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1.

Overview......................................................................................... 5

2.

Introduction ................................................................................... 11 2.1. Aims of the review ..............................................................11 2.2. Background on systematic reviews .....................................12 2.3. Challenges in conducting a systematic review on OHSMSs......................................................................... 12 2.4. Defining OHSMSs ..............................................................13 2.5. Voluntary and mandatory OHSMS initiatives ....................16 2.5.1. Voluntary OHSMS initiatives...............................17 2.5.2. Mandatory OHSMS initiatives .............................19 2.6. Controversy surrounding OHSMSs.....................................20 2.7. Existing literature reviews on OHSMSs .............................22 2.8. Framework for the review of OHSMS effectiveness ..........24

3.

Methods .......................................................................................... 27 3.1. Literature search..................................................................27 3.2. Selection of studies..............................................................27 3.2.1. Inclusion and exclusion criteria ............................27 3.3. Quality appraisal (QA) ........................................................31 3.3.1. Quality appraisal of quantitative evidence............31 3.3.2. Quality appraisal of qualitative evidence..............32 3.4. Data extraction (DE) ...........................................................32 3.5. Evidence synthesis ..............................................................32

4.

Results............................................................................................. 34 4.1. Publications identified through the literature search...........34 4.2. Quality of the literature investigating OHSMSs .................38 4.3. Effectiveness of voluntary OHSMSs ..................................41 4.3.1. Studies of implementation ....................................41 4.3.2. Studies of intermediate outcomes .........................44 4.3.3. Studies of economic outcomes..............................46 4.3.4. Summary of results in studies of voluntary OHSMSs ............................................................... 48 4.4. Effectiveness of mandatory OHSMSs.................................48 4.4.1. Studies of implementation ....................................51 4.4.2. Studies of intermediate outcomes .........................54 4.4.3. Studies of final OHS outcomes.............................55 4.4.4. Studies of economic outcomes..............................59 4.4.5. Studies of results in studies of mandatory OHSMs ................................................................. 61

Table of Contents

Effectiveness of Occupational Health & Safety Management Systems: A Systematic Review

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