[Evidence-based prevention of work-related fatalities: a systematic approach]

To produce a systematic proposal of preventive measures directed at individual and occupational risk factors for work-related traumatic fatalities, and to assess the usefulness of such a process.

The process is based on the adaptation of the Haddon matrix (dimensions of time, action level and specific groups of workers), establishing their components from the results of a previous etiological investigation on factors related to fatal occupational injuries. The content of each cell of the matrix is completed by the identification of specific preventive measures through a review of the scientific literature.

The matrix is formed by the rows pre-injury, injury and post-injury (time dimension); columns are worker, agent, workplace and social environment (action level); and specific groups of workers, defined by economic activity, gender, age, type of employment contract, and non-routine tasks or workplaces. Measures proposed include training and design of safe working procedures at a worker's action level, passive protective elements at the injurious agent level, organisation and environmental conditions at the workplace level and effectiveness of prevention and emergency care systems at the social environment level.

Use and adaptation of Haddon matrix based on prior results derived from etiologic investigations of fatal occupational injuries, helps to systematically identify preventive measures aimed at hazard identification. This approach can help prioritise and select the most appropriate preventive actions.