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

1.0 IntroductionInjuries among workers have adverse consequences for the worker, theemployer and the general population. Workers suffer both physical andmonetary losses following an on-the- job injury. Employers often incurproduction problems and rising insurance premiums as a result of an injuredemployee. Increased insurance premiums and production costs often translateto higher product prices for consumers. In addition, injured workers and theirfamilies may incur negative psychological or emotional effects following aworkplace injury.Injury/illness prevention and loss control programs (IPCs) are developed andenacted in the workplace as a means to protect workers, meet regulatoryrequirements, reduce the adverse consequences of worker injuries, andmanage costs. Employers often establish prevention programs as a proactiveway of reducing injury frequency, and they set up loss control programs tominimize the costs and disability associated with injuries after they’veoccurred. Studies of workplace IPCs are heterogeneous in both the factorsstudied and the outcomes evaluated. The effects of IPCs have provendifficult to study because a standard concept or definition of what constitutes“injury/illness prevention and loss control programs” is not used by eitherpractitioners or researchers. Also, it is difficult to determine which specificcomponents of broad-based IPCs are directly affecting worker injuries.Injury/illness prevention and loss control programs are an aggregate of humanresource, safety management, regulatory compliance, environmentalprotection and disability management policies. Teasing out the effects thatthe intermingled policies have on employees is difficult. A specificprogram’s effectiveness may not be accurately represented whenheterogeneous IPCs are combined and considered only at the organizationallevel.Employers are faced with selecting from an array of workplace IPCs and areoften guided by regulatory need and product marketing rather thanscientifically credible evidence on program effectiveness. In an attempt toprovide employers with scientific knowledge to assist in selecting effectiveIPCs, researchers have evaluated programs, policies, practices and conceptssuch as safety climate, safety culture, leadership training, organizationalpolicies/practices (OPPs) and occupational health and safety managementsystems (OHMS) (1). The research has attempted to quantify the effects thatIPCs have on reducing injury frequency, severity and associated costs (1).The difficulty in studying IPCs is that they are multidimensional, overlappingand applied differently depending on the type and physical location of theworkplace. A systematic review of the IPC literature would provide4 Institute for Work & Health