INFORTUNISTICA. — Infortunistics studies accidents from the medico-legal and social points of view. The word infortunio derives from the Latin in (= against) and fors (= fortunate chance). A very ancient definition is that of the Frenchman Marestaing (1869), according to whom an accident consists in “an assault upon the human body arising from the sudden and violent action of an external cause.” Today the definition most commonly used is that of Moriani, according to whom an accident is “the event whereby a violent cause, which in the environment is capable of causing injury, brought into contact with a human being by chance, injures that person’s body or psyche to a certain extent.”
An accident is therefore characterized by the following attributes: causality and unforeseeability, a sudden event foreign to the will of the person who suffers it, and the external and abnormal nature of the event.
The causality and unforeseeability of the harmful event are to be understood in the sense that, although the possibility of an accident may be foreseeable in general terms, neither the moment at which it will occur nor the person who will be affected by it is known.
An event is sudden and foreign to the will of the person who suffers it when it develops not only unexpectedly but also within a short period of time, without the intervention of that will which, in legal terms, is called, according to the circumstances, negligent or intentional.
The external nature of the event is to be understood in the sense that the damage must be the consequence of an injurious external fact and not of purely physiological or pathological phenomena occurring according to the ordinary laws of physiology and pathology. There are accidents in which the external nature of the cause producing the damage is not evident, as in the case of an epileptic who falls from the top of a staircase on which he is working; yet in such circumstances the external event is not constituted by epilepsy but by the conditions in which the worker was working.
According to Biondi, the abnormal nature of the event means that the harmful occurrence must consist of something unusual in the work which interrupts its normal course. According to Diez, its abnormality in relation to the work is not an indispensable characteristic of an accident; what is abnormal is the fact that a given occurrence, even if normal in the work process, produces harm. Inattention, negligence, and recklessness likewise constitute an abnormal phenomenon inserted into the course of the work.
Italian insurance laws, like the overwhelming majority of foreign insurance laws, refrain from defining an accident in order to leave the way open for broader applications of a law enacted to protect workers against occupational risks.
In Royal Decree no. 1765 of 17 August 1935 (provisions for compulsory insurance against occupational accidents and diseases), the subject matter of the insurance is specified in Article 2 as follows: “the insurance covers all cases of accident occurring through a violent cause on the occasion of work, from which there has resulted death or permanent incapacity for work, total or partial, or temporary total incapacity involving abstention from work for more than three days.”
The practical application of the law has given rise to disputes among accident victims concerning the interpretation to be given to the phrase “violent cause on the occasion of work.”
As regards the phrase “violent cause,” it is generally held that this must be understood to include not only that which produces the harm suddenly, but also every other event producing harm through the repetition of injurious actions within a short period of time, during a single work shift. Such is the case of acute dilation of the heart arising after a series of excessive exertions during a work shift. It is also accepted that the harm need not follow immediately; it is sufficient that the harmful event mark the beginning of morbid processes which will subsequently develop, even at a later time. This may be the case with pulmonary tuberculosis that manifests itself later as a result of severe chest trauma.
The violent cause may consist of mechanical factors, chemical, microbial, meteorological, or electrical agents, as well as physical overexertion, severe emotions, and so forth.
The occasion of work lies in the risk to which the work has given rise.
A distinction is made between general risk and specific risk; the former weighs equally upon the worker and upon people in general, while the latter affects the worker performing a particular task; the former does not confer entitlement to compensation, whereas the latter does. Compensation is nevertheless allowed in cases of aggravated general risk, as when a worker, in the interest of the enterprise, is obliged to submit to the action of harmful factors from which, if free to do so, he could withdraw. A typical example of aggravated general risk may arise when a worker is struck by lightning while working in a field planted with tall trees during bad weather, being compelled to remain at the workplace by indispensable requirements of the enterprise.
These distinctions provide the basis for determining whether or not accidents in itinere are compensable. The damage is not compensable when the accident occurs while the worker is taking the ordinary routes to reach the workplace; in that case, in fact, the worker is exposed to a general risk, and the purpose of going to work is not sufficient to establish a causal link between the work and the damage. On the other hand, damage resulting from the use of particularly dangerous means of transport, such as aerial cableways, cable cars, etc., which the worker must necessarily use to reach the workplace, is compensable; so too when the worker is obliged to cross footbridges or negotiate difficult paths laid along the edge of precipices, generally not used by others, or to travel along railway tracks, etc.
In any event, compensation is not linked to the risk encountered only during the time strictly assigned to the work and at the actual workplace; accidents occurring during short work breaks are also compensable, as are those occurring when the worker moves from one point to another to receive orders or to attend to the body’s physiological needs.
As regards the risk encountered in performing duties unrelated to those proper to the worker, compensation is held not to be payable when the work is performed for amusement or for the worker’s own benefit or that of third parties; on the other hand, damage resulting from efforts to save fellow workers or superiors is compensable, as is damage caused by the criminal acts of third parties (assaults, brawls, etc.), provided that the accident was caused by reasons directly or indirectly connected with the work.
On the basis of the rules set out above, anthrax is recognized as a compensable accident, whereas malarial infection is not, because anyone who contracts malaria in a given locality is the victim of a general risk common to all the inhabitants of that region; in the event of death from pernicious malaria, however, Article 329 of the Consolidated Text of the Health Laws provides for the payment of a subsidy. Likewise compensable are a frigore pneumonia, tetanus, rabies, and tuberculosis inoculated through wounds (attendants in anatomical rooms, butchers, etc.).
Occupational diseases are distinguished from accidents; they arise from unavoidable conditions of unhealthiness inherent in certain kinds of work. In occupational diseases there is neither the fortuitousness nor the unforeseeability that, by contrast, are attributes of an accident.
In Italy, insurance against industrial accidents and occupational diseases was made compulsory by Royal Decree of 17 August 1935, no. 1765. Article 7 provides that the cost of insurance must be borne exclusively by the employer, and Article 11 establishes that notification of the accident must be made within two days of the date on which the employer became aware of it and must be accompanied by a medical certificate. Article 21 then lists the insurance benefits, which are as follows: 1) a daily allowance for temporary incapacity; 2) an annuity for permanent incapacity; 3) an annuity for survivors in the event of death; 4) medical and surgical treatment; 5) the provision of prosthetic appliances. Article 39 contains the rules to be followed in determining the wage on the basis of which the amount of the annuity payable to the worker or survivors is to be calculated. Under Article 25, the amount of the incapacity annuity may be reviewed at the request of the annuity holder or the insurance institution in the event of a reduction or increase in working capacity; and under Articles 32 and 33, the injured person may not, without just cause, refuse to undergo the medical and surgical treatment, including operative procedures, that the insurance institution deems necessary, even after the annuity has been established. Insurance is administered by the Istituto Nazionale per l'Assicurazione contro gli infortuni sul lavoro, with the exceptions specified in Article 48. Provisions exist concerning the settlement of disputes regarding entitlement to benefits and their liquidation (additional Article 51). For assessing the percentage degree of incapacity, there is a table listing the most important anatomical and functional impairments that entitle the person concerned to the establishment of an annuity. Among the measures benefiting workers who have suffered injury at work, mention should be made of the Istituto Nazionale per l'Assistenza ai grandi invalidi del lavoro, established by Law of 19 July 1929, no. 1416.
Finally, mention should be made of the Ente Nazionale di Propaganda per la Prevenzione Infortuni, a body governed by public law, legally recognized by Royal Decree of 25 October 1938, no. 2176, and of the Istituti di patronato e di assistenza sociale, reorganized by Decree of 29 July 1947, no. 804.
It has been demonstrated that more than half of all industrial accidents are attributable to the human factor; scholars’ efforts therefore aim, through the analysis of occupations and the development of occupational psychophysiological profiles, to identify the capacities most heavily engaged according to the work performed, in order to implement effective vocational guidance and, where possible, effective selection.