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

evidence with a positive effect were exercise, supervisor practices, andworkstation adjustment and training.However in two intervention categories where the results showed moderatelevels of evidence, the interventions evaluated were very different betweenstudies and “practices to consider” were not clear-cut. The exerciseinterventions included a workplace-based program and a home-basedprogram, so either intervention does not seem to be a practice to consider.The supervisor practices interventions were also varied, as each study used adifferent intervention to try to change behaviour to reduce injuries.The third category with a moderate level of evidence was workstationadjustment and training. This is significant because, when initiated asseparate interventions, ergonomic training and workstation adjustment eachshowed a moderate level of evidence for NO effect. Even though theworkstation adjustments varied across all the studies, a practice to consideris that workstation adjustment and training appear to be more effective whenused together compared to using either intervention independently.An important message is that the current state of the peer-reviewed literatureprovides limited high quality studies and the majority of the better qualitystudies examining IPCs are completed in office environments.As more research is conducted and supported by employers, labour andgovernment, here are some issues to consider:• Researchers should use concurrent worksite control groups as opposedto study designs with simulated controls, statistical controls or crossoverdesigns. True concurrent controls contribute results that are moregeneralizable across industrial sectors.• Field studies should have adequate sample sizes to reduce the risk ofmistakenly concluding an intervention has no effect, simply becausethe sample is too small.• Researchers should present outcomes using standard approaches thatare common to the reporting requirements demanded of stakeholderswhen using workers’ compensation, injury records or other regulatedinjury reporting systems.• Covariates and confounders should be measured and adjusted forusing multivariate statistical models. This is especially true when theresearchers are unable to randomize workers into either interventionor control groups.The review resulted in many lessons learned about search strategies, thevaried use of terms across disciplines and which interventions were beingstudied. However, two major points emerged from trying to consider the IPCliterature as a whole rather than studying only one part.40 Institute for Work & Health