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IWH Speaker Series
The challenges of estimating exposure to workplace carcinogens in Canada
Paul Demers, Occupational Cancer Research Centre
Organizations such as the International Agency for Research on Cancer have identified over 60 workplace carcinogens, and many more suspected carcinogens, to which thousands of Canadians continue to be exposed. However, relatively little is known regarding how many are exposed, where and how they are exposed, and their level of exposure. This data is essential for effective cancer prevention efforts and CAREX Canada was created to fill this data gap. In this presentation I will present an overview of the project, including the creation of a Canadian Workplace Exposure Database, and present some key results for high priority carcinogens in Ontario.
IWH Speaker Series
Examining changes in injuries submitted as no-lost-time claims in Ontario between 1991 and 2006
Peter Smith, Institute for Work & Health
Since 1991, Ontario has seen a divergence in workers’ compensation claim rate trends for injuries that do and do not require time off work. While claims requiring time off work (lost-time claims) have reduced by 46 per cent, claims that do not require time away from work after the day of injury (no-lost-time claims) have remained relatively stable (declining by 9 per cent). At this plenary we will report the results of a recently completed project at the Institute for Work & Health which sought to examine: the factors associated with an increased risk of no-lost-time claims (between 1991 and 2006); trends in the health-care costs associated with no-lost-time claims (between 1991 and 2006); and compare the nature of injury and event leading to injury associated with no-lost-time claims during the introduction of a mandatory experience rating program in the province of Ontario (by extracting injury information from 9,250 no-lost-time claims over four different time periods (1991, 1996, 2000 and 2005). Results related to these objectives will be presented and implications for occupational health and safety injury surveillance and workers’ compensation policy will be discussed.
IWH Speaker Series
Where should we be going, and how should we get there?
Ben Amick, Institute for Work & Health
Leading indicators of occupational health and safety system performance help leaders and decision-makers make evidence informed decisions about targeting strategies, policy needs, organizational changes needed and system equity issues. They create a common ground for discussion and debate about what key occupational health and safety system actors are doing, how well they are doing it and where policy influences practice. A key group of leading indicators are about organizational performance. Yet there remains little consensus on what are the best leading indicators of organizational performance are reflecting little consensus in the scientific community. In Ontario, the Ministry of Labour (MOL), Workplace Safety and Insurance Board (WSIB) and the Health and Safety Associations (HSAs) collaborated to develop a leading indicator. The work was lead by the Health and Safety Associations and supported by the Institute for Work & Health. The project resulted in a short two-page questionnaire to be administered to management representatives of 1000 Ontario employers. Over 800 employers participated and IWH linked the employer data to WSIB claims data. Results will be presented to show the reliability and validity of the eight questions developed as a leading indicator of organizational performance. Next steps for the use of the metric will be discussed. The project raised many questions and has resulted in a larger survey of 5000 Ontario employers to build on this work and to determine the feasibility of developing a benchmarking knowledge base for the Ontario Prevention System.
IWH Speaker Series
Worker representation in OHS – a good idea going where?
Andy King, United Steel Workers
Although worker participation in OHS is much discussed in theory and practice, worker representation receives much less attention. A key element in improving OHS throughout history, worker representation was formally recognized by the Ham Commission in Ontario in 1976 as a constitutive element of a fair occupational health and safety system. It has been subject to evolving policies since, many of which seek to minimize its significance and reduce worker participation to individual responsibility. The Labour OHCOW Academic Collaboration (LOARC) was created to provide a forum for exploring the role and potential of worker representation. In this presentation, we will discuss the origins of worker representation in OHS, the importance of activism, the significance of Ham’s recommendations and their subsequent adoption into legislation, the challenge of globalization and economic restructuring, and the threat of relativism.
IWH Speaker Series
Futures studies: its role in setting research agendas for work and health
Niki Ellis, Institute for Safety, Compensation and Recovery Research
Futures studies are developing as a discipline, and are increasingly being used by business and government in strategic planning. The Institute for Safety, Compensation and Recovery Research (ISCRR) is a new Australian institute that has been modelled on the Institute for Work & Health in Toronto. It will be using a futures methodology to determine trends relevant to safety (and health), compensation and recovery for up to the period 2030, knowledge needs for the future and thus research priorities for 2011/14. The theory underpinning this work will be presented, along with the proposed method which will combine data text mining for relevant future trends and structured consultations, both virtual and face-to-face, through a think tank supported by leading-edge social network and collaborative project management technology. The methodology will be illustrated with a case study of work undertaken in the Centre for Military and Veterans’ Health in 2007-08, led by the author.
IWH Speaker Series
Modeling work disability prevention: An unmet challenge yet
Patrick Loisel, Work Disability Prevention CIHR Strategic Training Program
Models, as theoretical representations of complex individual and social issues, help to understand issues and find appropriate solutions. Modeling work disability prevention is progressively developing from several domains and is in search of its own unifying perspective. A practical use of this will be discussed.
IWH Speaker Series
Work disability prevention knowledge transfer initiatives for physical therapists in Alberta
Doug Gross, University of Alberta
This presentation describes the results of clinician- and system-level KT initiatives aimed at understanding an observed mismatch between clinical practice and current evidence in work disability prevention by physical therapists by fostering best practice have been developed and implemented in Alberta. The clinician-level project included development and dissemination of a best practice resource guide and “tool kit” for work disability prevention by physical therapists, creation of a network of peer-selected Educationally Influential physical therapists, province-wide seminars for practicing clinicians, and use of these resources in the academic training curriculum. The system-level initiative involved a soft tissue injury continuum of care model designed by the Workers’ Compensation Board of Alberta that involved staged, evidence-based application of various types of physical therapy and rehabilitation services. Both projects were evaluated for their impact on return-to-work outcomes.
IWH Speaker Series
The impact of temporary employment and job tenure on sickness absence
Heather Scott-Marshall, Institute for Work & Health; Emile Tompa, Institute for Work & Health
Previous studies have suggested that temporary employment and job tenure are associated with work-related health risk exposures and the ability to take a sickness absence, but these studies have not considered the nature of the employment contract in a longitudinal framework. This study investigates the impact of temporary employment on work-related and all-cause sickness absences of one week or more with a focus on how these outcomes are moderated by factors related to social protection (job tenure, union membership and firm size).
IWH Speaker Series
Trying to get back: The challenges faced by registered nurses returning to work
Laurie Clune, Institute for Work & Health
Nursing is a profession that is at high risk for injuries. The successful return of nurses to their pre-injury role is essential given the global nursing shortage. This study sought to describe the return-to-work processes in southern Ontario hospitals through the experiences of injured registered nurses (IRN). The purpose of the study is to describe with a sample IRNs and others involved in hospital injury management how return to work happens in hospitals. This research employed institutional ethnography as the approach to examine the topic. Participants in this study included a convenience sample of six IRNs and 22 others involved in hospital injury management practices. Most IRNs interviewed in this study were unable to return to work. Hospitals faced challenges in finding accommodated work for IRNs given organizational commitments to patient safety and fiscal efficiency. The findings afford new insights and can inform hospital injury management practices used with registered nurses.
IWH Speaker Series
“It’s like we’re forcing them to do it” Vocational retraining challenges facing providers and workers in Ontario’s Labour-Market Re-Entry program
Ellen MacEachen, Institute for Work & Health
Although there have been many studies of return to work, we know little about the situation of injured workers who cannot return to their old workplace and go through a workers’ compensation vocational retraining program. This presentation shows the results of a qualitative study that examined how vocational retraining works in practice in Ontario’s Labour Market Re-Entry (LMR) program in order to provide some understanding of this neglected dimension of return to work.
IWH Speaker Series
A systematic review of the effectiveness of training and education for the protection of workers
Lynda Robson, Institute for Work & Health
Occupational health and safety (OHS) training is widely acknowledged as an important means of addressing the risks associated with occupational hazards, but we are often not sure how effective training is. This presentation will report on a systematic literature review of recent, high quality research studies about the effectiveness of training.
IWH Speaker Series
Return-to-work coordination, the what, when, how, where and by whom: Findings from the Intervention Mapping Project
Carlo Ammendolia, Institute for Work & Health
In Ontario, as in other jurisdictions, return to work (RTW) and disability prevention have become high priorities for employers and insurers given the increasing duration of lost-time claims in recent years. Research evidence suggests that RTW coordination may be helpful in improving RTW. However, details on how to successfully implement a RTW program based on RTW coordination are lacking. Intervention mapping is a methodology that is used to develop and implement complex interventions or programs. We used this approach to develop a RTW program based on RTW coordination that is tailored to the Ontario setting. In this plenary, the methodology used and the findings will be described.
IWH Speaker Series
The role of patients' beliefs in predicting return to work following operatively managed tibial fracture
Jason Busse, Institute for Work & Health
What role do patients’ beliefs play in their likelihood of recovery from severe physical trauma? Can these beliefs be measured in order to help predict long-term outcomes? Dr. Jason Busse, an IWH scientist, will present findings from a study that explored these questions. He and his research team developed and validated an instrument designed to capture the impact of patients’ beliefs on functional recovery from injury. The instrument, called the somatic preoccupation and coping (SPOC) questionnaire, was administered to 359 patients who had undergone operations for tibial shaft fractures. The relationship between their SPOC scores and functional outcomes one year later were then measured.
IWH Speaker Series
An interdisciplinary and participatory approach to prevention
Alec Farquhar, Occupational Health Clinics for Ontario Workers Inc.
Over its 20 year history, the Occupational Health Clinics for Ontario Workers (OHCOW) has a rich experience in linking efforts to detect and prevent occupational injury and disease. Much has been learned about the best ways for an interdisciplinary clinical team to support participatory prevention interventions in the workplace. This presentation will review that history and the lessons learned for the future.
IWH Speaker Series
Forecasting and modelling worker injury rates in Ontario
Ian Moore, Institute for Work & Health
Ian Moore, a post-doctoral fellow at IWH, will discuss a study that investigated three forecasting models to assess which one works best with time-series data on workers’ compensation lost-time, no-lost-time and total claim rates.
IWH Speaker Series
How the front-line "works" at Ontario's WSIB
Joan Eakin, University of Toronto
This presentation will report on an ethnographic study of front-line service work in Ontario's Workplace Safety and Insurance Board (WSIB), specifically the work of adjudicators, nurse case managers and customer service representatives servicing small businesses. The aim of the study was to understand and explain, from a sociological perspective and in relation to institutional context, the nature, logic and social relations of work at the front lines. The presentation will reflect on the relevance and implications of these findings for key stakeholders in the compensation system: injured/ill workers, employers, the WSIB and the OHS system as a whole.
IWH Speaker Series
Income dynamics and adult mortality in Canada and the United States
Jacob Etches, Institute for Work & Health
Income level is a well-known risk factor for mortality among working-aged adults. Job loss and unemployment are also often correlated with increased risk of death. Very little research has investigated income drops, a plausible mediator of a causal effect of unemployment on health, and its association with mortality. In this presentation, Institute for Work & Health Research Associate Jacob Etches will discuss a study that is using tax and survey data to investigate the effect of income level and income drops in Canada and the United States, as well as the induction times for the effects of income level and income drops. The difficulty of establishing the direction of causality for correlations between these exposures and mortality will also be discussed.
IWH Speaker Series
Measuring what matters: Conceptualizing return to work through concept mapping
Rhysa Tagen Leyshon, University of Western Ontario
The evaluation and comparison of return-to-work (RTW) programs and interventions is difficult because no standard, valid outcome measure exists. RTW outcomes are typically measured using administratively based scales that fail to take the perspectives of workers and other stakeholders into consideration. As a first step in developing any outcome measure, the outcomes of interest and importance to key stakeholders need to be established. In this presentation, Rhysa Tagen Leyshon of the Graduate Program in Health and Rehabilitation at the University of Western Ontario, will discuss a study that set out to generate a trusted and credible conceptual framework of successful RTW reflecting the values of all stakeholders equally and fairly.
Alf Nachemson Memorial Lecture
No small matter: Unpacking the problem of health and safety in small workplaces
Joan Eakin, University of Toronto
Most workers in Canada and internationally are employed in small and medium-sized enterprises. Ensuring health and safety in such workplaces presents enduring and unresolved challenges to occupational health systems. Dr. Eakin’s research has examined how working conditions and health-related practices in small workplaces are shaped by their distinct features and social relations, and by the regulatory and service environment that governs them. Drawing on a series of her studies, Dr. Eakin will “unpack” some prevailing assumptions and approaches to prevention, return to work and service provision to this sector, and suggest how they might be reframed. She will also describe how the injured worker community and Ontario’s Workplace Safety and Insurance Board have used this body of research.