Evaluation of an occupational health care programme: negative results, positive results or a failure?

Among personnel of the city of Amsterdam the incidence of disability as a result of musculoskeletal problems amounts to 15 per 1000 person-years in the refuse collecting department. A disability prevention programme in accordance with literature was started to decrease this high incidence of disability. In the process-evaluation after 2 years from the start of the project it turned out that only three of the ten preventive measures advocated were realized. These meagre results were explained by strategic factors such as lack of motivation among management and the fact that policy on worker health protection was isolated from the overall company policy. Recommendations for future evaluation research are given.