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barriers, e.g. areas in which OHSMS implementation is especially difficult, such as small business, part-time or temporary employment, or contractors. The overall conclusion by Gallagher et al. (2003) is that although the evidence is “suggestive rather than conclusive”, it would seem that OHSMSs can work, if/when a set of very demanding conditions are met.

2.8 Framework for the review of OHSMS effectiveness This section describes the major concepts applied to the studies involved in the current systematic review. For inclusion in the review, a study had to describe an OHSMS intervention and then do at least one of the following: i) provide change measures of OHSMS implementation; ii) estimate the effect of the intervention on intermediate/final OHS outcomes or economic outcomes; or iii) study facilitators of or barriers to OHSMS implementation or effectiveness. These concepts will be more fully explained below. The key relationships among these concepts are indicated in Figure 2.8.1.

Figure 2.8.1: Review framework

INTERVENTION

IMPLEMENTATION

Workplace or extra- workplace initiative

Change in workplace OHSMS

INTERMEDIATE

OHS

OUTCOMES

FINAL OHS

(e.g., safety

OUTCOMES

climate)

(e.g., injury rate)

ECONOMIC OUTCOMES (e.g., firm insurance premiums)

FACILITATORS OF AND BARRIERS TO IMPLEMENTATION

FACILITATORS OF AND BARRIERS TO EFFECTIVENESS (ONCE IMPLEMENTED)

OHSMS intervention The scope of the review included interventions directed at developing the OHSMS in one or more workplaces. It therefore included studies of extra-workplace initiatives such as legislation, or voluntary programs arising through the government, its agencies, insurance carriers, groups of employers, etc. It also included studies of workplace- level initiatives, through which a workplace might attempt to improve its OHSMS, using either a scheme developed externally (e.g., British Standards Institute’s OHSAS 18001) or one developed internally. A minimalist definition of an OHSMS intervention was adopted. In order to count as

Institute for Work & Health

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