title: Effectiveness of health and safety in small enterprises: a systematic review of quantitative evaluations of interventions.
abstract: BACKGROUND
  This systematic review was conducted to identify effective occupational health and safety interventions for small businesses.
  
  
  METHODS
  The review focused on peer-reviewed intervention studies conducted in small businesses with 100 or fewer employees, that were published in English and several other languages, and that were not limited by publication date. Multidisciplinary members of the review team identified relevant articles and assessed their quality. Studies assessed as medium or high quality had data extracted, which was then synthesized.
  
  
  RESULTS
  Five studies were deemed of medium or high quality, and proceeded to data extraction and evidence synthesis. The types of interventions identified: a combination of training and safety audits; and a combination of engineering, training, safety audits, and a motivational component, showed a limited amount of evidence in improving safety outcomes. Overall, this evidence synthesis found a moderate level of evidence for intervention effectiveness, and found no evidence that any intervention had adverse effects.
  
  
  CONCLUSIONS
  Even though there were few studies that adequately evaluated small business intervention, several studies demonstrate that well-designed evaluations are possible with small businesses. While stronger levels of evidence are required to make recommendations, these interventions noted above were associated with positive changes in safety-related attitudes and beliefs and workplace parties should be aware of them.
authors.affiliation: The Institute for Work & Health, 481 University Avenue, Toronto, Ontario, Canada. cbreslin@iwh.on.ca
authors.forename: F Curtis
authors.initials: FC
authors.lastname: Breslin
authors.forename: Natasha
authors.initials: N
authors.lastname: Kyle
authors.forename: Philip
authors.initials: P
authors.lastname: Bigelow
authors.forename: Emma
authors.initials: E
authors.lastname: Irvin
authors.forename: Sara
authors.initials: S
authors.lastname: Morassaei
authors.forename: Ellen
authors.initials: E
authors.lastname: MacEachen
authors.forename: Quenby
authors.initials: Q
authors.lastname: Mahood
authors.forename: Rachel
authors.initials: R
authors.lastname: Couban
authors.forename: Harry
authors.initials: H
authors.lastname: Shannon
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Amick
mesh_terms: D003132:Commerce; D005069:Evaluation Studies as Topic; D006801:Humans; D009784:Occupational Diseases / Q000517:prevention & control*; D016272:Occupational Health; D017132:Workplace