Lehtola Marika M, Rautiainen Risto H, Day Lesley M, Schonstein Eva, Suutarinen Juha, Salminen Simo, Verbeek Jos H
Finnish Institute of Occupational Health, Cochrane Occupational Health Field, Kupio, Finland.
Scand J Work Environ Health. 2008 Oct;34(5):327-36. doi: 10.5271/sjweh.1279. Epub 2008 Oct 14.
This study reviewed the effectiveness of interventions in preventing occupational injuries among workers in agriculture.
Randomized controlled trials, controlled before-after studies, and interrupted time-series studies assessing interventions aimed at preventing injuries among workers in agriculture were considered. MEDLINE and five other databases were searched up to June 2006. Two authors independently assessed the eligibility of studies and the methodological quality of the ones included. Randomized controlled trials were combined in a meta-analysis. Interrupted time-series studies were reanalyzed to assess the immediate and progressive effect on injuries.
Five randomized controlled trials and three interrupted time-series studies met the inclusion criteria. Six studies evaluated educational interventions and financial incentives, and two studies evaluated the effect of legislation. Three randomized controlled trials on educational interventions with 4670 adult participants did not indicate any injury-reducing effect, with a rate ratio of 1.02 (95% confidence interval 0.87-1.20), nor did two randomized controlled trials among children (6895 participants). Financial incentives decreased the injury level immediately after the intervention in one interrupted time-series study. Banning endosulfan pesticide in Sri Lanka led to a significant decrease in the trend of poisonings over time. Legislation requiring rollover protective structures on all tractors in Sweden did not produce a reduction in injuries, but the same requirement for new tractors was associated with a decrease in fatal injuries.
The reviewed studies provided no evidence that educational interventions are effective in decreasing injury rates among agricultural workers. Financial incentives may be a better means of reducing injury rates. Banning highly toxic pesticides may be effective. Legislation on safety devices on tractors yielded contradictory results.
本研究回顾了预防农业工人职业伤害干预措施的有效性。
纳入评估旨在预防农业工人伤害的干预措施的随机对照试验、前后对照研究和中断时间序列研究。检索截至2006年6月的MEDLINE及其他五个数据库。两位作者独立评估研究的纳入资格及所纳入研究的方法学质量。对随机对照试验进行荟萃分析。对中断时间序列研究重新分析以评估对伤害的即时和渐进影响。
五项随机对照试验和三项中断时间序列研究符合纳入标准。六项研究评估了教育干预和经济激励措施，两项研究评估了立法的效果。三项涉及4670名成年参与者的教育干预随机对照试验未显示出任何降低伤害的效果，率比为1.02（95%置信区间0.87 - 1.20），针对儿童的两项随机对照试验（6895名参与者）也是如此。在一项中断时间序列研究中，经济激励措施在干预后立即降低了伤害水平。斯里兰卡禁止使用硫丹农药导致中毒趋势随时间显著下降。瑞典要求所有拖拉机安装翻车保护结构的立法并未降低伤害，但对新拖拉机的相同要求与致命伤害的减少有关。
所回顾的研究没有提供证据表明教育干预能有效降低农业工人的伤害率。经济激励措施可能是降低伤害率的更好手段。禁止使用剧毒农药可能有效。关于拖拉机安全装置的立法产生了相互矛盾的结果。
