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

compensation and medical bills is much easier to quantify. Employers knowthat if they have an experience modification ratio/rating (the number used tocalculate workers’ compensation insurance premium) of greater than one,their costs will rise. Whereas they may choose not to invest in a trainingprogram and still have the same amount of injuries, thus saving money upfront.RTW/DM was the only intervention category associated with a strong levelof evidence in having a positive effect on injuries/illnesses and workers’compensation claims/costs. The RTW/DM studies, except for Brown et al.1992, used “usual care” as the control/concurrent comparison group. Thisfact should not be surprising as the programs focused on treating injuredemployees. It would not be ethical or informative to determine if caring forthe employee provided better outcomes than withholding care.A moderate level of evidence was found for five intervention categories.• Supervisor practices have a positive effect on reducinginjuries/illnesses.• Workstation adjustments and training have a positive effect onreducing injuries/illnesses.• Exercise has a positive effect on reducing injuries/illnesses.• Workstation adjustment alone has no effect on reducinginjuries/illnesses.• Ergonomic training alone has no effect on reducing injuries/illnesses.The category of workplace adjustments aggregated studies that made differenttypes of adjustments. There is not enough evidence to group each adjustmentseparately and the study authors typically aggregated all the changes into an“adjustment” category when they performed their analyses. Reporting theeffects of adjusting only one piece of equipment would be preferable.However, it is not often practical as most programs would offer a range ofpotential workstation adjustments to accommodate the vast heterogeneity ofemployees and workstations often encountered in office environments.Similarly, the training and exercise interventions in different studies were notidentical in the topics covered or in the way they were administered toemployees.There were enough studies of ergonomic training programs to separate themfrom other training programs. Although there is moderate evidence showingthat ergonomic training programs alone do not have a positive effect oninjuries, an important observation is that when they are combined withworkstation adjustments, there is moderate evidence to support a positiveeffect. These findings point to the effectiveness of multi-component injuryA systematic review of injury/illness prevention and loss controlprograms (IPCs)33