Italy’s president has demanded guarantees that all the nation’s roads are safe following the Genoa highway bridge collapse, after he hugged and comforted mourners at a state funeral for many of the dead in the grieving port city.

Hours earlier, the toll from Tuesday’s bridge collapse rose unofficially to 43 with the discovery of four more bodies in the rubble and the death in hospital of the most severely injured survivor.

Firefighter Stefano Zanut told Sky TG24 TV they had extracted from the broken concrete the crushed car that an Italian couple on holiday with their nine-year-old daughter had been travelling in.

Zanut said the last body pulled out of the wreckage was that of a young Italian man, an employee of Genoa’s refuse company, who was working under the bridge when it collapsed.

The man’s mother had refused to leave a tent set up a few hundred yards away from the rubble until his body was found.

San Martino Hospital said a Romanian truck driver who had suffered severe cranial and chest injuries in the bridge collapse died Saturday evening.

Before the state funeral ceremony began in a pavilion on Genoa’s fairgrounds, President Sergio Mattarella offered quiet words of comfort to families of the victims.

Bridge Collapses in Genoa
(PA Graphics)

He then took his place with other Italian leaders, including Prime Minister Giuseppe Conte and the transportation and infrastructure minister, in the cavernous hall.

Mattarella was embraced tightly for a long moment by a woman who was among the grieving.

Families of 19 of the dead had their loved ones’ coffins taken to the hall for the funeral mass led by Genoa’s archbishop, Cardinal Angelo Bagnasco.

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The coffins of Edi Bokrina and Marius Djerri, left, were draped with the Albanian flag (Nicola Marfisi/AP)

Among the coffins were those of two young Albanian Muslim men who lived and worked in Italy.

Their remains were blessed at the end of the Catholic service by a Genoa imam, who drew applause when he prayed for God to “protect Italy and all Italians”.

At other funerals elsewhere in Italy on Friday, angry mourners accused authorities of negligence and incompetence for failing to keep the bridge safe.

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Italian President Sergio Mattarella embraces a relative of a victim during the funeral (Luca Zennaro/ANSA via AP)

During the state funeral, applause rang out and many fought back tears as a prelate read out the first names of some 30 victims who have so far been identified.

The mourners also applauded Italian firefighters, police and volunteers for the civil protection department as they arrived for the funeral.

Mattarella toured what is left of the Morandi Bridge, which broke apart in a fierce rainstorm, sending a long stretch of road crashing 150 feet into a dry river bed and near several apartment buildings.

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Coffins of some of the victims lined up during the funeral service (Luca Zennaro/ANSA via AP)

Those buildings have been evacuated and local authorities have said they will have to be demolished.

Mattarella did not speak at the funeral, held on a national day of mourning, but after the ceremony ended he told reporters the bridge collapse “is an unacceptable tragedy”.

He called the funeral “a moment of grief, shared grief, by all of Italy”.

He demanded that “responsibility be ascertained with rigour” for the collapse of the bridge, which linked two major roads, one leading to Milan and the other to France.

Prosecutors say they are focusing their probe on possible design flaws or inadequate maintenance of the bridge, which was completed in 1967.

“I, too, have travelled over this bridge many times, even recently,” said Mattarella, demanding that authorities commit to carrying out their “duty to guarantee the safety of our roads”.

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Sampdoria’s forward Fabio Quagliarella, left, and Genoa’s defender Domenico Criscito arrive at the funeral of some of the victims (Simone Arveda/ANSA via AP)

The mood at the state funeral was subdued, although families voiced frustration and anger that public infrastructure is not safe in Italy.

“These are mistakes that keep on repeating. And now, for the umpteenth time, angels have flown into heaven and paid for the mistakes of other human beings, severe mistakes,” said one mourner, a local man who would only give his first name, Alessandro.

Also attending the Mass were players and managers from the city’s two main football teams, Genoa and Sampdoria.

Their weekend matches were postponed out of respect for the dead.