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

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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
employers with valuable information concerning which workplace programshave scientific evidence demonstrating effectiveness.The heterogeneity in existing research provides a challenge for researcherswho would like to synthesize the IPC evidence by conducting a systematicreview. The systematic review process provides a structured methodologyfor evaluating, synthesizing and discovering gaps in the literature (2; 3; 4; 5).The purpose of this systematic review was to identify studies that evaluatedthe effect of IPCs on reducing the frequency and/or severity of workplaceinjuries. Studies that met our design and quality criteria were evaluated indetail, and study data were synthesized. The review included both primaryand secondary prevention studies. By definition, loss control programsfocused on secondary prevention. Based on our synthesis, we maderecommendations about program effectiveness related to primary andsecondary prevention of work-related injuries and illnesses. We alsodiscussed the need for further, high quality workplace intervention studies.1.1 Organization of the reportFollowing this introduction, readers will find:• a detailed description of the methods we used to search for and selectrelevant studies• details about quality assessment, data extraction and best evidencesynthesis of the methodology of quantitative studies• results of the systematic review, including information about thenumber of studies found; their methodological quality; the types ofinterventions examined; and study characteristics• results of our synthesis of evidence according to interventioncategories• conclusions about the levels of evidence• messages about the current state of the peer-reviewed literature andrecommendations for future intervention research and evaluationA systematic review of injury/illness prevention and loss controlprograms (IPCs)5
Page 1 and 2: A systematic review of injury/illne
Page 3 and 4: Table of ContentsForeword ………
Page 5: ForewordIn recent years, the Instit
Page 9 and 10: forward. In 1970, the Occupational
Page 11 and 12: Figure 1: IPC frameworkInput(to wor
Page 13 and 14: publish the results of the review i
Page 15 and 16: A key part of the literature would
Page 17 and 18: 2.4 Level 2 - Quality AssessmentIn
Page 19 and 20: allowed us to insure the answers pr
Page 21 and 22: Table 4: Best evidence synthesis gu
Page 23 and 24: Figure 3: Flowchart of systematic r
Page 25 and 26: • Return-to-work/disability manag
Page 27 and 28: etween groups, but only 32% adjuste
Page 29 and 30: Workstationadjustment andtrainingRo
Page 31 and 32: focused on just RTW (Durand et al.
Page 33 and 34: ExerciseThree medium quality studie
Page 35 and 36: compensation and medical bills is m
Page 37 and 38: interventions provide an insufficie
Page 39 and 40: Researchers and practitioners also
Page 41 and 42: 5.0 MessagesBefore making recommend
Page 43 and 44: 1) Of the articles that remained af
Page 45 and 46: 11) Agency for Healthcare Research
Page 47 and 48: Carayon P, Haims MC, Hoonakker PLT,
Page 49 and 50: workers: Randomized controlled work
Page 51 and 52: Nelson NA, Silverstein BA. Workplac
Page 53 and 54: pain in sedentary office workers -
Page 55 and 56: Appendix A: Content expertsNameBarb
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Appendix C: Stakeholder search term
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Appendix D - Literature search term
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A systematic review of injury and i
Page 63 and 64:
Zohar DZohar D,Modifying Supervisor
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Level 1 Guide for ReviewersThe guid
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Appendix G: Quality Appraisal Revie
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Q4. Were time-based comparisons use
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If there are no major significant d
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Q17. Was the calendar duration of t
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a) YesBaseline differences were obs
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5. List the jurisdiction where the
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have intended to prevent both “as
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Sample SizeEg: C 1 , C 2 , …(or I
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29. If injury rates were calculated
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38. Describe for each injury/illnes
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Appendix J: Quality assessment tabl
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StudyTime-Based ComparisonsRandom A
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Appendix K: Intervention descriptio
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InterventionCategoryErgonomictraini
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InterventionCategoryBricklayingmeth
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InterventionCategoryTraining &equip
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Appendix L: Study description*key t
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InterventioncategoryPrograms(regula
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InterventioncategoryWorkstationadju
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InterventioncategoryErgonomictraini
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InterventioncategoryAuthor, Year QA
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InterventioncategoryWorkstationadju
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