Patrice Duguay

Costs of occupational injuries and diseases in Québec.

PROBLEM Occupational injuries and diseases are costly for companies and for society as a whole. This study estimates the overall costs of occupational injuries and diseases in Québec, both human and financial, during the period from 2005 to 2007. METHOD The human capital method is used to estimate lost productivity. A health indicator (DALY) is used in combination with a value of statistical life (VSL) to estimate, in monetary terms, the pain and suffering costs resulting from occupational injuries. RESULTS The costs of occupational injuries and diseases occurring in a single year in Québec are estimated at

Summer outdoor temperature and occupational heat-related illnesses in Quebec (Canada).

4.62 billion, on average, for the 2005-2007 period. Of this amount, approximately

Effect of summer outdoor temperatures on work-related injuries in Quebec (Canada)

1.78 billion is allocated to financial costs and

Estimating occupational exposure to carcinogens in Quebec

2.84 billion to human costs. The average cost per case is

But other than mesothelioma? An estimate of the proportion of work-related cancers in Quebec.

38,355. In view of the limitations identified in the study, it can be argued that this is an underestimation of the costs. Result analysis allows the injury/disease descriptors and industries for which the costs are highest to be identified. PRACTICAL APPLICATIONS The results of these estimates are a relevant source of information for helping to determine research directions in OHS and prevention. The methodology used can be replicated for the purposes of estimating the costs of injuries and diseases in other populations.

Association between outdoor ozone and compensated acute respiratory diseases among workers in Quebec (Canada)

BACKGROUND Predicted rise in global mean temperature and intensification of heat waves associated with climate change present an increasing challenge for occupational health and safety. Although important scientific knowledge has been gathered on the health effects of heat, very few studies have focused on quantifying the association between outdoor heat and mortality or morbidity among workers. OBJECTIVE To quantify the association between occupational heat-related illnesses and exposure to summer outdoor temperatures. METHODS We modeled 259 heat-related illnesses compensated by the Workers׳ Compensation Board of Quebec between May and September, from 1998 to 2010, with maximum daily summer outdoor temperatures in 16 health regions of Quebec (Canada) using generalized linear models with negative binomial distributions, and estimated the pooled effect sizes for all regions combined, by sex and age groups, and for different time lags with random-effect models for meta-analyses. RESULTS The mean daily compensation count was 0.13 for all regions of Quebec combined. The relationship between daily counts of compensations and maximum daily temperatures was log-linear; the pooled incidence rate ratio (IRR) of daily heat-related compensations per 1 °C increase in daily maximum temperatures was 1.419 (95% CI 1.326 to 1.520). Associations were similar for men and women and by age groups. Increases in daily maximum temperatures at lags 1 and 2 and for two and three-day lag averages were also associated with increases in daily counts of compensations (IRRs of 1.206 to 1.471 for every 1 °C increase in temperature). CONCLUSION This study is the first to quantify the association between occupational heat-related illnesses and exposure to summer temperatures in Canada. The model (risk function) developed in this study could be useful to improve the assessment of future impacts of predicted summer outdoor temperatures on workers and vulnerable groups, particularly in colder temperate zones.

0322 The usefulness of compensation statistics to detect heat-related health outcomes in a temperate climate: the experience of Quebec0322 The usefulness of compensation statistics to detect heat-related health outcomes in a temperate climate: the experience of Quebec

Objective To quantify the associations between occupational injury compensations and exposure to summer outdoor temperatures in Quebec (Canada). Methods The relationship between 374 078 injuries compensated by the Workers’ Compensation Board (WCB) (between May and September, 2003–2010) and maximum daily outdoor temperatures was modelled using generalised linear models with negative binomial distributions. Pooled effect sizes for all 16 health regions of Quebec were estimated with random-effect models for meta-analyses for all compensations and by sex, age group, mechanism of injury, industrial sector and occupations (manual vs other) within each sector. Time lags and cumulative effect of temperatures were also explored. Results The relationship between daily counts of compensations and maximum daily temperatures reached statistical significance for three health regions. The incidence rate ratio (IRR) of daily compensations per 1°C increase was 1.002 (95% CI 1.002 to 1.003) for all health regions combined. Statistically significant positive associations were observed for men, workers aged less than 45 years, various industrial sectors with both indoor and outdoor activities, and for slips/trips/falls, contact with object/equipment and exposure to harmful substances/environment. Manual occupations were not systematically at higher risk than non-manual and mixed ones. Conclusions This study is the first to quantify the association between work-related injury compensations and exposure to summer temperatures according to physical demands of the occupation and this warrants further investigations. In the context of global warming, results can be used to estimate future impacts of summer outdoor temperatures on workers, as well as to plan preventive interventions.

Carcinogens exposure prevalence as a first step toward preventing occupational cancers: challenges and drawbacks

BACKGROUND We estimated the extent of exposure to occupational carcinogens in Quebec, Canada, to help raise awareness of occupational cancers. METHODS Proportions of workers exposed to 21 recognized and 17 probable carcinogens (according to Quebec occupational health regulation and the International Agency for Research on Cancer [IARC] classification) were extracted from various sources: workplace monitoring data, research projects, a population survey, radiation protection data, exposure estimates from the Carcinogen Exposure Canada (CAREX Canada) Project database, and published exposure data. These proportions were applied to Quebec labor force data. RESULTS Among the 38 studied, carcinogens with the largest proportions of exposed workers were solar radiation (6.6% of workers), night shift work/rotating shift work including nights (6.0%), diesel exhaust fumes (4.4%), wood dust (2.9%) and polycyclic aromatic hydrocarbons (2.0%). More than 15 carcinogens were identified in several industrial sectors, and up to 100,000 young workers are employed in these sectors. CONCLUSION Although crude, estimates obtained with different data sources allow identification of research and intervention priorities for cancer in Quebec.

Are immigrants, ethnic and linguistic minorities over-represented in jobs with a high level of compensated risk? Results from a Montréal, Canada study using census and workers' compensation data.

BACKGROUND More than 30 exposures in the workplace are proven carcinogens. In the present study, we aimed to estimate the burden of occupational cancer in Quebec so as to increase awareness among stakeholders and to prioritize research activities. METHODS Work-attributable fractions-that is, the proportions of cancers attributable to work-as published in Finland and the United Kingdom were applied to Quebec 2002-2006 cancer incidence and mortality data to estimate the number of work-related cases for 28 cancer sites. RESULTS Overall, 6.0% of incident cancers (men: 9.1%; women: 2.7%) and 7.6% of cancer deaths (men: 11.8%; women: 2.8%) could be attributable to work, resulting annually in an average of 2160 new cancer diagnoses and 1190 cancer deaths in Quebec. Incident cancers of the lung, prostate, skin, bladder, and (female) breast were the most numerous; cancer sites resulting in more deaths were lung, (female) breast, and pleura. During the same period, compensation statistics reported annual averages of 94.3 incident cancers and 61.9 cancer deaths, mostly involving mesothelioma (64% of compensated incident cancers) and lung cancer (30% of compensated incident cancers). CONCLUSIONS Increased recognition of workplace cancers by all stakeholders, from workers and employers to treating physicians, will foster appropriate preventive measures for safer workplaces.

Climate change and occupational health and safety in a temperate climate: potential impacts and research priorities in Quebec, Canada

Respiratory effects of ozone in the workplace have not been extensively studied. Our aim was to explore the relationship between daily average ozone levels and compensated acute respiratory problems among workers in Quebec between 2003 and 2010 using a time-stratified case-crossover design. Health data came from the Workers’ Compensation Board. Daily concentrations of ozone were estimated using a spatiotemporal model. Conditional logistic regressions, with and without adjustment for temperature, were used to estimate odds ratios (ORs, per 1 ppb increase of ozone), and lag effects were assessed. Relationships with respiratory compensations in all industrial sectors were essentially null. Positive non-statistically significant associations were observed for outdoor sectors, and decreased after controlling for temperature (ORs of 0.98; 1.01 and 1.05 at Lags 0, 1 and 2 respectively). Considering the predicted increase of air pollutant concentrations in the context of climate change, closer investigation should be carried out on outdoor workers.