Effectiveness of the Labour Inspection Authority's regulatory tools for work environment and employee health: study protocol for a cluster-randomised controlled trial among Norwegian home-care workers

Anne-Marthe R Indregard, Stein Knardahl, Jan Shahid Emberland, Øivind Skare, Håkon A Johannessen, Anne-Marthe R Indregard, Stein Knardahl, Jan Shahid Emberland, Øivind Skare, Håkon A Johannessen

Abstract

Introduction: There is a need to evaluate whether, and to what degree, labour inspections or other regulatory tools have the desired effects on psychosocial, organisational and mechanical work environment, and employee health. The Norwegian Labour Inspection Authority (NLIA) uses different tools and strategies to enforce compliance with occupational safety and health (OSH) legislation. The aim of the present study is to evaluate the effects of labour inspections and other regulatory tools employed by the NLIA. The home-care service is one of the fastest growing occupations and a prioritised area for the NLIA, hence the present study will investigate regulatory tools in this sector.

Methods and analysis: The research project has been designed as a longitudinal, cluster-randomised, controlled trial and will be conducted among Norwegian home-care workers. The objective of the research project is to evaluate the effects of the NLIA's regulatory tools (inspection and guidance) on: (1) compliance with OSH legislation and regulation; (2) psychosocial, organisational and mechanical work environment; (3) employee health in terms of musculoskeletal and mental health complaints; and (4) sickness absence. Public home-care services have been randomised to three intervention groups and one control group. Home-care services in the intervention groups will receive one of three intervention activities from the NLIA: (1) inspection from the Labour Inspection Authority; (2) guidance through an online interactive risk-assessment tool; and (3) guidance on psychosocial, organisational and mechanical work environment through workshops. The interventions will be performed at the organisational level (home-care service), and the effects of the interventions on the working environment and health complaints will be measured at the individual level (home-care employees).

Ethics and dissemination: This project has been approved by the Regional Committees for Medical and Health Research Ethics (REC) in Norway (REC South East) (2018/2003/REK sør-øst C), the Norwegian Center for Research Data (566128), and will be conducted in accordance with the World Medical Association Declaration of Helsinki. The results will be reported in international peer-reviewed journals.

Trial registration number: NCT03855163.

Keywords: cluster-randomised controlled trial; effect evaluation; employee health; occupational safety and health; work environment.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Illustration of the process from OSH legislation and regulation to the different outcomes. OSH, occupational safety and health.
Figure 2
Figure 2
Flow chart illustrating the timeline of the research project.
Figure 3
Figure 3
Percentage of the population with mental distress (HSCL-5 ≥2) according to the different population mean scores on the HSCL-5-scale. HSCL, Hopkins Symptom Checklist.

References

    1. Takala J, Hämäläinen Päivi, Saarela KL, et al. . Global estimates of the burden of injury and illness at work in 2012. J Occup Environ Hyg 2014;11:326–37. 10.1080/15459624.2013.863131
    1. International Labour Office Global strategy on occupational safety and health: conclusions adopted by the International labour conference at its 91st session, 2003, 2004.
    1. World Health Organization (WHO) Declaration on workers health. Approved at the seventh meeting of the who collaborating centres for occupational health. Italy: WHO, 2006.
    1. Andersen JH, Malmros P, Ebbehoej NE, et al. . Systematic literature review on the effects of occupational safety and health (OSH) interventions at the workplace. Scand J Work Environ Health 2019;45:103–13. 10.5271/sjweh.3775
    1. Johannessen HA, Løchting I, Bakke B, et al. . Effekter av myndighetstiltak på arbeidsmiljø og helse. En systematisk kunnskapsoppsummering STAMI; 2017.
    1. Tompa E, Kalcevich C, Foley M, et al. . A systematic literature review of the effectiveness of occupational health and safety regulatory enforcement. Am J Ind Med 2016;59:919–33. 10.1002/ajim.22605
    1. Blanc F. From chasing violations to managing risks: origins, challenges and evolutions in regulatory inspections. Edward Elgar Pub, 2018.
    1. Mischke C, Verbeek JH, Job J, et al. . Occupational safety and health enforcement tools for preventing occupational diseases and injuries. Cochrane Database Syst Rev 2013;20 10.1002/14651858.CD010183.pub2
    1. Tollånes M, Knudsen A, Vollset S. Disease burden in Norway in 2016. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, NY raekke. 138, 2018.
    1. Duijts SFA, Kant I, Swaen GMH, et al. . A meta-analysis of observational studies identifies predictors of sickness absence. J Clin Epidemiol 2007;60:1105–15. 10.1016/j.jclinepi.2007.04.008
    1. Knardahl S, Johannessen HA, Sterud T, et al. . The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses. BMC Public Health 2017;17:176 10.1186/s12889-017-4059-4
    1. Knardahl S, Sterud T, Nielsen MB, et al. . Arbeidsplassen og sykefravær - Arbeidsforhold av betydning for sykefravær.. Tidsskrift for velferdsforskning. 2016;19:179–99.
    1. Stansfeld S, Candy B. Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health 2006;32:443–62. 10.5271/sjweh.1050
    1. Sterud T, Tynes T. Work-Related psychosocial and mechanical risk factors for low back pain: a 3-year follow-up study of the general working population in Norway. Occup Environ Med 2013;70:296–302. 10.1136/oemed-2012-101116
    1. Johannessen HA, Tynes T, Sterud T. Effects of occupational role conflict and emotional demands on subsequent psychological distress: a 3-year follow-up study of the general working population in Norway. J Occup Environ Med 2013;55:605–13. 10.1097/JOM.0b013e3182917899
    1. Dellve L, Lagerström M, Hagberg M. Work-system risk factors for permanent work disability among home-care workers: a case-control study. Int Arch Occup Environ Health 2003;76:216–24. 10.1007/s00420-002-0414-5
    1. Utaaker E, Madshus AC, Flesjø M, et al. . På Rett vei I hjemmetjenesten? Rapport for perioden 2002–2004, 2006.
    1. Jang Y, Lee AA, Zadrozny M, et al. . Determinants of job satisfaction and turnover intent in home health workers: the role of job demands and resources. J Appl Gerontol 2017;36:56–70. 10.1177/0733464815586059
    1. Denton MA, Zeytinoğlu IU, Davies S. Working in clients' homes: the impact on the mental health and well-being of visiting home care workers. Home Health Care Serv Q 2002;21:1–27. 10.1300/J027v21n01_01
    1. Quinn MM, Markkanen PK, Galligan CJ, et al. . Occupational health of home care aides: results of the safe home care survey. Occup Environ Med 2016;73:237–45. 10.1136/oemed-2015-103031
    1. Chan A-W, Tetzlaff JM, Altman DG, et al. . Spirit 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med 2013;158:200–7. 10.7326/0003-4819-158-3-201302050-00583
    1. Health and Care Services Act Act relating to municipal health and care services, etc. (health and care services act), 2011. Available:
    1. Turner EL, Li F, Gallis JA, et al. . Review of recent methodological developments in group-randomized trials: part 1—design. Am J Public Health 2017;107:907–15. 10.2105/AJPH.2017.303706
    1. Genet N, Boerma WGW, Kringos DS, et al. . Home care in Europe: a systematic literature review. BMC Health Serv Res 2011;11:207 10.1186/1472-6963-11-207
    1. The Norwegian Labour Inspectorate Årsrapport 2017 (Norwegian), 2018. Available:
    1. Dallner M, Elo A-L, Gamberale F, et al. . Validation of the General Nordic Questionnaire (QPSNordic) for psychological and social factors at work. Copenhagen: Nordic Council of Ministers, 2000.
    1. Wannstrom I, Peterson U, Asberg M, et al. . Psychometric properties of scales in the General Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic): Confirmatory factor analysis and prediction of certified long-term sickness absence. Scand J Psychol 2009;50:231–44. 10.1111/j.1467-9450.2008.00697.x
    1. Zapf D, Vogt C, Seifert C, et al. . Emotion work as a source of stress: the concept and development of an instrument. European Journal of Work and Organizational Psychology 1999;8:371–400. 10.1080/135943299398230
    1. Statistics Norway Samordnet levekårsundersøkelse 2009 - Tverrsnitt. Tema: Arbeidsmiljø. [Coordinated Living Conditions Survey 2009 - Cross Sectional. Focus: Work environment. Oslo: Statistics Norway, 2010.
    1. Smedley J, Egger P, Cooper C, et al. . Manual handling activities and risk of low back pain in nurses. Occup Environ Med 1995;52:160–3. 10.1136/oem.52.3.160
    1. Idler EL, Benyamini Y. Self-Rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 1997;38:21–37. 10.2307/2955359
    1. Derogatis LR, Lipman RS, Rickels K, et al. . The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci 1974;19:1–15. 10.1002/bs.3830190102
    1. Kristensen TS, Borritz M, Villadsen E, et al. . The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work & Stress 2005;19:192–207. 10.1080/02678370500297720
    1. Steingrímsdóttir Ólöf A, Vøllestad NK, Røe C, et al. . Variation in reporting of pain and other subjective health complaints in a working population and limitations of single sample measurements. Pain 2004;110:130–9. 10.1016/j.pain.2004.03.016
    1. Downie WW, Leatham PA, Rhind VM, et al. . Studies with pain rating scales. Ann Rheum Dis 1978;37:378–81. 10.1136/ard.37.4.378
    1. Pallesen S, Bjorvatn B, Nordhus IH, et al. . A new scale for measuring insomnia: the Bergen insomnia scale. Percept Mot Skills 2008;107:691–706. 10.2466/PMS.107.7.691-706
    1. Johannessen HA, Gravseth HM, Sterud T. Psychosocial factors at work and occupational injuries: a prospective study of the general working population in Norway. Am J Ind Med 2015;58:561–7. 10.1002/ajim.22431
    1. Moore GF, Audrey S, Barker M, et al. . Process evaluation of complex interventions: medical Research Council guidance. BMJ 2015;350:h1258 10.1136/bmj.h1258
    1. Søberg M. Labour Inspections and its impact on enterprises’ compliance with safety regulations. Safety Science Monitor 2013;17:1–12.
    1. Krzywinski M, Altman N. Comparing samples—part II. Nat Methods 2014;11:355–6. 10.1038/nmeth.2900
    1. Rutterford C, Copas A, Eldridge S. Methods for sample size determination in cluster randomized trials. Int J Epidemiol 2015;44:1051–67. 10.1093/ije/dyv113
    1. Martinson BC, Murray DM, Jeffery RW, et al. . Intraclass correlation for measures from a worksite health promotion study: estimates, correlates, and applications. Am J Health Promot 1999;13:347–57. 10.4278/0890-1171-13.6.347
    1. Deaton A, Cartwright N. Understanding and misunderstanding randomized controlled trials. Soc Sci Med 2018;210:2–21. 10.1016/j.socscimed.2017.12.005
    1. Hariton E, Locascio JJ. Randomised controlled trials - the gold standard for effectiveness research. BJOG: Int J Obstet Gy 2018;125 10.1111/1471-0528.15199
    1. Ford MT, Matthews RA, Wooldridge JD, et al. . How do occupational stressor-strain effects vary with time? A review and meta-analysis of the relevance of time lags in longitudinal studies. Work & Stress 2014;28:9–30. 10.1080/02678373.2013.877096
    1. Dormann C, Griffin MA. Optimal time lags in panel studies. Psychol Methods 2015;20:489–505. 10.1037/met0000041
    1. Podsakoff PM, MacKenzie SB, Lee J-Y, et al. . Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol 2003;88:879–903. 10.1037/0021-9010.88.5.879

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj