The state of the evidence
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Occupational incidents, accidents, injuries, ill health and fatalities can be reduced through occupational safety and health (OSH) interventions. The effectiveness of these interventions can be evaluated through research studies, with different methods and data providing different degrees of evidence of effectiveness. Reviews compile and analyse findings from multiple research studies. By bringing together findings from multiple studies, reviews can be used to compare interventions and better understand evidence about the effectiveness of interventions. However, existing reviews of studies of OSH interventions are limited and vary in quality.
This study was part of a wider research programme that RAND Europe is conducting to support Lloyd’s Register Foundation in their plans to address these issues through the development of a Global Safety Evidence Centre.
We conducted a systematic review of reviews. The aim was to assess and summarise existing reviews of OSH interventions to provide a comprehensive synopsis of the evidence regarding effectiveness of OSH interventions and to describe the quality of that evidence. We searched five different databases and a total of 53 review articles met our inclusion criteria and were included in the review. Data were extracted in line with the study aims and synthesised via a thematic analysis approach.
We identified two main themes: inadequacy of the evidence base, and unclear quality of the reviews themselves. The primary studies included within reviews were often of poor quality, lacking objective measures and theories of change, and, as such, contributed to a sparse and varied evidence base. Moreover, the reviews themselves varied widely in how robust they were and often lacked clear definitions of safety.
The findings from this review indicate that, despite some high-quality reviews, the evidence base remains limited and varied in quality and that further research is needed to provide a robust evidence base. To support such an evidence base, underpinning work could seek to establish standardised definitions and measures, further explore appropriate methods to appraise evidence and study quality within this field and encourage theoretical frameworks and theories of change for OSH interventions.
