A systematic review of the effectiveness of occupational health and safety training 1

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1 Roson t l Sn J Work Envron Hlt. 2012;38(3): o: /sjw.3259 A systmt rvw t tvnss ouptonl lt n sty trnn 1 y Lyn S Roson, PD, 2 Crol M Stpnson, PD, Pul A Sult, PD, Bnjmn C Amk III, PD, Emm L Irvn, BA, Donl E Ert, PD, Stll Cn, MS, Amr R Blky, MS, Ann M Wn, BSN, Trr L Hottn, ED, Rort H Ptrs, MS, Jut A Clrk, MA, Kmrly Culln, MS, Cty J Rotun, ED, Pul L Gru, PD 1 Appnx Supplmntry tls A K 2 Corrsponn utor Insttut or Work & Hlt, 481 Unvrsty Av, Sut 800, Toronto, ON M5G 2E9, Cn. [E-ml: lroson@w.on.] Sn J Work Envron Hlt 2012 vol 38, no 3 1

2 Systmt rvw t tvnss OHS trnn Appnx: Fur A n Tls A K TRAINING FACTORS (.. lrnn prnpls, tmn, ormt, trnr) IMMEDIATE OUTCOMES (.. rton to trnn, knowl, ls, sklls, tttus, motvton to t, vorl ntnt) INTERMEDIATE OUTCOMES (.. vors, zr ontrols, zrs, xposurs) IMPACTS (.. njurs, llnsss, tlts, slts, osts) INDIVIDUAL FACTORS (.. morp tors, ontv lts, oupton, tnty, lnu lts, lrnn styl, prvous trnn, lt sttus, pr-trnn tttus, xptns, motvton to lrn) PRE-INTERVENTION WORKPLACE FACTORS (.. pr-trnn ns ssssmnt, mpowrmnt, sty ultur) POST-INTERVENTION WORKPLACE FACTORS (.. post-trnn mntnn ntrvntons, mpowrmnt, sty ultur) WORKPLACE Fur A. Conptul mol workpl trnn ntrvntons or prmry prvnton n OHS EXTERNAL ENVIRONMENT Tl A. Trms or ltrtur sr Trm Ctory Ext Sr Trms Work-rlt mploymnt/ ouptons work/ workr$.mp./ workpl$.mp. Euton n trnn ntrvnton ln trnn.mp. uton/ utonl msurmnt/ utonl sttus/ -trnn.mp. xtr trnn.mp. lt uton/ Hlt Euton/mt [Mtos] lt knowl, tttus, prt/ nsrv trnn/ Insrv Trnn/, o, mt ntrvnton?.mp. on mn trnn.mp. pr trnn.mp. trnn.mp. OHS outoms n tors tn tvnss Btwn-roup vluton sn sntsm/ nts/ nts, ouptonl/ nt prvnton/ rrrs.mp. vo?rl n.mp. lm$.mp. Costs n Cost Anlyss / umultv trum sorr/ onom vluton.mp. Evluton Stus/ lttors.mp. twn roups.mp. omprson.mp. k prours.mp. k/ zrous sustns/ zrous wst/ Hlt Knowl, Atttus, Prt/ lt protton.mp. KNOWLEDGE/ ml r.mp. ouptonl sss/ ouptonl xposur/ ouptonl lt/ Ouptonl Hlt Srvs/ prormn ntors.mp. prsntsm.mp. prmry prvnton/ prottv tors.mp. prt.mp. rnormnt.mp. rturn on nvstmnt.mp. Rsk Ftors/ sty/ sty ultur.mp. workrs ompnston/ wouns n njurs / rnom$.mp. T sr ws lmt to umns n (Enls or Frn) n yr= Trms wr lso us to xlu pultons: lt promoton, t, xrs, smokn, wt loss n ton. T trms r prsnt usn Mln syntx. Ts ws pt or otr tss. Sr trms wr omn usn t ollown Booln lo: trms wtn t sm tory wr omn usn OR n t trms n rnt tors wr omn usn AND. 2 Sn J Work Envron Hlt 2012 vol 38, no 3

3 Roson t l Tl B. Rlvn ssssmnt qustons, st 1. [OHS=ouptonl lt n sty.] Quston Exlusonry rspons 1 Is t stuy xmnn workr populton? No 2 Is t stuy onrn wt ny t ollown? No An ntrvnton stuy (wt pr- n post- msurs) ssssn t tvnss n OHS uton/trnn prorm Ftors tt my ltt or nt t tvnss OHS uton/trnn prorms A novl ppro to prov OHS uton/trnn prorms Splz tnqus/mtos (, omputr-s trnn) tt v n us to prov OHS uton/trnn prorms Ftors tt t ompln wt OHS uton/trnn prorms 3 Dos t stuy prsnt normton tt s st sr s onjtur or tstmonls wt no supportn vn? Ys 4 Dos t stuy ous on workrs urrnt stt knowl rrn n OHS ssu, w smply nts tt tr s urtr Ys n or uton/trnn on ts ssu? 5 Is t stuy puls n Enls or Frn? No Is t t pulton twn 199 n 2007? No Tl C. Et trnn on knowl (rltv to no-trnn ontrol). [ANCOVA=nlyss ovrn; =stnrz mn rn; NR=not rport;=stnr rror.] Gry t l (3) Grn t l (34) Hrrnton & Wlkr (45) Hrrnton & Wlkr (5) Rzzo t l (47) Intrvnton (lvl nmnt numr trnn sssons; zr typ ) Mult-omponnt lt trnn or nurss (H;5;E) Mult-omponnt ronoms (H;2;E) Computr-s om ronoms trnn (L;1;E) 1) Computr-s r sty trnn t l r lty (M;2;P) 2) Instrutor-l r sty trnn (L;2;P) 1) Instrutor-rt omputr ronoms (L;1;E) 2) Vo n pmplts; omputr ronoms (L;1;E) Mto lmttons sor N Tm Outom (mto msurmnt) Rsults, s rport n ornl pulton Drton t Sttstl snn (twn 8 NR 0 Knowl + P< wks Knowl n ls + P<0.01 or ntrton sln knowl n roup n ANCOVA Et sz Knowl + P< # ) 4 2) ) 45 2) 39 0 ) Knowl on zrs ) Knowl on sty vors 15 1( # 1( # 2( # 2( # Knowl 1) + 2) + ANCOVA 1() P<0.05 1() P<0.05 2() P<0.05 2() P<0.05 ANCOVA 1) P<0.05 2) P<0.05 1() () 1.0 2() () ) ) 0.78 Mor tls on t ntrvntons r n Tl 4. Lvl lrnr nmnt n t ntrvnton, s sr n mtos: low (L), mum (M), or (H). Hzr typ: olol (B), ml (C), ronom (E), pysl (P), sty (S). Mtoolol lmttons sor s sr n Mtos, wt rn 0 (no lmttons) to 8 (most lmttons). Totl numr sujts n t ntrvnton n ontrol roups n nlyss. Sujts r popl unlss nt otrws. Mto us to msur outom: mnstrtv rors (A), lnl xm (C), osrvtons (O), pysl proprty msurmnt (P), qustonnr/ry, voluntry rstry (R). Drton t, s rport y ornl utors or twn-roup rsults. Wn not rport y t ornl utors, t trmnton ws m y t rvwrs (nt y #), u y t utors ppro to nlyss. A postv vlu nts trnn mor tv tn ontrol. Sttstl snn, s rport y ornl utors or twn-roup tst. Wn not rport y t ornl utors, t ws trmn y rvwrs (nt y #) wn sln smlrty roups wt rspt to t outom oul stls (usn rtron p>0.05). Tsts wr onut on post-ntrvnton t only, unlss nt otrws. ws lult y rvwrs rom post-ntrvnton t wn sln smlrty t roups wt rspt to t outom oul stls (usn rtron P>0.05). A postv vlu nts trnn mor tv tn ontrol Sn J Work Envron Hlt 2012 vol 38, no 3 3

4 Systmt rvw t tvnss OHS trnn Tl D. Et trnn on tttus n ls (rltv to no-trnn ontrol). [ANCOVA=nlyss ovrn; = stnrz mn rn; NS=not sttstlly snnt; NC=not lult y rvwrs us sln ssmlrty roups wt rspt to outom msurs; =stnr rror] Grn t l (34) Hrrnton & Wlkr (45) Hrrnton & Wlkr (5) Intrvnton (lvl nmnt numr trnn sssons; zr typ ) Mult-omponnt ronoms (H;2;E) Computr-s om ronoms trnn (L;1;E) 1) Computr-s r sty trnn t l r lty (M;2;P) 2) Instrutor-l r sty trnn (L;2;P) Mto lmttons sor N Tm wks Outom (mto msurmnt) ) Sl-y ) Outom xpttons Rsults, s rport n ornl pulton Drton t )+ )+ Sttstl snn (twn ANCOVA: ) 0.82 ) P<0.01 or ) 0.87 ntrton sln sl-y n roup ) P=0.00 Et sz Atttus + P= # ) 4 2) 45 0 ) Atttus to zrs ) Atttus to sty vors 1() - 1( 2() - 2() - ANCOVA on roups 1,2 n ontrol 1() NS 1() NS 2() NS 2() NS 1() NC 1() () () Mor tls on t ntrvntons r n Tl 4. Lvl lrnr nmnt n t ntrvnton, s sr n mtos: low (L), mum (M), or (H). Hzr typ: olol (B), ml (C), ronom (E), pysl (P), sty (S). Mtoolol lmttons sor s sr n Mtos, wt rn 0 (no lmttons) to 8 (most lmttons). Totl numr sujts n t ntrvnton n ontrol roups n nlyss. Sujts r popl unlss nt otrws. Mto us to msur outom: mnstrtv rors (A), lnl xm (C), osrvtons (O), pysl proprty msurmnt (P), qustonnr/ry, voluntry rstry (R). Drton t, s rport y ornl utors or twn-roup rsults. Wn not rport y t ornl utors, t trmnton ws m y t rvwrs (nt y #), u y t utors ppro to nlyss. A postv vlu nts trnn mor tv tn ontrol. Sttstl snn, s rport y ornl utors or twn-roup tst. Wn not rport y t ornl utors, t ws trmn y rvwrs (nt y #) wn sln smlrty roups wt rspt to t outom oul stls (usn rtron p>0.05). Tsts wr onut on post-ntrvnton t only, unlss nt otrws. ws lult y rvwrs rom post-ntrvnton t wn sln smlrty t roups wt rspt to t outom oul stls (usn rtron P>0.05). A postv vlu nts trnn mor tv tn ontrol. Tl E. Et trnn on vors (rltv to no-trnn ontrol). [ANCOVA=nlyss ovrn; =stnrz mn rn; NC=not lult y rvwrs us sln ssmlrty roups wt rspt to outom msurs; NS=not sttstlly snnt; PPE=prsonl prottv qupmnt; PS=psyosol; RM ANOVA=rpt msurs nlyss vrn; =stnr rror; UP=unvrsl prutons.] Arntz & Arntz (50) Bor (53, 54) Brsson t l (31) Intrvnton (lvl nmnt numr trnn sssons; zr typ ) Group susson volnt nnts (ot roups wt volnt nnt orms) (M; multpl; S) 1) Mult-omponnt ronoms (H;1;E) 2) Ltur (L;1;E) Mult-omponnt ronoms (H;2;E) or : 1) <40 yrs 2) 40 yrs Mto lmttons sor N Tm Outom (mto msurmnt) Exposurs to volnt nnts 1) 103 2) ) 207 2) ) Workstton zrs (O) ) Posturl vors (O) ) 3 posturl vors (O) ) 10 workstton zrs (O) Rsults, s rport n ornl pulton Drton t Sttstl snn (twn Et sz - P= () - # 1() - # 2( # 2( # All # 1() NC, +, + 1(, NC, NC, NC, NC, +, -, NC, +, + 2(, NC, + 2() NC, +, +, +, +, +, NC, +, +, + P 0.05 (RM ANOVA on ll 3 roups) All # 1) P=NC, 0.00, ) P=0.02, NC, NC, NC, NC, 0.02, 0.15, NC,, () P=0.99, n, () P=NC, 0.00, 0.07, 0.15, 0.01, 0.00, NC, 0.01,, () NC, 0.49, () 0.34, NC, NC, NC, NC, 0.35, -, NC, 0.29, () 0.01, NC, () NC, 0.38, 0.19, 0.15, 0.2,, NC, 0.30, 0.14, () () () 2() 4 Sn J Work Envron Hlt 2012 vol 38, no 3

5 Roson t l Tl E. Contnu Eklö t l (40); Eklö & Hr (4) Grn t l (34) Hl t l (33) Jnsn t l (51) Rsmussn t l (49) Intrvnton (lvl nmnt numr trnn sssons; zr typ ) Mult-omponnt ronoms nlun PS tors (H;1;E) Tr stuy rms wt rnt trts or k: 1) nvul 2) suprvsors 3) roup Mult-omponnt ronoms (H;2;E) Formlz uton prorm on skn r (H;3;C) Trn-t-trnr prorm n ptnt ltn tnqus (H;2;E) Mto lmttons sor N 3 1) 18 2) 18 3) 18 (unt: work Tm wks ~4 9 Mult-omponnt rm sty (H;2;S) 1 ~171 rms Outom (mto msurmnt) ) % ronom motons ) Avr numr ronom motons Posturl xposurs (O) wt work vors ) Pysl xrton ) Hnln vor ) Rn moton (O) ) Atv sty vors ) PPE us Rsults, s rport n ornl pulton Drton t 1( 2( 3( 1( # 2( # 3( # Sttstl snn (twn 1() P=0.02 2() P=0.02 3() P=0.0 1,2,3 () P=0.24 n ovrll tst All s on n t. + P<0.01 or ntrton posturl xposurs n roup n ANCOVA ) v) v) + v # ) - ) ) Usn n t: ) P=0.02 ) P<0001 ) P=0.80 v) P=0.54 v) P=0.0 v) P= 0.11 ) NS ) NS ) NS Usn n t: ) P=0.035 ) P=0.005 Et sz 1() () (1.98 1() () () ) 0.51* ) 0.83 * ) 0.03 * v) 0.17 * v) 0.52 * v) 0.32 * ) ) ) 0.25 Rzzo t l (47) 1) Instrutor-rt omputr ronoms (L;1:E) 2) Vo n pmplts; omputr ronoms (L;1:E) 1) 45 2) Work ts 1) + 2) + ANCOVA: 1) P<0.05 2) P<0.05 1) NC 2) Wrt t l (52) Computr-ssst wt prolmsolvn; UP vors (M;1;B) UP vors (O) + Usn n t: P= Mor tls on t ntrvntons r n Tl 4. Lvl lrnr nmnt n t ntrvnton, s sr n mtos: low (L), mum (M), or (H). Hzr typ: olol (B), ml (C), ronom (E), pysl (P), sty (S). Mtoolol lmttons sor s sr n Mtos, wt rn 0 (no lmttons) to 8 (most lmttons). Totl numr sujts n t ntrvnton n ontrol roups n nlyss. Sujts r popl unlss nt otrws. Mto us to msur outom: mnstrtv rors (A), lnl xm (C), osrvtons (O), pysl proprty msurmnt (P), qustonnr/ry, voluntry rstry (R). Drton t, s rport y ornl utors or twn-roup rsults. Wn not rport y t ornl utors, t trmnton ws m y t rvwrs (nt y #), u y t utors ppro to nlyss. A postv vlu nts trnn mor tv tn ontrol. Sttstl snn, s rport y ornl utors or twn-roup tst. Wn not rport y t ornl utors, t ws trmn y rvwrs (nt y #) wn sln smlrty roups wt rspt to t outom oul stls (usn rtron P>0.05). Tsts wr onut on post-ntrvnton t only, unlss nt otrws. ws lult y rvwrs rom post-ntrvnton t wn sln smlrty t roups wt rspt to t outom oul stls (usn rtron P>0.05). A postv vlu nts trnn mor tv tn ontrol. In som ss, t wr stmt rom Fur (nt y*). Sn J Work Envron Hlt 2012 vol 38, no 3 5

6 Systmt rvw t tvnss OHS trnn Tl F. Et trnn on lt (rltv to no-trnn ontrol). [ANCOVA=nlyss ovrn; =stnrz mn rn; MSK=musuloskltl; NS=not sttstlly snnt; PS=psyosol; =stnr rror; UE=uppr xtrmty; US=uppr spn.] Intrvnton (lvl nmnt numr trnn sssons; zr typ ) Mto lmttons sor N Tm Outom (mto msurmnt) Rsults, s rport n ornl pulton Drton t Sttstl snn (twn Et sz Bno t l (55) Trnn on ol uttr us wt rtl mploys (H;1;S) Cuttr-rlt njury rt (A) - p = 0.8 # Rt rto: Bor (53, 54) 1) Mult-omponnt ronoms (H;1;E) 2) Ltur (L;1;E) 1) 85 2) 8 12 Uppr-oy MSK symptom sor 1) + # 1,2) P< ) + # (RM ANOVA on ll 3 roups) Brsson t l (31) Duy & Hzltt (32) Eklö t l (40); Eklö & Hr (4) Mult-omponnt ronoms (H;2;E) or : 1) <40 yrs 2) 40 yrs 1) Inormton on vo us or tn trns (L;1;E) 2) Prtl trnn on vo us or tn trns (H;2;E) Mult-omponnt ronoms nlun PS tors (H;1;E) Tr stuy rms wt rnt trts or k: 1) nvul 2) suprvsors 3) roup 4 1) 12 2) 328 1) 35 2) ) 18 2) 18 3) 18 (unt: work 2 MSK sorr prvln (C) Vo qulty sor (P) MSK or y symptom prvln 1) + 1) P=0.1 # 1) ) - # 2) P=0.4 # 2) ) + 2) + 1) - # 2) - # 3) - # P=0.18 (RM ANOVA on ll 3 roups) 1,2,3) P=0.90 n ovrll tst n t 1) 0.04 * 2) 0.30 * 1) ) ) Grn t l (34) Mult-omponnt ronoms (H;2;E) wks MSK symptom sor : ) UE ntnsty ) UE rquny ) UE urton v) US ntnsty v) US rquny v) US urton ) ) v) + v) + v ) P=0. ) P=0.9 ) P=0.7 v) P=0.8 v) P=0.4 v) P=0.7 ) - ) 0.03 ) v) 0.15 v) 0.27 v) 0.37 Hl t l (33) Formlz uton prorm on skn r (H;3;C) Skn symptom svrty (C + P= (s on n t) 0.05* Jnsn t l (51) Rsmussn t l (49) vn Poppl t l (58) Trn-t-trnr prorm n ptnt ltn tnqus (H;2;E) Mult-omponnt rm sty (H;2;S) 1 ~930 Ltn ronoms or mtrl nlrs (H;3;E) Low k pn : ) pst yr ) pst 3 Frm-rlt njury rts; ll njurs Low-k pn pst mont prvln ) ) Usn n t: ) P= ) P=0.1 ) 0.04 ) P=NS (Posson rrsson mol) Rt rto: P= Mor tls on t ntrvntons r n Tl 4. Lvl lrnr nmnt n t ntrvnton, s sr n mtos: low (L), mum (M), or (H). Hzr typ: olol (B), ml (C), ronom (E), pysl (P), sty (S). Mtoolol lmttons sor s sr n Mtos, wt rn 0 (no lmttons) to 8 (most lmttons). Totl numr sujts n t ntrvnton n ontrol roups n nlyss. Sujts r popl unlss nt otrws. Mto us to msur outom: mnstrtv rors (A), lnl xm (C), osrvtons (O), pysl proprty msurmnt (P), qustonnr/ ry, voluntry rstry (R). Drton t, s rport y ornl utors or twn-roup rsults. Wn not rport y t ornl utors, t trmnton ws m y t rvwrs (nt y #), u y t utors ppro to nlyss. A postv vlu nts trnn mor tv tn ontrol. Sttstl snn, s rport y ornl utors or twn-roup tst. Wn not rport y t ornl utors, t ws trmn y rvwrs (nt y #) wn sln smlrty roups wt rspt to t outom oul stls (usn rtron P>0.05). Tsts wr onut on post-ntrvnton t only, unlss nt otrws. ws lult y rvwrs rom post-ntrvnton t wn sln smlrty t roups wt rspt to t outom oul stls (usn rtron P>0.05). A postv vlu nts trnn mor tv tn ontrol. In som ss, t wr stmt rom Fur (nt y*). Sn J Work Envron Hlt 2012 vol 38, no 3

7 Roson t l Tl G. Rltv tvnss rn lvls nmnt on outoms. [ANCOVA=nlyss ovrn; =stnrz mn rn; HPD=rn protton v; I=ntrvnton; NC=not lult y rvwr us sln ssmlrty roups wt rspt to outom msur; NS=not sttstlly snnt; PPE=prsonl prottv qupmnt; Q&A=quston & nswr ssson; RM ANOVA=rpt msurs nlyss vrn; =stnr rror; UE MSK=uppr xtrmty musuloskltl ] Bor (53, 54) Duy & Hzltt (32) Hrrnton & Wlkr (5) Hon t l (2) Lölr t l (42) Lusk t l (5, ) Prry & Ly (57) Intrvnton (lvl nmnt numr trnn sssons; zr typ ) I1) Prtptory uton (ns-on mo, prolm solvn, pplton to work r) (H;1;E) I2) Trtonl uton (ltur, normtonl nout, Q&A ssson) (L;1;E) I1) Drt vo r trnn (volzton, postur, rsprton, rls tnson n vol pprtus, rsonn, n vo projton) (H;2;E) I2) Inrt vo r trnn (normton on vo prouton, tors ssot wt lty vo) (L;1;E) I1) Computr-s nstruton on r sty; srns ontn nrrton, ntrton, nmton or vo; som wt qustons n ntrtv ms (M;2;S) I2) Lturs & prnt mtrls (L;2;S) Mto lmttons sor I1) Computr w/ tlor k ) 2 nl. rn tst rsult; HPD prt ) 3 (H;1;P) I2) Commrl vo w/ rn tst rsult (M;1;P) I1) Ltur, prolm-solvn n prt rrn skn r (M;7;C) I2) Inormtonl ppr on skn r (L;1;C) I1) Tlor: Computr-s trnn tlor to workr s sl-rport prt. Us tul, ontv ppros, monstrton, rt prt, vrous xprn, prsuson n rol-moln tnqus. Prsnt n ntrtv ormt, wt k (H;1:P) I2) Non-tlor: As ov, ut lvr to ll prtpnts n unorm mnnr (H;1;P) I3) Vo (L;1;P) I1) Euton ntrvnton (ltur, sls, prsntton y rspt r rmr, monstrton n opportunty or ns-on prt) (H;1;C) I2) Stnr r-rtton mtn or pst ppltors (L;1;C) N Tm Outom (mto msurmnt) ) Workstton zrs (O) ) Posturl vors (O) ) UE MSK symptoms Vo qulty (Dyspon Svrty Inx) (P) Rsults, s rport n ornl pulton Drton t I1 vrsus I2: ) # ) # # I1 vrsus I2: Fr sty outoms : ) knowl on zrs I1 vrsus I2: # # ) knowl on sty # vors v) +# ) tttus on zrs v) tttus on sty vors 403 ) 0 wks ) yrs tr 1st ssson ) 2 ) 1 ) 1 v) 1 v) 1 v) ) Intnton to us HPDs ) Us HPDs Sttstl snn (twn RM ANOVA: ) NS ) NS ) NS 1, 2, ontrol: RM ANOVA: P=0.18 ) P=NS ) P=NS 1,2, ontrol: ANCOVA: ) P=NS v) P=NS RM ANOVA: ) P=0.001 ) NS Et sz Sn J Work Envron Hlt 2012 vol 38, no 3 7 ) ) ) ) 0.41 ) 0.2 ) 0.5 v) 0.21 ) 0.13 ) Drmtts (C) + Multpl lost rrsson: P= Us rn protton ) Sty knowl ) PPE us otr tn lovs ) Full PPE ompln v) Drml xposur v) Sty ntntons v) Rsk prptons I1 vrsus I3: + I2 vrsus I3: - I1 vrsus I2: v) + v) + v RM ANOVA: 1 vrsus 3: P=0.49 I2 vrsus 3: P=0.18 ) P<0.05 ) P<0.05 ) NS v) NS v) P<0.05 v) P<0.05 I1 vrsus I3: NC I2 vrsus I3: ) v) v) v) Mor tls on ntrvntons n Tl 4. Lvl nmnt, s sr n Mtos: low (L), mum (M) or (H). Lvl lrnr nmnt, s sr n Mtos: low (L), mum (M) or (H). Hzr typ: olol (B), ml (C), ronom (E), pysl (P), sty (S). Mtoolol lmttons sor, s sr n Mtos, wt rn 0 (no lmttons) to 8 (most lmttons). Totl numr sujts n t ntrvnton n ontrol roups n nlyss. Sujts r popl unlss nt otrws. Mto us to msur outom: lnl xm (C), osrvtons (O), pysl proprty msurmnt (P), qustonnr/ry. Drton t: + nts t r lvl nmnt trnn ws mor tv tn lowr, s rport y t ornl utors or twnroup rsults, wn vll. Wn not rport, t trmnton ws m y t rvwrs (nt y #), u y t utors ppro to nlyss. Sttstl snn: As rport y ornl utors or twn-roup tst, wn vll. Wn not rport, t ws lult y rvwrs (nt y #) wn sln smlrty oul stls (usn rtron P>0.5). Tsts wr onut on post-ntrvnton t only, unlss nt otrws. Et sz ws lult rom post-ntrvnton t wn sln smlrty t roups wt rspt to t outom oul stls, usn rtron P> nts trnn wt t r lvl nmnt ws mor tv tn low. 0.04

8 Systmt rvw t tvnss OHS trnn Tl H. Alortm ppl to r vrsus lowr nmnt trnn vn to trmn ts strnt. [=stnrz mn rn; IQR=ntrqurtl rn.] Strnt vn Mtoolol qulty Mnmum quntty Consstny ts Et sz rtron Stron Goo 2 stus IQR (or rn) os not nlu zro Sunt: Knowl = 0.25 Atttus & Bls = Bvors = Hlt = 0.04 Goo or Fr 5 stus IQR (or rn) os not nlu zro Mt mtoolol qulty, quntty n onsstny rtr or sunt ut not stron vn Sunt Goo Not ppll IQR (or rn) os not nlu zro Insunt Goo or Fr 3 stus IQR (or rn) os not nlu zro T rtron n ny on t our omns not mt Sunt: Knowl = 0.25 Atttus & Bls = Bvors = Hlt = 0.04 Lr: Knowl = 0.38 Atttus & Bls = 0.25 Bvors = 0.20 Hlt = 0.08 Sunt: Knowl = 0.25 Atttus & Bls = Bvors = Hlt = 0.04 Sunt: Knowl = 0.25 Atttus & Bls = Bvors = Hlt = 0.04 Mtoolol qulty tors or stus: Goo (0 1 lmttons sor), Fr (3 4), n Lmt ( 5). Intrqurtl rn ws trmn wn tr wr v or mor t szs n t oy vn; otrws t ull rn ws us. Crtr or sunt n lr t szs wr n y t rsr tm. Ts wr oprtonlz y rqurn t mn t sz or oy vn to qul to or rtr tn t rtron. Tl I. Fnl os vn on t rltv tvnss r vrsus lowr nmnt trnn, y outom. [=stnrz mn rn; FB=k; =stnr rror ; ntrvnton (sp lvls lrnr nmnt ; # sssons) Mtoolol qulty Clult t szs Knowl Atttus Bvors Hlt Hon t l (2); rn protton (H vrsus M;1) Fr Lölr t l (42); rmtts prvnton (M vrsus L;7 vrsus 1) Fr Lusk t l (5, ); rn protton (H vrsus L;1) Fr Prry & Ly (57); s pst us (H vrsus L;1) Fr + Prry & Ly (57); s pst us (H vrsus L;1) Goo ) 0.14 * v) Mor tls ntrvntons r n Tl 4. Sp lvls lrnr nmnt ontrst n t stuy, trmn s sr n Mtos: low (L), mum (M), or (H). Rrs to t ssss mtoolol qulty t sp outom t nlu n t tl: Goo, 0 1 mtoolol lmttons sor; Fr, 2 4. vlus n rom Tl G wr rr ovr to Tl I wn t mtoolol qulty t t ws r or oo. Wn stuy rport multpl msurs smlr onpt, only tr mn rport r (nt y *). T stnr rror or t ontrutn nvul msurs n oun n Tl G. A postv vlu or nts t r nmnt trnn s mor tv tn t lowr nmnt trnn. Numr ullts prn nvul t szs orrspon to tos us n Tl G. Et sz not lull, ut rton s nt. 8 Sn J Work Envron Hlt 2012 vol 38, no 3

9 Roson t l Tl J. Summry mtoolol qulty ssssmnts stus. [K=knowl; A=tttus n ls; B=vors; H=lt; CSG=omprlty stuy roups; II=ntrvnton mplmntton; OA=outom ssssmnt; SA=sttstl nlyss.] Intl stuy smpl sz Outoms ssss Mtoolol ssssmnts: our omns CSG II OA SA Mtoolol lmttons sor us n vn syntss Arntz & Arntz (50) *1500 B P P N P 5 Bno t l (55) *900 H P P P P 4 Bor (53, 54) 154 B, H N N Y N Brsson t l (31) *58 B, H P P Y N 4 Duy & Hzltt (32) 55 H N N Y N Eklö t l (40); 39 B, H P P P Y 3 Eklö & Hr (4) Gry t l (3) *250 K N N N N 8 Grn t l (34) 87 K, A, B, H P P P P 4 Hrrnton & Wlkr (45) 102 K, A P N P Y 4 Hrrnton & Wlkr (5) 141 K, A N P P P 5 Hl t l (33) 375 B, H Y Y Y Y 0 Hkmn & Gllr (44) 15 B Y P Y Y 1 Hon t l (2) 12 A, B P Y Y P 2 Jnsn t l (51) 210 B, H P P N N Lölr t l (42) 521 H P P Y P 3 Lusk t l (5, ) 2219 B P P P P 4 Prry & Ly (57) 400 K, B Y P Y Y 1 Rsmussn t l (49) 990 B,H Y Y P Y 1 Rzzo t l (47) *150 K N N Y P 5 Vn Poppl t l (58) 312 H P P P N 5 Wn t l (43) 10 K, B P P P P 4 Wrt t l (52) 0 B P P P Y 3 Intl stuy smpl sz rrs to t ntl sz t smpl wt rspt to nvul workrs. Wr t stnton ws prmtt, ts ws t sz t stuy smpl ollown xlusons on t ss llty, ntl nlty to ontt n ntl rusl to prtpt, ut or ny loss smpl or rsons non-rspons urn msurmnt or wtrwl. Astrsks (*) nt ss n w numrs wr tr stmt y t rvwrs or wr rport s pproxmt y t utors. E t ollown omns potntl s ws rst ssss y svrl tms n t mtoolol qulty ssssmnt orm: CSG, II, OA n SA. T rvwrs tn ssss wtr ty wr onnt tt t potntl or s n tt omn n mnmz: Ys (Y); Prtly (P); No (N). Sn outom ws ssss npnntly, t tl sows t stronst t ssssmnts mon ll outoms or stuy. Lmttons sor s rv rom t our omn-sp mtoolol ssssmnts (s Mtos) n rns rom 0 (no lmttons) to 8 (most lmttons). Tl K. Dtrmnton t strnt vn or outom n stus t rltv tvnss r vrsus lowr nmnt trnn [IQR=ntrqurtl rn; N=numr stus; NA=not ppll/not vll] Outom Goo Summry oy vn n tl G N IQR Mn t szs Fr Assssmnt oy vn usn vn syntss lortm Numr oo or r stus Consstny Mn t szs Strnt vn Knowl 0 1 NA NA Too w NA NA Insunt Atttus 0 1 NA Too w NA Sunt Insunt Bvors Enou Consstnt Lss tn Insunt sunt Hlt 0 1 NA 0.0 Too w NA Lr Insunt Dsrptors nt t rsult ssssn tur oy vn usn t vn syntss lortm sown n Tl H. T rsultn onluson out strnt vn ollown t ssssmnt oy vn nst t vn syntss lortm (tl H). Sn J Work Envron Hlt 2012 vol 38, no 3 9

In which direction do compass needles always align? Why?

In which direction do compass needles always align? Why? AQA Trloy Unt 6.7 Mntsm n Eltromntsm - Hr 1 Complt t p ll: Mnt or s typ o or n t s stronst t t o t mnt. Tr r two typs o mnt pol: n. Wrt wt woul ppn twn t pols n o t mnt ntrtons low: Drw t mnt l lns on