Safety interventions for the prevention of accidents at work - A systematic review

Background: Limited knowledge regarding the relative effectiveness of workplace accident prevention approaches creates barriers to informed decision-making by policy makers, public health practitioners, workplace, and worker advocates.
Objective: The objective of this review was to assess the effectiveness of broad categories of safety interventions in preventing accidents at work.
Method: Studies were identified through electronic bibliographic searches, government policy databanks, and Internet search engines. The last search was carried out on July 9, 2015. The following types of safety interventions were included: Attitudes, Behaviors, Physiological modifications, Climate/norms/culture, Structural conditions (including physical environment, engineering, legislation and enforcement, sectorial-level norms).
Statistical methods: Random-effects inverse variance weighted meta-analytic methods were used for studies with low or moderate levels of heterogeneity. For studies with greater heterogeneity and those using serial measures, we relied on narrative analyses to synthesize findings. In total 100 original studies were included for synthesis analysis, including 16 RCT study designs,
30 CBA study designs, and 54 studies using serial measures (ITS study designs). These studies represented 120 cases of safety interventions. Engineering controls are more effective at reducing injuries than other approaches. Multifaceted approaches combining intervention elements on the organizational level, or across levels, provided moderate to strong effects, Evidence supports regulation/legislation as contributing to the prevention of accidents at work, but with lower effect sizes. All in all the relative effectiveness of workplace safety
interventions is in accordance with the Public Health Hierarchy of Hazard Control.