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Silvana Salerno Occupational health researcher ENEA Casaccia silvana.salerno@enea.it

COMPENSATING FOR THE INEQUALITIES EXPERIENCED AS A WOMAN AND/OR AN IMMIGRANT : THE CASE OF MUSCULO-SKELETAL OCCUPATIONAL DISEASES IN ITALY. Silvana Salerno Occupational health researcher ENEA Casaccia silvana.salerno@enea.it. INTRODUCTION OBJECTIVES METHODS RESULTS DISCUSSION.

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Silvana Salerno Occupational health researcher ENEA Casaccia silvana.salerno@enea.it

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  1. COMPENSATING FOR THE INEQUALITIES EXPERIENCED AS A WOMAN AND/OR AN IMMIGRANT: THE CASE OF MUSCULO-SKELETAL OCCUPATIONAL DISEASES IN ITALY Silvana Salerno Occupational health researcher ENEA Casaccia silvana.salerno@enea.it

  2. INTRODUCTION OBJECTIVES METHODS RESULTS DISCUSSION

  3. International studies in Canada and Europe showed gender inequalities in the recognition of work related diseases. Karen Messing reported the case of Sweden (World Health Organization, A review of the evidence, 2006)

  4. KATHERINE LIPPEL (2002) reported systemic discrimination against women workers for musculoskeletal disorders in Quebec (Canada) * * p<0.10

  5. ISABELLE PROBSTreported lower success rate in Switzerland (2009, 2013) for musculoskeletal disorder of women

  6. Laurent Vogel reported disability rates on average lower for women: 15.1 % against 16.8 % in Belgium (2011) Tab. 4 – Private sector, list system, permanent work disability , 2009 Source: Vogel L. (modified) Women and occupational diseases: the case of Belgium (2011)

  7. Florence Chappert reported inequalities on “Gender, health and working conditions” in France (2014) GENDER DIFFERENCES IN THE ACCEPTANCE RATE IN THE PRIVATE SECTOR IN FRANCE (n. 18.296.201 employers) Source: Chappert F. (modified) Dossier Genre et conditions de travail, ANACT 2014

  8. WHAT ABOUT ITALY? • No studies on gender or immigrant success rate on occupational diseases have been performed in Italy • In 2008 a law introduced (D. L. n. 81/2008) the “gender” and “immigrant” and “ageing” compulsory occupational risk assessment • In 2008 upper limb overloadhad been included in the new list system of occupational diseases considering that musculoskeletal diseases represented the highest rank among italian women

  9. INTRODUCTION OBJECTIVES METHODS RESULTS DISCUSSION

  10. MAIN QUESTIONS • DO ITALIAN STATISTICAL DATA ON OCCUPATIONAL DISEASES PRESENT GENDER INEQUALITIES IN THE SUCCESS RATE AS SHOWN IN OTHER COUNTRIES? • DO STATISTICAL DATA ON OCCUPATIONAL DISEASES PRESENT IMMIGRANT INEQUALITIES IN THE SUCCESS RATE? • IS UPPER LIMB OVERLOADSUCCESS RATE AN EXCEPTION ?

  11. INTRODUCTION OBJECTIVES METHODS RESULTS DISCUSSION

  12. Gender and immigrant analysis of statistical data records in declaring and accepting occupational health diseases in the list system (high probability > 50 %) and out of the list (the worker is encharged to prove the etiology) published by the National Institute for Insurance against Accidents at Work (INAIL) • Statistical Data on occupational health diseases on industries and services sectors (main concentration of occupational diseases in Italy followed by agriculture, state employment) have been analyzed taking gender and the condition of being immigrant (6 % of the total) with particular attention on musculoskeletal disorders • No data on overall workers (almost 75 % of the regular insured working population – 17.500.000, 9.400.000 women), nor overall hours worked are published. No prevalence or incidence rate is given or calculated

  13. LIST OF DISEASES (2008) Upper limb overload in the list

  14. Gender and immigrant success rate have been calculated (occupational health diseases declared/occupational health diseases accepted) within the years 2010-2013 (31 st october 2014) • Time-lapse for an occupational health disease in the list system is 120 days, not listed 180 days • Statistical analysis has been performed by 2 test and variables 2x2 have been analyzed to evaluate the main differences

  15. INTRODUCTION OBJECTIVES METHODS RESULTS DISCUSSION

  16. ALL OCCUPATIONAL HEALTH DISEASES - GENDERIndustry and services 2010-2013 (average)(INAIL- STATISTICAL DATA (up to date 31st october 2014)

  17. OCCUPATIONAL HEALTH DISEASES - IMMIGRANTSIndustry and services 2010-2013 (average)INAIL- STATISTICAL DATA (up to date 3Ist october 2014)

  18. ALL OCCUPATIONAL HEALTH DISEASES NOT LISTED GENDER- Industry and services 2010-2013 (average)(INAIL- STATISTICAL DATA (up to date 31st october 2014)

  19. OCCUPATIONAL HEALTH DISEASES NOT LISTEDIMMIGRANTS - Industry and services 2010-2013 (average)(INAIL- STATISTICAL DATA (up to date 31st october 2014)

  20. SUCCESS RATE OF LISTED AND NOT LISTED OCCUPATIONAL HEALTH DISEASES PER GENDER AND IMMIGRANTSIndustry and services 2010-2013 (average)(INAIL- STATISTICAL DATA (up to date 31st october 2014)

  21. DIFFERENCES IN THE DECLARATION OF OCCUPATIONAL DISEASES PER LIST, GENDER AND IMMIGRANTS (average)Industry and services 2010-2013 (average)(INAIL- STATISTICAL DATA (up to date 31st october 2014)

  22. ALL- Occupational health diseases “upper limb overload”Industry and services-2010-2013 (average) Statistical Data INAIL (up to date 31 st october 2014)

  23. IMMIGRANTS - Occupational health diseases - upper limb overload - Industry and services-2010-2013 (average) Statistical Data - INAIL (up to date 30 th october 2013)

  24. INTRODUCTION OBJECTIVES METHODS RESULTS DISCUSSION

  25. Gender success rate of occupational health diseases within and out of the list (industry and services) published by INAIL (up to date october 2014) is constantly lower among women Women declare more out of the list occupational diseases even among immigrants Gender success rate of musculoskeletal disorders, the most frequent occupational health disease among italian women, is also constantly lower among women even in carpal tunnel syndrome (all - 2% immigrants – 7 %) Migrant women success rate shows the lowest success rate facing double inequalities being woman and being immigrant. We have also to consider that immigrants are younger and work more hours per week than italians

  26. These results confirm gender inequalities in Italy as in Quebec (Lippel K., 2002) Sweden (Messing, 2006), Switzerland (Probst, 2009, 2013) Belgium (Vogel, 2011), France (Chappert, 2014) • Upper limb overload included in italian list of occupational diseases (2008) reduced gender inequalities but inequalities persist. Other occupational diseases need to be reconsidered in the list. • Psychological occupational health diseases are not listed and represent only 1 % of the declaration (INAIL, 2012)and are mainly related to women professions (such as helping professions) • The list of recognized diseases reflect male jobs in traditional industries more than the reality of work today (Vogel., 2011)

  27. The length of the disease may differ and so the time lapse can also represent an indirect discrimination • Women work considered “light” vs “heavy” (Messing, 1999) • Gender differences with same “job title” (Punnett, 2000) • Poor education of general and occupational health physicians on gender issues • Women scarcely employed as occupational health physicians at the workplaces (in the Latium region only 30 %) • Women scarcely enrolled in trade unions

  28. Acknowledgements: • Dott. Angela Goggiamani of the Medical General Department of INAIL and Dott. Andrea Bucciarelli of the Statistical Consultant of INAIL for kindly answering my questions

  29. THANK YOU FOR YOUR ATTENTION

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