IWH snapshot: Twenty years in the making

The Institute for Work & Health (originally named the Ontario Workers’ Compensation Institute) was established in 1990. It occupied part of a floor in a high-rise building and had only a handful of employees.

Talented researchers soon filled the Institute’s halls and many students – including several from across the country and overseas – came for specialized training in understanding issues affecting the world of work and health.

Twenty years later, the Institute for Work & Health’s two floors of offices are within arm’s reach of provincial legislature at Queen’s Park, the University of Toronto and major research hospitals in Toronto. Today, staff from many disciplines and professional backgrounds work together to help find solutions to help protect and improve the health of working people.

The need for a workplace health research centre

So how did the Institute for Work & Health come to be? In the late 1980s, two leaders from the then-known Ontario Workers’ Compensation Board (now the Workplace Safety and Insurance Board, or WSIB) identified the need for a workplace health research centre. Dr. Robert Elgie, the chair of the board of directors and Dr. Alan Wolfson, the president of the board, anticipated the value of having access to high quality research evidence concerning the effectiveness of therapies for the treatment of work-related musculoskeletal disorders to support the board’s responsibilities in purchasing health care for disabled workers.

In 1990, Institute researchers began to focus on two broad areas concerning the effectiveness of health care provided to disabled workers: the clinical management of work-related injury and disease and the quality and outcomes of the compensation board’s community-based rehabilitation services.

Key Institute expansions

During IWH’s first five years, its research program would expand to include understanding physical and psychosocial factors that may cause non-traumatic musculoskeletal injuries in the workplace, and examining labour market experiences that influence the health of the Canadian labour force.

Three large-scale research projects launched

In IWH’s early years, the three senior scientists who were brought on board to lead research projects knew they had to launch ambitious, large studies to make the Institute’s mark. Over the next year, the scientists – Drs. John Frank, Claire Bombardier and Harry Shannon – along with other researchers, began to construct what was one of the largest and most complex occupational health research projects in Canada at the time. The Ontario Universities Low-back Pain Study examined which factors contributed to low-back pain reports in workers at an auto assembly plant. “This study was one of the most in-depth and sophisticated studies ever done on the biomechanical and psychosocial factors affecting back injuries,” says Dr. John Frank, the Institute’s first scientific director.

In 1994, Institute researchers launched a study of the factors affecting the length of a person’s disability following sprains and strains. This was the first clinical study to identify workers soon after their injury and follow them through their treatment and recovery. It was called the Early Claimant Cohort (ECC) study. The researchers found that there were no health-related or return-to-work advantages from a treatment program emphasizing early and intensive therapy compared with usual care.

A major six-year study involving Institute researchers showed that an ergonomic program could reduce frequent and severe pain among office workers with repetitive strain injury. (These injuries are also known as musculoskeletal disorders or MSDs.) Additionally, the study showed that management practices were as important as workstation set-up in influencing these injuries.

These three large-scale projects successfully established and maintained the Institute’s reputation as a credible work-health research centre.

In 2000, the Institute implemented an evidence-based strategy for knowledge transfer and exchange (KTE), which would help put research findings into the hands of those who could use them. The KTE program has made major strides in involving stakeholders in the IWH research process. Additionally, the KTE team helps to extract key messages from research results and offers strategies to scientists to “transfer” a study’s findings more broadly. KTE efforts have made IWH a leader in this emerging field.

Systematic Review Program receives funds

Since early on in the Institute’s history, researchers have conducted systematic reviews (in-depth search and analysis of existing scientific literature) on specific topics related to work and health. Since 1996, IWH has been the home to the Cochrane Back Review Group, which is part of the international Cochrane Collaboration.

In 2005 – thanks to important multi-year funding from the WSIB – the Institute’s Prevention Reviews Program was established. More than one dozen reviews on the prevention of workplace injury and illness were conducted and various evidence-based guides were created that were based on the results from some of the systematic reviews.

More notable milestones and projects

Within the past 10 years, the Institute has continued to refresh and re-energize the occupational health and safety research landscape.

Several qualitative researchers joined the Institute to explore certain social and work situations that may be challenging to measure and quantify. Qualitative researchers were integral to many IWH projects including the return-to-work systematic review, research on young workers, studies of long-duration claims and vocational rehabilitation and several immigrant workers’ studies.

In 2006, a group of IWH scientists formed a unique research alliance with injured workers to examine the long-term impact of work injury. This group – now called the Research Action Alliance on the Consequences of Work Injury – received a major grant of $1 million from the Community-University Research Alliance program of the Social Science and Humanities Research Council.


Statisticians are vital to the majority of research projects at IWH. Statisticians use their skills and expertise to help design, carry out and interpret studies. Although some IWH projects use data sets from the WSIB, members of the statistics team are creating new and novel ways to use other data sets and resources from agencies such as Statistics Canada.

The good work that the Institute conducts and shares with the work and health community could not have been achieved without core financial support from our funders. The WSIB has provided vital funding since the Institute was established 20 years ago. Today the Institute for Work & Health is proud to be considered a world leader in work-health research.

Source: At Work, Issue 62, Fall 2010: Institute for Work & Health, Toronto