Effectiveness and implementation of health and safety programs in small enterprises: a systematic review of quantitative and qualitative literature

Reasons for the study

Small businesses have unique challenges with occupational health and safety (OHS). Overall, workers in a small business have a higher risk of workplace injury than workers in large firms, yet both workers and owners may not have a sense of this increased risk. Small businesses are more likely to face financial instability than larger firms. Together, these situations create a challenge in understanding and managing the risk of workplace accidents. This systematic review was conducted to provide an understanding of, and guidance on, how to implement OHS in small businesses, and to identify effective OHS programs


The systematic review, completed in 2008, showed that, to improve their OHS practices, small businesses need support that: helps them understand OHS rules and approaches, considers personal relationships and economic concerns, recognizes that they lack formal OHS system and resources, and considers issues related to their specific size and sector. Overall, there was moderate evidence that interventions could improve OHS outcomes in small businesses.

Related scientific publications

Breslin FC, Kyle N, Bigelow P, Irvin E, Morassaei S, MacEachen E, Mahood Q, Couban R, Shannon H, Amick B. Effectiveness of health and safety in small enterprises: a systematic review of quantitative evaluations of interventions. Journal of Occupational Rehabilitation. 2010;20(2):163-179. doi:10.1007/s10926-009-9212-1.
MacEachen E, Kosny A, Scott-Dixon K, Facey M, Chambers L, Breslin FC, Kyle N, Irvin E, Mahood Q. Workplace health understandings and processes in small businesses: a systematic review of the qualitative literature. Journal of Occupational Rehabilitation. 2010;20(2):180-198. doi:10.1007/s10926-009-9227-7.
MacEachen E, Breslin FC, Kyle N, Irvin E, Kosny A, Bigelow P, Mahood Q, Scott-Dixon K, Morassaei S, Facey M, Chambers L, Couban R, Shannon HS, Cullen KL, Amick B. Effectiveness and implementation of health and safety programs in small enterprises: a systematic review of quantitative and qualitative literature. Institute for Work & Health; 2008.

Related research summaries

Improving health and safety in small businesses . Sharing Best Evidence: Institute for Work & Health, January 2008.

Project status

Completed 2008

Research team

Ellen MacEachen, Institute for Work & Health (PI)
Curtis Breslin, Institute for Work & Health (PI)
Natasha Kyle, Institute for Work & Health
Agnieszka Kosny, Institute for Work & Health
Philip Bigelow, Institute for Work & Health
Quenby Mahood, Institute for Work & Health
Krista Scott-Dixon, Institute for Work & Health
Sara Morassaei, Institute for Work & Health
Marcia Facey, Institute for Work & Health
Lori Chambers, Institute for Work & Health
Rachel Couban, Institute for Work & Health
Harry Shannon, Institute for Work & Health
Kim Cullen, Institute for Work & Health
Ben Amick, Institute for Work & Health