Intervention Review

Interventions for preventing injuries in the construction industry

  1. Henk van der Molen1,*,
  2. Marika M Lehtola2,
  3. Jorma Lappalainen3,
  4. Peter LT Hoonakker4,
  5. Hongwei Hsiao5,
  6. Roger A Haslam6,
  7. Andrew R Hale7,
  8. Jos H Verbeek8

Editorial Group: Cochrane Injuries Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 31 JUL 2007

DOI: 10.1002/14651858.CD006251.pub2

Database Title

Additional Information

How to Cite

van der Molen H, Lehtola MM, Lappalainen J, Hoonakker PLT, Hsiao H, Haslam RA, Hale AR, Verbeek JH. Interventions for preventing injuries in the construction industry. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006251. DOI: 10.1002/14651858.CD006251.pub2.

Author Information

  1. 1

    Coronel Institute, Arbouw, Amsterdam, Netherlands

  2. 2

    Cochrane Occupational Health Field, Finnish Institute of Occupational Health, Centre of Expertise for Good Practices and Competence, Team of Knowledge Transfer in Occupational Health and Safety, Kuopio, Finland

  3. 3

    Finnish Institute of Occupational Health, Occupational Safety Team, Tampere, Finland

  4. 4

    University of Wisconsin, Madison, Center for Quality and Production Improvement, Madison, WI, USA

  5. 5

    National Institute for Occupational Safety and Health (NIOSH), Protective Technology Branch, Morgantown, WV, USA

  6. 6

    Loughborough University, Department of Human Sciences, Leicestershire, UK

  7. 7

    Delft University of Technology, Safety Science Group, Delft, Netherlands

  8. 8

    Cochrane Occupational Health Field, Finnish Institute of Occupational Health, Center of Expertise for Good Practices and Competence, Team of Knowledge Transfer in Occupatioanl Health and Safety, Kuopio, Finland

*Henk van der Molen, Arbouw, Coronel Institute, P.O. Box 8114, Amsterdam, 1005, Netherlands. vandermolen@arbouw.nl . h.f.vandermolen@amc.uva.nl .

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 16 JUL 2008

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

預防建築工人受傷的介入措施

建築工人通常會暴露於各種引起受傷的危害。目前有建議一些預防受傷的介入措施，但這些效果還不確定。

目標

評估用來預防建築工人受傷之介入措施的效果。

搜尋策略

我們檢索the Cochrane Injuries Group的專業登記資料庫，CENTRAL，MEDLINE，EMBASE，PsycINFO，OSHROM (包括NIOSHTIC與HSELINE)，EI Compendex。另外也檢索相關文章，回顧與網頁的參考文獻。檢索條件不限制語言或發表狀態。檢索所有的資料庫直到2006年6月為止。

選擇標準

所有用來預防建築工人致死或非致死傷害之介入措施的隨機對照試驗，前後對照試驗與間斷時間序列。

資料收集與分析

兩名作者分別摘錄資料並評估研究品質。關於間斷時間序列，我們重新分析並採用起始效果來測量介入後一年的受傷率改變量，以及持續效果用來測量介入前後時間趨勢的變化。

主要結論

五篇間斷時間序列研究符合納入標準。三篇研究評估規定的效果，一篇評估安全活動，而一篇評估無毒工作環境計畫相較於非無毒工作環境計畫對於致死與非致死傷害的影響。整體的方法學品質不高。管控的介入措施未顯示對於致死或非致死傷害的起始或持續效果，effect sizes分別為0.69 (95% confidence interval (CI)為−1.70至3.09)與0.28 (95% CI為0.05至0.51)。安全活動有起始與持續效果，減少非致死傷害的effect sizes分別為−1.82 (95% CI為−2.90至−0.75)與−1.30 (95% CI為−1.79至−0.80)。相較於無介入措施，無毒工作環境計畫有起始與持續效果，減少非致死傷害的effect sizes分別為−6.74 (95% CI為−10.02至−3.54)與−1.76 (95% CI為−3.11至−0.41)。

作者結論

大多數由安全的標準文件，諮詢者與安全課程建議的技術，人為因子與組織介入措施尚未充分的評估。沒有證據指出規定可以有效減少致死與非致死傷害。有限的證據指出多面向的安全活動與多面向的藥物計畫可以減少建築工人的非致死傷害。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

建築工人的職業傷害率是主要產業中最高的。由各種組織提出的幾種傷害控制策略，對於它們減少建築業傷害的效果仍然未知。系統性檢索預防建築工人職業傷害的文獻。評估研究品質與介入措施的效果。找到了五篇研究。有適當的證據指出規定本身對於預防建築工人非致死與致死傷害不具有效果。有限的證據指出安全活動與無毒工作環境計畫對於減少建築業非致死傷害的效果。只採取規定對於減少建築工人致死與非致死傷害不具有效果。需要其他的策略來增加雇主與員工對於安全規定的遵從性。在管理與建築工人間的連續性介入措施，如目標安全活動或無毒工作環境計畫，似乎可以有效減少長期傷害。大多數由安全的標準文件，諮詢者與安全課程建議的技術，人為因子與組織介入措施尚未充分的評估；目前迫切需要在實證基礎上解決這個差距。

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