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Background: This study characterized the risk of new-onset asthma among workers in Manitoba, Canada. Methods: Accepted time loss claims from the Workers' Compensation Board of Manitoba from 2006 to 2019, containing workers' occupations and industries, were linked with administrative health data from 1996 to 2020. After restricting the cohort to the first claim per person in an occupation and applying age and coverage exclusions, the cohort comprised 142,588 person–occupation combinations. Asthma cases were identified if workers had at least two medical records for asthma (International Classification of Diseases, Ninth Revision, 493) within a 12-month period, within the 2 years before 3 years after cohort entry. New-onset asthma was identified using a 3-year washout period. Asthma hazard ratios by occupation and industry were estimated using Cox proportional hazard models, adjusted for age, and stratified by sex. Results: Increased asthma risk was observed among workers with known asthmagen exposure, including male veterinary and animal health technologists and technicians (hazard ratio 3.97, 95% CI 1.78–8.86), male fish processing workers (3.40, 1.53–7.57), and male machining tool operators (2.91, 1.72–4.92). Increases were also observed for occupations with unknown or suspected allergens, including gas station attendants, drivers, mail/postal and related workers, public works and maintenance laborers, mine laborers and crane operators, and some indoor worker groups. Decreased risks were observed among nurses and residential and commercial installer and servicers. Conclusion: This database linkage study successfully identified occupations and industries with known sensitizing agents or irritants, and several occupation and industries not typically associated with work-related asthma, warranting further investigation.

OBJECTIVES: British Columbia (BC), Canada, experienced an unprecedented summer with record-breaking high temperatures in 2021. Yet the health impact has not been examined in occupational settings. This study aimed to characterize occupational heat-related illness (HRI) among BC workers estimated by incidence rates and associations between heatwaves and HRI, compare risks from 2021 and prior summers of 2001–2020, and assess differential impacts on worker groups by demographics and occupations. METHODS: We identified HRI from workers’ compensation claims that occurred between June and August from 2001–2021 in BC. Incidence rates were calculated using working population estimates from Statistics Canada’s Labour Force Survey. A time-stratified case-crossover design with conditional Poisson regression was used to examine the impact of heatwaves on occupational HRI. All analyses were stratified by year (2021 versus 2001–2020), age, sex, and occupation. RESULTS: Of the 521 claims identified, 107 (21%) occurred in 2021. Incidence rates for 2021 and prior summers were 3.97 [95% confidence interval (CI) 3.26–4.80] and 0.93 (95% CI 0.85–1.03) claims per 100 000 workers, respectively. This difference represents a 327% increase. Rates were higher in health occupations in 2021 versus 2001–2020. During 2001–2021, the risk of HRI during heatwave days was 4.33 (95% CI 2.98–6.27) times that during non-heatwave days, and the risk was higher among middle-aged workers and workers in trades, transport, and equipment operations. The 2021 heatwaves had greater impact on younger and female workers than those from prior summers. CONCLUSIONS: Heat is a crucial workplace hazard. Prevention strategies should prioritize at-risk workers and not be limited to heatwaves.

OBJECTIVE: The aim of this study was to investigate whether an integrated return-to-work (RTW) and vocational rehabilitation (VR) program – the Work Reintegration (WR) program – was associated with reduced work disability duration in the construction sector in Ontario, Canada. METHODS: Workers’ compensation data from the Ontario Workplace Safety and Insurance Board were extracted for lost-time construction worker claims following work-related injuries between 2009 and 2015. Claims receiving referrals to RTW and VR specialists (treatments) were matched with claims receiving no referrals (controls) during the periods before and after the WR program introduction. Multivariable difference-in-differences linear and quantile regression models were used to examine differences in cumulative disability days paid during two-years post-injury between treatment and control groups before and after the program change and the difference in these differences, overall, and at different disability distribution percentiles. RESULTS: The WR program introduction was associated with reductions in cumulative disability days paid for all claims but most notably among longer duration claims referred to RTW specialists (reduction of 274 days at the 90^th percentile in the disability distribution) and shorter duration claims referred to VR specialists (reductions of 255 and 214 days at the 25^th and 50^th percentiles in the disability distribution, respectively). CONCLUSIONS: The WR program introduction was effective in reducing cumulative disability days paid for construction worker claims but the effects varied at different percentiles in the disability distribution, as well as by specialist referral. The findings highlight the benefits of better integrated RTW and VR services to injured workers in the construction sector.

Mental health challenges in adolescence may affect labour market transitions in young adulthood. Policies addressing early labour market disconnection largely focus on early school-leaving and educational attainment; however, the role of low educational attainment on the path from adolescent mental health to labour market disconnection is unclear. Using the TRacking Adolescents' Individual Lives Survey from the Netherlands (n = 1,197), we examined the extent to which achieving a basic educational qualification (by age 22) in the contemporary Dutch education system, mediates the effect of adolescent mental health (age 11–19) on early adult labour market disconnection, defined as ‘not in education, employment, or training’ (NEET, age 26). We estimated the total effect, the natural direct and indirect effects, and the controlled direct effects of internalizing and externalizing symptoms on NEET by gender. Among young men, clinical levels of adolescent externalizing symptoms were associated with a 0.093 higher probability of NEET compared with no symptoms (95% confidence interval, CI: 0.001, 0.440). The indirect effect through educational attainment accounted for 15.1% of the total effect. No evidence of mediation was observed for the relationship between externalizing symptoms and NEET in young women. No evidence of mediation was observed for the relationship between adolescent internalizing symptoms and NEET in either gender. The findings imply that adolescent externalizing symptoms disrupts the achievement of a basic educational qualification, leading to a higher probability of NEET in young men. This mechanism may play a smaller role in the risk of NEET associated with internalizing symptoms and in young women.

A media surveillance analysis was conducted to identify COVID-19 workplace outbreaks and associated transmission risk for new and emerging occupations. We identified 1,111 unique COVID-19 workplace outbreaks using the Factiva database. Occupations identified in the media articles were coded to the 2016 National Occupational Classification (V1.3) and were compared and contrasted with the same occupation in the Vancouver School of Economics (VSE) COVID Risk/Reward Assessment Tool by risk rating. After nurse aides, orderlies, and patient service associates (n = 109, very high risk), industrial butchers and meat cutters, and poultry preparers and related workers had the most workplace outbreaks reported in the media (n = 79) but were rated as medium risk for COVID-19 transmission in the VSE COVID Risk Tool. Outbreaks were also reported among material handlers (n = 61) and general farm workers (n = 28), but these occupations were rated medium–low risk and low risk, respectively. Food and beverage services (n = 72) and cashiers (n = 60) were identified as high-risk occupations in the VSE COVID Risk Tool. Differences between the media results and the risk tool point to key determinants of health that compound the risk of COVID-19 exposure in the workplace for some occupations and highlight the importance of collecting occupation data during a pandemic.

OBJECTIVE: The aim of this study was to examine the impact of anxiety and depression disorders on sustained return to work (RTW) for men and women with musculoskeletal strain or sprain. METHODS: Accepted lost-time claims for spine and upper-extremity strain or sprain were extracted for workers in the Canadian province of British Columbia from 2009 to 2013 (N=84 925). Pre-existing and new onset anxiety and depression disorders were identified using longitudinal health claims data. Probability of sustained RTW was analyzed using Cox proportional hazards models, stratified by gender and adjusted for potential confounders. RESULTS: For pre-existing disorders, compared to men with no anxiety and no depression, men with anxiety only [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.84–0.93], depression only (HR 0.94, 95% CI 0.89–1.00), and anxiety and depression (HR 0.93, 95% CI 0.90–0.97) had lower probabilities of sustained RTW in adjusted models. The same direction of effect was found for women, but anxiety only had a smaller effect size among women compared to men (HR anxiety only 0.95, 95% CI 0.92–0.99; HR depression only 0.98, 95% CI 0.93–1.03, HR anxiety and depression 0.94, 95% CI 0.91–0.97). Among men and women, new onset disorders were associated with lower probability of sustained RTW and the effect estimates were larger than for pre-existing disorders. CONCLUSIONS: Findings suggest that workers’ compensation benefits and programs intended to improve RTW after musculoskeletal injury should take pre-existing and new onset anxiety and depression disorders into consideration and that gender-sensitive work disability strategies may be warranted.

Cancer is the leading cause of death in dogs, yet there are no established screening paradigms for early detection. Liquid biopsy methods that interrogate cancer-derived genomic alterations in cell-free DNA in blood are being adopted for multi-cancer early detection in human medicine and are now available for veterinary use. The CANcer Detection in Dogs (CANDiD) study is an international, multi-center clinical study designed to validate the performance of a novel multi-cancer early detection “liquid biopsy” test developed for noninvasive detection and characterization of cancer in dogs using next-generation sequencing (NGS) of blood-derived DNA; study results are reported here. In total, 1,358 cancer-diagnosed and presumably cancer-free dogs were enrolled in the study, representing the range of breeds, weights, ages, and cancer types seen in routine clinical practice; 1,100 subjects met inclusion criteria for analysis and were used in the validation of the test. Overall, the liquid biopsy test demonstrated a 54.7% (95% CI: 49.3–60.0%) sensitivity and a 98.5% (95% CI: 97.0–99.3%) specificity. For three of the most aggressive canine cancers (lymphoma, hemangiosarcoma, osteosarcoma), the detection rate was 85.4% (95% CI: 78.4–90.9%); and for eight of the most common canine cancers (lymphoma, hemangiosarcoma, osteosarcoma, soft tissue sarcoma, mast cell tumor, mammary gland carcinoma, anal sac adenocarcinoma, malignant melanoma), the detection rate was 61.9% (95% CI: 55.3–68.1%). The test detected cancer signal in patients representing 30 distinct cancer types and provided a Cancer Signal Origin prediction for a subset of patients with hematological malignancies. Furthermore, the test accurately detected cancer signal in four presumably cancer-free subjects before the onset of clinical signs, further supporting the utility of liquid biopsy as an early detection test. Taken together, these findings demonstrate that NGS-based liquid biopsy can offer a novel option for noninvasive multi-cancer detection in dogs.

Introduction: Previous Canadian epidemiologic studies have identified associations between occupations and prostate cancer risk, though evidence is limited. However, there are no well-established preventable risk factors for prostate cancer, which war¬rants the need for further investigation into occupational factors to strengthen existing evidence. This study uses occupation and prostate cancer information from a large sur¬veillance cohort in Ontario that linked workers’ compensation claim data to administra¬tive health databases. Methods: Occupations were examined using the Occupational Disease Surveillance System (ODSS). ODSS included 1 231 177 male workers for the 1983 to 2015 period, whose records were linked to the Ontario Cancer Registry (OCR) in order to identify and follow up on prostate cancer diagnoses. Cox proportional hazard models were used to calculate age-adjusted hazard ratios and 95% CI to estimate the risk of prostate cancer by occupation group. Results: A total of 34 997 prostate cancer cases were diagnosed among workers in ODSS. Overall, elevated prostate cancer risk was observed for men employed in man-agement/administration (HR 2.17, 95% CI = 1.98–2.38), teaching (HR 1.99, 95% CI = 1.79–2.21), transportation (HR 1.20, 95% CI = 1.16–1.24), construction (HR 1.09, 95% CI = 1.06–1.12), firefighting (HR 1.62, 95% CI = 1.47–1.78), and police work (HR 1.20, 95% CI = 1.10–1.32). Inconsistent findings were observed for clerical and farm¬ing occupations. Conclusion: Associations observed in white collar, construction, transportation, and protective services occupations were consistent with previous Canadian studies. Findings emphasize the need to assess job-specific exposures, sedentary behaviour, psy¬chological stress, and shift work. Understanding specific occupational risk factors can lead to better understanding of prostate cancer etiology and improve prevention strategies.

Introduction. Des études épidémiologiques canadiennes ont permis d’établir des liens entre certaines professions et le risque de cancer de la prostate, mais avec des données probantes limitées. Il n’y a pas de facteurs de risque évitables bien établis pour le cancer de la prostate, ce qui rend nécessaire l’examen approfondi des facteurs professionnels pour consolider les données existantes. Cette étude utilise des données sur les professions et sur le cancer de la prostate provenant d’une importante cohorte de surveillance en Ontario pour laquelle les données des demandes d’indemnisation des accidentés du tra¬vail sont jumelées aux bases de données administratives sur la santé. Méthodologie. Nous avons examiné les professions des 1 231 177 travailleurs de sexe masculin du Système de surveillance des maladies professionnelles entre 1983 et 2015 et nous avons jumelé ces travailleurs au Registre des cas de cancer de l’Ontario afin de détecter et suivre les cas de diagnostics de cancer de la prostate. Nous avons utilisé des modèles de risques proportionnels de Cox pour calculer les rapports de risques (RR) ajus¬tés selon l’âge et des intervalles de confiance (IC) à 95 % pour estimer le risque de cancer de la prostate par groupe professionnel. Résultats. Au total, 34 997 cas de cancer de la prostate ont été diagnostiqués parmi les travailleurs inscrits dans le Système de surveillance des maladies professionnelles. Dans l’ensemble, on a observé un risque élevé de cancer de la prostate chez les hommes tra¬vaillant dans les domaines de la gestion et de l’administration (RR = 2,17; IC à 95 % = 1,98 à 2,38), de l’enseignement (RR = 1,99; IC à 95 % = 1,79 à 2,21), du transport (RR = 1,20; IC à 95 % = 1,16 à 1,24), de la construction (RR = 1,09; IC à 95 % = 1,06 à 1,12), de la lutte contre les incendies (RR = 1,62; IC à 95 % = 1,47 à 1,78) et du travail policier (RR = 1,20; IC à 95 % = 1,10 à 1,32). Des résultats incohérents ont été observés en ce qui a trait aux emplois de bureau et à ceux du secteur agricole. Conclusion. Les associations observées dans les professions de cols blancs, de la construction, du transport et des services de protection concordent avec les résultats d’études canadiennes antérieures. Nos résultats mettent l’accent sur la nécessité d’éva¬luer les expositions spécifiques aux divers emplois, le comportement sédentaire, le stress psychologique et le travail par quarts. La compréhension de certains facteurs de risque professionnels permettrait de mieux comprendre l’étiologie du cancer de la prostate et d’améliorer les stratégies de prévention.

OBJECTIVES: We examined associations between labor market and health (LM-H) trajectories in the United States between 1988 and 2011 and whether associations differed across macroeconomic expansion/recession periods. METHODS: Working-age cohorts, derived from the US Panel Study of Income Dynamics, were followed over time to characterize LM-H trajectories. Poisson regression provided relative risks (RR) with robust 95% confidence intervals (CI) for the association between trajectories, adjusting for demographic and socioeconomic variables. RESULTS: LM trajectories ending in unemployment (RR 1.7‒2.5 across periods) or inactivity (RR 2.3–3.2) had a greater risk of worsening health trajectories, compared to stable employment. In contrast, RR for individuals returning to work following an intermediary period of unemployment/inactivity were attenuated across most periods. Stable-employed individuals had the highest probability of remaining in good health, whereas trajectories ending in unemployment or inactivity had the lowest probability. These overall relationships were consistent across macroeconomic periods. CONCLUSIONS: We found strong and consistent relationships between LM-H trajectories across macroeconomic periods. The attenuated (but not eliminated) risk among individuals returning to work following a period of unemployment/inactivity suggests that health outcomes are not only dependent on the LM end-state, but also on the distinct pattern over time.

Abstract Background The objectives of this study were (1) to identify age and sex trends in the disability burden of compensated work-related musculoskeletal disorders (MSDs) in Canada and Australia; and (2) to demonstrate a means of comparing workers’ compensation data internationally. Methods All non-fatal, work-related MSD claims with at least one day of compensated time-loss were extracted for workers aged 15–80 during a 10-year period (2004–2013) using workers’ compensation data from five Canadian and eight Australian jurisdictions. Disability burden was calculated for both countries by sex, age group, and injury classification, using cumulative compensated time-loss payments of up to two years post-injury. Results A total of 1.2 million MSD claims were compensated for time-loss in the Canadian and Australian jurisdictions during 2004–2013. This resulted in time-loss equivalent to 239,345 years in the Canadian jurisdictions and 321,488 years in the Australian jurisdictions. The number of time-loss years declined overall among male and female workers, but greater declines were observed for males and younger workers. The proportion of the disability burden grew among older workers (aged 55+), particularly males in the Canadian jurisdictions (Annual Percent Change [APC]: 7.2, 95% CI 6.7 to 7.7%) and females in the Australian jurisdictions (APC: 7.5, 95% CI 6.2 to 8.9%). Conclusions The compensated disability burden of work-related MSDs is shifting towards older workers and particularly older females in Australia and older males in Canada. Employers and workers’ compensation boards should consider the specific needs of older workers to reduce injuries and time off work. Comparative research made possible through research-stakeholder partnerships offers a unique opportunity to use existing administrative data to identify long-term trends in disability burden. Future research can apply similar approaches for estimating long-term trends in occupational health.

OBJECTIVES: This study aimed to identify return-to-work (RTW) trajectories among workers with work-related musculoskeletal disorders (MSD) and examine the associations between different MSD and these RTW trajectories. METHODS: We used administrative workers’ compensation data to identify accepted MSD lost-time claims with an injury date between 2010–2012 in British Columbia, Canada. Cox regression analyses were used to investigate differences in time to RTW between MSD. Validated day-to-day calendar measures of four RTW states (sickness absence, modified RTW, RTW, and non-RTW) were grouped into RTW trajectories spanning a one-year period using sequence analysis. RTW trajectories were clustered using decision rules that identified a shared trajectory structure. Poisson regression with robust standard errors was used to estimate relative risk ratios (RR) with 95% confidence intervals (CI) between MSD and RTW trajectory clusters. RESULTS: In a cohort of 81 062 claims, 2132 unique RTW trajectories were identified and clustered into nine RTW trajectory clusters. Half of the workers sustainably returned to work within one month. Workers with back strains were most likely to have trajectories characterized by early sustained RTW, while workers with fractures or dislocations were more likely to have prolonged sickness absence trajectories (RR 4.9–9.9) or non-RTW trajectories (RR 1.4–7.6). CONCLUSION: This is the first study that has characterized different types of RTW trajectories of workers with MSD using sequence analysis. The application of sequence analysis and the identification of RTW trajectories yielded a number of key insights not found using conventional cox regression analysis.

Water resources and management have become a critical global issue. During the half-millennium of its existence, the Roman Empire developed numerous strategies to cope with water management, from large-scale urban aqueduct systems, to industrial-scale water mills designed to cope with feeding growing city populations. Roman engineers encountered, adopted, and adapted indigenous hydraulic systems, and left lasting imprints on the landscape of the Mediterranean and temperate Western Europe by employing a range of water technologies. A recent academic study has enabled the identification of remains of and references to seventy-two dams from the Roman era, constructed in Spain between the 1st and 4th century AD. Such unique heritage, without comparisons in the Mediterranean makes Spain an emblematic case study for the analysis of Roman hydraulic engineering and water management policies. Fifty dams have been located and detailed. The twenty-two outstanding, although identified on the ground, have not been able to be acceptably characterized, due in some cases to their being ruins in a highly degraded state, others due to their being masked by repairs and reconstructions subsequent to the Roman era. A good example of such neglected dams is the buttress dam of Consuegra , in Toledo province (Castilla-La Mancha). Dating to the 3rd - 4th century AD, the Dam of Consuegra, on the basin of the Guadiana, with its over 600 metres length and 4,80 metres height, is a remarkable case of Roman engineering mastery. It had a retaining wall upstream, numerous buttresses and perhaps an embankment downstream, of which no remains are left. The application of 3D digital imaging technique to create a high quality virtual model of such monuments has proved to be successful especially for the study of the technological aspects related its construction. The case study of the Roman dam of Muel (Zaragoza) has shown, in fact, as best practices in digital archaeology can provide an original and innovative perspective on a long time studied monument. In this paper it will be explored how deploying recent computer technologies to the Roman dam at Consuegra can advance our understanding of the history of local and regional landscape change and the technology of water management. In summer 2016, the dam has been documented with terrestrial laser scanning with two FARO Focus 3D x330 and aerial photogrammetry image capturing with a DJI Phantom 4 drone. Data was processed in various 3D software applications to generate 3D representations of the dam including 3D point clouds, animations, and meshed models.

OBJECTIVES: This 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. METHODS: The 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. RESULTS: The 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$621 million), mood disorders (CAD$299 million) and migraine (CAD$245 million) accounted for the largest incremental productivity loss. CONCLUSIONS: Chronic 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.

Current work and health research is fragmented, focusing on jobs, exposures, specific worker groups, work organization, or employment contracts. An emphasis on the labor market in framing the work and health relationship conceptualizes work not only as an exposure that increases or lessens health risk but also as a life course experience that is dependent on place and time. The intention is to illustrate how the labor markets and health framework coupled with a life course perspective extends other epidemiological approaches to work and health to identify new research questions. Taking the changing nature of work and labor markets into account, this paper updates the labor markets and health framework. It then reviews, defines, and integrates key life course concepts. A model is developed that guides the understanding of how labor markets and health trajectories emerge from the consideration of the working life course in a social context. The application leads to new research questions investigating characteristics of labor markets and health trajectories that may lead to positive health outcomes over the life course.

OBJECTIVES: The aim of this study was to evaluate if safety certification reduces the risk of work injury among experienced manual tree-fallers. METHODS: This study used a retrospective cohort study design. Experienced manual tree-fallers employed in the Canadian province of British Columbia (N=3251) between 2003–2008 were enumerated from a mandatory faller registry. Registry records with demographic and certification data were linked to workers’ compensation claims for injury outcomes. Data were analyzed using discrete time survival analysis over a two-year period, centered on certification date with pre- and post-certification demarcated into four three-month periods. Models were adjusted for demographic, occupation/industry, previous injury, and seasonal/temporal effects. RESULTS: The relative risk (RR) of work injury during the post certification periods were elevated in comparison to the pre-certification reference period, but the 95% confidence intervals included “1” for all estimates by the end of follow-up, suggesting no statistically significant increased risk of injury. Results were consistent across different outcome measures of acute injury (ie, fracture or amputations) (N=186), musculoskeletal injury (ie, back strain) (N=137), and serious injury claims (ie, long duration, high cost and/or fatal) (N=155). CONCLUSION: Certification did not reduce the risk of work injury among experienced tree-fallers in the province of British Columbia. Non-statistically significant increases in the observed risk of work injury in the months immediately following certification may be attributable to an intervention effect or a methodological limitation related to a lack of individual-level, time-at-risk exposure data.

Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a work-related musculoskeletal disorder (MSD).We used administrative workers' compensation data to identify injured workers with an accepted MSD lost-time claim between 2010-2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories.MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months.Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a work-related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers' compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample.

OBJECTIVE: The aim of this study was to examine the risk of work injury across shift work types in a ­representative sample of Canadian workers. METHODS: We used the Survey of Labour and Income Dynamics to investigate trends in work injury by shift type between 1996–2006. Work injury was defined by receipt of workers’ compensation. Logistic regression was used to estimate the risk between shift type and worker injury after adjusting for potential confounders. RESULTS: The rate of work injury decreased overall between 1996–2006, but did not decline for night shift ­workers. Night shift work was associated with work injury for women [odds ratio (OR) 2.04, 95% confidence interval (95% CI) 1.13–3.69] and men (OR 1.91, 95% CI 1.21–3.03), while rotating shift work was associated with work injury for women (OR 2.29, 95% CI 1.37–3.82). The excess risk of work injury attributed to shift work was 14.4% for women and 8.2% for men based on population attributable fraction estimates. CONCLUSIONS: Rotating and night shift workers appear to have a higher risk of work injury, particularly among women. Regulatory agencies and employers need to identify and mitigate factors that give rise to increased work injury among these types of shift workers.

OBJECTIVE: This study examined the association between return-to-work (RTW) outcomes and sociodemographic, clinical, and work characteristics among a cohort of injured workers who underwent knee surgery between 2001–2005 in British Columbia, Canada. METHODS: Workers’ compensation databases were used to identify the retrospective cohort and abstract the study variables. Multinomial logistic regression provided odds ratios (OR) and 95% confidence intervals (95% CI) for the association between RTW (unspecified, partial, full, or non-RTW) and the independent variables. RESULTS: Data was abstracted for 1394 injured workers. Compared to men, women were more likely to have partial RTW (OR 2.55, 95% CI 1.53–4.23) and non-RTW (OR 2.61, 95% CI 1.35–5.03) than full RTW; low income earners were more likely than high income earners to have partial RTW (OR 3.05, 95% CI 1.86–4.99) and non-RTW (OR 4.07, 95% CI 2.19–7.57). Moreover, workers in trade, primary resource, and processing/manufacturing occupations were more likely than those in management occupations to have non-RTW than full RTW by the end of follow-up (OR 2.97, 95% CI 1.32–6.68; OR 9.31, 95% CI 3.41–25.41, and OR 2.71, 95% CI 1.07–6.5, respectively). Surgical and clinical factors were not associated with RTW outcomes. CONCLUSIONS: Using population-based data, our study found a link between sociodemographic and work characteristics and the type of RTW outcome following knee surgery for a work-related injury. Women and lower income earners tended not to have full RTW, after controlling for covariates. Workers in physically demanding occupations also tended not to have full RTW, suggesting that factors beyond clinical and surgical characteristics influence disability outcomes. RTW programs need to take into consideration these broader determinants of worker health.