A systematic review of injury/illness prevention and loss control ...

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High quality studiesNine studies were determined to be of high quality (Amick et al. 2003; Bohret al. 2000; Faucett et al. 2002; Gerr et al. 2005; Hlobil et al. 2005; Jensen etal. 2005; Jensen et al. 2006; Rempel et al. 2006; Martin et al. 2003). The highquality studies had quality scores ranging between 31 and 34 out of a possible36 (86-94%). Despite being categorized as high quality, only five of thestudies reported drop-out rates. Only six reported their recruitment rate andhad a recruitment rate > 40%.Medium quality studiesWe classified 44 of the studies as medium quality. The medium qualitystudies often differed from the high quality studies in randomization (only 16described randomization), not describing the loss to follow-up (14 describedloss to follow-up) or making adjustment for pre-intervention differencesbetween groups. Similar to the high quality studies, the medium qualitystudies did not generally describe recruitment rate (16 of 44 did) or reportdrop-out differences between the groups. All but one study had anadequately stated research question, as did the high quality studies. Themedium quality studies did not score 100% on any of the individual qualitycriteria, compared with nine questions in the high quality studies that didscore 100%.Low quality studiesNineteen studies were rated as low quality. The low quality studies scoredabove 90% on only the research question criterion. They scored above 50%on only four of the 16 quality criteria (were time-based comparisons used;was a research question clearly stated; was the intervention process described;when were outcomes measured). Overall, the low quality studies did notprovide detailed information regarding factors that could affect the validity ofthe statistics presented in the studies (e.g. drop out rates, loss to follow-up,confounders/covariates).3.3 Data extraction resultsData was extracted from the 53 high and medium quality studies. Of thesestudies, only 46 completed direct statistical testing between the interventionand control groups; therefore, only 46 studies are discussed in data extractionand evidence synthesis. The 46 studies were categorized by interventioncategory. The categories were developed and agreed upon by the mainauthors of this review. Appendix K includes the intervention categories anddetailed descriptions of interventions in each study.Intervention categoriesTwenty different interventions were identified. Five of the studies evaluatedmore than one intervention:22 Institute for Work & Health
• Return-to-work/disability management programs (RTW/DM) werethe most common intervention evaluated (eight of the 46 studies).• Ergonomic training was evaluated in seven studies.• Programs (regulatory) and workstation adjustment were eachevaluated in five studies.• Other intervention categories examined in two or three studiesincluded: arm supports, data entry devices, exercise, policy(employer-level) and manual lifting.• The remaining interventions were represented by single studies.The categories were established with an attempt to separate the interventionsinto programs, policies or practices. However, the heterogeneity of theinterventions, sectors and outcomes made this difficult. The categorization ofinterventions is important because it directly affects the strength andgeneralizability of the results.Appendix L lists the characteristics of the reviewed studies that are importantto consider when considering generalizability.Countries of originThe studies reviewed originated from 12 different countries. The majority ofthe studies were from the USA (n=26). Sweden and Canada were the onlyother countries that accounted for more than two studies (Sweden had fourand Canada had three).Types of industry/jobsOffice environments and data entry jobs were the most common industry andjob function in the reviewed studies. No other industry or sector dominatedthe studies reviewed. Both white collar and blue collar workers wererepresented almost equally.Study designsThe data extraction studies included 21 randomized field trials, 20 nonrandomizedfield trials, three randomized crossovers and two quasiexperimentaldesigns. Eight of the nine high quality studies were randomizedfield trials.Sample sizes and numbers lost to follow-upOver half of the studies did not report loss to follow-up numbers for all thegroups included in their study. The sample sizes ranged from 27 (Hager et al.1982) to over 5,000 (Wassell et al. 2000). The larger sample sizes weretypically in the policy and program interventions.A systematic review of injury/illness prevention and loss controlprograms (IPCs)23
Page 1 and 2: A systematic review of injury/illne
Page 3 and 4: Table of ContentsForeword ………
Page 5 and 6: ForewordIn recent years, the Instit
Page 7 and 8: employers with valuable information
Page 9 and 10: forward. In 1970, the Occupational
Page 11 and 12: Figure 1: IPC frameworkInput(to wor
Page 13 and 14: publish the results of the review i
Page 15 and 16: A key part of the literature would
Page 17 and 18: 2.4 Level 2 - Quality AssessmentIn
Page 19 and 20: allowed us to insure the answers pr
Page 21 and 22: Table 4: Best evidence synthesis gu
Page 23: Figure 3: Flowchart of systematic r
Page 27 and 28: etween groups, but only 32% adjuste
Page 29 and 30: Workstationadjustment andtrainingRo
Page 31 and 32: focused on just RTW (Durand et al.
Page 33 and 34: ExerciseThree medium quality studie
Page 35 and 36: compensation and medical bills is m
Page 37 and 38: interventions provide an insufficie
Page 39 and 40: Researchers and practitioners also
Page 41 and 42: 5.0 MessagesBefore making recommend
Page 43 and 44: 1) Of the articles that remained af
Page 45 and 46: 11) Agency for Healthcare Research
Page 47 and 48: Carayon P, Haims MC, Hoonakker PLT,
Page 49 and 50: workers: Randomized controlled work
Page 51 and 52: Nelson NA, Silverstein BA. Workplac
Page 53 and 54: pain in sedentary office workers -
Page 55 and 56: Appendix A: Content expertsNameBarb
Page 57 and 58: Appendix C: Stakeholder search term
Page 59 and 60: Appendix D - Literature search term
Page 61 and 62: A systematic review of injury and i
Page 63 and 64: Zohar DZohar D,Modifying Supervisor
Page 65 and 66: Level 1 Guide for ReviewersThe guid
Page 67 and 68: Appendix G: Quality Appraisal Revie
Page 69 and 70: Q4. Were time-based comparisons use
Page 71 and 72: If there are no major significant d
Page 73 and 74: Q17. Was the calendar duration of t
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a) YesBaseline differences were obs
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5. List the jurisdiction where the
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have intended to prevent both “as
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Sample SizeEg: C 1 , C 2 , …(or I
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29. If injury rates were calculated
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38. Describe for each injury/illnes
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Appendix J: Quality assessment tabl
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StudyTime-Based ComparisonsRandom A
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Appendix K: Intervention descriptio
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InterventionCategoryErgonomictraini
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InterventionCategoryBricklayingmeth
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InterventionCategoryTraining &equip
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Appendix L: Study description*key t
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InterventioncategoryPrograms(regula
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InterventioncategoryWorkstationadju
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InterventioncategoryErgonomictraini
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InterventioncategoryAuthor, Year QA
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InterventioncategoryWorkstationadju
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