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OBJECTIVES: In many countries, organisations are legally obliged to have occupational physicians screen employees regularly. However, this system is time-intensive, and there may be more cost-effective alternatives. Our objective is to compare the short-term effectiveness of periodic occupational health screening of hospital employees by an occupational physician with a system of electronic screening with targeted follow-up. METHODS: A randomized controlled trial was set up among personnel of four Belgian hospitals, with three measurement moments between June 2019 and December 2020, to compare differences in self-assessed health, healthcare use, productivity and intermediate outcomes over 19 months. Mixed effects models were used to assess differences in effectiveness. Superiority and non-inferiority post-hoc tests were used as a robustness check. The experiment coincided with the first two COVID-19 waves during which hospital employees were exposed to an exceptional period of occupational stress. RESULTS: In total, 1077 employees (34% of the target population) participated. Although we observed some immediate effects of the intervention (less trust in the physician, absenteeism, and healthcare use), all these effects disappeared over time. After 19 months, including two waves of COVID-19 hospitalizations, no significant differences were observed between employees screened through face-to-face contact and those screened electronically. CONCLUSIONS: Our study finds no indication that, in the short-term, substituting physician screening of the workforce with a quicker survey-based screening with targeted follow-up has different effects on the studied endpoints. However, as health and disease are often the result of a long-term process, more evidence is needed to determine long-term effects.

OBJECTIVES: Occupational health and safety (OHS) interventions` effect on worker productivity is an essential, but complex element of the value of these programs. The trustworthiness of economic evaluation studies, aiming to provide guidance to decision-makers in the field of OHS, depends at least partly on how accurately productivity changes are measured. We aim to review the methods used to estimate productivity changes in recently published economic evaluations of OHS interventions. METHODS: We performed systematic searches of economic evaluations of OHS programs published between 2007 and 2017 and reviewed these studies` methods to quantify the programs` impact on worker productivity RESULTS: Of the 90 identified studies, 44 used a human capital approach, 17 a friction cost approach, 13 stated productivity in natural units (eg, a cost-per-absence-day-avoided), 7 made use of compensation expenses, 4 used output-based methods, 4 an "ad hoc" approach, and 1 study did not state its method. Different approaches were combined in 19 studies. Within these methods, we observed a wide diversity in their precise implementation, especially regarding the measurement and valuation of absenteeism and presenteeism. CONCLUSIONS: Productivity is a key element of the economic attractiveness of investing in OHS. Economic evaluation studies of OHS would benefit from more methodological standardization in their approach to quantifying productivity change. Future research should better account for the methodological uncertainty that occurs in estimating it in order to demonstrate the impact that particular choices and approaches to productivity estimation can have on cost-effectiveness results.