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

Researchers and practitioners also use the terms “accidents” and “injuries”differently, which may have resulted in relevant studies being excluded. Thereview was focusing on injured workers and not the number or cause ofaccidents.Also, because of time constraints, the review team was unable to clarifyspecific questions with the study authors. The review was limited to articlespublished in the English, French and Spanish languages. It is possible thatarticles excluded on the basis of language might have provided relevantevidence that could have been used to answer the review question.Finally, the review team made a decision not to include articles where either achange in a hazardous exposure or a change in behaviour was the outcome.We recognize their omission could affect the interventions we examined andperhaps the overall conclusions. Certainly in multi-component programsexposures and/or behaviours may be targeted as leading indicators of programsuccess. However, the review team felt it was not reasonable to assume thatreducing an exposure or behaviour directly relates to a change in injuries orillnesses. Since the focus was on injury/illness and loss control programs, themost reasonable outcomes to evaluate program effectiveness were the directoutcomes.4.3 Strengths of this systematic reviewThe review was inclusive in regards to outcomes and interventions studied,and described a large amount of the IPC literature. The review team includedmembers with varied backgrounds and specializations (e.g. expertise in thesystematic review process, ergonomics, physical therapy, occupationalmedicine, industrial hygiene, safety and epidemiology). The outcomes andinterventions were therefore reviewed by knowledgeable professionals. Webelieve this broad expertise contributed to the internal validity of our review.We also contacted external experts to request potentially relevant publishedarticles, along with articles in press or in the grey literature. This providedanother means to ensure that as much relevant literature as possible wasreviewed. A specific author search was conducted on three authors knownby practitioners as experts in the IPC area (Geller, Krause and Peterson). Theauthor search was conducted to try to capture the articles that may have beenpublished in peer-reviewed journals not typically identified in databasesearches (e.g. Professional Safety).The review team used a quality control process to assess the early phase ofarticle exclusion. We also used a process of arbitrarily pairing reviewers ateach phase to improve independent assessment by at least two team members.Whenever possible, the reviewers used a transparent approach, and alldecisions were made using consensus.A systematic review of injury/illness prevention and loss controlprograms (IPCs)37