【Cochrane简语概要】鼓励工人穿戴防护装备以阻止其呼吸有害物质的方法
在许多工作场所,空气中通常含有有害健康的物质。这些可能包括细菌和病毒,各种气雾和烟雾,以及灰尘和颗粒,例如石棉或谷物。根据吸入的物质和数量,健康后果可能从轻微到危及生命不等。这些后果的范围从刺激感到包括癌症在内的短期和长期疾病。在许多工作环境中,呼吸防护设备 (RPE) 用于防止工人吸入有害物质。已经引入各种方法来教工人如何有效地使用呼吸防护设备。然而,目前还不清楚它们的工作表现如何。因此,我们希望了解是否有干预措施可以鼓励员工正确、频繁地使用呼吸防护设备。
(图片来源于网络)
研究发现
截至 2016 年 8 月 20 日,我们检索了相关研究。我们发现14项研究分析了行为干预促进呼吸防护设备使用的有效性。我们还找到了一个正在进行的研究。已经对2052个农场、医疗保健、生产线、办公室和炼焦炉的工人以及护理学生和混合职业人群进行了研究。我们没有发现有基于整个组织层面上进行并评价干预措施的任何研究。
这项研究发现了什么
所有研究都比较了不同的教育和培训干预措施,以鼓励工人正确或更频繁地使用呼吸防护设备。我们发现质量很差的证据表明,诸如教育和培训等行为干预措施不会增加使用呼吸防护设备或正确使用呼吸防护设备的工人的数量。
结论是什么?
我们的结论是,有低甚至非常低的质量证据表明,行为干预不能鼓励工人正确或更频繁地使用呼吸防护设备。新研究发表后,我们的结论可能会改变。我们需要更高质量的研究,以研究不同类型干预措施的有效性。这些干预措施应针对个人和组织,以改善有效的呼吸防护设备使用。此外,进一步的研究应考虑成功使用呼吸防护设备过程中的一些障碍,例如健康风险的经验,呼吸防护设备的类型以及雇主对呼吸防护设备使用的态度。
结论:
有非常低的质量证据表明,行为干预,即教育和培训,对工人使用RPE的频率或正确性没有相当大的影响。没有关于激励措施或组织级干预的研究。纳入的研究存在方法学上的局限性,因此我们需要更多的大型随机对照试验,在随机序列生成、随机隐藏和评价者盲法方面要有更清晰的方法,以评价行为干预措施在组织和个人层面上改善RPE使用的有效性 。此外,进一步的研究应考虑成功使用呼吸防护设备过程中的一些障碍,例如健康风险的经验,呼吸防护设备的类型以及雇主对呼吸防护设备使用的态度。
译者:梁昌昊;审校:张英英、鲁春丽;编辑排版:张晓雯,北京中医药大学循证医学中心
相关文章链接
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【Cochrane Plain Language Summary】Ways to encourage workers to wear protective equipment to stop them breathing in harmful substances
It is common at many workplaces for the air to contain substances that are harmful to health. These may include bacteria and viruses, various fumes and smoke, and dusts and particles such as asbestos or grain. Depending on what and how much of it is inhaled, the health consequences may vary from mild to life-threatening. These consequences range from feelings of irritation to short- and long-term illness including cancer. In many work settings respiratory protective equipment (RPE) is used to prevent workers from inhaling harmful substances. Various ways have been introduced to teach workers how to use RPE effectively. However it is unclear how well they work. Therefore, we wanted to find out if there are interventions that can encourage workers to use RPE correctly or more often.
Studies found
We searched for relevant research studies up to 20 August 2016. We found 14 studies that analysed the effectiveness of behavioural interventions to promote RPE use. We also located one ongoing study. Studies had been conducted with 2052 farm, healthcare, production line, office and coke oven workers as well as nursing students and people with mixed occupations. We did not find any studies where the researchers conducted and assessed an intervention at the level of a whole organization.
What the research says
All included studies compared different education and training interventions to encourage workers to use RPE correctly or more often. We found very low quality evidence that behavioural interventions such as education and training do not increase the number of workers that use RPE or that use RPE correctly.
What is the bottom line
We conclude that there is low to very low quality evidence that behavioural interventions do not encourage workers to use RPE correctly or more often. It is likely that our conclusions will change when new studies are published. We need better quality studies that look at the effectiveness of different types of interventions. These interventions should be targeted at both individuals and organisations, to improve effective RPE use. In addition, further studies should consider some of the barriers to the successful use of RPE, such as experience of health risk, types of RPE and the employer's attitude to RPE use.
Authors' conclusions:
There is very low quality evidence that behavioural interventions, namely education and training, do not have a considerable effect on the frequency or correctness of RPE use in workers. There were no studies on incentives or organisation level interventions. The included studies had methodological limitations and we therefore need further large RCTs with clearer methodology in terms of randomised sequence generation, allocation concealment and assessor blinding, in order to evaluate the effectiveness of behavioural interventions for improving the use of RPE at both organisational and individual levels. In addition, further studies should consider some of the barriers to the successful use of RPE, such as experience of health risk, types of RPE and the employer's attitude to RPE use.
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