Occupational health and safety and sustainable return to work management in small and medium-sized enterprises

Abstract

BackgroundThe sustainable retention of workers after a work-related injury poses particular challenges for small and medium-sized enterprises (SMEs). Although studies on SMEs have multiplied over the past 30 years and some of them have led to the emergence of new concepts and theories in occupational health and safety (OHS), little is known about what can be done in SMEs to improve the OHS management of absences caused by work-related injuries. The objective of this presentation will be to overview strategical elements (resources, structures, activities) that could also benefit to the sustainable return-to work (SRTW).MethodA scoping review (Levac et al. 2010) on OHS management in SMEs was conducted in a reflective, iterative and collaborative manner. The methodological approach includes searching for relevant publications from the 2000 year in scientific (e.g., SCOPUS, ProQuest) and non-scientific (e.g., NHSE, NIOSH) databases, combining several key concepts related to OHS management and SRTW. Criteria for the selection of the studies were: 1) focus on OHS management, generally (review), or empirically (workplace intervention study); 2) focus on SMEs globally or in a specific context (size of enterprise, sectors of activities). Two reviewers using an iterative consensus-based approach performed article selection, extraction of data, and analyses.ResultsThree groups of strategic elements are beneficial for OHS management in SME: diffusion of information, support to implement integrative adapted systems of management and training programs, and especially designed for SME or intermediaries.Diffusion of information about legislation for SMEs, and guidelines for compliance with regulations, provide SME motivation and resources to intervene on the proper factors on SRTW. External support to OSH interventions, provided by control authorities, associations and networks of companies, and external consultants allow sharing knowledge and OSH-related resources, promoting best practices in SME. The availability of knowledge of effective OSH interventions could also help to replication or adaptation in particular contexts of SME, helping the achievement of proper conditions for SRTW. This kind of collaborative support to SME, combined with the continual engagement of employers and communication between management and employees and among employees, play an essential role in all phases of preventive or corrective interventions. Finally, training programs specially designed for SMEs foster interventions by increasing the awareness and the knowledge of the personnel, who are more motivated to intervene or correctly behave. DiscussionOverall, the strategies, resources, structures and activities in the SME, seem to be specific to the legislation in place and the different levels of actions. Even if generally they do not explicitly have an aim to promote sustainable retention of workers after a work-related injury, they present some opportunities to do so, modalities being different depending on the size of enterprise, and the level of risk of work activities in the sector. The results of this scoping review provide input for methodological and conceptual thinking for future policies or programs, as well as some information about integration of SRTW to OHS approaches and intervention modalities.