MONITOR
A surveillance system for workers involved in the tunnelling construction of the "high speed train tract"

A project of Regional Government of Emilia Romagna and Tuscany realised with the cooperation of the Department of Public Health A-USL Bologna Sud, the Department of Public Health A-USL 10 Florence, the Occupational and Environmental Epidemiology Unit CSPO Florence, and the Department of Statistics of the University of Florence

The construction of the "high speed train tract" is one of the largest civil engineering projects undertaken in Italy in the last years.
The most relevant track is the Bologna-Firenze rail link, started in 1997 and of which currently about 75% has been dug, consisting of:
73 Km of line tunnels, ranging from a minimum length of 600 metres to a maximum of 18 Km, with a cross section of approximately 132 square metres
19 Km of service tunnels of which 8 windows (with a cross section of approximately 40 squares metres) and one emergency tunnel parallel to the longest line tunnel, with a cross section of approximately 30 square metres).
Approximately 3000 workers are employed in 22 industrial construction sites with up to 40 sites at the same time. About 90 companies (contractors, subcontractors) are involved.

This type of work is associated with serious risks deriving from the geological conditions of the land, the machinery used for digging and the transport of materials. All these conditions may be considered even more hazardous when there is insufficient work organisation. The most important risks are related to:

• On-the-job accidents, especially when a machine is reversed.
• Sudden landslide of rock.
• Personal injury while machine is in operation.
• Diesel exhausts.
• Presence and inhalation of silica dust.

Considering the exceptional nature of the construction project, the regional governments of the Emilia Romagna and Tuscany regions and the Local Agencies of the National Health Service, decided to improve programs of control and prevention and to test a surveillance system of working conditions and safety in order to (i) identify and prioritize problems (injuries surveillance); (ii) quantify and prioritize risk factors in tunnelling; (iii) develop new strategies to prevent occupational injuries and to implement the most effective injury control measures; (iv) improve communication and information between, local agencies, companies, trade union, workers, public institution, public opinion.

The system, realized with the package Access, has been designed to link
information produced by the Public Occupational Health Services and companies. An interactive two-way information flux allows their best use. Co-operation with employers, employees at the enterprise level and unions and employers’ associations will be sought, with particular attention to the small and medium enterprises involved in the realisation of such activities.

In figure 1 the data base structure is set down.

The monitoring system allows to produce six month report with the following information: state of the advancement of the various tunnel, environmental conditions (microclimate, dust, gas, etc.), number of workers, hours worked, injuries (frequency and severity rates).

The surveillance of the phenomenon of the accidents represents one of the principal objectives of the monitoring system. Ad hoc instruments (standard forms discussed and adapted with companies, educational training of the operators involved to standardize coding system) have been organized to implement and govern the injuries monitoring and analysis.
The system allows to monitor the injuries occurrence and to identify the critical tasks of work environment features to be targeted for preventive measures.
The phenomenon is described in terms of :

• Altogether injuries occurring in the enterprises involved in the project
• Frequency and severity rates specific by tunnel and area of work, construction phase, and individual variables (job, age, nationality)
  

Table 1. Frequency and severity rates: injuries with more than 3 day of temporary disability occurred in all workplaces (inside and outside tunnels)

Table 2.  Frequency and severity rates: injuries with more than 3 day of temporary disability occurred in  tunnelling

A system of quality and coherence control has been defined and the operators assigned   to the compilation of cards and to the data entry received a specific training.

The standard language, created and used in common with the companies, allows the monitoring system to be extended to the rest of the high speed project in Italy.

This database is accessible at  three different levels, corresponding to the three most-important-user categories: the occupational health services use the system at a nominative, fully disclosed level, because they have the legal ownership of the database; epidemiologists can access the system at two different disclosure levels: an anonymous individual level and an aggregate level. Other institutions, media and general public can access the aggregate data.