Prevention of work related eye injuries: long term assessment of the effectiveness of a multicomponent intervention among metal workers

Background: Systematic assessments of the effectiveness of interventions to prevent work related eye injuries are needed. Aim: To investigate the long term effectiveness of a multicomponent prevention campaign. Methods: The campaign (conducted in collaboration with the local Employers' Association and Trade Unions) targeted all 237 metal-ware factories in the district of Imola, Italy. Based on preliminary inspections, the main intervention included distribution to all factories of specific educational brochures and broadcasting/publication of television/radio programmes and local newspaper articles containing expert advice on the subject. This was followed by a four year "post-intervention reinforcement" period of unannounced official inspections. Main outcome measures analysed were eye injury rates (versus non-eye injury rates) among metal workers during "pre-intervention" (1988-90), "peri-intervention" (1991-92), "post-intervention reinforcement" (1993-96), "late post-intervention" (1997-2000), and "very late post-intervention" (2001-03) periods with respect to two comparison sectors (construction and wood/ceramics). Results: A Poisson regression in which the eye injury rates were modelled for each sector, period, and interaction, adjusting for non-eye injury rates, was chosen. The periods did not by themselves determine an overall reduction in eye injuries. The period/sector interaction terms were related to significant reductions for the metal sector when crossed with the "post-intervention reinforcement" (IRR = 0.77, 95% Cl 0.61 to 0.97;% decline = 23.4), the "late post-intervention" (IRR = 0.63, 95% Cl 0.50 to 0.79;% decline = 37.4), and the "very late post-intervention" (IRR= 0.58, 95% Cl 0.43 to 0.77;% decline = 42.4) periods, suggesting a sustained reduction in eye injury risk following the main intervention. Conclusion: Results suggest that a carefully coordinated, extensive, multicomponent intervention can lead to lasting reductions in the burden of eye injuries