Economic Evaluation of Interventions for Occupational Health and Safety: Developing Good Practice

Undertaking economic evaluations of workplace-based occupational health and safety interventions can be difficult, reflected by the significant lack of literature, evidence and guidance on the subject. Particular difficulties include: complex labour legislation; differences in the perception of health risks associated with work experiences amongst workplace parties and policy makers; the burden of costs and consequences being borne by different stakeholders in the system; conflicting incentives and priorities between the multiple stakeholders; lack of consensus about what ought to count as a benefit or cost of intervening or not intervening; multiple providers of indemnity and medical care coverage; and industry-specific human resources practices making it difficult to identify all work-related illnesses and injuries. In addition, most health economics methods books are designed for use in a clinical setting, which cannot be adapted for the workplace setting. In the face of such barriers, it is not surprising that few studies of occupational health and safety interventions contain an economic evaluation.

This book aims to lay the foundations for a systematic methodology of economic evaluation of workplace interventions, by identifying the main barriers to research of high quality and practical relevance, and proposing a research strategy to remedy these weaknesses. Context chapters provide a wealth of background material ranging from a presentation of the broad conceptualization of work and health, to suggestions for strategies in confronting the dearth of data often experienced by occupational health and safety researchers. They take into account the varying institutional and regulatory approaches in different international jurisdictions. Specific topic chapters delve into the principles and application of economic evaluation methods relevant to this setting: study design, type of analysis, costs, consequences, uncertainty, and equity are all covered, providing guidance on analytical and decision making challenges. The concluding chapter synthesizes the summaries, conclusions, challenges and recommendations from across the book, presenting these in a reference case.

Emile Tompa is Adjunct Assistant Professor in the Department of Economics at McMaster University. He has an MBA from the University of British Columbia, an MA in Economics from the University of Toronto, and a PhD in Economics from McMaster University. Tompa's current research agenda is focused on the economic evaluation of workplace interventions and the behavioural consequences of insurance and regulatory mechanisms for occupational health and safety. In the area of economic evaluation, he has completed a systematic review of workplace intervention studies with economic analyses, and has undertaken several evaluations of participatory ergonomics interventions. In the area of insurance and regulatory mechanisms, he is undertaking research on experience rating, occupational health and safety regulation, and the adequacy and equity of workers' compensation benefits. He is the academic lead of a five-year community-university research initiative on the consequences of work injury. Anthony Culyer has been at York since 1969 where his main roles have been as Assistant Director of the (then) Institute for Social and Economic Research, Head of the Department of Economics and Related Studies, Pro-Vice-Chancellor and then Deputy Vice-Chancellor of the University. He currently holds the Ontario chair in Health Policy and System Design at the University of Toronto and is a Professor of Economics at the University of York, England. He chairs the R&D Committee of the National Institute for Health and Clinical Excellence, the Policy and Editorial Committees of the Office of Health Economics, and the Research Advisory Council of the Workplace Safety and Insurance Board in Ontario. Roman Dolinschi holds a Master's in Economics from the University of Toronto. Dolinschi has a strong interest in the economic evaluation of occupational health and safety interventions. He has recently completed several economic evaluations of occupational health and safety interventions and a systematic review of workplace intervention studies with economic evaluations. Dolinschi is also actively involved in three research themes: labour-market experiences and health; the behavioural consequences of insurance and regulation in occupational health and safety; and workplace-based occupational health and safety interventions.