Mahmud Norashikin, Schonstein Eva, Schaafsma Frederieke, Lehtola Marika M, Fassier Jean-Baptiste, Reneman Michiel F, Verbeek Jos H
Faculty of Health Sciences, University of Sydney, Cumberland Campus C42, PO Box 170, Lidcombe, NSW, Australia, 1825.
Cochrane Database Syst Rev. 2010 Dec 8(12):CD008881. doi: 10.1002/14651858.CD008881.
Many employers and other stakeholders believe that health examinations of job applicants prevent occupational diseases and sickness absence.
To evaluate the effectiveness of pre-employment examinations of job applicants in preventing occupational injury, disease and sickness absence compared to no intervention or alternative interventions.
We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, PsycINFO and PEDro (to December 2009) not restricted by date, language or publication type.
We included randomised controlled trials (RCTs), controlled before-after studies (CBA), and interrupted time-series (ITS) of health examinations to prevent occupational diseases and injuries in job applicants.
Four review authors (NM, ML, JV, ES) independently selected studies, extracted data, and determined study quality. The studies were too heterogeneous for statistical pooling of results.
We included two RCTs, five CBA studies and two ITS. Seven studies with 5872 participants evaluated the screening process of pre-employment examinations and two studies with 2164 participants evaluated the measures to mitigate the risks found following the screening process.Of those studies that evaluated the screening process, one study found that a general examination did not reduce sick leave (Mean Difference -0.1 95% CI -0.5 to 0.3) but another study found that a more task focused examination did (MD -36 95% CI -68.3 to -3.8). One study found that incorporation of a bronchial challenge test decreased occupational asthma (trend change -2.6 95% CI -3.6 to -1.5). Three studies that included functional capacity evaluation found contradictory effects on injury rates and number of medical visits. The rates of rejecting job applicants varied from 2% to 35%.Neither of the two studies that evaluated risk mitigation found an increased injury rate after training or work accommodations had been implemented.We rated the evidence for all outcomes as very low quality.
AUTHORS' CONCLUSIONS: There is very low quality evidence that pre-employment examinations that are specific to certain jobs or health problems could reduce occupational disease, injury, or sickness absence. This supports the current policy to restrict pre-employment examinations to job-specific examinations. More studies are needed that take into account the harms of rejecting job applicants.
许多雇主和其他利益相关者认为，对求职者进行健康检查可预防职业病和病假缺勤。
与不进行干预或采用其他干预措施相比，评估对求职者进行入职前检查在预防职业伤害、疾病和病假缺勤方面的效果。
我们检索了CENTRAL（考克兰图书馆）、MEDLINE、EMBASE、CINAHL、PsycINFO和PEDro（截至2009年12月），检索不受日期、语言或出版物类型限制。
我们纳入了随机对照试验（RCT）、前后对照研究（CBA）以及健康检查的中断时间序列（ITS），以预防求职者的职业病和伤害。
四位综述作者（NM、ML、JV、ES）独立选择研究、提取数据并确定研究质量。这些研究的异质性过高，无法对结果进行统计合并。
我们纳入了两项RCT、五项CBA研究和两项ITS。七项研究共5872名参与者评估了入职前检查的筛查过程，两项研究共2164名参与者评估了减轻筛查过程中发现的风险的措施。在那些评估筛查过程的研究中，一项研究发现一般检查并未减少病假（平均差 -0.1，95%置信区间 -0.5至0.3），但另一项研究发现更侧重于任务的检查有此效果（平均差 -36，95%置信区间 -68.3至 -3.8）。一项研究发现纳入支气管激发试验可降低职业性哮喘（趋势变化 -2.6，95%置信区间 -3.6至 -1.5）。三项纳入功能能力评估的研究对伤害发生率和就诊次数的影响相互矛盾。拒绝求职者的比例从2%到35%不等。评估风险减轻措施的两项研究均未发现实施培训或工作调整后伤害发生率增加。我们将所有结果的证据质量评为极低。
证据质量极低，表明针对特定工作或健康问题的入职前检查可能会减少职业病、伤害或病假缺勤。这支持了当前将入职前检查限制为特定工作检查的政策。需要更多考虑拒绝求职者危害的研究。
