How a health and safety management training program may improve the working environment in small- and medium-sized companies

Preventive health measures in small and medium-sized enterprises: A scoping review on implementation strategies

OBJECTIVE

To describe implementation strategies for preventive health measures in SMEs and the effectiveness of the strategies on implementation outcomes.

METHODS

A literature search was performed in multiple electronic databases. Studies published between 2000 and 2021 that evaluated the implementation of preventive health measures in SMEs were included. Classification of implementation strategies was based on two complementary classification systems.

RESULTS

Nineteen studies, of which 5 RCTs were included. Eighteen distinct implementation strategies were reported. All studies applied a combination of implementation strategies, and nearly all reported a positive effect on one or more implementation outcomes: sustainability, acceptability, feasibility, penetration, fidelity, adoption, and appropriateness.

CONCLUSIONS

Overall, a positive effect of combined implementation strategies on the implementation outcome(s) was found. The 'distribution of educational materials' and 'provide ongoing consultation' combined show positive effects on sustainability.

Work-Related Psychosocial Stress in Small and Medium-Sized Enterprises: An Integrative Review

Background: Work-related psychosocial stress can cause mental and physical illnesses resulting in high costs for the individual, the economy and society. Small and medium-sized enterprises (SMEs) employ the majority of the world’s workforce and often have fewer financial and human resources compared to larger businesses. The aim of this review is to summarize current knowledge on work-related stress in SMEs according to well-established guidelines categorizing psychosocial factors at work. Methods: A systematic database search was carried out in PubMed, PsycINFO, PSYNDEX and Business Source Premiere from March to June 2019, updated in January 2020. Data of included studies were analyzed and mapped into five themes: “work content and task”, “organization of work”, “social relations”, “working environment” and “new forms of work”. Results: After full-text screening, 45 out of 116 studies were included for data extraction. Studies were very heterogeneous and of varying quality, mostly applying a cross-sectional study design. Psychosocial factors in SMEs have been researched with a focus on the work patterns “work organization” and “work content and task”. Conclusions: This review underlines the need for more and better quality research of psychosocial factors in SMEs, particularly in relation to ongoing and new challenges in the workplace, including stressors related to the process of digitalization or the development of safe working conditions during the emerge of new infectious diseases.

Effectiveness of safety training interventions for supervisors: A systematic review and narrative synthesis

A wealth of research demonstrates that work unit supervisors serve a critical function in protecting the safety and health of workers. A systematic review examined the effectiveness of workplace safety training interventions intended for various supervisor populations published from 2000 to 2019. A search of seven electronic databases was supplemented with hand searches from the reference lists of identified publications, relevant scientific journals, and the gray literature. This review included an assessment of the methodological quality using a modified version of the Quality Assessment Tool for Quantitative Studies. A total of 22 peer-reviewed studies met a set of inclusion criteria and were subsequently assessed for methodological quality. Training interventions were grouped into five topical domains: ergonomics, leadership, supervisor-worker interaction, injury, and disability management, and general safety education. Consistent evidence was found for the effectiveness of supervisory training interventions across several outcome measures. To our knowledge, this is the first study to synthesize the literature on supervisory training interventions in the area of occupational safety. While the results are encouraging, they must be viewed with caution due to the fact that the methodological rigor of the reviewed studies was low.

Human resource management training of supervisors for improving health and well-being of employees

BACKGROUND

Many workers suffer from work-related stress and are at increased risk of work-related cardiovascular, musculoskeletal, or mental disorders. In the European Union the prevalence of work-related stress was estimated at about 22%. There is consensus that stress, absenteeism, and well-being of employees can be influenced by leadership behaviour. Existing reviews predominantly included cross-sectional and non-experimental studies, which have limited informative value in deducing causal relationships between leadership interventions and health outcomes.

OBJECTIVES

To assess the effect of four types of human resource management (HRM) training for supervisors on employees' psychomental stress, absenteeism, and well-being. We included training aimed at improving supervisor-employee interaction, either off-the-job or on-the-job training, and training aimed at improving supervisors' capability of designing the work environment, either off-the-job or on-the-job training.

SEARCH METHODS

In May 2019 we searched CENTRAL, MEDLINE, four other databases, and most relevant trials registers (ICTRP, TroPHI, ClinicalTrials.gov). We did not impose any language restrictions on the searches.

SELECTION CRITERIA

We included randomised controlled trials (RCT), cluster-randomised controlled trials (cRCT), and controlled before-after studies (CBA) with at least two intervention and control sites, which examined the effects of supervisor training on psychomental stress, absenteeism, and well-being of employees within natural settings of organisations by means of validated measures.

DATA COLLECTION AND ANALYSIS

At least two authors independently screened abstracts and full texts, extracted data and assessed the risk of bias of included studies. We analysed study data from intervention and control groups with respect to different comparisons, outcomes, follow-up time, study designs, and intervention types. We pooled study results by use of standardised mean differences (SMD) with 95% confidence intervals when possible. We assessed the quality of evidence for each outcome using the GRADE approach.

MAIN RESULTS

We included 25 studies of which 4 are awaiting assessment. The 21 studies that could be analysed were 1 RCT, 14 cRCTs and 6 CBAs with a total of at least 3479 employees in intervention and control groups. We judged 12 studies to have an unclear risk of bias and the remaining nine studies to have a high risk of bias. Sixteen studies focused on improving supervisor-employee interaction, whereas five studies aimed at improving the design of working environments by means of supervisor training.Training versus no interventionWe found very low-quality evidence that supervisor training does not reduce employees' stress levels (6 studies) or absenteeism (1 study) when compared to no intervention, regardless of intervention type or follow-up. We found inconsistent, very low-quality evidence that supervisor training aimed at employee interaction may (2 studies) or may not (7 studies) improve employees' well-being when compared to no intervention. Effects from two studies were not estimable due to missing data.Training versus placeboWe found moderate-quality evidence (2 studies) that supervisor training off the job aimed at employee interaction does not reduce employees' stress levels more than a placebo training at mid-term follow-up. We found low-quality evidence in one study that supervisor training on the job aimed at employee interaction does not reduce employees' absenteeism more than placebo training at long-term follow-up. Effects from one study were not estimable due to insufficient data.Training versus other trainingOne study compared the effects of supervisor training off the job aimed at employee interaction on employees' stress levels to training off the job aimed at working conditions at long-term follow-up but due to insufficient data, effects were not estimable.

AUTHORS' CONCLUSIONS

Based on a small and heterogeneous sample of controlled intervention studies and in contrast to prevailing consensus that supervisor behaviour influences employees' health and well-being, we found inconsistent evidence that supervisor training may or may not improve employees' well-being when compared to no intervention. For all other types of interventions and outcomes, there was no evidence of a considerable effect. However, due to the very low- to moderate-quality of the evidence base, clear conclusions are currently unwarranted. Well-designed studies are needed to clarify effects of supervisor training on employees' stress, absenteeism, and well-being.

[Effects of workers' interpersonal helping behavior enhancement program]

OBJECTIVES

Interpersonal helping behavior in organizational citizenship behavior can enhance social support in the workplace. The purpose of this study was to determine whether a workers' interpersonal helping behavior enhancement program increased interpersonal helping behavior, social support, and quantitative workload, and reduced psychological stress responses.

METHODS

A total of 72 workers in a manufacturing company in Japan participated in this study. After excluding 24 participants due to incomplete answers to a questionnaire, retirement, or absence from training, a total of 26 participants working in branch B assigned to an intervention group (22 male and 4 female) and a total of 22 participants working in branch C assigned to a control group (19 male and 3 female) were used for per-protocol analyses. In addition, after excluding 10 participants due to incomplete answers at pre test, a total of 35 participants working in branch B assigned to an intervention group (30 male and 5 female) and a total of 27 participants working in branch C assigned to a control group (23 male and 4 female) were used for intention to treat (ITT) analyses. Interpersonal helping behavior was assessed using the Japanese version of the Organizational Citizenship Behavior Scale. The Brief Job Stress Questionnaire was used to measure quantitative workload, psychological stress responses, and social support. Only the intervention group participants attended a seminar on psychological education, performed role-playing, and did four weeks' homework (HW). Both the intervention and control group participants answered pre test (pre), post test (post), and follow-up test (follow-up) at the same times. To evaluate the effects of the workers' interpersonal helping behavior enhancement program, two-way analysis of variances were performed for per-protocol analyses. Interpersonal helping behavior, quantitative workload, psychological stress responses, and social support were used as the dependent variables, time (pre, post, follow-up) and group (intervention, control) were used as the independent variables. A linear mixed model was established for ITT analyses.

RESULTS

The post and follow-up scores of interpersonal helping behavior and coworker support were significantly higher than the pre scores in per-protocol analyses. However, the follow-up scores of coworker support were not significantly higher than the pre scores in the ITT analyses.

CONCLUSIONS

The workers' interpersonal helping behavior enhancement program significantly improved interpersonal helping behavior and coworker support. However, the scores of supervisor support, quantitative workload, and psychological stress responses did not change significantly. The workers' interpersonal helping behavior enhancement program may enhance interpersonal helping behavior and coworker support.

The Collision Auto Repair Safety Study (CARSS): a health and safety intervention

BACKGROUND

Collision repair employs approximately 205,500 people in 33,400 shops. Workers are exposed to a diverse array of chemical, physical, and ergonomic hazards.

METHODS

CARSS was based on a random and purposeful sample. Baseline and one baseline and one-year evaluations consisted of 92 questions addressing issues, such as Right-to-Know, fire protection, painting-related hazards, ergonomics, electrical safety, and personal protective equipment. Owners received a report and selected at least 30% of items found deficient for remediation. In-person and web-based services were provided.

RESULTS

Forty-nine shops were evaluated at baseline and 45 at follow-up. At baseline, 54% of items were present. This improved to 71% at follow-up (P < 0.0001). Respiratory protection improved 37% (P < 0.0001) and Right-to-Know training increased 30% (P < 0.0001). Owners completed 61% of items they selected for remediation.

CONCLUSIONS

Small businesses' interventions should address the lack of personnel and administrative infrastructure. Tailored information regarding hazards and easy-to-use training and administrative programs overcome many barriers to improvement.

Effectiveness of health and safety in small enterprises: a systematic review of quantitative evaluations of interventions

INTRODUCTION

This systematic review was conducted to identify effective occupational health and safety interventions for small businesses.

METHODS

The review focused on peer-reviewed intervention studies conducted in small businesses with 100 or fewer employees, that were published in English and several other languages, and that were not limited by publication date. Multidisciplinary members of the review team identified relevant articles and assessed their quality. Studies assessed as medium or high quality had data extracted, which was then synthesized.

RESULTS

Five studies were deemed of medium or high quality, and proceeded to data extraction and evidence synthesis. The types of interventions identified: a combination of training and safety audits; and a combination of engineering, training, safety audits, and a motivational component, showed a limited amount of evidence in improving safety outcomes. Overall, this evidence synthesis found a moderate level of evidence for intervention effectiveness, and found no evidence that any intervention had adverse effects.

CONCLUSIONS

Even though there were few studies that adequately evaluated small business intervention, several studies demonstrate that well-designed evaluations are possible with small businesses. While stronger levels of evidence are required to make recommendations, these interventions noted above were associated with positive changes in safety-related attitudes and beliefs and workplace parties should be aware of them.

Systematic Work Environment Management: experiences from implementation in Swedish small-scale enterprises

Small-scale enterprises face difficulties in fulfilling the regulations for organising Systematic Work Environment Management. This study compared three groups of small-scale manufacturing enterprises with and without support for implementing the provision. Two implementation methods, supervised and network method, were used. The third group worked according to their own ideas. Twenty-three enterprises participated. The effects of the implementation were evaluated after one year by semi-structured dialogue with the manager and safety representative. Each enterprise was classified on compliance with ten demands concerning the provision. The work environment was estimated by the WEST-method. Impact of the implementation on daily work was also studied. At the follow-up, the enterprises in the supervised method reported slightly more improvements in the fulfilment of the demands in the provision than the enterprises in the network method and the enterprises working on their own did. The effect of the project reached the employees faster in the enterprises with the supervised method. In general, the work environment improved to some extent in all enterprises. Extensive support to small-scale enterprises in terms of advise and networking aimed to fulfil the regulations of Systematic Work Environment Management had limited effect - especially considering the cost of applying these methods.