Article type
Year
Abstract
Background: The newly formed Cochrane Occupational Health Field (COHF) is focused on interventions that aim at reducing or changing exposure to health hazards at work, occupational disease, occupational disability and avoidable sickness absence.
Objectives: To describe and compare systematic reviews and protocols which have an occupational health focus.
Method: Systematic reviews in all Cochrane Review Groups have been searched to identify relevant reviews. Data regarding classification according to the COHF, characteristics of interventions, participants, primary outcomes and objectives of the reviews were extracted.
Results: Of 23 reviews identified, 3 (13%) were protocols, all included RCTs with 6 (26%) including CCTs and only 3 (13%) including other methodological designs. According to the new classification of occupational health interventions which has been proposed by the COHF, most (70%) outcome of interventions were 'disease signs and symptoms', most of the mode of actions of interventions fell in the category of 'disability management' and most (87%) were 'curative' in nature, that is only 13% fell in the category of primary prevention. Eight (40%) reviews considered adverse effects due to the interventions studied, with only 40% concluding that the interventions studied were effective.
Discussion and Conclusions: Whilst RCTs are methodologically the gold standard for intervention studies, they are not always feasible in the area of occupational health due to, amongst other things contamination of control groups. It is therefore important to; on one hand accept that occupational health research may never reach the high methodological standard as in pharmacological treatment trials for example, and the other hand to find ways of accommodating for this fact by finding new and better ways to synthesize evidence from non-randomised trials. Qualitative studies can contribute to reviews of effectiveness in a number of ways, such as describing the experience of the participants receiving the interventions and helping to understand the diversity of effects across studies, settings and groups.
None of the reviews studied interventions for disadvantaged groups, in terms of place of residence, race/ethnicity, education or socio-economic position. It is argued that future research needs to focus on reducing occupational health inequalities.
Objectives: To describe and compare systematic reviews and protocols which have an occupational health focus.
Method: Systematic reviews in all Cochrane Review Groups have been searched to identify relevant reviews. Data regarding classification according to the COHF, characteristics of interventions, participants, primary outcomes and objectives of the reviews were extracted.
Results: Of 23 reviews identified, 3 (13%) were protocols, all included RCTs with 6 (26%) including CCTs and only 3 (13%) including other methodological designs. According to the new classification of occupational health interventions which has been proposed by the COHF, most (70%) outcome of interventions were 'disease signs and symptoms', most of the mode of actions of interventions fell in the category of 'disability management' and most (87%) were 'curative' in nature, that is only 13% fell in the category of primary prevention. Eight (40%) reviews considered adverse effects due to the interventions studied, with only 40% concluding that the interventions studied were effective.
Discussion and Conclusions: Whilst RCTs are methodologically the gold standard for intervention studies, they are not always feasible in the area of occupational health due to, amongst other things contamination of control groups. It is therefore important to; on one hand accept that occupational health research may never reach the high methodological standard as in pharmacological treatment trials for example, and the other hand to find ways of accommodating for this fact by finding new and better ways to synthesize evidence from non-randomised trials. Qualitative studies can contribute to reviews of effectiveness in a number of ways, such as describing the experience of the participants receiving the interventions and helping to understand the diversity of effects across studies, settings and groups.
None of the reviews studied interventions for disadvantaged groups, in terms of place of residence, race/ethnicity, education or socio-economic position. It is argued that future research needs to focus on reducing occupational health inequalities.