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一项范围综述,旨在确定预防四种重要职业病的有效策略。

A scoping review to identify strategies that work to prevent four important occupational diseases.

机构信息

SafetyNet Centre for Occupational Health and Safety Research, Memorial University, St. John's, Newfoundland, Canada.

Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.

出版信息

Am J Ind Med. 2020 Jun;63(6):490-516. doi: 10.1002/ajim.23107. Epub 2020 Mar 29.

DOI:10.1002/ajim.23107
PMID:32227359
Abstract

BACKGROUND

Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts.

METHODS

To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants.

RESULTS

We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity.

CONCLUSIONS

This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.

摘要

背景

尽管许多职业病在很大程度上是可以预防的,但它们仍然非常普遍且代价高昂。需要采取有效的策略来减轻其对人类、经济和社会的影响。

方法

为了更好地了解哪些方法最有可能有助于预防与噪声相关的听力损失、职业性接触性皮炎、职业性癌症和职业性哮喘,我们进行了范围界定审查并咨询了一些关键信息提供者。

结果

我们共检查了 404 篇文章,发现各种类型的干预措施都被报道有助于预防职业病,但每种方法都有其局限性,而且往往自身还不够充分。我们的主要发现包括:立法和法规可以成为初级预防的有效手段,但它们的影响取决于法规的性质和执行程度;控制层次结构中的措施可以降低这些疾病的风险并减少暴露;监测、监督和筛查是有效的预防工具,可用于评估立法/政策变化的影响;教育和培训的效果取决于具体情况,并受到实施方式的影响;多方面的干预措施通常比单一活动的干预措施更有效。

结论

本范围界定审查确定了值得决策者和利益相关者进一步探索、值得研究人员未来进行系统评估的职业病预防策略。它还确定了重要的差距,包括缺乏对不稳定工人的研究以及需要更多严格评估干预措施有效性的研究。

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Am J Ind Med. 2020 Jun;63(6):490-516. doi: 10.1002/ajim.23107. Epub 2020 Mar 29.
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