**8. International health security and coordination of action to combat the accident phenomenon**

What is dealt with in Italy by the institutions responsible for preventing and combating the phenomenon of accidents at work finds an international reference at the institutional level, first of all in the role of the International Labor Organisation (ILO), the World Labor Organization.

Worldwide, it is estimated that every 15 sec a worker dies on the job due to an accident at work or an occupational disease. Every 15 sec, 153 workers have an accident at work. It is also estimated that 6300 people die every day from workrelated accidents or occupational diseases, causing more than 2.3 million deaths a year. The injuries which are prolonged work on-site annually 317 million, many of which involve sick leave from work. The human cost of these tragedies is enormous and the economic burden of inadequate occupational safety practices is estimated to be 4% of the world's gross domestic product each year.

The work that the ILO carries out in the field of health and safety at work intends to develop and increase awareness, worldwide, of the consequences of accidents, injuries, and occupational diseases in the workplace, through information and assistance activities for all male and female workers internationally, and supporting practical action at all levels. The ILO has adopted more than 40 conventions and recommendations relating specifically to occupational health and safety and has adopted over 40 codes of conduct. The recommendations and indications of the ILO constitute an important reference for the action of governments and in particular the Italian government, in its law enforcement policies, has carefully

### *The Social and Health Impact of Accidents at Work: The Analysis of the Italian Case DOI: http://dx.doi.org/10.5772/intechopen.101501*

followed the various ILO indications, in particular in recent months on aspects relating to the return to the work safely during the Covid-19 pandemic. In particular, the ILO document of May 2020 [18], which defines the actions necessary for returning to work in safe conditions, should be mentioned. This tool provides guidance to employers, workers, and their representatives on preventive measures for a safe return to work in the context of Covid-19. The tool follows the ILO's established principles and methods on risk management for occupational safety and health and requires the involvement of workers. The tool must be adapted to national guidelines and does not address higher risk sectors, such as health services, and has been considered in the provisions adopted by the Italian government in recent months.

The European reference institution is the European Agency for Safety and Health at Work Occupational Safaty and Health Administration (EU-OSHA). This institution works to make EU workplaces safer, healthier, and more productive, for the benefit of companies, workers, and governments, and to foster a culture of risk prevention aimed at improving working conditions in Europe. In particular, these EU-OSHA benchmark actions need to be considered:


The institutions that operate in Italy for prevention and safety at work act using the instrumentation and analysis carried out by the European OSHA Agency. In recent months, EU-OSHA is implementing a series of forecasting projects aimed at assessing the possible effects of new technologies and new ways of working as well as social changes on the health and safety of workers. Projects aim not only to identify new risks as they emerge but also to anticipate changes that could affect health and safety in the workplace. EU-OSHA foresight projects use a variety of methods, including literature reviews, expert consultations, and scenario development.

The purpose of this work program is to inform policymakers and to help define priorities for action and research. Foresight studies can have a major impact on decisions to be made, for example by helping policymakers find innovative solutions and promoting a long-term strategic approach.

The reference European policies and the indications of the European Commission must then be considered, which constitute the priority area of international health security for Italy. In this sense, the provisions of the EU Strategic Framework on health and safety in the workplace 2021–2027 must be considered: "Safety and health at work in a changing world of work" [19]. EU legislation on health and safety at work (OSH) is essential to protect the health and safety of the nearly 170 million workers in the EU. Protecting people from risks to health and safety in the workplace is in fact a key element in guaranteeing decent and lasting working conditions for all workers. This has made it possible to reduce occupational health risks and improve OSH standards within the EU and across all sectors.

However, challenges remain, and the covid-19 pandemic has exacerbated the risks that need to be addressed. The protection of the health and safety of workers, enshrined in the Treaties and the Charter of Fundamental Rights, is one of the basic elements of an EU economy serving citizens. The right to a safe and healthy workplace is reflected in Principle 10 of the European Pillar of Social Rights and is fundamental to achieving the United Nations Sustainable Development Goals, as well as being a constituent element of the European Union of health in progress of development.

The new OSHA 2021–2027 framework, announced in the European Pillar of Social Rights Action Plan, sets out the priorities and key actions needed to improve the health and safety of workers over the next few years in the post-world context pandemic, characterized by green and digital transitions, economic and demographic challenges, and the evolution of the concept of the traditional work environment.

## **9. Conclusions**

Undoubtedly, smart working has had a very positive effect in terms of contraction of the accident phenomenon, allowing an important reduction of accidents during the journey that have always presented greater criticalities both in terms of management and prevention, also because they are not immediately related to the working environment. However, the evolution towards an agile work model, made up of growing hybridization between face-to-face and remote activities, also poses new challenges in terms of managing the health and safety of workers. Beyond the indications of the law, and the employers' provisions, it is evident that some typical elements of smart working, of remote work, as it has taken shape in the experience of the last year, raise many questions about the actual capacity for the protection of the health and safety of workers, where, beyond the training and training obligations of the employer, a large part of the responsibility is entrusted to the worker: think of the necessary electrical and fire safety to be guaranteed inside the elected home workplace, at the workstation, which must be defined and equipped according to ergonomic criteria or the possibility of carrying out work remotely from places and contexts other than the usual, for which it is difficult to imagine that conditions and safety procedures.

Mobility from one workplace to another, outside the company, represents a potential factor in increasing health risks. The alternation of places increases the risk of the inadequacy of domestic workstations, which already appears to be a "critical" factor for the health of workers. A survey carried out by the Labor Consultants Studies Foundation shows that in Italy [20], in May 2021, almost half of the employed working from home (48.3%, estimated at 2.6 million employees) complained of the onset of problems physical resulting from this aspect; an element that is particularly accentuated among men (50.4%) and among young people, where 53.6% report this type of problem. This is a fact attributable to the presumed less attention in compliance with procedures and precautions aimed at protecting health, which grows in contrast with advancing age, but also to the more frequent movement to workplaces other than one's home, which presumably present greater limits in terms of safety and suitability of the workstations.

Another aspect worthy of attention, for the implications in terms of health and well-being of the worker, is the increase in work stress, generated by the dilation of time, by performance anxiety, by the weakening of company relations, all aspects highlighted by the survey cited as a direct consequence of the use of agile work and which together can contribute to causing an increase in work-related stress

### *The Social and Health Impact of Accidents at Work: The Analysis of the Italian Case DOI: http://dx.doi.org/10.5772/intechopen.101501*

and particular pathologies connected to it. According to this survey, almost half of smart working workers complain of greater stress and performance anxiety. Even the distortion of relationships with colleagues, bosses, customers, based on physical distancing, in the long-run has counterproductive effects for about one worker out of two: 49.7% in fact report the worsening of the climate in the company, the weakening of working relationships; 47% feel marginalized with respect to the dynamics of organizations, while about 40% begin to report real disaffection towards work. Finally, about a third (33%) declare that remote work is penalizing their career and professional growth.

The digitization of the way the work is carried out must therefore be considered for what it really is: it is not the mere introduction of new technical and organizational tools, but the promotion of a real context, a different environment that determines an overall impact on conditions of work and can lead to opportunities and problems at the same time. In general, the analysis of the trend in these months of progressive exit from the pandemic of accidents at work, occupational diseases, and the impact of smart working and work stress confirms that in this historical phase it is very important to avoid changes in the work induced by the economy compromise the conditions of well-being, human relations, and the reconciliation between lifetimes and work times. The challenge of well-being at work is the factor that goes with a decrease in the risk of accidents and illnesses. This is true in Italy as in the rest of Europe.
