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*OBJECTIVE: To evaluate the effect of a workplace injury prevention and wellness program compared to no intervention (control) on musicians' playing-related musculoskeletal pain intensity. The hypothesis was that musicians who completed the program would have a greater reduction in pain intensity than the control group. *DESIGN: Pragmatic parallel randomized controlled trial. *METHODS: Sixty-five orchestra musicians were recruited and completed patient-reported outcome measures (primary outcome: pain intensity over 11 months, using the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians; range: 0-40; lower is better) at baseline, 14 weeks (T1), and 11 months (T2). Following baseline assessment, participants were randomly assigned to the intervention (n = 33) or control (n = 32) groups, stratified by instrument and pain prevalence. The intervention group received a 14-week injury prevention and wellness program including education and exercise; the control group received no intervention. *RESULTS: Pain intensity means (standard deviation) were 7.8 (6.2), 8.0 (7.5), and 8.6 (5.7) in the control group, and 9.0 (6.6), 5.0 (4.2), and 6.7 (6.6) in the intervention group at T0, T1, and T2, respectively. Using intention-to-treat analyses (3 dropouts, n = 65 analyzed), between-group differences in pain intensity (95% confidence interval) were T1-T0: -4.2 (-7.5, -0.9); T2-T0: -3.7 (-7.1, -0.3), type III (overall) P = .03, favoring the intervention group. No adverse events were reported. *CONCLUSION: A workplace injury prevention and wellness program may have a clinically meaningful effect on reducing orchestra musicians' pain intensity. [ABSTRACT FROM AUTHOR]

Lobstering industry workers are known to have poor overall health and low safety records, but there is still a gap in information concerning Canadian lobster fishers. This study aimed to report occupational health and safety characteristics of an Atlantic Canada community of lobster fishers and to assess differences between captains and deckhands. Twenty-eight participants (10 captains, 18 deckhands) were questioned and self-reported on lifestyle, general health status, work-related musculoskeletal disorders and traumatic injuries. The data collected reveal both groups' high prevalence of cardiometabolic and musculoskeletal health issues. Captains reported more occupational exposition and health issues, and showed poorer lifestyle habits than deckhands. Fishers reported potential solutions to reduce occupational risks, presented as three types: lifestyle, working behaviours and leadership. This study evaluated a community of Canadian lobster fishers regarding their occupational health and safety. Potential avenues for mitigating occupational risk specific to this community will nurture future implementation. [ABSTRACT FROM AUTHOR]

Background: Work-related injuries and diseases have a significant impact on workers and their families, society, and the economy. There is a gap in the literature regarding the structures, content, quality, and outcomes of international occupational health systems serving injured and ill workers. This global round table was an attempt to elucidate, evaluate, and identify areas needing improvement. Methods: International occupational health professionals were identified via chain/snowball sampling and asked to answer five questions designed to evaluate the structures, processes, and outcomes of the workers' compensation systems in each country. Findings: Areas for improvement identified during this round table included timely access, reducing the impact of liability and eligibility determinations on access to medical care, equitable access to care, and the accuracy of reporting. Canada had successfully utilized a virtual approach to care for the geographically remote worker. Conclusions: International workers' compensation structures are designed to ensure timely access to quality care and services. Financial incentives optimize the safety of the working environment. There remain areas for improvement. Resources are limited, especially within the public health systems, which may delay care and affect quality. Informal and remote workers often do not have the same access to care. Occupational Health Services (OHS) and national reporting databases exist throughout the world but may not accurately capture data on informal, self-employed, small business, migrant, and remote workers. [ABSTRACT FROM AUTHOR]

This study explored the experiences of patients, caregivers, healthcare providers, and health service leaders of compassion in the care of people hospitalized with COVID-19. This study is a secondary analysis of qualitative data deriving from primary research data on recommendations for healthcare organizations providing care to people hospitalized with COVID-19. Participants comprised patients with COVID-19 (n = 10), family caregivers (n = 5) and HCPs in COVID-19 units (n = 12). Primary research data were analyzed deductively under the "lens" of compassion, as defined by Goetz. Four interacting themes were found: (1) COVID-19 – to care or not to care? The importance of feeling safe, (2) A lonely illness – suffering in isolation with COVID-19, (3) Compassionate care for people with COVID-19 across the hospital continuum, and (4) Sustaining compassionate care for people hospitalized with COVID-19 – healthcare provider compassion fatigue and burnout. Compassionate care is not a given for people hospitalized with COVID-19. Healthcare providers must feel safe to provide care before responding compassionately. People hospitalized with COVID-19 experience additional suffering through isolation. Compassionate care for people hospitalized with COVID-19 is more readily identifiable in the rehabilitation setting. However, compassion fatigue and burnout in this context threaten healthcare sustainability. Healthcare providers need to feel physically and psychologically safe to provide compassionate care for people hospitalized with COVID-19. People hospitalized with COVID-19 infection experience added suffering through the socially isolating effects of physical distancing. Compassion and virtuous behaviours displayed by healthcare providers are expected and valued by patients and caregivers, including during the COVID-19 pandemic. High levels of compassion fatigue and burnout threaten the sustainability of hospital-based care for people with COVID-19. [ABSTRACT FROM AUTHOR]

Extreme heat events directly impact worker health and cause additional cascading and transitional workplace impacts. However, current investigations on these impacts often rely on specific datasets (e.g., compensation claims, hospitalizations). Thus, to continue to work towards preventing and mitigating the occupational risks posed by extreme heat events, this study aimed to explore the occupational impacts of the 2021 Heat Dome in Canada using a qualitative content analysis method on a news-based dataset. A systematized review of news articles published before, during, and after the 2021 Heat Dome was conducted on academic (n = 8) and news (n = 5) databases, along with targeted grey literature. Two researchers qualitatively coded the articles in NVivo for occupational impacts or references mentioned within the articles. Overall, 52 different occupations were identified as being impacted by the 2021 Heat Dome. Impacts were diverse and ranged from work cancellations or delays to work modifications and reports of heat-related illnesses. The 2021 Heat Dome impacted the health and safety of many occupational groups and provided new insights into the expanding impacts that extreme heat events can have on the Canadian workforce. With climate projections showing a growing trend of more hot days and intense heat waves in Canada, addressing these concerns should be a critical priority. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Medical imaging involving ionizing radiation is common in the clinical setting. Little is known about the level of radiation safety training for medical trainees and attending physicians. We sought to identify the level of radiation safety knowledge and training at the undergraduate, postgraduate, and attending physician level. METHODS: A 29-question survey was sent by email to two sites in Canada. We pooled the results of medical students, residents, and attending physicians. The primary outcome was to describe the amount of radiation safety training among these groups. The secondary outcomes were to describe the frequency of radiation exposure, level of radiation knowledge, and preferred training method for radiation safety. RESULTS: Of 115 surveys that were properly completed, 31 (26.9%) medical students, 17 (14.7%) residents, and 67 (58.3%) attending physicians responded. A greater number of medical students (41.9%) reported they had zero hours of training time for radiation safety compared to attending physicians (14.9%) (p<0.05). A higher number of attending physicians (47.8%) and residents (64.7%) participated in patient care involving fluoroscopy daily or at least several times per week compared to medical students (3.2%) (p<0.001). Attending physicians had the greatest number of correct responses to radiation safety questions. Online courses and workshops were the preferred training methods. CONCLUSIONS: Radiation safety training is an important component of medical education for medical trainees and attending physicians. Current radiation safety training requirements and procedures at various levels of medical training in Canada should be addressed. Implementing radiation safety education may improve adherence to the radiation safety principles. [ABSTRACT FROM AUTHOR]

The number of agricultural fatalities and injuries related to agricultural quad bike use has risen substantially in the last two decades. Safe engineering design features such as crush protection and roll bars have proven potential to lessen the burden of injury but have traditionally not been included in many quad bike safety training programs. The aim of this study was to survey more than 700 young adults working in U.S. and Canadian agriculture to examine self-reported quad bike safety behaviors and awareness of quad bike safety design engineering features. We found that U.S. males continue to be at higher risk for quad bike-rollover incidents when compared to other groups. Even when accounting for other factors such as age and country, we found that participants who reported youth occupational quad bike use (≤14 years old) were up to 200% more likely to allow extra riders and up to 489% more likely to not wear a helmet when compared to participants who reported beginning occupational quad bike use in adulthood. These findings support the Agricultural Youth Work Guideline (AYWG) for occupational quad bike use at age 16. Less than 20% of young adults working in agriculture were aware of safe design features such as wide frames, stability ratings, crush protection devices, and accessories made by the original equipment manufacturer. There is tremendous need to educate the future agricultural workforce about the importance of choosing quad bikes with safer design features. [ABSTRACT FROM AUTHOR]

Background: Nurses working in critical care environments have experienced a great deal of psychological stress during the successive waves of the COVID-19 pandemic. Identifying factors that contribute to burnout and turnover intentions are important to retain intensive care unit (ICU) nurses. Purpose: The purpose of this study is to identify factors that are directly and indirectly associated with burnout and turnover intentions in ICU nurses. Methods: A cross-sectional design was used with survey data during the peak of the second wave of the COVID-19 pandemic. Data were collected through an online survey and analyzed using mediation analysis. A total of 236 ICU nurses across Canada participated in the study. Results: The results indicate that burnout mediates the relationship between moral distress, organizational support, resilience, and turnover intentions. Moreover, 49% of the participants were considering leaving. The reasons were related to lack of administrative support, poor work environment and safety concerns. Discussion: Organizational support and individual resilience can both play a role in turnover intentions through the prevention of burnout symptoms. Managers at all levels play an important role in mitigating the harmful effects of the pandemic. Conclusion: The pandemic has had a serious psychological impact on ICU nurses. Targeted interventions are needed to support this group. [ABSTRACT FROM AUTHOR]

To describe professional and personal experiences of nursing home care leaders during early waves of the COVID-19 pandemic. Qualitative interpretive description. Eight sites across 2 Canadian provinces. Sites varied by COVID-19 status (low or high), size (<120 or ≥120 beds), and ownership model (for-profit or not-for-profit). We recruited 21 leaders as participants: 14 managers and 7 directors of care. Remote Zoom-assisted semi-structured interviews conducted from January to April 2021. Concurrent data generation and inductive content analysis occurred throughout. Sampling ceased once we reached sufficient analytic variation and richness to answer research questions. Most participants were female, ≥50 years of age, and born in Canada. We found 4 major themes. (1) Responsibility to protect: Extreme precautions were employed to protect residents, staff, and leaders' families. Leaders experienced profound distress when COVID-19 infiltrated their care homes. (2) Overwhelming workloads: Changing public health orders and redeployment to pandemic-related activities caused administrative chaos. Leaders worked double shifts to cope with pandemic demands and maintain their usual work. (3) Mental and emotional toll: All participants reported symptoms of anxiety, depression, and insomnia, leading to ongoing exhaustion. Shifting staff focus from caring to custodial enforcement of isolation caused considerable distress, guilt, and grief. (4) Moving forward: The pandemic spotlighted deficiencies in the nursing home context that lead to inadequate quality of resident care and staff burnout. Some leaders indicated their pandemic experience signaled an unanticipated end to their careers. Nursing home leaders faced mental distress and inordinate workloads during the pandemic. This is an urgent call for systemic change to improve working conditions for leaders and quality of care and quality of life for residents. Nursing home leaders are at increased risk of burnout, which must be addressed to mitigate attrition in the sector. [ABSTRACT FROM AUTHOR]

A reappraisal of mitigation strategies against occupational hazards is required to ensure that all health workers – not just those in perceived "high-risk" work environments - are protected. This will mean reducing community-level risks and ensuring that the same level of IPC measures, PPE training and supply is available when needed. Objective: The aims of this study were to investigate occupational and non–work-related risk factors of coronavirus disease 2019 among health care workers (HCWs) in Vancouver Coastal Health, British Columbia, Canada, and to examine how HCWs described their experiences. Methods: This was a matched case-control study using data from online and phone questionnaires with optional open-ended questions completed by HCWs who sought severe acute respiratory syndrome coronavirus 2 testing between March 2020 and March 2021. Conditional logistic regression and thematic analysis were utilized. Results: Providing direct care to coronavirus disease 2019 patients during the intermediate cohort period (adjusted odds ratio, 1.90; 95% confidence interval, 1.04 to 3.46) and community exposure to a known case in the late cohort period (adjusted odds ratio, 3.595%; confidence interval, 1.86 to 6.83) were associated with higher infection odds. Suboptimal communication, mental stress, and situations perceived as unsafe were common sources of dissatisfaction. Conclusions: Varying levels of risk between occupational groups call for wider targeting of infection prevention measures. Strategies for mitigating community exposure and supporting HCW resilience are required. [ABSTRACT FROM AUTHOR]

Background: Nurses are key healthcare workers whose adherence to infection prevention and control (IPC) measures is integral to the prevention of nosocomial spread of SARS-COV-2. Institutional trust is an important correlate of adherence. After initially surveying nurses early in 2020, we sought to evaluate how perceptions of IPC measures and institutional trust changed one year into the pandemic. Methods: We adapted an internationally distributed cross-sectional questionnaire, incorporating validated scales for items including institutional trust, and distributed it by email and Slack via the Canadian Association of Critical Care Nurses between April 29 and May 28, 2021. We evaluated adherence to IPC protocols, barriers and facilitators to IPC guideline adherence, and respondents’ level of institutitonal trust and compared results across the two time periods. Results: 141 nurses responded to the survey. In 2021, respondents reported lower rates of fear of becoming ill and providing care for patients with COVID-19 (T = 3.83, p = < 0.001). They reported higher levels of skill (T = 3.57, p < 0.001) and continued to report similarly high levels of professional expectations compared to 2020 (T = 0.85, p = 0.39). However, institutional trust dropped in 2021 (T = 4.31, p < 0.001), particularly in national and regional governmental trust. Interpretation: Respondents demonstrated less trust in national and regional governments compared to respondents in 2020, although they reported less overall concern for themselves and their families, and higher skills and knowledge around IPC procedures. Canadian nurses continue to have strong beliefs in the utility of PPE and IPC procedures, and strong social and professional expectations to adhere to IPC measures. [ABSTRACT FROM AUTHOR]

A continuing education program was designed to help nurses stay safe while providing nursing care to patients during the COVID-19 pandemic. The program addressed topics aimed at empowering nurses to advocate for their own health and safety as a result of increased knowledge related to caring for patients and communities during a global pandemic. A four-part, on-demand webinar series was offered from January 2021 through January 2022. The program had 1,025 international participants and 995 contact hours were issued. The Frontline Nursing During COVID-19: A New Paradigm continuing education program provided professional development to nurses around the world. It is critical to offer accessible programs that address safety and empowerment for nurses in clinical settings. [J Contin Educ Nurs. 2022;53(9):425–428.] [ABSTRACT FROM AUTHOR]

Background: Cultures of safety in farm work settings are under the authority of a responsible owner‐operator, who establishes rules, attitudes, and behaviors for farm work practices. This novel analysis provides new evidence to show that risks that can lead to injury and are commonly practiced on Canadian farms are indeed transferred between generations. Methods: Baseline data were provided by representatives from eligible and consenting farms (n = 589) in the province of Saskatchewan, Canada, during the first quarter of 2013. Mailed questionnaires were sent to participating farms and completed by a single respondent. Questionnaires included scaled assessments of hazards and safety practices by farm operators, and young workers on each farm. Descriptive and multiple regression analyses were used to examine relationships between farm owner‐operator risks and safety practices and those reported for the young workers. Findings: Graphical descriptive analyses showed that as farm owner‐operator risks increased, so did those reported for children and young workers. Similarly, as farm owner‐operator safe work practices increased, young worker hazards decreased, albeit more modestly. The young worker hazard scale increased by 0.20 (95% CI: 0.10‐0.30) points, and decreased by 0.08 (95% CI: –0.016 to –0.000) points for each one‐point increase in the owner‐operator hazard and safe work practices scales, respectively. Conclusions: Occupational health and safety risks and protections experienced on farms appear to be transferred between generations. This suggests the need to target farm owner‐operators, the responsible authority on the farm, as a focus of primary prevention strategies aimed at injury risks to children and young workers. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers exposure to antineoplastic drugs can lead to adverse health effects. Guidelines promote the safe handling of antineoplastic drugs, but no safe exposure limit was determined. Regular surface sampling contributes to ensuring workers safety. Methods: A cross-sectional monitoring is conducted once a year with voluntary Canadian centers, since 2010. Twelve standardized sampling sites were sampled. Samples were analyzed by high performance mass coupled liquid chromatography. The limits of detection (in ng/cm2) were: 0.001 for cyclophosphamide and gemcitabine; 0.3 for docetaxel and ifosfamide; 0.04 for 5-fluorouracil and paclitaxel; 0.003 for irinotecan; 0.002 for methotrexate; 0.01 for vinorelbine. Results: The surfaces from 109 centers were sampled between 01/01/2020–18/06/2020. Twenty-six centers delayed their participation because of the COVID-19 pandemic. 1217 samples were analyzed. Surfaces were frequently contaminated with cyclophosphamide (34% positive, 75th percentile 0.00165 ng/cm2) and gemcitabine (16% and <0.001 ng/cm2). The armrest of patient treatment chairs (84% to at least one drug), the front grille inside the biological safety cabinet (BSC) (73%) and the floor in front of the BSC (55%) were frequently contaminated. Centers that prepared ≥5000 antineoplastic drugs annually had higher concentration of cyclophosphamide on their surfaces (p < 0.0001). Contamination measured on the surfaces was reduced from 2010 to 2020. Conclusions: This large-scale study showed reproducible long term follow up of the contamination of standardized sites of Canadian centers and a reduction in surface contamination from 2010 to 2020. Periodic surface sampling help centers meet their continuous improvements goals to reduce exposure as much as possible. The COVID-19 pandemic had a limited impact on the program. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses' sources of distress is important when planning interventions to support them. Purpose: To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic. Design: Qualitative descriptive component within a larger mixed-methods study. Participants and research context: Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis was used to analyze the data. Ethical considerations: The study was approved by the ethics committee at the researchers' university in eastern Canada. Results: A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families' grief, (3) our safety, and (4) futility of care. Many nurses' stories also focused on the organizational preparedness of their institutions and concerns over their own safety. Discussion: Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed. Conclusion: Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses' well-being. [ABSTRACT FROM AUTHOR]

Objective: To examine long-haul truck drivers (LHTD) perceptions of COVID-19 and their use of health and safety practices. Methods: 146 LHTD completed an online survey to collect data on their experiences with COVID-19. Data were analyzed using descriptive and inferential statistics, and thematic analysis for open-ended responses. Results: LHTD were aged from 22 to 79 years (mean age 48.1 +/- 11.8); 82.2% were men. Almost half of the sample were not concerned about COVID-19. Those not concerned were significantly less likely to employ health and safety practices (eg, wearing masks, social distancing), were less educated and healthier. They also perceived COVID-19 to not be real or a serious threat to their health. Conclusions: Tailored education approaches are needed to provide evidence-based data on COVID-19 risks and complications. [ABSTRACT FROM AUTHOR]

This study explored social service providers' perceptions of risk and resilience while caring for their vulnerable clients during COVID-19. Participants (N = 68) from two agencies completed an online survey. Over half of participants had shifted to virtual service delivery; about 30% continued to have direct contact with clients. Using regression modeling, we found that age, gender, confidence in providing COVID-related care, worries about spreading SARS-CoV-2, and information and supports explained 36% of variance (Adjusted R2 =.357) in provider resilience. Social service agencies need to address provider worries, which may contribute more to resilience than providing information. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has overwhelmed health care systems globally. To understand how health care systems can best support frontline health care providers caring for patients in similar situations, it is necessary to gain insights into their experience. Purpose: This quality improvement study explored the lived experience of Canadian frontline medicine nurses caring for COVID-19 patients during the first wave of the pandemic. Method: A qualitative interpretive phenomenological approach was conducted. Forty-three eligible nurses participated in semistructured interviews and online surveys. Full transcription and thematic content analysis were performed. Results: Three overarching themes were deduced: (1) a traumatic experience, (2) living through the experience, and (3) achieving transcendence. Conclusion: Several recommendations were identified. These recommendations aim to aid health care systems in emergency preparation planning and future pandemic responses while supporting frontline health care providers' resilience and well-being. [ABSTRACT FROM AUTHOR]

Workers in the electric power industry commonly perform physically demanding jobs in hot environments, which combined with the protective clothing worn, places them at risk of disease and health problems related to occupational heat stress. With climate change fueling an increase in the occurrence of hot weather, a targeted approach to heat stress management within the industry is needed. To better understand current heat management practices and identify opportunities for refinement, we conducted an exploratory survey among 33 electric utility companies operating in the United States (n = 32) and Canada (n = 1). Forty-six employees responsible for health and safety of company workers completed 26 questions assessing heat stress as a workplace hazard and heat management practices within five categories: (1) use and administration of heat stress management program; (2) surveillance of heat stress and heat strain; (3) job evaluation and heat-mitigation guidance; (4) education and training programs; and (5) treatment of heat-related illness. While a majority of the respondents (87.0%) indicated heat stress is a workplace hazard and their organization has a heat stress management program (78.3%), less than half reported performing real-time monitoring of heat stress in the workplace (47.8%) or tracking worker heat strain (19.6%) (i.e., physiological response to heat stress). However, most organizations indicated they conducted pre-job evaluations for heat stress (71.7%) and implemented an employee training program on managing heat stress (73.9%). The latter included instruction on various short- and long-term heat-mitigation guidance for workers (e.g., use of work exposure limits, hydration protocols) and the prevention (52.2%) and treatment (63.1%) of heat-related illnesses. Altogether, our survey demonstrates that although many companies employ some form of a heat management program, the basic components defining the programs vary and are lacking for some companies. To maximize worker health and safety during work in hot environments, a consensus-based approach, which considers the five basic components of a heat management program, should be employed to formulate effective practices and methodologies for creating an industry-specific heat management strategy. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed and described potential clinical practice changes secondary to COVID-19 that emerged as an early response to the pandemic for speechlanguage pathologists (SLPs) engaged in voice, alaryngeal, and swallowing activities that may increase the risk of virus transmission. Method: SLPs from the United States and Canada (n = 665) who were engaged in clinical activities that might elevate the risk of COVID-19 exposure completed an online survey regarding their clinical practices. Topics assessed included potential clinical service modifications, COVID-19 testing and health, and potential financial impacts in the early time period of the pandemic. Results: The percentage of SLPs completing the most endoscopic procedures prepandemic (≥ 10/week) was reduced from 39% of respondents to 3% due to the pandemic. Those who completed the most tracheoesophageal puncture voice prosthesis changes (≥ 5/week) reported a reduction in frequency from 24% to 6%. Twenty-five percent of SLPs reported that they were tested for COVID-19, and 6% reported a positive result. Descriptive statistics suggest that COVID-19 testing rates of SLPs, the percentage of SLPs experiencing a financial impact, and the percentage who were furloughed varied across SLP work setting. Conclusions: These findings provide the first data characterizing the impact on COVID-19 on clinical practice for SLPs engaged in procedures such as endoscopy and laryngectomy care. The results indicate that, as frontline workers, SLPs were directly impacted in their practice patterns, personal health, safety, and financial security, and that these reported impacts occurred differently across SLP work settings. [ABSTRACT FROM AUTHOR]

Drawing on interviews with civil society actors in the AIDS Service Organization (ASO) sector in Canada, this article explores how these actors contribute to shaping the illness identities of people living with HIV/AIDS in the shadow of efforts to criminalize exposure to HIV. While the biographically disruptive qualities associated with an HIV diagnosis have been addressed in the medical sociology literature, we turn our attention to the key role played by ASOs as interlocutors in this process. Paying specific attention to the intersection of processes of medicalization and criminalization, we ask how they are re‐stigmatizing a condition that has shifted in the public consciousness from its earlier association with deviance and moral culpability. One important implication of our findings concerns the need to take greater account of how the illness identity and experience can be shaped by a 'biography of telling', of a renewed pressure to disclose intimate details of one's health status as a way to perform responsible practices of citizenship. [ABSTRACT FROM AUTHOR]

Background: Exposure to traumatic events is an occupational hazard with potential adverse psychological consequences. Previous research has focused mainly on urban practice settings; therefore, this study explored the distressing experiences encountered by rural/remote nurses and their perception of organizational support. Methods: Thematic analyses were conducted on open-ended data from a pan-Canadian survey of 3,822 regulated nurses, where 1,222 nurses (32%) reported experiencing an extremely distressing health care incident within the past 2 years. Among the respondents, 804 nurses (65%) reported that they did not receive psychological support from the organizations leadership following incidents. Findings: Three main themes regarding distressing events were: (a) involvement in profound events of death/dying, traumatic injury and loss, (b) experiencing or witnessing severe violence and/or aggression, and (c) failure to rescue or protect patients/clients. Three themes were identified regarding perceptions of organizational support including: (a) feeling well supported in the work setting with debriefing and reliance on informal peer support, (b) lack of acknowledgement and support from leaders on the nature and impact of distressing events, and (c) barriers influencing access to adequate mental health services in rural/remote settings. Conclusion/Application to Practice: Findings suggest that rural/remote nurses rely on informal, peer supports; there is a lack of organizational understanding of the potential risks to their psychosocial health and safety. They require more accessible, structured, appropriate, and timely supports within these settings. Increased understanding of the psychological hazards will assist organizations to establish workplace policies and practices designed to protect and support rural/remote nurses. [ABSTRACT FROM AUTHOR]

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Injury rates reported among healthcare practitioners tend to vary depending on position. Nurses and healthcare aides report different rates of injury, which suggests that position and job duties may be key injury antecedents. The outcomes related to workplace safety climate perceptions (e.g., injury rates, job satisfaction, turnover) require reflection to identify antecedents of safety perception. The purpose of this study was to examine workplace safety perceptions and well-being (e.g., stress, job satisfaction) of healthcare practitioners by position. A cross-sectional survey of care teams (e.g., nurses, healthcare aides, allied health professionals) was conducted across three inpatient units. Data (N = 144) were analyzed using hierarchical linear regression and binomial logistic regression to examine the relationship between safety climate and self-reported injuries and ANOVA to determine variations in safety climate perceptions by position. Results indicated that nurses, healthcare aides, and allied health professionals report differing levels of workplace safety climate perceptions. Nurses reported the poorest safety perceptions, lowest job satisfaction, and highest stress, while allied health professionals reported the highest safety perceptions and job satisfaction and the lowest stress. Safety climate perceptions were found to be significantly related to care practitioner reported stress, turnover intent, and job satisfaction. Considering the importance of safety climate perceptions for the well-being of care practitioners, healthcare organizations need to prioritize workplace safety to optimize practitioners' perceptions. This study makes a unique contribution to the safety climate literature by identifying the variation in safety climate perceptions by care practitioner position. Practical implications are offered for enhancing workplace safety perceptions. [ABSTRACT FROM AUTHOR]

Given shifting sex work criminalization and enforcement in Canada, this study examined worrying about workplace inspections by authorities amongst indoor sex workers in Vancouver (2014–2017). Data were drawn from a community-based prospective cohort of sex workers (AESHA). Bivariate and multivariable logistic regression were used to investigate factors associated with worry about inspections. 23.9% of participants experienced workplace inspections; 51.6% worried about inspections. In multivariable analyses, worrying about inspections was associated with recent im/migration [adjusted odds ratio (AOR) 3.13; 95% confidence interval (CI) 1.77–5.53], police harassment (AOR 3.49; 95% CI 1.92–6.34), and workplace violence (AOR 1.66, 95% CI 1.09–2.51). In a multivariable confounder model, worry was independently associated with barriers to health access (AOR 1.45, 95% CI 1.06–1.98). Im/migrant indoor workers are disproportionately impacted by concerns about workplace inspections, which was independently linked to enhanced barriers to health access. Current criminalization measures may exacerbate health inequities among im/migrant sex workers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Transportation accidents are a global health concern and a leading cause of death. OBJECTIVE: A pragmatic way to decrease these accidents is to examine the routine opportunities that lead to them. Opportunities for accidents were identified by qualitatively examining the tacit knowledge possessed by truck drivers who observe unsafe driving behaviors near their trucks. METHODS: Face-to-face interviews were conducted with 158 truck drivers from 30 states in the United States (US) and three Canadian provinces. During the interviews, truck drivers made 703 observations of unsafe actions they routinely observe car drivers doing near their trucks. The observations were coded and analyzed with the assistance of a qualitative data analysis software program. RESULTS: The findings revealed 20 unsafe driving behaviors that lead to elevated risk for car drivers. The most common unsafe action (observed by 89% of truckers) involved cars passing trucks and then cutting back into their lane too soon – the 'front no zone' safe space. Driving distractions comprised the second group of most commonly observed risky behaviors. CONCLUSIONS: The findings reveal that new drivers should receive truck driver awareness training as part of their licensing process and that public health campaigns be developed on the risks of driving near trucks. [ABSTRACT FROM AUTHOR]

BACKGROUND: Falls are among the leading causes of occupational injuries for workers exposed to outdoor winter conditions such as Personal Support Workers (PSWs). Slip resistant footwear is known to reduce the risk of falls, however, it is difficult to predict how well a particular boot will perform prior to purchasing them. Our recently developed Maximum Achievable Angle (MAA) test can be used to rate footwear objectively to address this gap. OBJECTIVE: To rate the slip resistance of a selection of winter footwear that meets the needs and preferences of PSWs. METHODS: We selected 40 representative types of footwear based on survey results from 677 PSWs and applied our MAA test to rate slip resistance. RESULTS: Comfort and slip resistance were rated the most important features for selecting winter footwear. Of the 40 types of footwear tested, six were found to have a good slip resistance on ice. CONCLUSION: The vast majority of winter footwear that meet the needs and preferences of PSWs, perform poorly on ice. Therefore, PSWs should consult our website (ratemytreads.com) for selecting appropriate footwear that will keep them safe in the winter. [ABSTRACT FROM AUTHOR]

Introduction Solar ultraviolet radiation (UVR) exposure places outdoor workers at risk of skin cancer and exposure is difficult to control. In response, the Sun Safety at Work Canada (SSAWC) project was undertaken (2014–2016). The purpose of this substudy was to characterize the UVR exposure levels of outdoor workers in the SSAWC project. Methods Thirteen workplaces in the provinces of British Columbia, Ontario, and Nova Scotia participated in an exposure monitoring campaign (late summer/early fall 2016). Study participants were workers from power utilities and municipalities. Participants wore a UVR measurement badge (light-sensitive polysulfone plastic) on their wrist, shoulder, or hardhat. Badge calibration and absorbance measurements were performed in the AusSun Research Lab. Personal UVR doses are presented as standard erythemal doses (SED) and compared with the internationally recommended exposure limit (1.3 SED), as well as to the total available UVR by date. Generalized linear models were used to examine determinants of solar UVR for personal UVR dose (for both SED and percent of ambient UVR). Models considered badge placement, date, province, industry, main job task, and the hours spent outdoors. Results Mean personal UVR dose of participating workers was 6.1 SED (nearly 5× the recommended limit). Just 14% of workers experienced 'acceptable' levels of solar radiation; 10% were exposed at >10 times the limit. In univariate analyses, workers in Ontario had the highest levels (mean 7.3 SED), but even in the lowest exposed province (British Columbia), the mean personal UVR dose was 4.5 SED. Utility workers had double the exposure of municipal workers (10.4 and 5.5 SED, respectively). In the determinants of exposure models, the differences by province were muted, but utility line workers and those in general maintenance had higher predicted exposures. Those who wore their badge on their hardhat also had higher values of SED in the fully adjusted determinants models. Conclusions Solar ultraviolet overexposure among outdoor workers is a concern, even in a country like Canada with relatively low ambient UVR. Implementation of sun safety programs should be supported in an effort to reduce exposure in this vulnerable group of workers. [ABSTRACT FROM AUTHOR]

Despite longstanding recommendations for the safe handling of hazardous drugs, it's not known whether nurses—including those who are pregnant—wear protective gloves and gowns when administering chemotherapeutic drugs. This study examines this practice among nurses in the Nurses' Health Study 3. Background: Many antineoplastic (chemotherapeutic) drugs are known or probable human carcinogens, and many have been shown to be reproductive toxicants in cancer patients. Evidence from occupational exposure studies suggests that health care workers who have long-term, low-level occupational exposure to antineoplastic drugs have an increased risk of adverse reproductive outcomes. It's recommended that, at minimum, nurses who handle or administer such drugs should wear double gloves and a nonabsorbent gown to protect themselves. But it's unclear to what extent nurses do. Purpose: This study assessed glove and gown use by female pregnant and nonpregnant nurses who administer antineoplastic drugs in the United States and Canada. Methods: We used data collected from more than 40,000 nurses participating in the Nurses' Health Study 3. The use of gloves and gowns and administration of antineoplastic drugs within the past month (among nonpregnant nurses) or within the first 20 weeks of pregnancy (among pregnant nurses) were self-reported via questionnaire. Results: Administration of antineoplastic drugs at any time during their career was reported by 36% of nonpregnant nurses, including 27% who reported administering these drugs within the past month. Seven percent of pregnant nurses reported administering antineoplastic drugs during the first 20 weeks of pregnancy. Twelve percent of nonpregnant nurses and 9% of pregnant nurses indicated that they never wore gloves when administering antineoplastic drugs, and 42% of nonpregnant nurses and 38% of pregnant nurses reported never using a gown. The percentage of nonpregnant nurses who reported not wearing gloves varied by type of administration: 32% of those who administered antineoplastic drugs only as crushed pills never wore gloves, compared with 5% of those who administered such drugs only via infusion. Conclusion: Despite longstanding recommendations for the safe handling of antineoplastic and other hazardous drugs, many nurses—including those who are pregnant—reported not wearing protective gloves and gowns, which are considered the minimum protective equipment when administering such drugs. These findings underscore the need for further education and training to ensure that both employers and nurses understand the risks involved and know which precautionary measures will minimize such exposures. [ABSTRACT FROM AUTHOR]

Objectives: The National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) was released in 2013. The objectives of this study were to 1) estimate the proportion of Canadian employers who were aware of the Standard, 2) examine the extent to which the Standard has been implemented, and 3) describe perceived barriers to implementing the Standard in Canadian organizations.Methods: A cross-sectional survey in Canadian employers was conducted between February 2015 and January 2017. A random sample of Canadian employers was selected, and the individuals who were knowledgeable about the occupational health policies of the organizations were interviewed by telephone. The participants answered questions about the awareness, implementation, perceived effects, and barriers to implementation. Descriptive statistics and chi-square tests were used to characterize the results.Results: A total of 1010 companies participated in the study. Overall, 17.0% reported that they were aware of the Standard; 1.7% and 20.3% reported that their organizations had implemented the entirety or elements of the Standard, respectively; and 71.4% of participants believed that elements of the Standard would be implemented within the next year. The perceived effects associated with implementation of the Standard included increased job satisfaction and employee retention while the greatest barrier to implementing the Standard was the belief that psychological health and safety are irrelevant in the workplace.Conclusions: Many Canadian employers are still unaware of the Standard's existence; however, most Canadian employers are positively inclined toward the Standard in its potential to help employee productivity and job satisfaction. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health care workers are known to be at high risk for occupational musculoskeletal disorders and injuries. Many different intervention strategies have been implemented in order to reduce the risk of injury to health care workers, however not many have been proven to be effective. A continuing care establishment in Ottawa, Canada, implemented a multidimensional kinesiology intervention program for injured employees. OBJECTIVE: To evaluate the effectiveness of the kinesiology intervention program on reducing subsequent rates for the nursing personnel and analyze the impact of age, position (RN, RPN, PCA) and sex on subsequent injuries. METHODS: The number of recorded work related musculoskeletal disorders (WRMSD) for each patient care worker was counted from 2007-2011. The control group included injured employees that were not referred to the kinesiologists, or who chose not to participate in the program. The intervention group included injured employees that were referred to the kinesiology service and followed their treatment program. RESULTS: The intervention group showed a statistically significant reduction of subsequent acute cases when compared to the control group. Nevertheless there was no significant impact regarding age, position or sex on subsequent acute cases. CONCLUSION: The kinesiology intervention program within the health care facility was effective at reducing subsequent WRMSD rates within the nursing personnel. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hand-arm vibration syndrome (HAVS) is caused by prolonged occupational exposure to hand-transmitted vibration. Although HAVS is preventable, disease awareness and prevention knowledge are lacking in high-risk workplaces; this may contribute to under-diagnosis, delays in seeking care, and poor health outcomes. Posters may be used to increase awareness in the workplace. OBJECTIVE: To conduct a pilot survey in workers with HAVS about poster use in their workplaces, their recommendations for poster campaigns and training programs, and their evaluation of HAVS awareness and prevention posters. METHODS: All eligible HAVS patients in the Occupational Health Clinic at St. Michael's Hospital, in Toronto, Canada, were asked to complete a questionnaire on workplace poster use and to evaluate a set of HAVS posters. RESULTS: Fifty workers participated; almost all were males, aged 50 and older, working in construction. Most indicated having non-HAVS specific awareness posters in their workplaces. There was a positive evaluation of the design, content, and potential usefulness of the posters. The poster depicting finger blanching stood out most. The poster depicting anti-vibration gloves rated highest for relatability and effectiveness at conveying disease importance. CONCLUSIONS: Participants supported the proposed use of industry-specific HAVS awareness posters in their workplaces. Future research should evaluate the effectiveness of these posters in the workplace. [ABSTRACT FROM AUTHOR]

A random sample of human service workers employed by a large public administration organization in Canada (n = 1574) was surveyed to assess the workers’ experiences with negative interpersonal interactions with colleagues, supervisors, and managers and to determine key organizational factors (i.e., supervision, workload, team dynamics, and workplace culture) that predict experiences of workplace violence. The findings support the need to develop workplace environments that support positive intrapersonal relationships between workers, foster mechanisms for improved interpersonal team functioning, promote equality among workers, and improve supervisor-to-worker attentiveness within supervisory relationships. Implications for human services workplace settings are discussed. [ABSTRACT FROM PUBLISHER]

The number of older workers in the workforce is increasing substantially, and advanced age is associated with factors that could influence musculoskeletal injury risk and work capacity. This study’s goals were to test whether psychophysical estimates of maximum acceptable weight of lift (liftmax) differed between younger and older workers, and to examine potential explanatory factors. Twenty-four female workers (half 50 + years; half 20–32 years) self-adjusted a box’s mass to their perceivedliftmaxduring four lifting tasks. Older workers’liftmaxvalues were significantly lower (by approximately 24%) than their younger counterparts. There were no age-related differences in resting heart rate, or peak joint angles and final heart rate during the lifting trials. However, the older group demonstrated lower grip strength (by 24%), and lower heart rate reserve during the trials (by 18%). These results question whether current maximum acceptable lifting weights based on psychophysical information are appropriately protective for female workers greater than 50 years of age. Practitioner Summary:This psychophysical study demonstrated that older female workers (aged 50–63 years) selected maximum acceptable lift masses that were (on average) 24% lower than younger workers (aged 20–32 years), which corresponded with lower grip strength and heart rate reserve. Current maximum acceptable lifting weights based on psychophysical information may not protect female workers greater than 50 years of age. [ABSTRACT FROM PUBLISHER]

Background The long version of the organizational, policies and practices (OPP) had a high burden and short versions were developed to solve this drawback. The 11-item version showed promise, but the ergonomic subscale was deficient. The OPP-14 was developed by adding three additional items to the ergonomics subscale. The aim of this study is to evaluate the factor structure using confirmatory factor and Rasch analyses in healthy firefighters. Methods A sample of 261 firefighters (Mean age 42 years, 95 % male) were sampled. A confirmatory factor and Rasch analyses were used to assess the internal consistency, factor structure and other psychometric characteristics of revised OPP-14. Results The OPP-14 demonstrates sound factor structure and internal consistency in firefighters. Confirmatory factor analysis confirmed the consistency of the original 4-domain structure (CFI = 0.97, TLI = 0.96, and RMSEA = 0.053). The 5 items showing misfit initially with disordered thresholds were rescored. The four subscales satisfied Rasch expectations with well target and acceptable reliability. Conclusions The OPP-14 scale shows a promising factor structure in this sample and remediated deficits found in OPP-11. This version may be preferable for musculoskeletal concerns or work applications where ergonomic indicators are relevant. [ABSTRACT FROM AUTHOR]

In this article, I use qualitative interviews with 121 workers in several industry sectors in Canada in temporary and permanent employment to examine the different ways in which workers managed and coped with workplace safety hazards given varying levels of employment insecurity. I found that temporary employment workers expressed more definite fears about the risk of reprisals if they reported injuries and hazards. However, there were also substantial differences among temporary workers in their reprisal fears, mistrust of management and uncertainty about reporting. I explore these differences by examining workers’ narratives on reporting and their efforts to construct some level of employment and safety security within relatively insecure contexts. I identify some of the key sources of worker mistrust and consider the different ways in which workers actively sought to balance and negotiate some measure of control over both hazards and security in their employment in a context of considerable uncertainty. These included a complex combination of compromises, coping responses and strategic efforts through which they built knowledge and trust with other workers, supervisors and line managers. I identify the contradictory challenges for temporary employment workers as tensions which intensified as employment security and safety weakened, often forcing workers to reconstruct the boundaries of acceptable risk. I conclude with a discussion of the theoretical contributions of a trust-based analysis of workers’ responses to hazards and injuries. [ABSTRACT FROM AUTHOR]

Measuring trunk posture in the workplace commonly involves subjective observation or sell-report methods or the use of costly and time-consuming motion analysis systems (current gold standard). This work compared trunk inclination measurements using a simple data-logging inclinometer with trunk flexion measurements using a motion analysis system, and evaluated adding measures of subject anthropometry to exposure prediction models to improve the agreement between the two methods. Simulated lifting tasks (n = 36) were performed by eight participants, and trunk postures were simultaneously measured with each method. There were significant differences between the two methods, with the inclinometer initially explaining 47% of the variance in the motion analysis measurements. However, adding one key anthropometric parameter (lower arm length) to the inclinometer-based trunk flexion prediction model reduced fire differences between the two systems and accounted for 79% of the motion analysis method's variance. Although caution must be applied when generalizing lower-arm length as a correction factor; the overall strategy of anthropontetric modeling is a novel contribution. In this lifting-based study by accounting for subject anthropometry, a single, simple dam-logging inclinometer shows promise for trunk posture measurement and may have utility in larger-scale field studies where similar types of tasks are performed. [ABSTRACT FROM AUTHOR]

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Background Workplace safety is a concern in the employment of persons with intellectual disability, due to both real concerns for employee well-being, and the effect that negative perceptions of safety risk can have on hiring. Method This study involved a retrospective analysis of workplace insurance claim records for workers with and without disability in a Canadian social enterprise. Results Workers with intellectual disability sustained fewer injuries and experienced fewer absences due to injury than workers without disability. Lost-time injury rates for this business were not significantly different from those reported by other employers in the jurisdiction. Conclusion Workplace safety is a concern for all workers, but fear of increased injury rates and heightened compensation costs should not be perceived as a risk when hiring individuals with intellectual disability. [ABSTRACT FROM AUTHOR]