Mieke Koehoorn

Descriptive Epidemiology of Serious Work-Related Injuries in British Columbia, Canada

Objective This study examined the rates and distribution of serious work-related injuries by demographic, work and injury characteristics in British Columbia, Canada from 2002–2008, using population-based data. Methods Claims for workers with a serious injury were extracted from workers’ compensation data. Serious injuries were defined by long duration, high cost, serious medical diagnosis, or fatality. Workforce estimates were used to calculate stratum-specific rates. Rate-ratios (RR) and 95% CIs were calculated using negative binomial regression for the comparison of rates, adjusting for gender, age and occupation. Results Women had a lower overall serious injury rate compared to men (RR: 0.93, 95% CI: 0.87–0.99). The 35–44 age group had the highest overall rate compared to the youngest age group. The rate for severe strains/sprains was similarly high for men and women in the 35–44 age group, although there was a differential pattern by gender for other injury types: the rate of fracture was similar across age groups for men, but increased with age for women (RR: 2.7, 95% CI: 2.2–3.3); and the rate of severe falls increased with age for men and women, with a larger three-fold increase for older women (men: RR: 1.8, 95% CI: 1.7–2.1; women: RR: 3.2, 95% CI: 2.7–3.7). Conclusions The risk of serious injuries is higher among specific age groups with different patterns emerging for men and women. Variations persisted within similar injury types and occupation groups in our adjusted models. These results provide evidence for the burden of serious injuries and a basis for future analytic research. Given projected demographic shifts and increasing workforce participation of older workers, intervention programs should be carefully implemented with consideration to demographic groups at risk for serious injuries in the workplace.

Gender Inequalities in Access to Health Care among Adults Living in British Columbia, Canada

INTRODUCTIONnExisting literature is inconclusive as to whether disparities in access to health care between men and women are mainly driven by socioeconomic or gender inequalities. The aim of this study was to assess whether gender was independently associated with perceived unmet health care needs among a representative sample of British Columbia adults.nnnMETHODSnUsing data from the 2011/2012 Canadian Community Health Survey, logistic regression analyses were conducted to investigate the independent effect of gender on perceived unmet health care needs adjusting for potential individual and contextual confounders.nnnRESULTSnAmong 12,252 British Columbia adults (51.9% female), the prevalence of perceived unmet health care needs was 12.0%, with a significantly greater percentage among women compared with men (13.7% vs. 10.1%; p < .001). After adjusting for multiple confounders, women had independently increased odds of perceived unmet health care needs (adjusted odds ratio, 1.37; 95% CI, 1.11-1.68).nnnDISCUSSIONnThe current study found that, among a representative sample of British Columbia adults and adjusting for various individual and contextual factors, female gender was associated independently with an increased odds of perceived unmet health care needs.nnnCONCLUSIONnThese findings suggest that within Canadas universal health system, gender further explains differences in health care access, over and above socioeconomic inequalities. Interventions within and outside the health sector are required to achieve equitable access to health care for all residents in British Columbia.

Surveillance of mesothelioma and workers' compensation in British Columbia, Canada

Objectives To determine the rate of workers compensation for mesothelioma cases in the Canadian province of British Columbia, examine trends in mesothelioma cases and compensation over time, and identify factors associated with compensation status for mesothelioma cases. Methods Mesothelioma cases in the provincial cancer registry were linked at the individual level with accepted claims for mesothelioma in the provincial workers compensation system for the period 1970–2005. Results 391 of the 485 workers compensated claims were linked (81% match rate) with a record in the cancer registry for an overall mesothelioma compensation rate of 33% over the study period and a high of 49% in the last 5u2005years. Compensation rates were lower for women, older (retired) as well as younger workers, and sites other than the pleura. Conclusions Although the workers compensation rate for mesothelioma increased over time, the rate was much lower than anticipated for cases believed to be work-related cancers. Several key factors may significantly influence awareness by clinicians and workers of the work-relatedness of mesothelioma and of workers compensation benefits. Regulatory agencies need to develop policies or effective notification systems to ensure that all newly diagnosed mesothelioma cases seek compensation benefits.

The Relationship between Age and Work Injury in British Columbia: Examining Differences across Time and Nature of Injury.

The Relationship between Age and Work Injury in British Columbia: Examining Differences across Time and Nature of Injury: Peter SMITH, et al. Institute for Work and Health, Canada—

Population-based asbestosis surveillance in British Columbia

Objectives: To investigate the use of multiple health data sources for population-based asbestosis surveillance in British Columbia, Canada. Methods: Provincial health insurance registration records, workers’ compensation records, hospitalisation records, and outpatient medical service records were linked using individual-specific study identifiers. The study population was restricted to individuals ⩾15 years of age living in the province during 1992–2004. Results: 1170 new asbestosis cases were identified from 1992 to 2004 for an overall incidence rate of 2.82 (men: 5.48, women: 0.23) per 100u2009000 population; 96% of cases were male and average (SD) age was 69 (10) years. Although the annual number of new cases increased by 30% during the surveillance period (βu200a=u200a2.36, pu200a=u200a0.019), the observed increase in annual incidence rates was not significant (βu200a=u200a0.02, pu200a=u200a0.398). Workers’ compensation, hospitalisation and outpatient databases identified 23%, 48% and 50% of the total new cases, respectively. Of the new cases, 82% were identified through single data sources, 10% were only recorded in the workers’ compensation records, and 36% only in each of the hospitalisation and outpatient records. 84% of hospitalisation cases and 83% of outpatient cases were not included in the workers’ compensation records. The three data sources showed different temporal trends in the annual number of new cases and annual incidence rates. Conclusions: Single data sources were not sufficient to identify all new cases, thus leading to serious underestimations of the true burden of asbestosis. Integrating multiple health data sources could provide a more complete picture in population-based surveillance of asbestosis and other occupational diseases.

The relationship between chronic conditions and absenteeism and associated costs in Canada

OBJECTIVESnThis study aimed to measure and compare the relationship between chronic diseases and the number of absent workdays due to health problems and the associated costs among working Canadians.nnnMETHODSnThe study sample included respondents to the 2010 Canadian Community Health Survey between aged 15-75 years who reported employment in the past three months. Respondents reported their number of absent workdays due to health problems and chronic conditions. A negative binomial regression was used to estimate the incremental absent workdays associated with having a particular chronic condition (of 16 conditions), conditional on other chronic conditions and confounders. For each condition, we calculated the incremental number of absent workdays, the incremental productivity loss attributed to absenteeism per employee, and the overall productivity loss in the population.nnnRESULTSnThe final sample consisted of 28 678 respondents representing 15 468 788 employed Canadians. The average number of absent workdays due to health problems was 1.35 days over a 3-month period. The three conditions with the greatest association with absent workdays were mood disorders, heart disease, and bowel disorders. They were associated with 1.17, 0.81, and 0.80 additional absent workdays, respectively, compared to workers without this condition, holding other conditions and confounders at their means. At the national working population level, back problems (CAD

Measuring gender when you don't have a gender measure: constructing a gender index using survey data

621 million), mood disorders (CAD

Characteristics of work-related fatal and hospitalised injuries not captured in workers’ compensation data

299 million) and migraine (CAD

Prevention in dangerous industries: does safety certification prevent tree-faller injuries?

245 million) accounted for the largest incremental productivity loss.nnnCONCLUSIONSnChronic conditions, especially mood disorders and back problems, are associated with substantial work productivity loss. The study findings can help policy-makers and employers prioritize their programs and resources aimed at reducing absenteeism among the working population with chronic conditions.

Return-to-work for multiple jobholders with a work-related musculoskeletal disorder: A population-based, matched cohort in British Columbia

BackgroundDisentangling the impacts of sex and gender in understanding male and female differences is increasingly recognised as an important aspect for advancing research and addressing knowledge gaps in the field of work-health. However, achieving this goal in secondary data analyses where direct measures of gender have not been collected is challenging. This study outlines the development of a gender index, focused on gender roles and institutionalised gender, using secondary survey data from the Canadian Labour Force survey. Using this index we then examined the distribution of gender index scores among men and women, and changes in gender roles among male and female labour force participants between 1997 and 2014.MethodsWe created our Labour Force Gender Index (LFGI) using information in four areas: responsibility for caring for children; occupation segregation; hours of work; and level of education. LFGI scores ranged from 0 to 10, with higher scores indicating more feminine gender roles. We examined correlations between each component in our measure and our total LFGI score. Using multivariable linear regression we examined change in LFGI score for male and female labour force participants between 1997 and 2014.ResultsAlthough women had higher LFGI scores, indicating greater feminine gender roles, men and women were represented across the range of LFGI scores in both 1997 and 2014. Correlations indicated no redundancy between measures used to calculate LFGI scores. Between 1997 and 2014 LFGI scores increased marginally for men and decreased marginally for women. However, LFGI scores among women were still more than 1.5 points higher on average than for men in 2014.ConclusionsWe have described and applied a method to create a measure of gender roles using survey data, where no direct measure of gender (masculinity/femininity) was available. This measure showed good variation among both men and women, and was responsive to change over time. The article concludes by outlining an approach to use this measure to examine the relative contribution of gender and sex on differences in health status (or other outcomes) between men and women.