occupational safety and health education and training for underserved populations

Occupational safety and health education and training for underserved populations

Affiliations.

1 National Council for Occupational Safety and Health.
2 NIOSH's Training Research and Evaluation Branch.
3 Job Through Advocacy.
4 Chicago School of Public Health, University of Illinois.
PMID: 25053607
PMCID: PMC4540323
DOI: 10.2190/NS.24.1.d

This article presents an analysis of the essential elements of effective occupational safety and health education and training programs targeting underserved communities. While not an exhaustive review of the literature on occupational safety and health training, the paper provides a guide for practitioners and researchers to the key factors they should consider in the design and implementation of training programs for underserved communities. It also addresses issues of evaluation of such programs, with specific emphasis on considerations for programs involving low-literacy and limited-English-speaking workers.

Keywords: health education; occupational safety; training programs; underserved communities.

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OCCUPATIONAL SAFETY AND HEALTH EDUCATION AND TRAINING FOR UNDERSERVED POPULATIONS

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occupational safety and health education and training for underserved populations

Source: New Solut. 24(1):83-106
Alternative Title: New Solut
Personal Author: O’CONNOR, TOM ; FLYNN, MICHAEL ; WEINSTOCK, DEBORAH ; ZANONI, JOSEPH O’CONNOR, TOM ; FLYNN, MICHAEL ; WEINSTOCK, DEBORAH ; ZANONI, JOSEPH Less -
Description: This article presents an analysis of the essential elements of effective occupational safety and health education and training programs targeting underserved communities. While not an exhaustive review of the literature on occupational safety and health training, the paper provides a guide for practitioners and researchers to the key factors they should consider in the design and implementation of training programs for underserved communities. It also addresses issues of evaluation of such programs, with specific emphasis on considerations for programs involving low-literacy and limited-English-speaking workers. More ▼ -->
Subjects: [+] Accidents, Occupational Health Education Humans Occupational Diseases Occupational Health Safety Management United States Vulnerable Populations
Keywords: [+] Health Education Occupational Safety Training Programs Underserved Communities
Pubmed ID: 25053607
Pubmed Central ID: PMC4540323
Document Type: Journal Article
Funding: CC999999/Intramural CDC HHSUnited States/
Collection(s): CDC Public Access
Main Document Checksum: [+] urn:sha256:da2945cfc68f6e13c09dc6080630ae96f6d354cec5395605457396cb0601aa2d
Download URL: https://stacks.cdc.gov/view/cdc/32976/cdc_32976_DS1.pdf

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Safety and Health for Immigrant Workers

The United States workforce, like the population in general, is becoming more ethnically diverse. “We are and always will be a nation of immigrants,” President Obama stated recently in announcing his initiative on immigration reform. The Pew Research Center’s Hispanic Trends Project estimates that immigrants will make up roughly 23% of adults of working age in 2050, up from 15% in 2005 (Passel & Cohn, 2008). It is also predicted that immigrants and their children will make up 83% of the growth in the working age population of the U.S. during this same time period (Congressional Budget Office, 2005). Immigration from Latin America to the U.S. has grown dramatically over the past 2 decades and will figure prominently in these numbers. Currently, about 18 million Latino immigrants live in the U.S. (Batalova & Terrazas, 2010).

Latino workers suffer significantly higher rates of workplace fatalities (5.0 per 100,000 workers) than all workers combined (4.0), non-Latino white workers (4.0) or non-Latino black workers (3.7) (Cierpich, Styles, Harrison, et al., 2008). Considered alone, Latino immigrants to the U.S. have a workplace fatality rate of 5.9 per 100,000 which is almost 50% higher than the rate for all workers (4.0). In 2013, two-thirds of work-related deaths among Latinos were among foreign-born individuals, up from slightly more than half in 1992. These data suggest that fatalities among immigrant workers may be the driving force behind the elevated rates of workplace injuries and illnesses among Latinos in the U.S.

According to the BLS 2013 Census of Fatal Occupational Injuries, Hispanic or Latino workers were the only racial/ethnic group with an increase in workplace fatalities in 2013. The 797 Hispanic or Latino worker deaths constituted the highest total since 2008 and a 7 percent increase over 2012.

What can we do to improve safety and health among immigrant populations? To remain safe, effective, and competitive, companies must understand the diversity that currently exists in the workforce and how workers of different backgrounds approach on-the-job safety.

We have summarized key factors for improving safety and health of immigrant workers below. More details can be found in the article “Safety & the Diverse Workforce Lessons from NIOSH’s Work with Latino Immigrants” published earlier in the year in Professional Safety.

Knowledge as a Barrier to Safety

Many immigrants take jobs in industries unfamiliar to them when they come to the US. As such workplace safety training is critical. However, immigrant workers frequently report not receiving any safety training on the job and the training that they do receive can be of poor quality.

Therefore, determining effective ways to provide safety training to immigrant workers is an essential step in reducing occupational health disparities (O’Connor, Flynn, Weinstock, et al., 2011). Such efforts must go beyond simple translations of existing English-language materials; the format, content and messages should be customized for the target audience (Brunette, 2005).

Language as a Barrier to Safety

Language differences between immigrant workers and their supervisors and coworkers are one of the most frequently cited challenges companies face in promoting safety among immigrant workers (Gany, et al., 2011). This is particularly common in areas of the U.S. that have little to no bilingual infrastructure (Gouveia & Saenz, 2000; Pew Hispanic Center, 2005). Developing a bilingual capacity within an organization, either through training or hiring, will become increasingly important in economic sectors with high immigrant participation such as the construction and service sectors.

Cultural Differences as Barriers to Safety

Cultural factors that may affect safety at work include: how immigrants understand work and their relationship to their coworkers and employers; how these understandings compare to their native-country experiences; how they perceive the dangers at work relative to other risks they face each day (for example unemployment or deportation); how they adapt to workplace dangers; and how these understandings are similar and different from other groups of workers. For example, a study of Latino immigrant workers in Chicago, IL showed that workers’ behaviors reflected a culture that placed a high value on hard work and being perceived as such by their employer (Gomberg-Munoz, 2010). These workers were observed making overt demonstrations of their productivity to curry favor with employers and cultivate a reputation as better employees, which led to a competitive edge in the labor market relative to U.S.-born workers. While this strategy may prove effective in securing employment, it can lead to an increased risk of injury over time. Employers seeking to create a safe work environment must recognize these evolving value systems and adaptations so they can be addressed during training or in one-on-one interactions.

Another common mistake is for managers and institutions to focus on the immigrant’s culture without examining or accounting for the culture of the organization or that of workers from the dominant cultural group. It is important for organizations to develop an understanding of their own internal culture and the degree to which relying on “the way we do things here” may inadvertently exclude workers from different backgrounds. Understanding and overcoming cultural barriers to safety requires sensitivity to the different cultural backgrounds of the employees in any given company, knowledge of the organizational culture, and an appreciation of where these may hinder or facilitate a common understanding and practice.

Social Structures as a Barrier to Safety

Effective communication and training and improved cultural understanding are not the only factors involved in improving safety for a diverse workforce. Structural realities contribute to occupational health inequities for immigrant workers as well. Structural realities are shaped by laws, policies and practices, such as large macroeconomic trends like globalization (Siqueira, Gaydos, Monforton, et al., 2013); systemic discrimination such as racism (Okechukwu, Souza, Davis, de Castro, 2014; Krieger, 2010; Krieger, Waterman, Hartman, et al., 2006); and industry practices, such as a growing reliance on temporary workers (Landsbergis, Grzywacz & LaMontagne, 2014). Eliminating structural barriers often requires changes in policies and practices at levels beyond that of the individual worker or organization (e.g., industry, federal government, international regulatory body). While individual workers or organizations can advocate over time for structural change to eliminate barriers to safety, they often can take short-term actions to mitigate the effects of structural barriers on safety.

One example is the structural barrier to obtaining proper-fitting safety equipment for diverse workers. Many PPE specifications in the U.S. are based on measurements taken from military male recruits in the U.S. during the 1950s to 1970s (Spahr, Kau, Hsiao, et al., 2003). These data do not account for the range of body shapes and sizes of the modern civilian workforce and, consequently, structurally exclude women, nonwhites and individuals with unique body sizes or shapes (Hsiao, Friess, Bradtmiller, et al., 2009). Current initiatives are focused on developing better methods to collect anthropometric data and ensure that datasets used to design PPE are more inclusive (see http://www.cdc.gov/niosh/npptl/topics/respirators/headforms/).

Formative research by NIOSH suggests that alternative-sized PPE (PPE designed for women and unisex PPE) may be more widely available than previously thought; Poor advertising and restrictive (e.g. bulk) purchasing policies within organizations, however, often prevent the alternative-sized PPE from reaching workers who might benefit from it (DeLaney, 2012). Updating the anthropometric databases and creating better fitting PPE will take time. In the short-term individual companies can take action to investigate what alternative-sized PPE is currently available and how they can adapt their purchasing procedures to make it more accessible to their workforce.

To remain effective, competitive and safe organizations must ensure that they have the internal capacity to successfully manage employees from an increasingly diverse workforce. Safety professionals are called on to develop and implement safety programs that account for this diversity. To keep all its workers safe and healthy, a company must understand the diversity that currently exists in the workforce, how workers approach on-the-job safety, and develop a plan to overcome barriers that exist. Efforts to create institutional capacity to effectively work with a diverse workforce require both short and long term planning in key areas such as personnel, program, and partnerships. Some key questions to ask as you evaluate your company’s institutional capacity include:

How has your company evaluated its capacity to respond to the demographic changes in the workforce and how can it systematically fill the gaps it identifies (e.g. bilingual infrastructure, PPE fit)?
Are the current practices and policies at the company inclusive of the current workforce? What can be done to ensure that the policies can adapt to the changing workforce?
How does your organization identify possible barriers to safety that workers from different backgrounds face at work? What internal and external resources or organizations exist to help your organization address these barriers?

Share with us what has worked in your company.

Michael Flynn, MA

Social Scientist, Training Research and Evaluation Branch

Assistant Coordinator, Priority Populations and Health Disparities Program

For more information

AJIM Special Issue: Achieving Health Equity in the Workplace (May 2014 vol 57(5) AJIM)

New Solutions– New Solut. 2014;24(1):83-106. Occupational safety and health education and training for underserved populations. O’Connor T, Flynn M, Weinstock D, Zanoni J.

NIOSH Occupational Health Disparities webpage

Batalova, J. & Terrazas, A. (2010). Frequently requested statistics on immigrants and immigration in the U.S. Migration Information Source. Retrieved from www.migrationinformation.org/feature/display.cfm?ID=818#2

Brunette, M. (2005). Development of educational and training materials on safety and health: Targeting Hispanic workers in the construction industry. Family & Community Health, 28 (3), 253-266.

Cierpich, H., Styles, L., Harrison, R., et al. (2008). Work-related injury deaths among Hispanics-United States, 1992-2006. Journal of the American Medical Association, 300 (21), 2479-2480.

Congretional Budget Office. (2005). The role of immigrants in the U.S. labor market. Washington, DC: Author.

DeLaney, S. (2012, March). Web-based marketing of alternative-sized PPE for a diverse workforce. Poster presented at the NIOSH-PPT program stakeholder meeting. Pittsburgh, PA.

Flynn, M. “Safety & the Diverse Workforce: Lessons From NIOSH’s Work With Latino Immigrants” Professional Safety, June 2014.

Gany, F., Dobslaw, R., Ramirez, J., et al. (2011). Mexican urban occupational health in the U.S.: A population at risk. Journal of Community Health, 36(2), 175-179. doi:10.1007/s10900-010-9295-9

Gomberg-Muñoz, R. (2010). Willing to work: Agency and vulnerability in an undocumented immigrant network. American Anthropologist, 112 (2), 295-307. doi:10.1111/j.1548-1433.2010.01227.x

Gouveia, L. & Saenz, R. (2000). Global forces and Latino population growth in the Midwest: A regional and subregional analysis. Great Plains Research, 10, 305-328.

Krieger, N., Waterman, P.D., Hartman, C., et al. (2006). Social hazards on the job: Workplace abuse, sexual harassment, and racial discrimination—A study of black, Latino and white low-income women and men workers in the U.S. International Journal of Health Services, 36(1), 51-85.

Landsbergis, P.A., Grzywacz, J.G. & LaMontagne, A.D. (2014). Work organization, job insecurity and occupational health disparities. American Journal of Industrial Medicine, 57(5), 495-515.

O’Connor, T., Flynn, M.A., Weinstock, D., et al. (2011). Education and training for underserved populations. Paper presented at the Eliminating Health and Safety Disparities at Work Conference, Chicago, IL.

Passel, J.S. & Cohn, D.V. (2008). U.S. population projections: 2005-2050. Washington, DC: Pew Research Center.

Pew Research Center.(2005). The new Latino south: The context and consequences of rapid population growth (pp.1-45). Washington, DC: Author, Hispanic Center.

Siqueira, C.E., Gaydos, M., Monforton, C., et al. (2014). Effects of social, economic and labor policies on occupational health disparities. American Journal of Industrial Medicine, 57 (5), 557-572.

Spahr, J., Kau, T., Hsiao, H., et al. (2003, Oct.). Anthropometric differences among Hispanic occupational groups. Paper presented at the National Occupational Injury Research Symposium. Pittsburgh, PA.

23 comments on “Safety and Health for Immigrant Workers”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy » .

During Immigration process, most of the immigrants focusing on immigration process and visa status only, but most of the people not considering their health status. So for a long time they will face a lot of health problems. Every immigrant should these tips to prevent health problems.

Hi, this is Peter and we have extensive experience in working with immigrant workers. I can confirm that language and misinterpretation of words and their meanings is a big hazard in relation to on site safety. While specific knowledge is tested and language skills may be found acceptable, sometime workers in health and safety training claim they understood the concept but their answers are automated and their awareness and actual understanding is low and they don’t stress enough the importance of health and safety. In cases where another language is dominant we use qualified trainers to explain and address health and safety issues in that specific language – which we find it raises the awareness, and responsibility in relation to health and safety procedures.

Thanks for the post Michael.

I have to say that I really enjoyed reading it as it covers a topic close to my heart (workplace safety) and introduced me to a new facet of it that I’d never considered before – the difficulty of training and ensuring the safety of staff with poor English skills.

I’ve worked in supplying ppe and safety equipment for longer than I care to admit and usually try to partner with those buying our products by not only supplying the equipment, but also helping them with advice on compliance issues and also how to change the safety culture of their organisation.

I think that, going forward, I need to ask a few targeted question to see what the demographics of the organisation is, highlighting the additional challenges presented by those with poor language skills and highlighting the need for additional training in the correct use of ppe and safety equipment, as well proper adoption of all safety processes and procedures.

Having tried to assemble flat-pack furniture with Chinese assembly instructions before, this should have hit home to me earlier and I can only imagine the difficulty some immigrant workers may have with the correct use of more complicated safety equipment.

I hope all employers take a moment to make sure that those employees with poor language skills truly understand the correct use of equipment and the procedures and policies designed to protect them from injury.

Thanks again Michael for the eye-opener post.

Karen Baker Safety Officer

Thank you for the informative article, I really enjoyed the statistics. I was quite shocked that namely Latinos suffer from more workplace injuries, is it really that connected to the language barrier? In our company, [name removed], we base our whole philosophy on taking little baby steps with new employees. Especially if they are immigrants, we always assign one of our senior workers to help out and observe at the job. I think that employers should go even as far as offering language courses, maybe funded by the government? I don’t know if that’s quite possible or not, but it’s rather a good start. Kind regards, Lorelai Vano

America has a good reputation when it comes to receiveing immigrants. With the American Lottery, 50000 new people get into American each year. And their health is such an important issue. Great work that they are putting the health of immigrants first. God bless America

Thanks for this post! I really enjoyed the statistics! Can we publish a revision in our website?

thanks for the article.i really enjoyed reading.

Thanks a lot this for great post about the Immigrant Workers it is a great step your article is awesome.

Thank you so much for this article. it is really helpful and very informative post…Thanks again….

American is very much welcome in come of immigratng….Thank you so much for the post.

thanks for this great information.

WOW !! What a Cool blog and great shared to Immigrant Workers. I like your awesome tropic and valuable information.

Nice article, I really enjoyed this article. Thanks a lot this for a very informative post about the Immigrant workers. Keep it up.

The same thing happens here in the UK. I read an article on Tier 1 Application, you realise that most immigrants are mostly concerned about thier gaining entry into the UK that they neglect the most basic things. The increasing emphasis quantitative elements like rules, money, etc is causing immigrants to forget the most important qualitative things like health and safety.

Nice piece of informative article

Thank you so much for the informative post.

Thanks for this information of Safety and Health. These are the important steps of safety and health.

Very Helpful Post and the great article to Immigrant Workers Laws. Thanks to author your Awesome Tropic and Valuable information. Truly I like it and Looking forward to reading your Up next post.

Very important post! Wonderfully summarized key factors for improving safety and health of immigrant workers here thanks for the nice post.

Great blog! Nice key factors for improving safety and health of immigrant workers, thank you so much for helping us just by sharing the post.

I really appreciate your writing about immigrants health and safety measures.

And we still need to add the emotional health issues that arise in a new context, anxiety, depression, loneliness, extreme sadness, the sense of not belonging or not being adequate, etc. Caring for the mental health of immigrants in the workplace is also important. Research says that it may take up to 10 years for an immigrant to get adjusted to a new country. Thank you Mr. Flynn for this great article.

El lenguaje como barrera para la seguridad Las diferencias de idioma entre los trabajadores inmigrantes y sus supervisores y compañeros de trabajo son uno de los desafíos más citados que enfrentan las empresas para promover la seguridad entre los trabajadores inmigrantes (Gany, et al., 2011). Esto es particularmente común en áreas de los EE. UU. Que tienen poca o ninguna infraestructura bilingüe (Gouveia & Saenz, 2000; Pew Hispanic Center, 2005). El desarrollo de una capacidad bilingüe dentro de una organización, ya sea a través de la capacitación o la contratación, será cada vez más importante en los sectores económicos con alta participación de inmigrantes, como los sectores de la construcción y los servicios.

Saludos cordiales,

Lic. Carolina Rosetti.

From Google Translate: Language as a barrier to security Language differences between immigrant workers and their supervisors and co-workers are one of the most cited challenges companies face in promoting safety among immigrant workers (Gany, et al., 2011). This is particularly common in areas of the US that have little or no bilingual infrastructure (Gouveia & Saenz, 2000; Pew Hispanic Center, 2005). Developing a bilingual capacity within an organization, either through training or recruitment, will become increasingly important in economic sectors with high immigrant participation, such as the construction and service sectors.

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Training Employees from Underserved Populations

Connection and “the training triangle”.

Connection is the first piece of what I like to call “The Training Triangle.” To connect with students/employees, we, as trainers, must be able to relate to that employee, or at least understand the employee’s point of view. We cannot allow our own personal biases, assumptions, attitudes or egos to get in the way of connecting to our employees. We need to deliver our message in a way the employee will understand, accept and find relevant to them.

Underserved populations

Limited choices/options for personal or professional growth.
Lack of direction and/or motivation.
Lack of family structure and/or support.
Poor or toxic relationships with family or friends (trust issues).
Lack of personal discipline, quality habits or time management.
Poor financial education, ability to budget resources.
Low self-esteem or self-worth.

Nature or nurture

The social impacts to Gen Y & Z are:

Technology-based skills, goods and services.
Instant feedback, whether gratification and/or rejection.
Texting (constant communication).
Disposable/replaceable goods and services (questionable security).
Surface/shallow relationships (less face-to-face communication).
Social media (“madness”).
Options (too many/too few).

Your training program

Why You Should Care About TCIA’s Online Education

Managing a Diverse Workforce with the Skills-Motivation Matrix

Warren Williams

Changes coming to OSHA regions

Washington — OSHA plans to open a new regional office, merge two of its regions and rename its regional offices.

These changes are expected to be finalized before Oct. 1.

The new regional office – located in Birmingham, AL – will oversee agency efforts in Arkansas, Kentucky, Louisiana, Mississippi, Tennessee, the Florida Panhandle and its home state.

“The Birmingham Region will address the area’s growing worker population and the hazardous work done by people employed in food processing, construction, heavy manufacturing and chemical processing,” OSHA says in a May 8 press release announcing the changes.

The numbered designations for regions are going away. Instead, OSHA will refer to each region by its home-office location .

For example, Region 6 will be known as the Dallas Region. It will oversee agency efforts in Texas, New Mexico and Oklahoma. Also, with the addition of the Birmingham office, the Atlanta Region will oversee OSHA activities in Georgia, North Carolina and South Carolina, as well as the rest of Florida not under the new office’s oversight.

Regions 9 and 10 will merge into what will be known as the San Francisco Region “to improve operations and reduce operating costs.” Seven of the eight states in those two regions are State Plan states .

“The changes reflect the nation’s demographic and industrial changes since the passage of the [ Occupational Safety and Health Act of 1970 ] and will allow our professionals to better respond to the needs of all workers, including those historically underserved,” OSHA administrator Doug Parker said. “With a stronger enforcement presence in the South and more consolidated state oversight and whistleblower presence in the West – an area dominated by states that operate their OSHA programs – we can direct our resources where they’re needed most.”

Once the changes are finalized, OSHA will update its website to show the new regional maps and contact information.

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Occupational Safety and Health Administration

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News Releases

Department of Labor plans to restructure workplace safety, health regional operations strategically to protect workers

Osha national news release.

May 8, 2024

OSHA creates two regions to reflect changing demographics, population, areas of need

WASHINGTON – The Department of Labor today announced strategic changes to the structure of its Occupational Safety and Health Administration's regional operations designed to direct its resources effectively and make the agency more resilient.

The changes include the creation of a new OSHA regional office in Birmingham, Alabama, overseeing agency operations in the state, and those in Arkansas, Kentucky, Louisiana, Mississippi and Tennessee as well as the Florida Panhandle. The Birmingham Region will address the area's growing worker population and the hazardous work done by people employed in food processing, construction, heavy manufacturing and chemical processing.

OSHA is also planning to merge Regions 9 and 10 into a new San Francisco Region to improve operations and reduce operating costs.

As part of the changes, the agency will also rename its regions to associate them by geography, rather than its current practice of assigning numbers to regions. As such, the area OSHA calls Region 4 will be renamed the Atlanta Region with jurisdiction over Florida, excluding the Panhandle; Georgia, North Carolina and South Carolina. The current Region 6 will be renamed the Dallas Region and have jurisdiction over workplace safety issues in New Mexico, Oklahoma and Texas.

The composition of OSHA's other regions will remain the same. When completed, the agency's regions will be renamed as follows:

View a map of OSHA's new regional structure and boundaries .

"The changes reflect the nation's demographic and industrial changes since the passage of the OSH Act and will allow our professionals to better respond to the needs of all workers, including those historically underserved," explained Assistant Secretary for Occupational Safety and Health Doug Parker. "With a stronger enforcement presence in the South and more consolidated state oversight and whistleblower presence in the West — an area dominated by states that operate their OSHA programs — we can direct our resources where they're needed most."

OSHA plans to fully transition to its new regional structure later in fiscal year 2024. Once implemented, the agency's regional maps and contact information online will be updated publicly.

Media Contacts:

Patrick Malone, 202-997-3512, [email protected] Paloma Renteria, 202-579-1643, [email protected]

Release Number: 24-876-NAT

REVIEW article

Effectiveness of occupational safety and health interventions: a long way to go.

$\r\nGaia Vitrano$

Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy

Background: Occupational Safety and Health (OSH) has become an area of increasing concern for organizations and institutions. As it evolves, it has gradually posed ongoing challenges, becoming more complex, for organizations. Consequently, more comprehensive studies are required to advance academic and institutional research. From this perspective, this study aims to gather research contributions on the effectiveness of existing interventions for OSH improvement and identify areas for further exploration.

Methods: According to the nature of scientific literature, the overall process of a literature review was investigated following an integrative approach, which involved searching for, selecting, and analyzing various literature in a creative and integrated manner, without a predefined structure.

Results: The analysis suggests that there is room for improvement in understanding the effectiveness of OSH interventions and more concrete guidance is still desirable. Based on the literature, some research areas for future developments in OSH interventions are identified. One potential area to explore further is fostering human-centered technological development and a more conscious network of stakeholders, with higher coordination, shared knowledge, and open communication.

Implications: Focusing on the proposed directions will support scholars and practitioners in pursuing continuous OSH improvement through more effective and well-grounded workplace interventions and encourage organizations to be proactive in daily OSH management.

1 Introduction: a practical issue

Considering the international statistics on occupational accidents and diseases, an alarming situation with an increasing trend is evident. Recently, the International Labor Organization (ILO) ( 1 ) estimated the annual global work deaths to be 2.78 million, ~7,600 per day ( 2 ). Work-related deaths in Asia account for two-thirds of the total global workplace fatalities, whereas those in Africa and Europe account for < 12% ( 3 ). ILO calculated approximately 340 million occupational accidents worldwide and 160 million victims of work-related diseases annually, with an increasing trend ( 4 ). The corresponding loss of workdays accounts for US $3.2 trillion, comparable to nearly 4% of the global GDP ( 3 ). Workplace health and safety management and promotion may positively impact workers and leadership and engagement at all levels are key issues in changing the workplace culture ( 5 ).

In this context, effective Occupational Safety and Health (OSH) interventions are a leading priority, particularly for organizations struggling to manage health and safety in the workplace ( 6 , 7 ). OSH is a discipline focusing on the prevention of work-related injuries and diseases and the promotion of the health, safety, and wellbeing of the workers at the workplace by improving their working conditions ( 8 ). Advancing research on OSH toward more theoretical and strategic perspectives and investigating how to constantly improve OSH management at the system level could enhance OSH interventions on the ground ( 9 ). There is, in this respect, a growing interest in OSH management performance among public institutions, which are allocating considerable resources toward improving workplace OSH conditions ( 10 – 12 ); however, it is essential, and more studies are still needed, to assess the effectiveness of these efforts ( 13 ).

In the last years, scholars have emphasized that assessing the effectiveness of interventions is crucial for maximizing their impact and working for their continuous improvement ( 13 ). Nonetheless, their effectiveness is still rarely monitored and often assumed without proper assessment since considered too difficult to measure as interventions often operate in nuanced contexts, relying on myriad qualitative factors that are difficult to track ( 14 – 16 ). Hence, a discussion has been introduced in the literature on the effectiveness of OSH interventions, however, a comprehensive view of the overall problem is still not plain and understanding the status quo and identifying potential improvement areas will make scholars and practitioners aware of the major issues and will support them in pursuing higher effectiveness in OSH interventions.

In this regard, through a review of the OSH literature, this study aimed to gather research contributions on the effectiveness of existing interventions, derive knowledge on how researchers are moving forward toward more effective interventions for OSH improvement and identify areas that merit deeper exploration.

According to the nature of scientific literature, the overall literature review process has been investigated following an integrative approach ( 17 ), which involves searching for, selecting, and analyzing various literature in a creative and integrated manner, without a predefined structure. This allows researchers to provide a comprehensive understanding of complex concepts while not aiming to include all published work on the topic, which would potentially turn into an endless process, but rather to consistently pursue the research objective by combining different perspectives and obtaining relevant findings. Accordingly, this study examined a specific branch of literature that investigated the effectiveness of interventions from different perspectives, and options for their improvement without intentionally including all extant literature on OSH interventions, which is beyond the scope of this study.

2 Methods: literature review process

To examine the current state of interventions for OSH improvement, this study reviewed OSH literature, following Snyder's ( 17 ) integrative approach. Different types of literature reviews exist; according to Snyder ( 17 ), they can be classified as purely systematic, semi-systematic, or integrative reviews. A “best option” does not exist, and the choice depends on the field and scope of the study. This study adopted an integrative approach ( 18 ). According to Torraco ( 18 ), an integrative literature review is a sophisticated form of research that requires a great deal of research skill and insight and is not less rigorous than other types of research. An integrative literature review is a form of research that searches for, selects, and analyzes documents in an integrated manner ( 18 ), which implies that there is no canonical structure to follow; it is shaped by the research itself.

Since exhaustiveness for literature selection is outside of the scope, or simply not possible, in integrative literature reviews, authors are expected to justify the selection of included literature and analyze and critique the literature by applying techniques that are not set in advance, since there is no well-established format to organize collected articles ( 18 ).

Integrative literature reviews are suggested to address both mature and newly emerging topics and strategies for searching and reviewing documents change according to the maturity of the addressed topic. The OSH field might be considered a mature topic, although the literature is less structured and quite dispersed, with high research potential. In this case, an integrative approach can grasp different facets of the OSH literature and more sufficiently answer the research objective.

Although an integrative literature review article can be organized in various ways, it is expected to follow a process that includes the literature search, selection, analysis, and critical synthesis. Regarding other review types, readers of an integrative literature review expect transparency concerning the review process, that is, how the findings of the study are obtained ( 18 ). Integrative literature reviews combine different search processes, which do not prevent researchers from performing systematic searches; instead, they provide the chance to perform more than one systematic search complemented by other sources derived from a snowballing process. Therefore, a single systematic search would not be exhaustive and might ignore relevant sources; hence, an integrative literature search provides added value.

2.1 The search process

During the search process, two main systematic searches were applied to investigate the OSH literature from theoretical and practical perspectives. This supported the subsequent snowball sampling process until the final eligible documents for review were identified. Out of the 132 pertinent documents, 84 were considered more significant, and explicitly included in the discussion. The search process phases are illustrated in Figure 1 .

Figure 1 . The search process.

The main search protocol in the Scopus database was developed to deepen the core themes of this study and identify possible seminal documents. It aimed to locate documents in the OSH field dealing with the actual effectiveness of interventions developed to improve OSH in the workplace. It was divided into three major blocks:

• The context: OSH.

• The area of application: interventions, and synonyms.

• The aim: performance, outcome, and synonyms.

The resulting query was TITLE-ABS-KEY ([“occupational” W/3 “health” W/3 “safety” OR “OSH” OR “OHS” AND “occupational” AND “health” AND “safety”] W/4 [“intervention * ” OR “initiative * ” OR “program * ” OR “instrument * ” OR “project * ” OR “measure * ” OR “practice * ”] AND [“performance * ” OR “effect * ” OR “effic * ” OR “indicator * ” OR “outcome * ” OR “output * ” OR “impact * ”]). A total of 1,042 documents were identified.

The choice of keywords and all potential synonyms was based on the Authors' previous knowledge of the topic and was complemented by reading the keywords applied in a recent EU-OSHA report for the European project SESAME ( 19 ). This project was developed in collaboration with nine EU Member States and identified effective programs at the operational and policy level that could lead to improvements in OSH in Micro and Small Enterprises (MSEs), by defining “what works, for whom, and in what circumstances” ( 20 ). The operator W/4 (within 4) was used instead of AND because the selected documents should only refer to OSH interventions (or synonyms) and not to general ones developed in the OSH field. However, it was not possible to precisely quantify the maximum distance between the words “intervention” and “performance”, and the operator AND was applied.

By reading documents, it seemed that studies with a system view of OSH matters showed higher effectiveness in OSH interventions; therefore, another complementary search protocol was performed in the Scopus database to examine a specific cluster of documents. The resulting query was TITLE-ABS-KEY ([“occupational” W/3 “health” W/3 “safety”] OR [“OSH”] OR [“OHS”] AND [“occupational” AND “health” AND “safety”] W/3 [“network * ” OR “system * ” OR “framework * ”]). A total of 1,208 documents were identified.

Once the first batch of documents was identified, other documents were selected following both backward and forward approaches by examining the cited studies of the selected documents ( Figure 1 ). Both authors employed these approaches to integrate additional documents into the analysis. Consensus was achieved through a comparison of newly included documents by both authors, and any discrepancies were reviewed together to determine their inclusion or exclusion.

This process was guided by co-citation analysis conducted using the VOSviewer software, which is open-source software used to visualize and analyze networks that display connections between different elements, visualizing clusters of similar elements, i.e., relationships between authors, concepts, or topics within a corpus of texts. In particular, co-citation analysis identifies connections between documents, authors, or journals based on their co-citation patterns. This analysis facilitated the tracing of seminal studies and connections between different areas of study. However, despite its advantages, co-citation analysis relies on cited articles and citations take time to accumulate, making it challenging to relate new publications directly to existing literature. For this reason, a forward approach, which involves identifying recent documents citing seminal studies identified through co-citation analysis, was considered crucial to also include new relevant publications.

The search and selection processes were considered reasonably exhaustive when documents almost converged, that is when selected studies showed a significant number of commonly cited sources.

2.2 Data analysis

Among the relevant studies for analysis, a document reduction was performed by reading the abstracts, titles, and keywords and eliminating those that were outside of the scope. The final batch of documents to be included was determined by reading the full studies of the selected abstracts. Both authors meticulously reviewed the documents, collaborating to identify the final set of studies for inclusion. Specifically, one author primarily undertook the task of reviewing documents from the two systematic searches and the snowballing sampling process, while the other mostly supervised the whole process, defining the set of documents for analysis.

To ensure a quality data analysis process, documents were analyzed and coded into a data form that included the normal identification data and the core literature review data, which was selected by reading the studies. This approach facilitated the process of comparing primary sources because, owing to the built data extraction form, documents were reduced to a single-page format with similar data extracted for each of them, which is critical for the review process ( 21 ). As in the previous stages, both authors engaged in document analysis, with one primarily responsible for inputting data into the extraction form, while the other oversaw and refined the information by reviewing the full texts of the selected studies.

Once the documents were coded into the data extraction form, a constant data comparison approach was implemented to identify the main patterns and lines of research by iteratively comparing the studies and collaborative discussing them between the two authors undertaking the task ( 21 , 22 ). The results of this process are presented in the results section, where the literature review findings are grouped by topic.

3 Results: effectiveness discussion in the OSH literature

The literature review examined current research streams focusing on understanding successful interventions that can improve workplace OSH management. For these reasons, the selected documents address effectiveness from different perspectives by including both theoretical analyses of interventions' effectiveness and practical studies from real-world applications.

Through a comprehensive analysis of these documents, the review identified a highly debated topic embedded in the discussion of OSH interventions—the OSH Management Systems (OSHMSs)—to which a sub-section is dedicated. It is worth noting that in the OSH field, a prominent part of OSH interventions relies on OSHMSs, which are designed to foster improvement in OSH management at the organizational level. This connection emphasizes the significance of delving into OSHMSs when discussing OSH interventions, making them a natural area of investigation within the discussion of OSH interventions.

Before reviewing the literature, definitions of OSH interventions and OSHMSs are stated below.

• OSH interventions are actions taken to prevent injuries and diseases in the work environment by improving employees' safety, health, and wellbeing.

• OSHMSs do not share a consensus on what they are ( 14 ). The OSHMSs are either mandatory or voluntary ( 14 , 23 ). Mandatory OSHMSs are developed from government legislation, and their use is enforced through inspections, fines, etc., as specified by the EU Directive 89/391/EEC ( 24 ). Voluntary OSHMSs are established to guide action at the national and enterprise levels, although they are not intended to replace national regulations. ILO ( 25 ) defined a voluntary OSHMS as: “A set of interrelated or interacting elements to establish OSH policy and objectives, and to achieve those objectives.” Frick et al. ( 26 ) defined a voluntary OSHMS as a comprehensive framework for policy development, risk assessment, risk management, and evaluation of effectiveness within an organization. In addition, every employer should establish a voluntary OSHMS in their workplace to better manage occupational accidents and diseases and continuously improve OSH performance ( 25 ). OSHMSs usually arise through private enterprises, employer groups, the government and its agencies, insurance carriers, professional organizations, and standards associations. The introduction of international standards, such as the ISO 45001:2018 ( 27 ), moves in this direction by providing frameworks for OSHMSs to manage risks and opportunities.

The following sections cover the effectiveness of OSH interventions (Section 3.1) and OSHMSs (Section 3.2), and Table 1 summarizes the essential findings.

Table 1 . Findings on the effectiveness of OSH interventions and OSHMSs.

3.1 Effectiveness of OSH interventions

A significant segment of the OSH literature focuses on the evaluation of OSH interventions to detect how they have (or should have) effectively contributed to improving OSH work conditions and a few examples are reported below. Micheli et al. ( 28 ) conducted research aiming to understand the mechanisms determining the success or failure of OSH interventions, considering both barriers and drivers along with contextual factors. Utilizing a multiple case study approach, 58 techno-organizational interventions were evaluated to assess the key factors influencing the interventions' outcomes. In another study, Olsen et al. ( 29 ) showed how the application of realist analysis and program theory to a specific New Zealand intervention could be generally used as a framework for evaluating, developing, and improving other national interventions. Fridrich et al. ( 15 ), as another example, introduced a Context, Process, and Outcome (CPO) evaluation model designed to assess complex organizational health interventions (OHIs), which was tested in an OHI at a Swiss hospital.

General interventions, potentially applicable to several working environments, have often been described in the literature ( 6 , 14 , 15 , 28 , 30 – 39 ). Other studies, attempting to develop more effective interventions, have targeted specific working contexts, such as Small and Medium-sized Enterprises (SMEs), which are normally more vulnerable than larger organizations and require ad hoc measures ( 6 , 7 , 40 , 41 ). Other studies have examined precise typologies of interventions, such as musculoskeletal disorders ( 42 ) and training ( 43 , 44 ).

Several scholars have expressed concerns about the limited guidance provided for building up effective interventions ( 13 , 28 , 36 , 38 ). In this regard, several systematic literature reviews on OSH interventions have aimed to detect possible categories of interventions with higher effectiveness ( 7 , 14 , 30 , 35 , 44 , 45 ). However, most of these reviews concluded that there were little to no quantitative results to assess the effectiveness of interventions. Owing to the considerable variability in the environment, interventions often exhibited a high degree of heterogeneity, making systematic comparisons challenging in literature reviews ( 14 , 44 , 45 ).

Predicting the true impact of interventions can be challenging ( 15 ) as their success is likely to depend on various factors such as their nature, specific workplace characteristics, and the broader external environment ( 14 ). Typically, these interventions are assessed under controlled ideal conditions, leading to outcomes that may not always meet expectations ( 28 , 46 ). As such, further research is needed to enhance the effectiveness of these interventions, an aspect that sometimes does not receive the attention it deserves ( 35 , 47 – 49 ). In this vein, scholars have questioned the appropriate methodology for evaluating interventions, and some have highlighted challenges linked to the diverse results (due to the high heterogeneity of the results) seen in quantitative evaluations. Some systematic literature reviews have implicitly emphasized the need to understand the mechanisms (what has or has not worked) that positively or negatively affect interventions ( 9 , 14 , 30 , 33 ). Recent studies have been exploring alternative methods to evaluate and compare interventions, moving away from the commonly used Randomized Control Trials (RCTs). Instead, there is a growing interest in methodologies grounded in program theory ( 20 ). This allows the analysis of interventions through a more qualitative approach by considering the chains of events that affect their development and effectiveness. Thus, similar interventions can lead to divergent results because several contextual factors and mechanisms can affect the outcome, leading to success or failure. As Zwetsloot et al. ( 6 ) pointed out: “Whether OSH implementation will be successful depends on mechanisms, the characteristics of organizations, and their context.” In this vein, recent scholarly studies, such as Hale ( 50 ), Pryor et al. ( 51 ), and Uhrenholdt Madsen et al. ( 52 ), have focused on the roles of various OSH stakeholders. Zwetsloot et al. ( 6 ) and Hasle et al. ( 53 ) have explored the orchestration of these diverse stakeholders aiming to identify potential improvement areas beyond the confines of individual organizations. Key stakeholders, including representatives from trade unions and employer associations, play a pivotal role in shaping interventions that are well-grounded in real settings ( 54 ).

Furthermore, several scholars have proposed models based on program theory both for designing ( 16 , 28 , 55 , 56 ) and evaluating ( 6 , 15 , 16 , 28 , 29 , 39 , 57 ) OSH interventions. Notably, Fridrich et al. ( 15 ) introduced a perspective that views the “context not only as a static and confounding factor that hinders or facilitates the implementation process but also as a transformable and essential part of the intervention.” Outcome evaluation is thus seen as a continuous process rather than a particular, time-limited intervention phase. This provides a dynamic view of program theory, enabling the monitoring of intervention effects over time, which is rarely performed. However, little evidence of the sustained positive impacts of such interventions over the long term has been provided in the literature ( 13 ).

Therefore, further research is required, and the OSHMSs presented below, from various angles, hold promise for enhancing workplace OSH management and potentially amplifying the positive effects of OSH interventions.

3.2 Effectiveness of OSHMSs

Through the review of OSHMS's literature, macro-research areas were identified ( Figure 2 ), and the findings are presented following the classification below.

• OSHMS impact, i.e., the estimated impact on organizations.

• OSHMS factors are elements that can facilitate (drivers) or hinder (barriers) OSHMSs' development.

• OSHMS regulations, i.e., the role played by laws and regulations.

• OSHMS indicators, i.e., how the effectiveness of OSHMs should be assessed and measured.

Figure 2 . The relationship between macro-research areas on OSHMSs.

Each of these categories highlights significant areas that previous scholars have identified and begun to address in recent years, contributing to a better understanding of OSHMSs and their effects on workplace OSH management. The results from the literature are presented below, highlighting both challenges and promising opportunities related to OSHMSs.

3.2.1 OSHMS impact

Regarding OSHMS impact, a significant amount of literature referred to voluntary OSHMSs, especially international standards—i.e., OHSAS 18001:2007 ( 58 ), ISO 45001:2018 ( 27 )—by assessing the estimated impact of those strategies on organizations. Two principal lines of thought exist regarding the impact of OSHMS standards.

• A positive effect, i.e., higher OSH performance ( 59 – 70 ).

• A neutral effect since a certification does not guarantee better OSH performance ( 71 – 80 ).

Scholars have highlighted the positive impacts of OSHMSs on organizations, particularly emphasizing two major aspects: OSH performance like work-related and fatal accident rates ( 63 , 66 , 67 ) and financial performance such as sales growth, enhanced labor productivity, and reduced accident-related expenses ( 59 , 60 , 68 ). While none stated that OSHMSs negatively affect an organization's OSH performance, it is recognized that simply obtaining a voluntary OSHMS certification does not necessarily imply better organizational OSH performance, since it needs to be sustained by the organization's culture and management ( 71 ). Furthermore, OSHMSs might sometimes address generic concerns rather than the specific needs of an organization ( 72 , 80 ).

OSHMS audits are generally well-perceived and have the potential to be transformative tools, but, in some cases, become “a ritual rather than a means of improving workplace health and safety” ( 73 ). Notably, certified OSHMS adopters generally provide a higher level of OSH management than non-adopters. However, there are instances where the actual efforts toward OSH within certified organizations may seem less pronounced, suggesting that certification alone does not ensure a high level of OSH management for all adopters ( 70 ). Yet, the direct correlation between such certifications and enhanced OSH performance is not always linear ( 26 ). Building on this, Frick ( 81 ) outlined three integral components that define a robust OSHMS: procedures for risk assessment (what should be done), empowering stakeholders to implement procedures (how to do it), and management control (doing the right thing).

3.2.2 OSHMS factors

The effective implementation of OSHMSs relies on several factors that can facilitate or hinder their development. A comprehensive review by da Silva and Amaral ( 82 ) has provided a consistent number of OSHMS factors, those contributing to the success of OSHMSs and other potential obstacles in their implementation. This analysis was further enriched by incorporating insights from other scholarly studies to integrate and confirm the initially identified factors. Table 2 offers a consolidated overview, summarizing all the drivers and barriers associated with OSHMS implementation.

Table 2 . Drivers and barriers to OSHMS implementation.

The commitment of an organization and its approach to OSH management play a crucial role in facilitating or hindering OSHMS' development. Management commitment and good leadership ( 66 , 82 , 84 – 87 , 90 , 91 ) on one side and workers' awareness ( 83 ) and active participation ( 82 , 84 – 87 ) on the other are core drivers encouraging the establishment of OSHMSs. Positive OSH management strategies, such as transparent communication, robust risk assessments, and proactive supervision, act as drivers, while their neglect or mismanagement can be deterrents ( 82 ). Furthermore, the alignment of OSHMS efforts with other internal—like fostering a more inclusive organizational structure ( 93 )—and external—like collaborating with trade unions ( 85 )—processes is always welcome, and organizations can leverage them. Concerning external factors, Rocha ( 93 ) brought a fresh perspective by examining how national institutional settings influence OSHMS dynamics and recognizing that beyond an organization's internal capacities, the broader national context also plays a crucial role in shaping OSHMS outcomes. Consequently, organizations in different countries should deal differently with OSHMS requirements.

3.2.3 OSHMS regulations

Another stream of the literature focuses on the interplay of OSHMSs' effectiveness and regulations. While laws and regulations can sometimes be perceived as obstacles to the development of OSHMSs, their true value on OSH performance can be perceived when effectively managed and implemented ( 95 ). For instance, Hale and Swuste ( 96 ) called regulations “invisible barriers,” and Hollnagel ( 97 ) considered legislation as an “invisible barrier system.” There is a tendency for policymakers to have optimistic views about how mandatory OSHMSs operate ( 95 ). Hale et al. ( 98 ) viewed self-regulation—the application of voluntary norms and codes of good practice—as a way to reduce the perceived regulatory pressures on OSHMSs.

3.2.4 OSHMS indicators

To foster confidence in OSHMSs and motivate organizations to adopt them, it is essential to establish clear evaluation criteria and Key Performance Indicators (KPIs) ( 64 , 99 ). Three studies have been selected that identified optimal KPIs for OSHMSs ( 64 , 82 , 100 ). Podgórski ( 100 ), for instance, applied the Analytic Hierarchy Process (AHP) to select 20 KPIs out of a larger set of candidate indicators (109), categorized under areas such as Policy, Organizing, Planning and Implementation, Evaluation, and Action for Improvement.

4 Discussion: status quo and implications

The results of the literature review indicated that scholars wondered about the effectiveness of interventions, including OSHMSs, developed for OSH improvement.

4.1 About OSH interventions

Considering OSH interventions, practitioners have begun to describe several field interventions from an operational perspective. However, drawing broad conclusions from the literature has seldom been possible due to the unique dynamics at play. Several systematic literature reviews have analyzed interventions in an attempt to identify common threads and strategies to achieve higher effectiveness, but the diverse and varied environments often rendered them too distinct for direct comparison. Different theoretical lenses among researchers may indeed prevent the comparison of similar interventions. A critical realism perspective offers a promising approach to examining OSH interventions. The realist analysis, consistent with the above epistemological perspective, is rooted in understanding the underlying causal chains of events and their effects—essentially, discerning what works, for whom, under what conditions, and how ( 20 ). This aligns with the literature, where scholars have underlined the value of studying the mechanisms—what has or has not worked—of the interventions ( 14 , 30 , 33 ).

Given the above considerations, it is worth analyzing interventions not as black boxes but considering the different factors affecting them ( 28 ). Contextual factors play a paramount role in all phases of the design, implementation, and evaluation of interventions ( 15 ). Giving attention to these factors can enhance the probability of achieving desired outcomes. Quantitative assessments may not always be the most suitable or feasible for OSH interventions, as quantifiable data are rarely tracked and often difficult to retrieve. It is important to understand that qualitative methods can be equally insightful and, in certain settings, may be more appropriate.

The design, implementation, and evaluation phases should be equally considered, while processes with greater short-term benefits are still often prioritized, inhibiting the crucial final evaluation phase. Indeed, interventions should be evaluated in advance, and the study of ad hoc indicators would enable long-term monitoring of the impact of interventions ( 13 ). In addition, monitoring induces the development of more effective interventions that rely on grounded knowledge ( 29 ). Therefore, it is crucial to ensure continuity between interventions to gain mutual benefits and contribute value at the system level. Moreover, from a perspective of fostering human-centered technological development, there is a pressing need to transition from interventions that prioritize economic maximization to interventions that seek to reconcile the human, social, and environmental implications with economic-financial considerations.

The newly released ISO 45001:2018 ( 27 ) takes this direction by moving from a focus on individual system components toward a better understanding of the entire socio-technical system—i.e., multidirectional interactions and information flow across the system, networks of stakeholders and their interdependency, and the effects of internal and external factors and constraints ( 101 ).

4.2 About OSHMS impact

The second macro-area of the literature review included the implementation of OSHMSs in practice for OSH improvement, and similar considerations to OSH interventions applied to their effectiveness. Their development is comparable to that of field interventions and is generally more structured, long-lasting, and potentially more powerful when implemented in organizations. In Section 3.2, four macro-areas of research were detected for OSHMSs—their impact, influential factors, regulatory aspects, and performance indicators—and insights for effective OSHMSs were gathered.

Effective OSHMSs should ensure safe and healthy workplaces by continuously improving the OSH performance of organizations ( 25 ). The literature analysis highlighted that there is considerable research on OSH to study OSHMSs, their relationship with the surrounding environment, and the affecting factors. Although several studies explored ways to enhance the performance of OSHMSs and their potential is recognized, there remains a gap in understanding their tangible effectiveness at the organizational level. This presents an opportunity for both scholars and practitioners to delve deeper into this area of research.

4.3 About OSHMS regulations

The literature suggests that having certification is valuable, but it alone does not guarantee optimal effectiveness within a specific context. Certification is an important tool for organizations to ensure better performance; however, positive organizational culture and management are required ( 71 ).

“Regulatory burden” is a common periphrasis in the literature, which is clear proof that regulations are often perceived as potential barriers or “invisible barriers” ( 96 ) to OSH improvement. However, collaboration between organizations and policymakers can pave the way for more tailored and effective solutions. As national authorities increasingly recognize the importance of this collaboration, it presents an opportunity for both policymakers and organizations. Policymakers can secure interventions to prevent them from becoming backburners, and organizations can be incentivized to join such interventions by developing something that would fit well with their specificities.

4.4 About OSHMS factors

Other studies on OSHMSs have highlighted the key factors that promote their development and those that might pose challenges. As outlined in Table 2 , there are internal factors related to the organization's structure and external factors influenced by the outer environment. Some characteristics have been identified both as potential barriers and drivers. Identified factors are often classified by their characteristics as barriers or drivers and by considering whether their presence or absence facilitates or inhibits the development of OSHMSs. For example, a strong management commitment is vital for successful OSHMS implementation, while its unavailability is considered a barrier. Based on Kano et al.'s theory ( 102 ), these factors can be divided into three major categories: must-haves, performers, and delighters. Factors simply evaluated as barriers can be considered must-have requirements that would hinder the development of OSHMSs or interventions in general, such as a lack of time and resources ( 82 , 88 , 89 ). Most of these factors are regarded as performers because their existence can change the actual deployment of OSHMSs. For example, good leadership can support collaboration between individuals and, therefore, the OSHMSs' work, whereas bad leadership can inhibit their implementation. Lastly, delighters represent the factors that represent true value added. As highlighted by Frick ( 85 ), the involvement of trade unions offers invaluable insights and is a key driver for employers to leverage their field knowledge to build new competencies at the organizational level. Key stakeholders, including representatives from trade unions and employer associations, play a pivotal role in shaping interventions that are well-grounded in real settings.

4.5 About OSHMS indicators

In a similar vein, a few studies have looked at KPIs to measure the effectiveness of OSHMSs. As for OSH interventions, ad hoc indicators offer a means for longitudinally assessing OSHMS impact, enabling continuous monitoring of OSHMS effectiveness and also promoting the development of more robust systems. Indeed, by leveraging insights from prior OSHMS implementations, organizations can refine their practices, adhere to industry best standards, and mitigate the risk of unsuccessful initiatives.

4.6 Implications

As shown in the literature, higher coordination between OSH stakeholders improves the effectiveness of OSHMSs by increasing their adoption levels and, in general, OSH interventions ( 54 , 93 ). The EU-OSHA's ESENER report ( 103 ) emphasizes this element, noting that the “presence (and involvement) of employee representation is a factor in ensuring that such OSH policies and action plans are put into practice.” A conscious network of stakeholders is indeed vital to OSH improvement, which would enable any implemented intervention to be sustainable and effective in the long run ( 54 ). In addition, the broader environment, encompassing various contextual factors, plays a pivotal role in shaping national OSH management. National laws determine the key differences between nations concerning stakeholder involvement, functions, and more. As noted by Rocha ( 93 ), institutional effects strongly affect the OSH network of stakeholders and often remain relatively stable in the short term. Consequently, organizations across different nations should deal with these requirements differently, thus requiring tailored approaches.

Table 3 summarizes the above discussion by revealing the status quo of the effectiveness of OSH interventions and suggesting future research directions.

Table 3 . Status quo of OSH interventions' effectiveness and research directions.

5 Limitations

This study has a few limitations that stem from the integrative process of the literature review, which, beyond the benefits detailed in Section 2, entails some inherent limitations. Although reliability has been secured by providing details on the entire process of the literature review, from the search to the analysis and categorization of data, the replicability of the results is not as strong as for systematic literature reviews, where the process is fully falsifiable. The use of search protocols increases the replicability of the process by providing an initial batch of documents to be evaluated and identifying initial literature clusters.

The Authors believe that the applied literature review process enabled the results to reach a satisfactory level of comprehensiveness and exhaustiveness, which was otherwise unattainable through a systematic approach. The integrative literature review does not claim to be exhaustive in terms of the included documents, as it might have potentially turned into an endless process, but rather, consistently pursues the objective of the research by combining different perspectives, obtaining relevant results, and keeping the number of documents affordable ( 17 , 18 ).

In support of this, several studies in the OSH literature, such as Dyreborg et al. ( 9 ), Fridrich et al. ( 15 ), and Hasle et al. ( 55 ), have shown that systematic literature reviews may be unsuccessful in finding robust results due to high heterogeneity and lack of available standardized data. Research on health and safety has great potential because human-based science focuses on several thematic areas that address OSH issues from a multitude of aspects. However, this increases the amount of potentially retrievable information and the number of pertinent documents. Another direct consequence is the low awareness of keywords, which often have several synonyms, and their meanings might differ. For example, construction activities implemented in the workplace are predominantly called “projects,” whereas in the manufacturing industry, “intervention” is the most common term. In addition, because the literature has shown low topic categorization, there are no available frameworks for data classification. Therefore, this study suggested a straightforward structure to read the results by defining a fil rouge between OSH interventions and OSHMSs and their evaluation of effectiveness, which was constructed by iteratively comparing documents according to a data comparison approach ( 22 ).

Similar to most exploratory studies, the results cannot be considered exhaustive; instead, they enable the identification of patterns that might be beneficial to future research because they are still underdeveloped and have high potential. Consequently, other literature analyses are suggested to further explore and validate the findings of this study.

6 Conclusions

Through an integrative review of OSH literature, this study examined extant research contributions to the effectiveness of OSH interventions, including OSHMSs, by revealing their status quo and identifying room for improvement.

Studying appropriate ways to develop interventions is currently a matter of discussion. Since its inception, many steps have been taken; however, there is still a long road ahead. The literature includes several analyses of interventions implemented in the workplace and specifically, the OSHMSs for OSH improvement. Their implementation in organizations might be comparable to that of field OSH interventions, and they are generally more structured, long-lasting, and potentially more powerful. Their potential is high, as shown by theoretical research, yet there remains a rich vein of exploration regarding their real-world deployment within workplaces.

Based on the literature, some research streams for future developments in OSH interventions were identified and summarized in Table 3 . In particular, coordination among OSH stakeholders, knowledge awareness, and information sharing are only a few drivers that can improve the effectiveness of field OSH interventions. A conscious network of stakeholders would support the development of interventions and work toward continuous improvement ( 54 ). A recent EU-OSHA report ( 104 ) shares the same view by stating that orchestrated/coordinated actions may be more effective than unilateral ones in leveraging better OSH, but strong leadership is required. Further research in this direction is highly recommended and, except for a few studies, such as Hasle et al. ( 53 ) and Zwetsloot et al. ( 6 ), it is an unexplored path with high potential.

The Authors hope that future research will pursue the proposed directions that, from different perspectives, would support OSH improvement through interventions that leverage more structured processes and encourage organizations to be proactive in daily OSH management.

Author contributions

GV: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing, Project administration. GM: Conceptualization, Methodology, Validation, Writing – original draft, Writing – review & editing, Investigation, Project administration.

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research is part of the HumanTech Project, which is financed by the Italian Ministry of University and Research (MUR) for the 2023–2027 period as part of the ministerial initiative “Departments of Excellence” (L. 232/2016). The initiative rewards departments that stand out for the quality of the research produced and funds specific development projects.

Acknowledgments

This research presents some of the results of the projects CONDIVIDO (BRIC ID 01/2019) and PMP 5.0 (BRIC ID 01/2022), designed and developed by Politecnico di Milano, Università del Salento and the Department of Occupational and Environmental Medicine, Epidemiology and Hygiene of INAIL (the Italian National Institute for Insurance against Accidents at Work) and granted by INAIL itself.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: literature review, integrative review, interventions, effectiveness, occupational health, occupational safety, management, research agenda

Citation: Vitrano G and Micheli GJL (2024) Effectiveness of Occupational Safety and Health interventions: a long way to go. Front. Public Health 12:1292692. doi: 10.3389/fpubh.2024.1292692

Received: 12 September 2023; Accepted: 15 April 2024; Published: 09 May 2024.

Reviewed by:

Copyright © 2024 Vitrano and Micheli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Gaia Vitrano, gaia.vitrano@polimi.it

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Advancing social justice, promoting decent work ILO is a specialized agency of the United Nations

Migrated Content

ILO Centenary

A session of the international roundtable “The Role of Trade Union Education in Shaping the Future of Work” was held on March 5 at the Academy of Labour and Social Relations (ALSR) to commemorate the centenary of the institution. The event was attended by representatives of the Federation of Independent Trade Unions of Russia (FITUR), International Labour Organisation (ILO), countrywide trade unions as well as educational institutions of both Russian and international trade unions.

6 March 2019

40 Facts About Elektrostal

Written by Lanette Mayes

Modified & Updated: 10 May 2024

Reviewed by Jessica Corbett

Elektrostal is a vibrant city located in the Moscow Oblast region of Russia. With a rich history, stunning architecture, and a thriving community, Elektrostal is a city that has much to offer. Whether you are a history buff, nature enthusiast, or simply curious about different cultures, Elektrostal is sure to captivate you.

This article will provide you with 40 fascinating facts about Elektrostal, giving you a better understanding of why this city is worth exploring. From its origins as an industrial hub to its modern-day charm, we will delve into the various aspects that make Elektrostal a unique and must-visit destination.

So, join us as we uncover the hidden treasures of Elektrostal and discover what makes this city a true gem in the heart of Russia.

Key Takeaways:

Elektrostal, known as the “Motor City of Russia,” is a vibrant and growing city with a rich industrial history, offering diverse cultural experiences and a strong commitment to environmental sustainability.
With its convenient location near Moscow, Elektrostal provides a picturesque landscape, vibrant nightlife, and a range of recreational activities, making it an ideal destination for residents and visitors alike.

Known as the “Motor City of Russia.”

Elektrostal, a city located in the Moscow Oblast region of Russia, earned the nickname “Motor City” due to its significant involvement in the automotive industry.

Home to the Elektrostal Metallurgical Plant.

Elektrostal is renowned for its metallurgical plant, which has been producing high-quality steel and alloys since its establishment in 1916.

Boasts a rich industrial heritage.

Elektrostal has a long history of industrial development, contributing to the growth and progress of the region.

Founded in 1916.

The city of Elektrostal was founded in 1916 as a result of the construction of the Elektrostal Metallurgical Plant.

Located approximately 50 kilometers east of Moscow.

Elektrostal is situated in close proximity to the Russian capital, making it easily accessible for both residents and visitors.

Known for its vibrant cultural scene.

Elektrostal is home to several cultural institutions, including museums, theaters, and art galleries that showcase the city’s rich artistic heritage.

A popular destination for nature lovers.

Surrounded by picturesque landscapes and forests, Elektrostal offers ample opportunities for outdoor activities such as hiking, camping, and birdwatching.

Hosts the annual Elektrostal City Day celebrations.

Every year, Elektrostal organizes festive events and activities to celebrate its founding, bringing together residents and visitors in a spirit of unity and joy.

Has a population of approximately 160,000 people.

Elektrostal is home to a diverse and vibrant community of around 160,000 residents, contributing to its dynamic atmosphere.

Boasts excellent education facilities.

The city is known for its well-established educational institutions, providing quality education to students of all ages.

A center for scientific research and innovation.

Elektrostal serves as an important hub for scientific research, particularly in the fields of metallurgy, materials science, and engineering.

Surrounded by picturesque lakes.

The city is blessed with numerous beautiful lakes, offering scenic views and recreational opportunities for locals and visitors alike.

Well-connected transportation system.

Elektrostal benefits from an efficient transportation network, including highways, railways, and public transportation options, ensuring convenient travel within and beyond the city.

Famous for its traditional Russian cuisine.

Food enthusiasts can indulge in authentic Russian dishes at numerous restaurants and cafes scattered throughout Elektrostal.

Home to notable architectural landmarks.

Elektrostal boasts impressive architecture, including the Church of the Transfiguration of the Lord and the Elektrostal Palace of Culture.

Offers a wide range of recreational facilities.

Residents and visitors can enjoy various recreational activities, such as sports complexes, swimming pools, and fitness centers, enhancing the overall quality of life.

Provides a high standard of healthcare.

Elektrostal is equipped with modern medical facilities, ensuring residents have access to quality healthcare services.

Home to the Elektrostal History Museum.

The Elektrostal History Museum showcases the city’s fascinating past through exhibitions and displays.

A hub for sports enthusiasts.

Elektrostal is passionate about sports, with numerous stadiums, arenas, and sports clubs offering opportunities for athletes and spectators.

Celebrates diverse cultural festivals.

Throughout the year, Elektrostal hosts a variety of cultural festivals, celebrating different ethnicities, traditions, and art forms.

Electric power played a significant role in its early development.

Elektrostal owes its name and initial growth to the establishment of electric power stations and the utilization of electricity in the industrial sector.

Boasts a thriving economy.

The city’s strong industrial base, coupled with its strategic location near Moscow, has contributed to Elektrostal’s prosperous economic status.

Houses the Elektrostal Drama Theater.

The Elektrostal Drama Theater is a cultural centerpiece, attracting theater enthusiasts from far and wide.

Popular destination for winter sports.

Elektrostal’s proximity to ski resorts and winter sport facilities makes it a favorite destination for skiing, snowboarding, and other winter activities.

Promotes environmental sustainability.

Elektrostal prioritizes environmental protection and sustainability, implementing initiatives to reduce pollution and preserve natural resources.

Home to renowned educational institutions.

Elektrostal is known for its prestigious schools and universities, offering a wide range of academic programs to students.

Committed to cultural preservation.

The city values its cultural heritage and takes active steps to preserve and promote traditional customs, crafts, and arts.

Hosts an annual International Film Festival.

The Elektrostal International Film Festival attracts filmmakers and cinema enthusiasts from around the world, showcasing a diverse range of films.

Encourages entrepreneurship and innovation.

Elektrostal supports aspiring entrepreneurs and fosters a culture of innovation, providing opportunities for startups and business development.

Offers a range of housing options.

Elektrostal provides diverse housing options, including apartments, houses, and residential complexes, catering to different lifestyles and budgets.

Home to notable sports teams.

Elektrostal is proud of its sports legacy, with several successful sports teams competing at regional and national levels.

Boasts a vibrant nightlife scene.

Residents and visitors can enjoy a lively nightlife in Elektrostal, with numerous bars, clubs, and entertainment venues.

Promotes cultural exchange and international relations.

Elektrostal actively engages in international partnerships, cultural exchanges, and diplomatic collaborations to foster global connections.

Surrounded by beautiful nature reserves.

Nearby nature reserves, such as the Barybino Forest and Luchinskoye Lake, offer opportunities for nature enthusiasts to explore and appreciate the region’s biodiversity.

Commemorates historical events.

The city pays tribute to significant historical events through memorials, monuments, and exhibitions, ensuring the preservation of collective memory.

Promotes sports and youth development.

Elektrostal invests in sports infrastructure and programs to encourage youth participation, health, and physical fitness.

Hosts annual cultural and artistic festivals.

Throughout the year, Elektrostal celebrates its cultural diversity through festivals dedicated to music, dance, art, and theater.

Provides a picturesque landscape for photography enthusiasts.

The city’s scenic beauty, architectural landmarks, and natural surroundings make it a paradise for photographers.

Connects to Moscow via a direct train line.

The convenient train connection between Elektrostal and Moscow makes commuting between the two cities effortless.

A city with a bright future.

Elektrostal continues to grow and develop, aiming to become a model city in terms of infrastructure, sustainability, and quality of life for its residents.

In conclusion, Elektrostal is a fascinating city with a rich history and a vibrant present. From its origins as a center of steel production to its modern-day status as a hub for education and industry, Elektrostal has plenty to offer both residents and visitors. With its beautiful parks, cultural attractions, and proximity to Moscow, there is no shortage of things to see and do in this dynamic city. Whether you’re interested in exploring its historical landmarks, enjoying outdoor activities, or immersing yourself in the local culture, Elektrostal has something for everyone. So, next time you find yourself in the Moscow region, don’t miss the opportunity to discover the hidden gems of Elektrostal.

Q: What is the population of Elektrostal?

A: As of the latest data, the population of Elektrostal is approximately XXXX.

Q: How far is Elektrostal from Moscow?

A: Elektrostal is located approximately XX kilometers away from Moscow.

Q: Are there any famous landmarks in Elektrostal?

A: Yes, Elektrostal is home to several notable landmarks, including XXXX and XXXX.

Q: What industries are prominent in Elektrostal?

A: Elektrostal is known for its steel production industry and is also a center for engineering and manufacturing.

Q: Are there any universities or educational institutions in Elektrostal?

A: Yes, Elektrostal is home to XXXX University and several other educational institutions.

Q: What are some popular outdoor activities in Elektrostal?

A: Elektrostal offers several outdoor activities, such as hiking, cycling, and picnicking in its beautiful parks.

Q: Is Elektrostal well-connected in terms of transportation?

A: Yes, Elektrostal has good transportation links, including trains and buses, making it easily accessible from nearby cities.

Q: Are there any annual events or festivals in Elektrostal?

A: Yes, Elektrostal hosts various events and festivals throughout the year, including XXXX and XXXX.

Elektrostal's fascinating history, vibrant culture, and promising future make it a city worth exploring. For more captivating facts about cities around the world, discover the unique characteristics that define each city . Uncover the hidden gems of Moscow Oblast through our in-depth look at Kolomna. Lastly, dive into the rich industrial heritage of Teesside, a thriving industrial center with its own story to tell.

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There are a number of challenges to education and training interventions that aim to reduce occupational health disparities. Structural barriers often discourage worker-initiated action to advocate for improved safety and health conditions in workplaces even when workers have adequate knowledge of risks. Cultural differences also need to be considered in the design and implementation of education and training interventions. The paper will focus on effective and promising solutions to meeting the unique challenges of conducting education and training with populations that experience occupational health disparities. The paper will give an overview of a range of training methods available and will discuss the factors to be considered in selecting a training approach given a specific context in the workplace or community. Strategies for using education and training to facilitate changes in workplaces (research to practice)including changes in worker knowledge, attitudes, and behaviors a...

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