title: Preventive occupational health interventions in the meat processing industry in upper-middle and high-income countries: a systematic review on their effectiveness.
abstract: OBJECTIVE
  To investigate the effectiveness of occupational health interventions in the meat processing industry on work and health-related outcomes.
  
  
  METHODS
  A systematic literature review was performed. PubMed, Embase, and The Cochrane Library were searched. Studies were included when they reported on an intervention among employees in the meat processing industry and with outcomes related to work or health. Studies were assessed on risk of bias, and data were synthesized by type of intervention.
  
  
  RESULTS
  A total of 13 articles reporting on two randomized controlled trials and nine non-randomized intervention studies were retrieved. Studies were categorized into three topics: ergonomics programs, skin protection, and Q fever vaccination. All studies had high risk of bias. Based on four studies, there was limited evidence for workplace health and safety programs showing reductions in musculoskeletal injury severity, reduction of lost work days, and reduction of costs and claims for several musculoskeletal disorders. There was limited evidence for added rest breaks resulting in improved productivity at the end of a workday and in reductions of perceived discomfort in various body regions at the end of the workday. One study on skin protection showed reductions of eczema prevalence, although evidence was moderate. Based on four studies, there was high-quality evidence for strong effectiveness of Q fever vaccination.
  
  
  CONCLUSIONS
  This review presents evidence for the effectiveness of a variety of workplace interventions. There was limited evidence for effectiveness of ergonomic interventions, moderate evidence of a skin protection intervention, and strong evidence for Q fever vaccination.
authors.affiliation: Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Dilgtweg 5, 9751 ND, Haren, Groningen, The Netherlands, b.j.van.holland@umcg.nl.
authors.forename: Berry J
authors.initials: BJ
authors.lastname: van Holland
authors.forename: Remko
authors.initials: R
authors.lastname: Soer
authors.forename: Michiel R
authors.initials: MR
authors.lastname: de Boer
authors.forename: Michiel F
authors.initials: MF
authors.lastname: Reneman
authors.forename: Sandra
authors.initials: S
authors.lastname: Brouwer
mesh_terms: D019049:Developed Countries; D006804:Ergonomics; D006801:Humans; D008462:Meat-Packing Industry; D009784:Occupational Diseases / Q000517:prevention & control*; D009786:Occupational Health Services / Q000706:statistics & numerical data*; D015397:Program Evaluation; D017594:Publication Bias; D011778:Q Fever / Q000517:prevention & control; D012871:Skin Diseases / Q000517:prevention & control
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