Noti P, et al. An Occupational Heat–Health Warning System for Europe: The HEAT-SHIELD Platform. Int J Environ Res Public Health. 2019; 16(16). pii: E2890. doi: 10.3390/ijerph16162890.
34. Riccò M, Razio B, Poletti L, et al. Risk perception of heat related disorders on the workplaces: a survey among health and safety representatives from the autonomous province of Trento, Northeastern Italy. J Prev Med Hyg 2020;61(1):E48-E59 doi: 10.15167/2421-4248/jpmh2020.61.1.727

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