循证职业健康与安全干预措施:综述的综合概述。
Evidence-based occupational health and safety interventions: a comprehensive overview of reviews.
机构信息
Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria.
出版信息
BMJ Open. 2019 Dec 11;9(12):e032528. doi: 10.1136/bmjopen-2019-032528.
OBJECTIVES
Occupational injuries and diseases are a huge public health problem and cause extensive suffering and loss of productivity. Nevertheless, many occupational health and safety (OHS) guidelines are still not based on the best available evidence. In the last decade, numerous systematic reviews on behavioural, relational and mixed interventions to reduce occupational injuries and diseases have been carried out, but a comprehensive synopsis is yet missing. The aim of this overview of reviews is to provide a comprehensive basis to inform evidence-based decision-making about interventions in the field of OHS.
METHODS
We conducted an overview of reviews. We searched MEDLINE (Ovid), the Cochrane Library (Wiley), epistemonikos.org and Scopus (Elsevier) for relevant systematic reviews published between January 2008 and June 2018. Two authors independently screened abstracts and full-text publications and determined the risk of bias of the included systematic reviews with the ROBIS (Risk of Bias in Systematic Reviews) tool.
RESULTS
We screened 2287 abstracts and 200 full-texts for eligibility. Finally, we included 25 systematic reviews with a low risk of bias for data synthesis and analysis. We identified systematic reviews on the prevention of occupational injuries, musculoskeletal, skin and lung diseases, occupational hearing impairment and interventions without specific target diseases. Several interventions led to consistently positive results on individual diseases; other interventions did not show any effects, or the studies are contradictory. We provide detailed results on all included interventions.
DISCUSSION
To our knowledge, this is the first comprehensive overview of behavioural, relational and mixed interventions and their effectiveness in preventing occupational injuries and diseases. It provides policymakers with an important basis for making evidence-based decisions on interventions in this field.
PROSPERO REGISTRATION NUMBER
CRD42018100341.
目的
职业伤害和疾病是一个巨大的公共卫生问题,造成广泛的痛苦和生产力损失。然而,许多职业健康和安全(OHS)指南仍然不是基于最佳现有证据。在过去的十年中,已经进行了许多关于减少职业伤害和疾病的行为、关系和混合干预的系统评价,但仍缺乏全面的综述。本综述的目的是为 OHS 领域的干预措施提供一个全面的基础,以告知循证决策。
方法
我们进行了系统评价综述。我们在 2008 年 1 月至 2018 年 6 月期间,在 MEDLINE(Ovid)、Cochrane 图书馆(Wiley)、epistemonikos.org 和 Scopus(Elsevier)上搜索了相关的系统评价。两位作者独立筛选摘要和全文出版物,并使用 ROBIS(系统评价中的偏倚风险)工具确定纳入的系统评价的偏倚风险。
结果
我们筛选了 2287 篇摘要和 200 篇全文以确定是否符合入选标准。最终,我们纳入了 25 篇系统评价,这些评价在数据综合和分析方面的偏倚风险较低。我们确定了预防职业伤害、肌肉骨骼、皮肤和肺部疾病、职业性听力损伤以及没有特定目标疾病的干预措施的系统评价。一些干预措施在个别疾病上取得了一致的积极结果;其他干预措施没有显示出任何效果,或者研究结果相互矛盾。我们提供了所有纳入干预措施的详细结果。
讨论
据我们所知,这是首次对行为、关系和混合干预及其预防职业伤害和疾病的有效性进行全面综述。它为决策者在该领域的干预措施方面提供了循证决策的重要基础。
PROSPERO 注册号:CRD42018100341。