Evidence-based decision making in occupational health

The health problem is a key factor in the decisionprocess. Differing from the EBM model, in the evidencebasedoccupational health model the problem can involvea community of workers or an individual. Circumstancesare another key factor: the problem may be approacheddifferently in different settings, depending on the differentcontext and time in which it occurs. Unlike the EBMmodel, patients’ preferences should be viewed as thepreferences of the different stakeholders (the employer,the company management, the representative of theworkers, the inspection labour, the trade union and theworkers preferences), since interventions cannot becarried out unless the stakeholders’ needs and interestsare met. In comparison with clinical research, theresearch for evidence in occupational health is differentboth in the evidence searching stage (RCT studies areoften unavailable) and in the evidence appraisal stage(evidence alone is not always an adequate guide to actionand applicability, and economic evaluation and barriersto implementation should be considered).