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Economic evaluations of ergonomic interventions preventing work-related musculoskeletal disorders: a systematic review of organizational-level interventions

机译：预防与工作有关的肌肉骨骼疾病的人机工程学干预措施的经济评估：组织级干预措施的系统评价

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Work-related musculoskeletal disorders (WMSD) represent a major public health problem and economic burden to employers, workers and health insurance systems. This systematic review had two objectives: (1) to analyze the cost-benefit results of organizational-level ergonomic workplace-based interventions aimed at preventing WMSD, (2) to explore factors related to the implementation process of these interventions (obstacles and facilitating factors) in order to identify whether economic results may be due to a successful or unsuccessful implementation. Systematic review. Studies were searched in eight electronic databases and in reference lists of included studies. Companion papers were identified through backward and forward citation tracking. A quality assessment tool was developed following guidelines available in the literature. An integration of quantitative economic results and qualitative implementation data was conducted following an explanatory sequential design. Out of 189 records, nine studies met selection criteria and were included in our review. Out of nine included studies, grouped into four types of interventions, seven yielded positive economic results, one produced a negative result and one mixed results (negative cost-effectiveness and positive net benefit). However, the level of evidence was limited for the four types of interventions given the quality and the limited number of studies identified. Our review shows that among the nine included studies, negative and mixed economic results were observed when the dose delivered and received by participants was low, when the support from top and/or middle management was limited either due to limited participation of supervisors in training sessions or a lack of financial resources and when adequacy of intervention to workers’ needs was low. In studies where economic results were positive, implementation data showed strong support from supervisors and a high rate of employee participation. Studies investigating the determinants of financial outcomes of prevention related to implementation process are very seldom. We recommend that in future research economic evaluation should include information on the implementation process in order to permit the interpretation of economic results and enhance the generalizability of results. This is also necessary for knowledge transfer and utilization of research results for prevention-oriented decision-making in occupational health and safety.
机译：与工作有关的肌肉骨骼疾病（WMSD）代表着主要的公共卫生问题，对雇主，工人和医疗保险体系造成了经济负担。这项系统的审查具有两个目标：（1）分析旨在预防WMSD的基于组织的，符合人体工程学的工作场所干预的成本效益结果;（2）探索与这些干预措施的实施过程相关的因素（障碍和促进因素） ），以确定经济结果是由于成功实施还是失败导致。系统评价。在八个电子数据库和纳入研究的参考清单中搜索了研究。通过向后和向前的引文跟踪识别同伴论文。根据文献中提供的指南开发了质量评估工具。在解释性顺序设计之后，对定量经济结果和定性实施数据进行了整合。在189笔记录中，有9项符合选择标准的研究已包括在我们的评价中。在9项纳入研究的研究中，将其分为4种类型的干预措施，其中7项产生了积极的经济结果，一项产生了负面的结果，另一项则产生了混合的结果（负成本效益和正净收益）。但是，鉴于所确定的研究质量和数量有限，四种干预措施的证据水平有限。我们的评论表明，在所纳入的九项研究中，当参与者的给药和接受剂量较低，高层管理人员和/或中层管理人员的支持有限或由于主管人员参加培训课程的次数有限时，观察到了负面和混合的经济结果或缺乏财务资源，以及干预措施不足以满足工人的需求。在经济成果良好的研究中，实施数据显示出主管的大力支持和较高的员工参与率。很少研究与执行过程有关的预防的财务结果的决定因素。我们建议在未来的研究中，经济评估应包括有关实施过程的信息，以允许对经济结果进行解释并增强结果的可概括性。这对于知识转移和利用研究结果，以预防为导向的职业健康与安全决策也是必要的。

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