Curtis Breslin

Age related differences in work injuries and permanent impairment: a comparison of workers’ compensation claims among adolescents, young adults, and adults

Background: There is growing evidence that adolescent workers are at greater risk for work injury. Aims: To investigate the severity of work injuries across age groups. Methods: Workers’ compensation records were used to examine work related injuries among adolescents (15–19 years old), young adults (20–24 years old), and adults (25+ years old) between 1993 and 2000. The incidence of compensated injuries was calculated for each age group and compared by gender, industry, and type of injury. The presence and degree of permanent impairment in each age group was also examined. Results: For males, adolescents and young adults had higher claim rates than adults. For females, adults had the highest claim rates and young adults the lowest. Rates of permanent impairment indicated that age was positively associated with severity of injury. Conclusions: Indicators of health consequences, in particular presence of permanent impairment, provide preliminary evidence that compensated work injuries sustained by youth are not as serious as injuries sustained by adults. Nevertheless, there was evidence that some young workers sustain injuries that have long term consequences. Documenting the consequences of the injuries that young workers sustain has implications for secondary prevention efforts and health services policy.

Workplace Health Understandings and Processes in Small Businesses: A Systematic Review of the Qualitative Literature

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.

Evaluating the implementation of health and safety innovations under a regulatory context: A collective case study of Ontario’s safer needle regulation

BackgroundImplementation effectiveness models have identified important factors that can promote the successful implementation of an innovation; however, these models have been examined within contexts where innovations are adopted voluntarily and often ignore the socio-political and environmental context. In the field of occupational health and safety, there are circumstances where organizations must adopt innovations to comply with a regulatory standard. Examining how the external environment can facilitate or challenge an organization’s change process may add to our understanding of implementation effectiveness. The objective of this study is to describe implementation facilitators and barriers in the context of a regulation designed to promote the uptake of safer engineered medical devices in healthcare.MethodsThe proposed study will focus on Ontario’s safer needle regulation (2007) which requires healthcare organizations to transition to the use of safer engineered medical devices for the prevention of needlestick injuries. A collective case study design will be used to learn from the experiences of three acute care hospitals in the province of Ontario, Canada. Interviews with management and front-line healthcare workers and analysis of supporting documents will be used to describe the implementation experience and examine issues associated with the integration of these devices. The data collection and analysis process will be influenced by a conceptual framework that draws from implementation science and the occupational health and safety literature.DiscussionThe focus of this study in addition to the methodology creates a unique opportunity to contribute to the field of implementation science. First, the study will explore implementation experiences under circumstances where regulatory pressures are influencing the organizations change process. Second, the timing of this study provides an opportunity to focus on issues that arise during later stages of implementation, a phase during the implementation cycle that has been understudied. This study also provides the opportunity to examine the relevance and utility of current implementation science models in the field of occupational health where the adoption of an innovation is meant to enhance the health and safety of workers. Previous work has tended to focus almost exclusively on innovations that are designed to enhance an organization’s productivity or competitive advantage.

Employment and work safety among 12 to 14 year olds: listening to parents

BackgroundSurvey research indicates that a surprising number of 12 to 14 year olds in North America engage in some form of paid work, and work-related injuries for this age group are reported at rates similar to older teens. Parents exhibit significant involvement in many aspects of their teens’ work and may influence perceptions of work safety, yet few studies have explored this phenomenon from a qualitative perspective with parents of working 12 to 14 year olds.MethodsThis paper focuses on parental perceptions and understandings of work safety based on focus groups conducted with urban Canadian parents of young teens who work for pay. Parents discussed the types of job held by their 12 to 14 year olds, the perceived costs and benefits to working at this age, and their understanding of risk and supervision on the job. A grounded theory approach was used to thematically analyze the focus group transcripts.ResultsParents in this study held favourable attitudes towards their 12 to 14 year olds’ working. Parents linked pro-social moral values and skills such as responsibility, work ethic, time management, and financial literacy with their young teen’s employment experience. Risks and drawbacks were generally downplayed or discounted. Perceptions of workplace safety were mitigated by themes of trust, familiarity, sense of being in control and having discretion over their 12 to 14 year olds’ work situation. Further, parental supervision and monitoring fell along a continuum, from full parental responsibility for monitoring to complete trust and delegation of supervision to the workplace.ConclusionsThe findings suggest that positive parental attitudes towards working overshadow occupational health and safety concerns. Parents may discount potential hazards based on the presence of certain mitigating factors.

132 Accommodations best served soft: supporting the needs of disabled young adults in the workplace

Introduction A disability may add to the challenges faced by young adults during the school-to-work transition. Few studies have examined differences in soft (e.g., scheduling modification) and hard accommodation need (e.g., ergonomic adaptation) among disabled young adults, and the factors associated with accommodation need. Methods An online survey was conducted of 155 Canadian disabled young adults (mean age=25.8±5.1). Respondents were either employed or seeking employment, and recruited using a registry from a national disability organisation. Respondents were asked about their need for 16 soft and hard accommodations. Demographic (e.g., gender), health (e.g., disability type, work limitations), and work characteristics (e.g., work status, hours worked/week, permenant vs short-term contract) were collected. Participants were also asked about perceived barriers to accessing accommodations using eight items (e.g., disclosure difficulites, cost of accommodation). Multivariable logistic analyses were conducted to examine the factors associated with soft and hard accommodation need. Result Most participants reported psychological (79%) and learning disabilities (45%), and 68% had >1 disability. Over half (55%) were employed at the time of the survey, and 80% worked in non-standard employment conditions (e.g., part-time or short-term work). An average of five perceived accommodation barriers were indicated. More soft accommodations (mean=6.3, 95% CI: 6.00 to 6.30) were needed than hard accommodations (mean=4.9, 95% CI: 4.60 to 5.20). Soft accommodation need was associated with less perceived accommodation barriers (OR=−0.83, 95% CI: 0.73 to 0.94), not working (OR=−0.39, 95% CI: 0.16 to 0.91) and greater work limitations (OR=1.1, 95% CI: 1.01 to 0.12). Hard accommodation need was associated with less perceived accommodation barriers (OR=−0.88, 95% CI: 0.78 to 0.99). Discussion Offering soft accommodations may be a particularly important strategy for organisations to support the employment of disabled young adults. Interventions that address perceived barriers to accessing accommodations may result in a greater requirement for workplace supports that benefit the school-to-work transition.

P215 Measuring occupational health and safety vulnerability: what can it add to our understanding of injury risk and primary prevention activities

Vulnerability is a commonly used, but not well defined, metric in the prevention system. This presentation will describe a recently developed measure to define OH&S vulnerability. In this presentation we will describe the development of a new measure of occupational health and safety (OH&S) vulnerability. The purpose of this measure was to allow the identification of workers at increased risk of injury, and to enable to monitoring and surveillance of OH&S vulnerability in the labour market. This measure conceives of OHS vulnerability as a combination of exposure to hazards in combination with the presence of one of three other dimensions that increase injury risk. These three other dimensions are: inadequate protection from workplace policies and practices, low worker awareness of OHS rights and responsibilities, and low worker empowerment to take part in making work safer. Using a sample of approximately 2,000 workers in Ontario and British Columbia we have demonstrated that although younger workers, temporary workers and workers in small businesses were vulnerable, they were vulnerable in different ways. Temporary workers were more likely to experience vulnerability in relation to hazards and lack of awareness or empowerment, while workers in small businesses were more likely to experience vulnerability related to workplace policies and procedures. In a second study, we have found the impacts of the different dimensions of vulnerability are super-additive (i.e. the impacts of the combination of dimensions of vulnerability is greater than their impact in isolation), on risk of injury and worrying about getting injured at work. Taken together, this new measure of vulnerability can be used to better understand how different workplace contexts place workers at increased risk of injury, thus informing primary prevention at the workplace and system levels.