Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire SK17 9JN, UK.
Occup Med (Lond). 2011 Aug;61(5):311-20. doi: 10.1093/occmed/kqr099.
No previous systematic review of the evidence base has been undertaken to help occupational health professionals understand how to reliably lower the instance of occupational ill-health through reducing risk-taking behaviour.
To evaluate the effectiveness and processes of occupational-based behavioural interventions for workers exposed to dermal and respiratory hazards.
A systematic review was conducted. Sixteen electronic databases were searched using key words. Bibliography, health and safety websites and hand searches of key journals were also undertaken. Articles were included if they evaluated an intervention targeting workers' behavioural compliance, addressed dermal or respiratory hazards, used before and after measures with a control group comparison and used behaviour-related exposure indicators such as airborne exposure, health effects, behaviour observations and self-reported work practices. Data were extracted according to potential sources of bias, impact and behavioural change processes used.
Ten of 550 articles identified as potentially relevant were included. A predominance of small effect sizes, particularly for larger samples, demonstrated limited but positive impact upon exposure. Studies contained too much heterogeneity for reliable meta-analysis. None of the studies covered the full range of behaviour change components necessary for reducing exposure risk.
We conclude that future interventions could enhance their effectiveness through improving design quality, reporting and basing their content upon evidence-based behavioural change approaches. Using a comprehensive range of evidence-informed behaviour change ingredients should improve occupational health professional's ability to reliably reduce occupational ill-health where exposure cannot totally be designed out of the workplace.
目前尚无系统的综述研究来帮助职业健康专业人员了解如何通过减少冒险行为来可靠地降低职业健康受损的发生率。
评估针对接触皮肤和呼吸道危害的工人的基于职业的行为干预措施的效果和过程。
进行了系统综述。使用关键词搜索了 16 个电子数据库。还查阅了参考书目、健康和安全网站以及主要期刊的手工检索。如果文章评估了针对工人行为合规性的干预措施，针对皮肤或呼吸道危害，使用前后对照且使用与行为相关的暴露指标（如空气暴露、健康影响、行为观察和自我报告的工作实践），则将其纳入。根据潜在的偏倚来源、影响和使用的行为改变过程提取数据。
在确定的 550 篇潜在相关文章中，有 10 篇被纳入。较小的效应量占主导地位，特别是对于较大的样本，表明暴露的影响有限但积极。研究的异质性太大，无法进行可靠的荟萃分析。没有一项研究涵盖了减少暴露风险所需的所有行为改变组成部分。
我们得出结论，未来的干预措施可以通过提高设计质量、报告质量并以基于循证的行为改变方法为基础来提高其效果。使用全面的循证行为改变成分应能提高职业健康专业人员在无法完全消除工作场所暴露的情况下可靠降低职业健康受损的能力。
