Workplace Health Understandings and Processes in Small Businesses: A Systematic Review of the Qualitative Literature
- 795 Downloads
Introduction Small businesses (SBs) play an important role in global economies, employ half of all workers, and pose distinct workplace health problems. This systematic review of qualitative peer-reviewed literature was carried out to identify and synthesize research findings about how SB workplace parties understand and enact processes related to occupational health and safety (OHS). Methods The review was conducted as part of a larger mixed-method review and in consultation with stakeholders. A comprehensive literature search identified 5067 studies. After screening for relevance, 20 qualitative articles were identified. Quality assessment led to 14 articles of sufficient quality to be included in the meta-ethnographic findings synthesis. Results This review finds that SBs have distinctive social relations of work, apprehensions of workplace risk, and legislative requirements. Eight themes were identified that consolidate knowledge on how SB workplace parties understand OHS hazards, how they manage risk and health problems, and how broader structures, policies and systems shape the practice of workplace health in SBs. The themes contribute to ‘layers of evidence’ that address SB work and health phenomena at the micro (e.g. employer or worker behavior), meso (e.g. organizational dynamics) and macro (e.g. state policy) levels. Conclusions This synthesis details the unique qualities and conditions of SBs that merit particular attention from planners and occupational health policy makers. In particular, the informal workplace social relations can limit workers’ and employers’ apprehension of risk, and policy and complex contractual conditions in which SBs are often engaged (such as chains of subcontracting) can complicate occupational health responsibilities. This review questions the utility of SB exemptions from OHS regulations and suggests a legislative focus on the particular needs of SBs. It considers ways that workers might activate their own workplace health concerns, and suggests that more qualitative research on OHS solutions is needed. It suggests that answers to the SB OHS problems identified in this review might lie in third party interventions and improved worker representation.
KeywordsQualitative research Systematic review Prevention Small business Occupational health
This study was funded by the Ontario Workplace Safety & Insurance Board Prevention Reviews Initiative and The Institute for Work & Health. We thank the scholars who assisted with the assessment and translation of some papers in this review, and also the reviewer of this paper for the helpful suggestions for improvement. We are grateful to Shanti Raktoe and Diana Pugliese for their editorial support.
- 1.The Small Business Economy. Report to the President. [Website] 2009 [cited 2009 Nov 17, 2009]; Available from: http://www.sba.gov/advo/research/sb_econ2009.pdf.
- 2.State USDo. Small Business in the United States. 2009 [cited 2009 June 19, 2009]; Available from: http://economics.about.com/od/smallbigbusiness/a/us_business.htm.
- 3.Canada I. Small business research and policy: key small business statistics. [Website] 2005 [cited 2009 June 24, 2009]; Available from: http://www.ic.gc.ca/eic/site/sbrp-rppe.nsf/eng/rd01224.htm.
- 4.Audretsch D, van der Horst R, Kwaak T, Thurisk R. First section of the annual report on EU small and medium-sized enterprise. [Report on Website] 2009 [cited 2009 19 Nov 2009]; Available from: http://ec.europa.eu/enterprise/policies/sme/files/craft/sme_perf_review/doc_08/spr08_annual_reporten.pdf.
- 5.Walters D. Working safety in small enterprises in Europe: toward a sustainable system for worker participation and representation. Brussels: European Trade Union Confederation 2002.Google Scholar
- 7.Frick K. Health and safety representation in small firms: a Swedish success under threat. In: Walters D, Nichols T, editors. Workplace Health and Safety–International Perspectives on Worker Representation. Basingstoke: Palgrave Macmillian; 2009. p. 154–67.Google Scholar
- 10.Health NIfOSa. Identifying high-risk small-business industries: the basis for preventing occupational injury, illness, and fatality. Cincinatti, OH: U.S. Department of Health and Human Services; 1999.Google Scholar
- 13.Lamm F, Walters D. Regulating occupational health and safety in small businesses. In: Bluff E, Gunningham N, Johnstone R, editors. OHS regulation for a changing world of work. Sydney: The Federation Press; 2004. p. 94–119.Google Scholar
- 14.Antonsson A. Small companies. 1997. p. 466–77.Google Scholar
- 15.Lamm F. A research design for Occupational Health and Safety in the small business sector 1997.Google Scholar
- 16.Olson E. A move to ease safety rules for some employers. New York Times 2009. C6.Google Scholar
- 17.MacEachen E, Breslin C, Kyle N, Irvin E, Kosny A, Bigelow P, et al. Effectiveness and Implementation of Health and Safety in small enterprises. Toronto: Institute for Work & Health; 2008.Google Scholar
- 18.Breslin C, Kyle N, Bigelow P, Irvin E, Morassaei S, MacEachen E, et al. Effectiveness of health and safety in small enterprises: A systematic review of quantitative evaluations of interventions. J Occup Rehabil. doi: 10.1007/s10926-009-9212-1.
- 19.Sandelowski M, Barroso J. Handbook for synthesizing qualitative research. New York: Springer; 2007.Google Scholar
- 20.Pope C, Mays N, Popay J. Synthesizing qualitative and Quantitative Health Evidence: a guide to methods. Maidenhead: Open University Press 2007.Google Scholar
- 21.MacEachen E, Chambers L, Clarke J, Mahood Q. Literature on work and health in small businesses. Toronto: Prevention Intitaives, WSIB; 2006.Google Scholar
- 22.Spencer L, Ritchie J, Lewis J, Dillon L. Quality in qualitative evaluation: a framework for assessing research evidence: National Centre for Social Research; 2003 June. Report No.: Occasional Papers Series No. 2.Google Scholar
- 23.MacEachen E, Clarke J, Franche RL, Irvin E. Systematic review of the qualitative literature on return to work after injury. Scan J Work Environ Health. 2006;32(4):257–69.Google Scholar
- 26.Noblit G, Hare R. Meta-ethnography: synthesizing qualitative studies. Sage Publications; 1988.Google Scholar
- 31.Eakin JM, MacEachen E, Clarke J. ‘Playing it smart’ with return to work: small workplace experience under Ontario’s policy of self-reliance and early return. Policy Practi Health Saf. 2003;1(2):19–42.Google Scholar
- 41.Wulfhorst B, Schobel K, Schwanitz X. Prevention of work-related skin diseases in hairdressers First results. Prev Rehabil. 1996;8(1):22–8.Google Scholar
- 44.Fishwick T. Human factors in small and medium sized enterprises–some safety problems and solutions. Loss Prevention Bulletin (Rugby) 2005.Google Scholar
- 50.Massey C. Growing small and medium enterprises in New Zealand: He tangata, he tangata, he tangata. An inaugural professorial address. Massey University, Wellington, New Zealand 2007.Google Scholar
- 57.Zoller HM. Manufacturing health: employee perspectives on problematic outcomes in a workplace health promotion initiative. West J Commun. 2004;68(3):278–301.Google Scholar
- 58.Frick K, Walters D. Worker representation n health and safety in small enterprises: lessons from a Swedish approach. Int Labour Rev. 1998;137(3):367–89.Google Scholar
- 60.Quinlan M. The implications of labour market restructuring in industrialised societies for occupatiopnal health and safety. Stockholm: National Institute fro Working Life; 1997.Google Scholar
- 61.Quinlan M. Submission to the standing committee on law and justice: Inquiry into workplace health and safety in New South Wales. Sydney, University of New South Wales, Department of Industrial Relations and Organisational Behaviour 1997.Google Scholar
- 63.Walters D. One step forward, two steps back: worker representation and health and safety in the United Kingdom. Occup Health Policy. 2006;36(1):87.Google Scholar