Systematic literature review on the effects of occupational safety and health (OSH) interventions at the workplace

Johan Hviid Andersen,Jens Peter Bonde,Per Malmros,Niels Erik Ebbehoej,Elizabeth Bengtsen,Esben Meulengracht Flachs

doi:10.5271/sjweh.3775

Abstract

Objectives The aim of this review was to assess the evidence that occupational safety and health (OSH) legislative and regulatory policy could improve the working environment in terms of reduced levels of industrial injuries and fatalities, musculoskeletal disorders, worker complaints, sick leave and adverse occupational exposures. Methods A systematic literature review covering the years 1966‒2017 (February) was undertaken to capture both published and gray literature studies of OSH work environment interventions with quantitative measures of intervention effects. Studies that met specified in- and exclusion criteria went through an assessment of methodological quality. Included studies were grouped into five thematic domains: (i) introduction of OHS legislation, (ii) inspection/enforcement activity, (iii) training, such as improving knowledge, (iv), campaigns, and (v) introduction of technical device, such as mechanical lifting aids. The evidence synthesis was based on meta-analysis and a modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results The search for peer-reviewed literature identified 14 743 journal articles of which 45 fulfilled the inclusion criteria and were eligible for meta-analysis. We identified 5181 articles and reports in the gray literature, of which 16 were evaluated qualitatively. There was moderately strong evidence for improvement by OHS legislation and inspections with respect to injuries and compliance. Conclusions This review indicates that legislative and regulatory policy may reduce injuries and fatalities and improve compliance with OHS regulation. A major research gap was identified with respect to the effects of OSH regulation targeting psychological and musculoskeletal disorders.

Highlights

The assessment of moderately strong evidence for the effect of introduction of legislation on injuries/fatalities and inspection/enforcement activity on injuries/fatalities and compliance was due to several studies pointing in the same direction
This review indicates that OSH activities such as the introduction and enforcement of legislation and workplace inspections are effective in reducing injuries and improving compliance
The GRADE system weighs randomized controlled studies as the highest evidence, but very few RCT have been performed in the OSH area

Summary

Introduction

Introduction of legislationThere were 16 studies retained in this domain: 11 were undertaken in the US [31,32,33,34,35,36,37,38,39,40,41], 2 in the UK [42, 43], and 1 each in Spain [44], Canada [45] and Germany [46]. There was moderately strong evidence that the introduction of OHS legislation has an effect on reducing injuries and fatalities based on these ten medium quality studies (table 1). Studies considered the introduction of different legislations such as broad OHS regulations [31, 44, 46], self-regulation [45], machine regulation [32], mine safety regulation [34], needle stick regulation [38] vertical fall arrest standard [47], and standards introduced in manufacturing [35, 36]. Violence-assault rates among hospital workers were assessed on a study where the Hospital Safety and Security Act in California in 1995 reduced assault rates by around 50% in the follow-up period [33].

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Conclusion