Economic evaluation of interventions for occupational health and safety - Emile Tompa

Undertaking economic evaluations of occupational health and safety interventions can be difficult for a number of reasons. This is reflected by the significant lack of evidence on their cost-effectiveness. Particular challenges include: complex labour legislation, differences in the perception of health risks associated with work experiences amongst workplace parties and policy makers, costs and consequences being borne by different stakeholders in the system, conflicting incentives and priorities between the multiple stakeholders, lack of consensus about what ought to count as a benefit or cost of intervening or not intervening, multiple providers of indemnity and medical care coverage, and industry-specific human resources practices that make it difficult to identify all work-related illnesses and injuries. Advancement of the application of economic evaluation methods in this literature is further hindered by the fact that most methods books are designed for use in a clinical setting and cannot be easily applied to the workplaces. In the face of such barriers, it is not surprising that few studies of occupational health and safety interventions contain an economic evaluation. This book aims to lay the foundations for a systematic methodology of economic evaluation of workplace interventions, by identifying the main barriers to research of high quality and practical relevance, and proposing a research strategy to overcome them. Context chapters provide a wealth of background material ranging from a presentation of the broad conceptualization of work and health, to suggestions for strategies in confronting the dearth of data often experienced by occupational health and safety researchers. The institutional and regulatory approaches in different international jurisdictions are covered in one of the context chapters. Specific topic chapters delve into the principles and application of economic evaluation methods relevant to workplaces and system level interventions. Study design, type of analysis, costs, consequences, uncertainty, and equity are all covered, providing guidance on meeting many analytical and decision-making challenges. The final chapter synthesizes the summaries, conclusions, challenges and recommendations from across the book, presenting the synthesis as a reference case.