The Burden of Occupational Disease and Injury in New Zealand: Technical Report
7. Lessons for Prevention
Few (only about 6%) of the New Zealand publications were focused directly on prevention. That is, most papers were focused on describing the nature and extent of problems, and the absolute and relative risks associated with these, but did not specifically examine or test approaches to preventing the exposures or the occurrence of injury or disease. This step of describing the problem, and assessing the absolute and relative importance of the problem, is a necessary step in order for appropriate interventions and prevention activity to be planned, implemented and evaluated. In addition, some of the papers made suggestions regarding what interventions might be appropriate based on the study findings. However, this current focus of research activity appears to be to the exclusion of research examining interventions.
The lack of rigorous evaluation of occupational health and safety prevention programmes is not unusual. In fact, it is not uncommon in most areas of public health. There are many reasons for this. These include lack of recognition of the need for evaluation, lack of funds set aside in intervention projects to conduct proper evaluations, difficulty identifying appropriate methods under which the evaluation could be conducted, and lack of appropriate baseline data that can be used for comparison.
It is important that prevention programmes be properly trialled and evaluated, so that useful measures are implemented more widely, and measures that are not useful are not continued.
The earlier discussion about diseases of long latency and the difficulties these raise for recognising emerging and continuing problems is important when considering prevention activity. Monitoring of outcomes (diseases and injuries) remains important, but a comprehensive prevention campaign needs to be informed by surveillance methods aimed at identifying problems as early as possible. This reinforces the potential value of monitoring exposures in some form.
The findings of the New Zealand-based research reinforce the need to intervene as early as possible when there are work-related hazards that raise significant risk of injury or disease. This is particularly the case for diseases with prolonged latency.