title: Air temperature exposure and outdoor occupational injuries: a significant cold effect in Central Italy.
abstract: OBJECTIVE
  To investigate the short-term effect of air temperature on outdoor occupational injuries (out_OI) in Central Italy, also by taking different geographical factors and employment sectors of workers into account.
  
  
  METHODS
  Out_OI for all of Tuscany (Central Italy), from 2003 to 2010 (n=162,399), were provided by the National Institute of Insurance for Occupational Illness and Injury. Representative daily meteorological data of the geographical area under study were obtained from the European Reanalysis-interim climatological reanalysis archive. Relationships between short-term changes in air temperature and out_OI were studied through Generalised Additive Models.
  
  
  RESULTS
  The exposure-response curves of out_OI and short-term changes in air temperature generally showed significant out_OI increases when cold conditions occurred. The air temperature breakpoint corresponded to the 10th centile (-0.8°C) of the air temperature time series used in this study: a 1°C decrease in temperature below the 10th centile corresponded to a 2.3% (CI 1.3% to 3.3%) increase of out_OI throughout all of Tuscany. The cold effect was strongest in plain areas, especially when out_OI occurred in vehicles other than cars. No relationships of injuries with temperature extremes were observed in workers who generally spend half or most of their time outdoors, such as construction, land and forestry workers. However, these latter outdoor workers showed significant linear associations of injuries with typical (far-from-extreme) temperatures.
  
  
  CONCLUSIONS
  This large population-based study highlights the significant and independent effects of short-term air temperature changes (especially cold) in triggering out_OI. These findings represent the first step towards developing a geographically differentiated, operative outdoor-temperature-occupational-health warning system aimed at preventing outdoor work injuries.
authors: Institute of Biometeorology, National Research Council, Florence, Italy Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy.
authors: Marco
authors: M
authors: Morabito
authors: Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy.
authors: Maurizio
authors: M
authors: Iannuccilli
authors: Institute of Biometeorology, National Research Council, Florence, Italy.
authors: Alfonso
authors: A
authors: Crisci
authors: Institute of Biometeorology, National Research Council, Florence, Italy LaMMA Consortium (Environmental Modelling and Monitoring Laboratory for Sustainable Development), Tuscany Region, Florence, Italy.
authors: Valerio
authors: V
authors: Capecchi
authors: CeRIMP-Centro Regionale Infortuni e Malattie Professionali, Tuscany Region, Florence, Italy.
authors: Alberto
authors: A
authors: Baldasseroni
authors: Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy Department of Agrifood Production and Environmental Sciences, University of Florence, Florence, Italy.
authors: Simone
authors: S
authors: Orlandini
authors: Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy Clinica Medica e Cardiologia, University of Florence, Florence, Italy.
authors: Gian Franco
authors: GF
authors: Gensini
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D003080:Cold Temperature; D006801:Humans; D006813:Humidity; D007558:Italy; D014919:Wind