One of the roles of Occupational and Environmental Medicine (OEM) is to publish research which assists occupational physicians and other occupational health professionals to undertake their day-to-day practice more effectively. Although evidence-based medicine has been an important area of development in other areas of the health care system, its application in occupational health practice has been slower.1 With the changing spectrum of activities in occupational health practice and the increasing amount of scientific information, this area has been identified by the new editorial team as a high priority in the next phase of OEM’s growth and development.

What do we mean by evidence-based occupational health practice? Traditionally, a major area of activity has been to develop the scientific basis for identifying causes of occupational disease and injury and to assist the setting of suitable occupational exposure limits. Over the past 65 years OEM has played a major role in providing the evidence base for this process. For example, the recent paper by Tony Newman Taylor has identified the important role that OEM played in publishing several of the key papers which identified asbestos as a cause of mesothelioma and lung cancer.2 There are many more examples where high quality published research in OEM has provided the evidence base for the identification of adverse health outcomes from work hazards.

Despite this success, there are many other areas of occupational health practice where the evidence base is not as strong. One such area is highlighted by the recent focus on the formal evaluation of interventions which aim to reduce the impact of hazards in workplaces and/or to improve the management of occupational health disorders. Until recently, the implementation of interventions has often relied on intuition and the application of general occupational health principles rather than hard scientific evidence. To address this knowledge gap, more intervention trials and evaluation studies in an occupational setting are being published to identify effective workplace measures to reduce the impact of problems such as upper limb disorders3 and sickness absence.4

The need for a stronger evidence base has prompted the emergence of formal systematic reviews in many areas of medicine, including occupational disease prevention and management. These are often published under the auspices of the Cochrane Collaboration, which has established an occupational health field led by the Finnish Institute of Occupational Health (http://www.ttl.fi/internet/partner/cochrane/). OEM has published many systematic reviews relevant to occupational health practice covering a diverse range of topics such as psychological predictors for return to work following low back pain,5 the risk of work injury from chronic health problems,6 the prevention of latex allergy7 and the factors predictive of work ability.8 Unfortunately, systematic reviews of well established workplace interventions have often demonstrated that there is insufficient evidence to show that these interventions are effective. Moreover, the evidence can be conflicting and often there are too few studies of sufficient quality to assess the evidence. These problems have been highlighted in a recent review of methods to prevent back pain in nurses.9 OEM has played an important role in promoting methods to ensure validated approaches when undertaking searches of the primary literature,10 identifying relevant interventions11 and undertaking systematic reviews,12 but more needs to be done in this area.

Another important area of research is the development of more reliable and complete data sources to better inform occupational health policy and practice. Reliance on workers’ compensation data, in particular for occupational diseases, has been shown to be a poor indicator of the extent and impact of such conditions and this has led to the rise of alternative sources of data, such as occupational disease surveillance systems. These also have significant limitations and an important challenge is to undertake rigorous assessments of the reliability, validity and coverage of such systems, and especially of bias both in numerators and denominators.13 New methods which can be borrowed from other disciplines, such as pharmacosurveillance, need to be evaluated.14

A long established area of occupational health practice is the introduction of health promotion programmes in workplaces to reduce the impact of common chronic diseases, such as diabetes and coronary artery disease, but the evidence base is limited. While the combination of health promotion and worker health protection has been shown to be effective, the utility of health promotion programs in isolation has yet to be demonstrated.15 Workplace health promotion programmes are increasingly being developed, but there are many research challenges to be overcome before occupational physicians and other health practitioners can provide evidence-based advice in this area.16

An enhanced evidence-based approach among occupational health professionals can be achieved but has been shown to be very resource intensive.17 OEM is well placed to play an increasing role in strengthening the evidence base for occupational health practice by publishing and disseminating papers resulting from rigorous studies aiming to demonstrate the effectiveness or otherwise of the diverse activities in occupational health practice. It has the leading impact factor among the occupational health journals and strong links with the occupational health community, for instance it is the adopted journal of the Faculty of Occupational Medicine, Royal College of Physicians of London. OEM’s new deputy editor and a new associate editor, with special responsibilities for promoting and handling papers with particular relevance to occupational health practice, both have research and occupational medicine backgrounds. We also plan to continue to expand and develop our publication of systematic reviews and strengthen OEM’s link with the Cochrane occupational health field. For these reasons, this journal should remain at the forefront of research in important areas of occupational health practice. We wish to encourage more papers on the themes discussed in this editorial and we will review them with an eye to their application to practice in addition to the usual research criteria.