Inspections with penalties linked to lower injuries: IWH review

Institute for Work & Health systematic review on regulatory enforcement finds strong evidence for effectiveness of inspections with fines and citations

There’s strong evidence that regulatory health and safety inspections that result in a citation or penalty are effective in reducing work-related injuries. This is according to a recent systematic review conducted by the Institute for Work & Health (IWH), which also found that general deterrence—the mere chance that employers may get inspected one day—is not as effective.

What this shows is employers do take steps to prevent work-related injuries for employees when there are direct consequences to them, says Dr. Emile Tompa, an IWH senior scientist and the lead author on the systematic review. But, clearly, no system can have the resources needed to inspect every workplace or issue fines or citations for every violation.

The key to making general deterrence more effective may lie in increasing employer awareness about the financial implications of non-compliance or making information public about employers that don’t comply, Tompa suggests. He presented the findings from the systematic review at an IWH plenary earlier this year (see slidecast).

There are many different ways to regulate occupational health and safety, and with the changing labour market context—growing global competition, a rise in contingent work, tightening public resources—it can be a challenge to determine the right mix of regulatory and enforcement mechanisms, says Tompa.

The cost of regulatory enforcement can be substantial, so gathering evidence on effective regulatory approaches is really critical, adds Tompa, who recently submitted his study to the Journal of Occupational and Environmental Medicine. Regulation and enforcement may be ineffective for many reasons, and we hope that the findings of this systematic review will help inform the decisions made by policy-makers on the right mix of enforcement levers.

The current systematic review confirms the key finding of a 2007 systematic review on the same subject, which Tompa also led. The earlier review, which covered the research from 1970 to 2003, found strong evidence that citations and penalties reduce the frequency or severity of injuries (for more on that review, see the Research Highlight.

This new review covers the evidence from 1990 to 2013. Unlike the earlier review, which considered only final outcomes such as injuries, illnesses and fatalities, this update also looks at intermediate outcomes such as compliance. It touches on six themes: introduction of occupational health and safety (OHS) laws; introduction of smoke-free workplace laws; inspection sequence; general versus specific deterrence of inspection and penalties; nature of enforcement; and awareness campaigns.

Tompa and his team found strong evidence for the effectiveness of inspections with citations and penalties in reducing injuries and moderate evidence that inspections without penalties have no effect in reducing injuries. They found moderate evidence that the first inspection has the largest impact on compliance rates, with the impact of second, third or subsequent inspections being substantially lower.

The team did not find evidence of an impact of OHS consultative activity. More research is needed to determine whether consultations are effective when offered more comprehensively and extensively than was the case in the studies included in this review, says Tompa.

There is moderate evidence indicating that new OHS laws or regulations have no effect on reducing injuries. But the studies on new regulatory standards were quite diverse. Some of the new standards were narrowly focused, such as the introduction of a lockout/tagout regulation, and others were very broad, such as the introduction of legislation on the internal responsibility system. Tompa cautions against drawing the conclusion that new laws are not needed.

What we’re talking about here are systems that already have robust legislative frameworks, and the regulations examined in some of the studies were incremental in terms of the protection they provided on a specific hazard, says Tompa. He adds that some of the studies might have been conducted too soon after a regulatory change came into effect, whereas outcomes such as raised awareness and reduced injuries may take more time to materialize.

In addition to the above, one remarkable finding relates to a subset of OHS legislation, the smoke-free workplace laws that many jurisdictions introduced in the 2000s. The team found strong evidence that these new laws were effective in cutting down exposure to second-hand smoke and moderate evidence they reduced respiratory symptoms.

It may be that new regulatory standards are effective when they’re clear and directly linked to the desired outcomes, says Tompa. Another thing about smoking bans is that it’s easy to tell whether workplaces are complying or not, whereas it might be more difficult to tell whether workplaces are compliant with other types of regulations, such as an ergonomic standard, he adds.

Tompa’s systematic review is one of two systematic reviews at IWH on regulatory enforcement. A second was led by Dr. Ellen MacEachen, a former senior scientist and now adjunct scientist at IWH. Her review looked at the conditions and processes of enforcing OHS regulation, focusing on the challenges that inspectors face when enforcing health and safety laws in the context of workplace psychosocial health issues, non-standard work or work performed through complex supply chains. Watch for the results of this review in a future issue of At Work.

Source: At Work, Issue 81, Summer 2015: Institute for Work & Health, Toronto

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