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The workers' safety reps coordinating committee for Piedmont’s principal hospitals surveyed the organisation of prevention in the area in 2004. The survey covers 28 of the 34 hospitals in this region of northern Italy, and some 48,000 hospital staff.
Consultation of workers' safety reps is the significant variable in identifying hospitals that have a coherent prevention policy in place. Risk awareness among medical directors, risk assessment, programming of preventive measures and training are all markedly better in hospitals that have regular, systematic consultations with workers' reps.
The trade union survey also points to failings in the Italian legislation on the organisation of prevention. The rules on preventive services leave employers a fairly free hand. The Piedmontese regional authorities have laid down more specific criteria for hospitals, but they are not legally binding, and fewer than 40% of hospitals apply them. The law requires the “periodic meeting” - the Italian equivalent of the health and safety committee - to be held at least once a year. This is clearly too far apart to properly monitor workplace prevention policy, and totally unrealistic for complex workplaces like hospitals that are typified by large workforces (averaging over 1,800) and multiple risks. Only one in four hospitals betters the legal minimum and holds more than one meeting a year. It partly explains the failings of risk assessments: in 44% of cases, they are done without consulting workers' reps first, and in over half of cases (52.9%) with no firm timetable for the preventive measures to be taken. More than 45% of risk assessments ignore reproductive health protection.
The information supplied to workers' reps is often deficient. Half the time, they are not informed about dangerous substances that staff are exposed to, and in over 60% of cases, safety reps are given no information on work equipment, plant and machinery. Three-quarters of reps have no more than two hours a week for their duties.
Relations with sub-contractors are another problem area. All the hospitals in the survey permanently outsource some tasks. But only a third of them (32.2%) systematically coordinate prevention with the sub-contracting firms.
The authors report that some of the failings and breaches of rules have been cured since the survey. Their conclusions make a series of recommendations that should help give direction to union action for occupational health.
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