title: Effectiveness of joint health and safety committees: a realist review.
abstract: BACKGROUND
  Joint health and safety committees (JHSCs) are widely acknowledged as important to a healthy and safe work environment. However, it is also generally believed that having a JHSC is necessary but not sufficient; the JHSC must be effective.
  
  
  METHODS
  A systematic review was undertaken to find empirical studies regarding the effectiveness of JHSCs; realist review methodology was applied to determine context-mechanism-outcome patterns. Experts from across Canada and from various sectors and perspectives including government, employers, and unions, were brought together to inform the synthesis.
  
  
  RESULTS
  Thirty-one studies met inclusion criteria. Mechanisms identified as important determinants of JHSC effectiveness across various jurisdictions include adequate information, education and training; appropriate committee composition; senior management commitment to JHSCs; and especially a clear mandate with a broad scope and corresponding empowerment (through legislation and/or union presence).
  
  
  CONCLUSIONS
  Consistent empowerment mechanisms emerge as determinants of successful JHSCs across contexts despite few evidence-based details for best practice implementation. Intervention research is warranted.
authors.affiliation: Global Health Research Program (GHRP), School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. annalee.yassi@ubc.ca
authors.forename: Annalee
authors.initials: A
authors.lastname: Yassi
authors.forename: Karen
authors.initials: K
authors.lastname: Lockhart
authors.forename: Mona
authors.initials: M
authors.lastname: Sykes
authors.forename: Brad
authors.initials: B
authors.lastname: Buck
authors.forename: Bjorn
authors.initials: B
authors.lastname: Stime
authors.forename: Jerry M
authors.initials: JM
authors.lastname: Spiegel
mesh_terms: D026683:Advisory Committees / Q000458:organization & administration*; D001315:Australia; D002170:Canada; D006801:Humans; D007750:Labor Unions; D009784:Occupational Diseases / Q000517:prevention & control*; D016272:Occupational Health; D060051:Occupational Injuries / Q000517:prevention & control*; D011209:Power, Psychological; D006113:United Kingdom; D014481:United States; D017132:Workplace / Q000458:organization & administration*