The Cochrane Reviews highlighted here are freely available while this Special Collection is featured on The Cochrane Library homepage.
The International Labour Organisation celebrates the World day for Safety and Health at Work on the 28th of April, with a theme for 2013 of prevention of occupational diseases (www.ilo.org). Labour unions worldwide also commemorate workers who have died at work or as a result of exposure at work on this day.
Fortunately, many statistics indicate that workplace health and safety have improved over time. Occupational injury rates in the US show a steady decline over the past 100 years, and exposure to chemical agents in the US and Europe has also decreased considerably in the past forty odd years. However, uncertainty about what specific interventions led to these improvements makes it difficult to select appropriate interventions in countries where rates remain high. Moreover, there are still occupational health statistics that are not favourable at all. Noise-induced hearing loss, work-related musculoskeletal disorders, stress-related complaints and skin disorders remain very prevalent. Other less prevalent conditions (for example HIV and Hepatitis C) have extremely serious consequences, and so protecting workers from these risks remains a high priority.
The Cochrane Occupational Safety & Health Review Group has selected a number of recent Cochrane Reviews that explore the evidence for interventions aimed at preventing occupational diseases. These can be used by employers to develop preventive policy and practice and achieve tangible health benefits for their employees.
 Creely KS, Cowie H, Van TM, Kromhout H, Tickner J, Cherrie JW. Trends in inhalation exposure–a review of the data in the published scientific literature. Ann Occup Hyg 2007;51(8):665-78.
INFECTIOUS AND PARASITIC DISEASES
Antibiotic prophylaxis for leptospirosis
Leptospira infection is a global zoonosis with significant health impact for agricultural workers and those persons whose work or recreation takes them into endemic areas. This systematic review assessed the current literature for evidence for or against use of antibiotic prophylaxis against Leptospira infection (leptospirosis).
Antibiotic prophylaxis for mammalian bites
Bites by mammals are a common problem and they account for up to 1% of all visits to hospital emergency rooms. Dog and cat bites are the most common and people are usually bitten by their own pets or by an animal known to them. School-age children make up almost a half of those bitten. Prevention of tetanus, rabies and wound infection are the priorities for staff in emergency rooms. The use of antibiotics may be useful to reduce the risk of developing a wound infection. This systematic review aimed to determine if the use of prophylactic antibiotics in mammalian bites is effective in preventing bite wound infection.
Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure
Populations such as healthcare workers (HCWs), injection drug users (IDUs), and people engaging in unprotected sex are all at risk of being infected with the human immunodeficiency virus (HIV). Animal models show that after initial exposure, HIV replicates within dendritic cells of the skin and mucosa before spreading through lymphatic vessels and developing into a systemic infection (CDC 2001). This delay in systemic spread leaves a “window of opportunity” for post-exposure prophylaxis (PEP) using antiretroviral drugs designed to block replication of HIV (CDC 2001). PEP aims to inhibit the replication of the initial inoculum of virus and thereby prevent establishment of chronic HIV infection. This systematic review aimed to evaluate the effects of antiretroviral PEP post-occupational exposure to HIV.
Behavioral interventions to reduce the transmission of HIV infection among sex workers and their clients in high-income countries
Interventions to change behaviour among sex workers and their clients have been identified as a strategy to reduce HIV transmission. However, there has been no systematic review that has examined and summarized their effects. This systematic review aimed to identify and evaluate the effects of the studies performed on behavioural interventions to reduce the transmission of HIV infection among sex workers and their clients in high-income countries.
Behavioral interventions to reduce the transmission of HIV infection among sex workers and their clients in low- and middle-income countries
Various interventions have been adopted to reduce HIV transmission among sex workers and their clients but the effectiveness of these strategies has yet to be investigated using meta-analytic techniques. This systematic review aimed to evaluate the effectiveness of behavioural interventions to reduce the transmission of HIV infection among sex workers and their clients in low- and middle-income countries.
Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff
Surgeons and their assistants are especially at risk of exposure to blood due to glove perforations and needle stick injuries during operations. The use of blunt needles can reduce this risk because they don’t penetrate skin easily but still perform sufficiently in other tissues. This systematic review aimed to determine the effectiveness of blunt needles compared to sharp needles for preventing percutaneous exposure incidents among surgical staff.
Influenza vaccination for healthcare workers who work with the elderly
Healthcare workers’ (HCWs) influenza rates are unknown, but may be similar to the general public and they may transmit influenza to patients. This systematic review aimed to identify studies of vaccinating HCWs and the incidence of influenza, its complications and influenza-like illness (ILI) in individuals aged ≥60 years in long-term care facilities (LTCFs).
Vaccines for preventing hepatitis B in health-care workers
Hepatitis B virus (HBV) causes acute and chronic liver diseases. Hepatitis B vaccination is recommended for health-care workers. This systematic review aimed to assess the beneficial and harmful effects of hepatitis B vaccination in health-care workers.
MENTAL AND BEHAVIOURAL DISORDERS
Preventing occupational stress in healthcare workers
Healthcare workers can suffer from occupational stress which may lead to serious mental and physical health problems. This systematic review aimed to evaluate the effectiveness of work and person-directed interventions in preventing stress at work in healthcare workers.
Preventive staff-support interventions for health workers
Healthcare workers need to be supported to maintain sufficient levels of motivation and productivity, and to prevent the debilitating effects of stress on mental and physical well-being. This systematic review aimed to assess the effects of preventive staff-support interventions to healthcare workers.
Psychological debriefing for preventing post traumatic stress disorder (PTSD)
Over approximately the last fifteen years, early psychological interventions, such as psychological ‘debriefing’, have been increasingly used following psychological trauma. Whilst this intervention has become popular and its use has spread to several settings, empirical evidence for its efficacy is noticeably lacking. This systematic review aimed to assess the effectiveness of brief psychological debriefing for the management of psychological distress after trauma, and the prevention of post traumatic stress disorder.
Psychosocial interventions for prevention of psychological disorders in law enforcement officers
Psychosocial interventions are widely used for the prevention of psychological disorders in law enforcement officers. This systematic review aimed to assess the effectiveness and comparative effectiveness of psychosocial interventions for the prevention of psychological disorders in law enforcement officers.
DISEASES OF THE SENSORY SYSTEM
Interventions to prevent occupational noise-induced hearing loss
Millions of workers worldwide are exposed to noise levels that increase their risk of hearing impairment. Little is known about the effectiveness of hearing loss prevention interventions. This systematic review aimed to assess the effectiveness of non-pharmaceutical interventions for preventing occupational noise exposure or occupational hearing loss compared to no intervention or alternative interventions.
Interventions to promote the wearing of hearing protection
Noise-induced hearing loss can be prevented by eliminating or lowering noise exposure levels. Where the source of the noise cannot be eliminated, workers have to rely on hearing protection equipment. Several trials have been conducted to study the effectiveness of interventions to influence the wearing of hearing protection. This systematic review aimed to evaluate the effectiveness of interventions to enhance the wearing of hearing protection among persons regularly exposed to high noise levels.
DISEASES OF THE CIRCULATORY SYSTEM
Non-pharmacological interventions for preventing venous insufficiency in a standing worker population
Chronic venous insufficiency (CVI) is a common problem, affecting up to 50% of the population in industrialised countries. It is a chronic condition which, if untreated, can progress to serious complications that in turn can interfere with working ability. Standing at work is a known risk factor for CVI, yet the true effect of non-pharmacological preventive strategies remains unknown. This systematic review aimed to evaluate the efficacy of non-pharmacological strategies and devices to prevent CVI in a standing worker population.
DISEASES OF THE RESPIRATORY SYSTEM
Interventions for preventing voice disorders in adults
Poor voice quality due to a voice disorder can lead to a reduced quality of life. In occupations where voice use is substantial it can lead to periods of absence from work. This systematic review aimed to evaluate the effectiveness of interventions to prevent voice disorders in adults.
Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma
Dampness and mould in buildings have been associated with adverse respiratory symptoms, asthma and respiratory infections of inhabitants. Moisture damage is a very common problem in private houses, workplaces and public buildings such as schools. This systematic review aimed to determine the effectiveness of remediating buildings damaged by dampness and mould in order to reduce or prevent respiratory tract symptoms, infections and symptoms of asthma.
DISEASES OF THE SKIN AND SUBCUTANEOUS TISSUE
Interventions for preventing occupational irritant hand dermatitis
Occupational irritant hand dermatitis (OIHD) is an important cause of discomfort in the working population. Different preventive measures are in place but it is not clear how effective these are. This systematic review aimed to assess the effect of interventions for preventing OIHD in healthy people who work in occupations where the skin is at risk of damage.
DISEASES OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE
Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults
Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. This systematic review aimed to assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults.
Exercises for prevention of recurrences of low-back pain
Back pain is a common disorder that has a tendency to recur. It is unclear if exercises, either as part of treatment or as a post-treatment programme, can reduce back pain recurrences. This systematic review aimed to investigate the effectiveness of exercises for preventing new episodes of low-back pain or low-back pain-associated disability.
Insoles for prevention and treatment of back pain
There is lack of theoretical and clinical knowledge of the use of insoles for prevention or treatment of back pain. The high incidence of back pain and the popularity of shoe insoles call for a systematic review of this practice. This systematic review aimed to determine the effectiveness of shoe insoles in the prevention and treatment of non-specific back pain compared to placebo, no intervention, or other interventions.
Lumbar supports for prevention and treatment of low back pain
Lumbar supports are used in the treatment of low-back pain patients, to prevent the onset of low-back pain (primary prevention) or to prevent recurrences of a low-back pain episode (secondary prevention). This systematic review aimed to assess the effects of lumbar supports for prevention and treatment of non-specific low-back pain.
Manual material handling advice and assistive devices for preventing and treating back pain in workers
Training and the provision of assistive devices are considered major interventions to prevent back pain and its related disability among workers exposed to manual material handling (MMH). This systematic review aimed to determine the effectiveness of MMH advice and training and the provision of assistive devices in preventing and treating back pain.
PREVENTION OF ANY OCCUPATIONAL DISEASE
Pre-employment examinations for preventing occupational injury and disease in workers
Many employers and other stakeholders believe that health examinations of job applicants prevent occupational diseases and sickness absence. This systematic review aimed to evaluate the effectiveness of pre-employment examinations of job applicants in preventing occupational injury, disease and sickness absence compared to no intervention or alternative interventions.
Acknowledgements: Jos Verbeek, Thais Morata and Jani Ruotsalainen from the Cochrane Occupational Safety & Health Review Group for drafting the introductory text, providing the image, comments and edits, and for selecting the reviews included in this special collection.
Image credit: Iisakki Härmä
Date published: 22 April 2013
Contact: Cochrane Editorial Unit (firstname.lastname@example.org)