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      Economic Evaluation of Occupational Safety and Health Interventions From the Employer Perspective : A Systematic Review

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          Abstract

          Objectives:

          The aim of this systematic review was to evaluate the cost-effectiveness of occupational safety and health interventions from the employer perspective.

          Methods:

          A comprehensive literature search (2005 to 2016) in five electronic databases was conducted. Pre-2005 studies were identified from the reference lists of previous studies and systematic reviews, which have similar objective to those of this search.

          Results:

          A total of 19 randomized controlled trials and quasi-experimental studies were included, targeting diverse health problems in a number of settings. Few studies included organizational-level interventions. When viewed in relation to the methodological quality and the sufficiency of economic evidence, five of 11 cost-effective occupational safety and health (OSH) interventions appear to be promising.

          Conclusion:

          The present systematic review highlights the need for high-quality economic evidence to evaluate the cost-effectiveness of OSH interventions, especially at organizational-level, in all areas of worker health.

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          Most cited references42

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          Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria.

          The aim of the Consensus on Health Economic Criteria (CHEC) project is to develop a criteria list for assessment of the methodological quality of economic evaluations in systematic reviews. The criteria list resulting from this CHEC project should be regarded as a minimum standard. The criteria list has been developed using a Delphi method. Three Delphi rounds were needed to reach consensus. Twenty-three international experts participated in the Delphi panel. The Delphi panel achieved consensus over a generic core set of items for the quality assessment of economic evaluations. Each item of the CHEC-list was formulated as a question that can be answered by yes or no. To standardize the interpretation of the list and facilitate its use, the project team also provided an operationalization of the criteria list items. There was consensus among a group of international experts regarding a core set of items that can be used to assess the quality of economic evaluations in systematic reviews. Using this checklist will make future systematic reviews of economic evaluations more transparent, informative, and comparable. Consequently, researchers and policy-makers might use these systematic reviews more easily. The CHEC-list can be downloaded freely from http://www.beoz.unimaas.nl/chec/.
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            Psychosocial work environment and mental health--a meta-analytic review.

            To clarify the associations between psychosocial work stressors and mental ill health, a meta-analysis of psychosocial work stressors and common mental disorders was undertaken using longitudinal studies identified through a systematic literature review. The review used a standardized search strategy and strict inclusion and quality criteria in seven databases in 1994-2005. Papers were identified from 24,939 citations covering social determinants of health, 50 relevant papers were identified, 38 fulfilled inclusion criteria, and 11 were suitable for a meta-analysis. The Comprehensive Meta-analysis Programme was used for decision authority, decision latitude, psychological demands, and work social support, components of the job-strain and iso-strain models, and the combination of effort and reward that makes up the effort-reward imbalance model and job insecurity. Cochran's Q statistic assessed the heterogeneity of the results, and the I2 statistic determined any inconsistency between studies. Job strain, low decision latitude, low social support, high psychological demands, effort-reward imbalance, and high job insecurity predicted common mental disorders despite the heterogeneity for psychological demands and social support among men. The strongest effects were found for job strain and effort-reward imbalance. This meta-analysis provides robust consistent evidence that (combinations of) high demands and low decision latitude and (combinations of) high efforts and low rewards are prospective risk factors for common mental disorders and suggests that the psychosocial work environment is important for mental health. The associations are not merely explained by response bias. The impact of work stressors on common mental disorders differs for women and men.
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              A review of the literature on preventive occupational health and safety activities in small enterprises.

              The scientific literature regarding preventive occupational health and safety activities in small enterprises has been reviewed in order to identify effective preventive approaches and to develop a future research strategy. During the last couple of years, there has been a significant increase in the number of studies of small enterprises, but the research community is scattered between many different disciplines and institutions. There is a lack of evaluation of intervention studies, both in terms of effect and practical applicability. However, there is sufficiently strong evidence to conclude that employees of small enterprises are subject to higher risks than the employees of larger ones, and that small enterprises have difficulties in controlling risk. The most effective preventive approaches seem to be simple and low cost solutions, disseminated through personal contact. It is important to develop future intervention research strategies which study the complete intervention system: from the intermediaries through dissemination methods to the resulting preventive activities of the small enterprises.
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                Author and article information

                Journal
                J Occup Environ Med
                J. Occup. Environ. Med
                JOEM
                Journal of Occupational and Environmental Medicine
                Lippincott Williams & Wilkins
                1076-2752
                1536-5948
                February 2018
                06 November 2017
                : 60
                : 2
                : 147-166
                Affiliations
                Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (Dr Grimani, Dr Bergström, Aboagye, Drs Jensen, Lohela-Karlsson), Facultad de Ciencias Económicas, Universidad Nacional de Colombia, Bogotá, Colombia (Casallas), and Facultad de Ciencias Económicas y Administrativas, Universidad Jorge Tadeo Lozano, Bogotá, Colombia (Casallas).
                Author notes
                Address correspondence to: Aikaterini Grimani, PhD, Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, Box 210, SE 171 77 Stockholm, Sweden ( aikaterini.grimani@ 123456ki.se ).
                Article
                JOEM-17-6579 00006
                10.1097/JOM.0000000000001224
                5794237
                29112631
                f9eb8762-278f-4779-ad4d-6141145545ce
                Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

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