The Institute for Work and Health Evidence for OT (12-24-07)
Occupational therapy practitioners who specialize in the work and industry practice area have a new resource for evidence-based information about effective interventions to enhance work performance, prevent injury and disability, and facilitate clients’ successful return to work. The Web site for the Institute for Work and Health (IWH), a Canadian independent, nonprofit research organization, is a “must stop” for occupational therapy practitioners interested in keeping abreast of the latest evidence-based understandings of health and safety in the workplace.
IWH’s research agenda is to investigate the prevention, treatment, and management of work-related injuries and disabilities. IWH’s knowledge transfer agenda engages the research staff and consultants to develop a series of Web-based systematic reviews available as scientific reports and laypersons’ summaries. These agendas are supported by the Ontario Workplace Safety and Insurance Board, along with research grants from the Canadian Institutes of Health Research, the U.S. National Institutes of Health, and the Social Sciences and Humanities Research Council of Canada, along with affiliation with four universities: the University of Toronto, University of Waterloo, McMaster University, and York University.
Click on the Knowledge Transfer section of the Web site at www.iwh.on.ca to find the research publications of the Institute, including the collection of systematic reviews; if you’d like to be notified of newly posted reviews, sign up by using the link for sr-@alertservice. Also available are the research program’s working papers, presenting preliminary findings of current research, a list of peer-reviewed published papers (including some of the systematic reviews), and several helpful tool kits.
Systematic Reviews of Note
Interventions in Health Care Settings To Protect Musculoskeletal Health: A Systematic Review (2006)
This review found at least two studies with medium- to high-quality evidence (quality indicators determined by the study group) related to the effect of two occupational safety and health interventions: patient handling (instituting zero-lift policies, using overhead or floor lifts, and training workers to use the patient-handling equipment) and exercise training (aerobic or strength training or both) for health care workers who had pain.
The studies evaluating the effectiveness of a patient-handling intervention found positive effects as measured by reduced numbers of lost work days, injury rates, and workers’ compensation rates 36 months post-intervention. The exercise training studies found declines in the frequency, intensity, and/or duration of pain symptoms reported by workers. The results of this review indicate that occupational therapists providing prevention interventions to individuals who are at risk for musculoskeletal disorders while working with patients should focus on multicomponent patient-handling techniques and exercise training programs to prevent pain and injury.
The Effectiveness of Participatory Ergonomic Interventions: A Systematic Review (2006)
In this evidence synthesis on the effect of workplace-based, employee-centered ergonomic interventions on improving health outcomes, 9 of the 10 studies included in the review showed positive effects of participatory ergonomics on health outcomes, including partial evidence of a small positive effect on improving musculoskeletal symptoms and partial evidence of a positive impact on musculoskeletal pain and discomfort, reduced injuries, lost days of work, and workers’ compensation claims. With their client-centered and occupation-based approach, occupational therapy practitioners can be valuable members of a team using a participatory ergonomics approach that results in positive health outcomes for workers. The review also noted key facilitators and barriers to the participatory ergonomic process, and this finding is leading IWH to conduct a future review on this topic.
Workplace Interventions To Prevent Musculoskeletal and Visual Symptoms and Disorders Among Computer Users: Systematic Review (2006)
This review found medium- to high-quality studies with a mixed level of evidence on the effect of ergonomic training, arm supports, alternative keyboards, and rest breaks on musculoskeletal or visual health. This review also found moderate evidence that alternative pointing devices (e.g., trackball, mouse) have a positive impact on musculoskeletal outcomes, whereas workstation adjustments were shown to have no effect on musculoskeletal or visual health. Although the review authors do not make specific recommendations regarding these interventions, they are clear in their recommendation that more research is required.
Workplace-Based Return-to-Work Interventions: A Systematic Review of the Quantitative and Qualitative Literature (2004)
Quantitative evidence relevant to occupational therapy indicated a moderate level of evidence that ergonomic worksite visits and involvement of an individual to coordinate return to work are effective in reducing the duration of work disability. The findings from the qualitative literature indicate that involvement of rehabilitation and occupational health care providers is important because they serve as a bridge between the workplace and the health care system.
This Web site contains a few other systematic reviews of note, including “Factors Associated With Occupational Disease Among Young People” and “Risk Factors for Work Injury Among Youth.” In addition, the site lists in-progress reviews of interest: “Participatory Ergonomics Interventions: Implementation and Process” and “Effectiveness of Workplace Programs in Preventing Upper-Extremity Disorders.”
The systematic reviews (layperson summary format and scientific reports) and other features of IWH’s Web site offer occupational therapy–relevant, evidence-based information and materials, and are an important contribution to one’s personal evidence-based practice library. For specialists in work and industry practice, it is indeed a “one-stop shop” for remaining current with the evidence in this field.
Jessica Scheer, PhD, is a medical anthropologist and research professor at the School of Public Health and Health Services at George Washington University in Washington, DC. She has served as a consultant with AOTA’s Evidence-Based Practice Project since 1998.
Scheer, J. (2007). The Institute for Work and Health: Evidence for OT. OT Practice, 22, 23–24.