Introduction

Back belt purchases, once a safety solution touted as a ‘best practice’ for preventing back injuries especially in material handling jobs, took off in the 1980's and 1990's. Back belts were a simple yet practical and cost effective solution. Workers wearing back belts appeared in many warehouses and retail establishments. Many early studies produced conflicting results. It was not until the publication of Wassel's (2000) Walmart study that NIOSH chose to formally not support the use of back belts (NIOSH, 1996). Then in the early part of the 21st century, a systematic review looked at all the evidence and found there was no support for back belt use in preventing back injuries (Amendolia, 2003).

How is it that back belts could be defined as a best practice? How do we develop a compendium of ergonomic best practices? Best practices are the most effective techniques, methods, processes or practices at preventing injury or controlling the costs related to an injury. While best practices are often defined through standards which are based on the best available evidence – the scientific evidence can change. Best practices evolve and require keeping up with the most up-to-date ergonomic practices that are successful. Leaders engage in best practices. But the challenge in ergonomics is how to know what is true scientifically credible evidence. What is a health and safety manager to do when multiple product representatives attest to the science supporting the product? How can a safety professional sift through the mass of scientific publications?

The occupational health and safety research community has also sought to better clarify the evidence it can bring to the safety professional. Lavis (2004) has proposed a basic model for how science informs evidence-based decision making.

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While innovations may be sparked by new ideas, actionable messages evolve from systematic reviews of research. A systematic review provides a concise and transparent synthesis of research evidence, making it a valuable aid to practitioners and researchers as an objective synopsis of the literature on a particular topic.

Linking Science to Defining Best Practices

For those interested in applying research there is a need to sift through the pool of research that is marketing one scientific approach over another and search for the scientific studies that provide the evidence base for practice. In health care, systematic reviews have become the language of scientific consensus, bringing together a large and diverse number of research studies to answer the question "what drug or medical treatment works." Systematic reviews often place single studies, which are used to advance a specific safety approach, into the broader safety research field.

Systematic reviews are different than what are now termed narrative reviews: Systematic reviews have the following advantages as cited in Lavis (2004):

  1. The likelihood of being misled by research is lower with a systematic review – bias in the conclusions about the effectiveness of the ergonomic interventions is reduced.

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