The scope of thehotel and catering (Ho.Re.Ca.)which employs over one million people in Italy, is characterized by small-sized companies, seasonality and high workloads. From a recent analysis based on the MalProf system, published by the Surveillance Systems and Integrated Risk Management Section of the Department of Medicine, Epidemiology, Occupational and Environmental Hygiene (Dimeila) of theInaila clear prevalence of musculoskeletal diseases emerges and a widespread underestimation of risks.
In Italy the sector includes more than 300 thousand companies that employ one million workers per year (Inail statistical database – 2023 data), 90% of the accommodation facilities employ fewer than 10 people and many of them are family-run. The analysis does not include food & beverage wholesalers and distributors intended for catering services and other suppliers in the production chain.
The hotel and restaurant industry includes a wide range of tasks and jobs they present multiple and diversified risks and which also depend on the different workplaces in which the employees are employed (kitchens, hotels, restaurant rooms, etc.).
A common characteristic is given by the workload which is often huge, especially during peak hours and requires great concentration, also given the contact with the public. Stress factors can be linked to the monotony and repetitiveness of work often accompanied by substantial training gaps. The flexibility required by the professions carried out can influence the work-life balance: very often the working hours are long,
irregular and can take place on evening, night and weekend shifts.
Furthermore, workplace safety standards integrate with those of food safety “Hazard analysis critical control point” (HACCP), enhancing the level of complexity in risk management in this sector.
The study reveals particular attention to risks within some work environments such as kitchens, while there is less awareness of the risks of dining room staff and their support activities (cleaning work, supply of goods, etc.).
Health risks:
- risks from physical agents: noise and vibrations from equipment and tools;
- risks from biological, infectious, allergic and toxic agents, for example due to the presence of airborne agents not capable of inducing allergies and sensitization (for example flours, detergents, etc.) and due to food contamination due to inadequate hygiene or management and storage of food or due to contact with unsanitized surfaces or uncleaned utensils;
- risk from chemical/carcinogenic agents due to improper use of detergents or cleaning products or due to the presence of particulate matter (even ultrafine) containing combustion products, such as volatile organic products and carbonyl compounds;
- manual handling for lifting and transporting heavy loads and awkward postures, repeated movements, often associated with other unfavorable working conditions, often linked to inadequate workplace design.
Transversal risks:
- excessive workloads;
- fast pace, long shifts, etc.;
- lack of control at work: monotony, lack of initiative, etc.;
- physical or verbal violence from customers or colleagues;
- ergonomics of limited spaces and inadequate equipment
Environmental risks:
- noise coming from the surrounding environment (due to particular positions of the accommodation facilities, for example near airports, railway stations, motorway junctions, etc.);
- microclimate: hot or cold working environments, sometimes also combined with air currents and open doors;
- exposure to solar radiation and high temperatures, including from hobs and ovens, or exposure to low temperatures in the case of activities inside or near cold storage rooms;
- exposure to radon (for example in environments located below street level or due to its presence in construction materials such as tuff).
A separate discussion concerns the presence of asbestos which can be found both in the buildings that house the accommodation facilities and in the older ovens with poor air exchange in the rooms, sometimes associated with insufficient localized extraction systems.
Reports of occupational disease in 2024
The number of occupational disease reports registered by INAIL in 2024 in the Industry and Services sector is just under 74,000. Compared to 2023 (approximately 60,000 complaints), almost 14,000 more cases have been recorded; as regards the recognized cases (the so-called positive ones) from 2019 to 2024 the relative weight of the Ho.Re.Ca. sector fell from 2.3% (2019) to 2,0% (2024).
The peak was reached in 2021 when the same percentage reached 2.5%.
Only the data for the year 2020, considering absolute numbers, indicate a decline in complaints in all sectors due to the Covid-19 pandemic.
The information provided by the MalProf system for the specific sector shows a clear majority of disorders of the musculoskeletal system, which cover over 50% of the total pathologies detected. This is followed by spinal diseases with over 25% and upper limb overload diseases with 19% (Carpal Tunnel Syndrome – CTS).
There are also mental illnesses, skin diseases, deafness and asthma, with percentages that however do not exceed 1% of the total illnesses, in line with what is outlined in the list of risks to which workers in the sector can be exposed.
Furthermore, several malignant tumors are reported which represent 0.6% of the total pathologies and noise-induced deafness and other ear disorders (0.4%).
The data extracted from Marel (Surveillance system for diseases and emerging risks at work which collects information on the exposures from which the pathologies derive), confirming the results set out above, delves into the causal agents with a positive link with the pathologies: more than 65% of the agents are represented by movements repeated (of the upper and lower limbs), manual handling of loads and fixed and/or incongruous postures. The chemical agentsalone, constitute almost a fifth of the causal factors of pathologies in the sector; followed by asbestos and physical agents such as vibrations and, to a lesser extent, noise.
The workers most affected by musculoskeletal or neuropathic pathologies, especially affecting the upper limb, are bartenders, chefs in hotels and restaurants, preparation workers cooking and distribution of food and unqualified personnel in catering services such as busboys, dishwashers, etc said to the cleaners.
Furthermore, as regards the female gender, the jobs most associated with spondylosis are those of maids.
In general, therefore, with regards to specific diseases, also considering the processing carried out on previous data from the same MalProf System, a high association is highlighted between the Ho.Re.Ca. sector. and arthrosis, mononeuropathies and synovitis, as well as allergic dermatitis.
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