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

4.0 ConclusionsThis systematic review used a standardized approach to review and appraisethe literature, synthesize the results and then answer the review question:“Are injury/illness prevention and loss control programs effective in reducingworkplace injury/illnesses and/or workers’ compensation claims?”The literature reviewed was heterogeneous in both the interventions andoutcomes studied. Many industry sectors were evaluated. The quality of thestudies reviewed ranged from very poor to very high. The higher qualitystudies were typically conducted in office environments rather than in sectorsconsidered more industrial.From an initial number of just over 12,000 articles, we identified 53 studies inwhich the methodological quality was ranked as either high (nine studies) ormedium (44 studies). Seven of the medium quality studies did not includestatistical comparisons between groups, and they were excluded. As a result,46 studies were included in the evidence synthesis.Based on the criteria for evidence synthesis (Table 4), at least three highquality studies with consistent findings were needed to determine theexistence of “strong evidence.” The levels of evidence were based on thequality, quantity and consistency of effects among the studies reviewed indata extraction.Across all studies, the results suggest a mixed level of evidence for the effectof injury/illness prevention and loss control programs. However, when the“prevention” interventions were separated from the “loss control” programs,as suggested by our stakeholder groups, the results took on a differentappearance. The prevention programs still provide a mixed level of evidence.The loss control programs – those focusing on reducing the duration ofinjuries, associated injury costs and insurance costs – show a strong level ofevidence for positive effects on both the duration and costs ofinjuries/illnesses.While previous systematic reviews have shown that RTW programs havepositive effects (4) and have a cost benefit (9), this fact becomes even moreimportant when you consider RTW/DM in the broad spectrum of workplaceprograms, policies and practices. The evidence raises the question whetheremployers focus on loss control programs because such programs directlyaffect their costs and are easier to justify when compared to preventionprograms. Prevention programs are more difficult to relate to cost savings asthere is no guarantee that spending $10,000 on a training program will savetwice that amount by reducing injuries. The money spent on workers’32 Institute for Work & Health