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Interventions for preventing injuries in the construction industry

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Abstract

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Background

Construction workers are frequently exposed to various types of injury‐inducing hazards. A number of injury prevention interventions have been proposed, yet the effectiveness of these is uncertain.

Objectives

To assess the effects of interventions for preventing injuries among workers at construction sites.

Search methods

We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, PsycINFO, OSH‐ROM (including NIOSHTIC and HSELINE), EI Compendex. The reference lists of relevant papers, reviews and websites were also searched. The searches were not restricted by language or publication status. All databases were searched up to June 2006.

Selection criteria

Randomized controlled trials, controlled before‐after studies and interrupted time series of all types of interventions for preventing fatal and non‐fatal injuries among workers at construction sites.

Data collection and analysis

Two authors independently extracted data and assessed study quality. For interrupted time series, we reanalysed the studies and used an initial effect, measured as the change in injury‐rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention.

Main results

Five interrupted time series studies met the inclusion criteria. Three studies evaluated the effect of regulations, one evaluated a safety campaign, and one a drug‐free workplace program on fatal or non‐fatal injuries compared to no drug‐free workplace program. The overall methodological quality was low. The regulatory interventions did not show either an initial or sustained effect on fatal or non‐fatal injuries, with effect sizes of 0.69 (95% confidence interval (CI) ‐1.70 to 3.09) and 0.28 (95% CI 0.05 to 0.51). The safety campaign did have an initial and sustained effect, reducing non‐fatal injuries with effect sizes of ‐1.82 (95% CI ‐2.90 to ‐0.75) and ‐1.30 (95% CI ‐1.79 to ‐0.80) respectively. The drug‐free workplace program did have an initial and sustained effect, reducing non‐fatal injuries compared to no intervention, with effect sizes of ‐6.78 (95% CI ‐10.02 to ‐3.54) and ‐1.76 (95% CI ‐3.11 to ‐0.41) respectively.

Authors' conclusions

The vast majority of technical, human factors and organisational interventions which are recommended by standard texts of safety, consultants and safety courses, have not been adequately evaluated. There is no evidence that regulations for reducing fatal and non‐fatal injuries are effective. There is limited evidence that a multifaceted safety campaign and a multifaceted drug program can reduce non‐fatal injuries in the construction industry.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

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Interventions for preventing injuries in the construction industry

Occupational injury rates among construction workers are the highest among the major industries. While several injury control strategies have been proposed by various organizations, their effectiveness for reducing the rate of injuries in the construction industry remains uncertain.

A systematic search of the literature was conducted on preventing occupational injuries among construction workers. The quality of the studies was assessed and the effectiveness of interventions was evaluated. Five studies were identified.

There is moderate evidence that regulation alone is not effective in preventing non‐fatal and fatal injuries in the construction industry. There is limited evidence that a safety campaign and a drug‐free workplace program are effective in reducing non‐fatal injuries in the construction industry.

Introducing regulation alone is not effective in reducing fatal and non‐fatal injuries in the construction industry. Additional strategies are needed to increase the compliance of employers and workers to the safety measures as prescribed by regulation. Continuing interventions among management and construction workers, such as a targeted safety campaign or a drug‐free workplace program, seem to have an effect in reducing injuries in the longer term.

The vast majority of technical, human factors and organisational interventions which are recommended by standard texts of safety, consultants and safety courses, have not been adequately evaluated; there is an urgent need to address this gap in the evidence base.