Understanding western Canada's high risk of work injury

What is driving the higher risk of job injury in western Canada? New research from the Institute for Work & Health suggests it goes beyond the type of work found in the west.

Workers in Saskatchewan, Alberta and British Columbia have about a 30 to 45 per cent higher risk of work injury compared to their Ontario-based counterparts. And this higher risk still exists even after taking a wide range of factors into account, including the type of industries in which people work.

This finding comes from new research conducted by the Institute for Work & Health (IWH) and led by IWH Scientist Dr. Curtis Breslin. Published in May 2013 issue of the Annals of Epidemiology (vol. 23, no. 5, pp. 260-266; doi:10.1016/j.annepidem.2013.03.008), the research looks at geographic differences in work injuries for all workers in Canada.

The study focuses on the degree to which personal factors (such as age and gender), work characteristics (such as nature of job and industrial sector) and area-level factors (such as a region’s socioeconomic status) are associated with provincial differences in work injury risk. When the researchers learned that these factors do not appear to account for provincial differences, it led them to suggest that something else was affecting workplaces at the jurisdictional level.

Given that, in Canada, primary responsibility for occupational health and safety falls on the provinces, the finding that important determinants of work injury are potentially operating at a provincial level may be useful to provincial governments in planning prevention strategies, says IWH Research Operations Coordinator Sara Morassaei, lead author of the submitted journal article. This study cannot say what those “determinants” are, although Morassaei adds that it raises the possibility that broader elements, such as a jurisdiction’s economic or health and safety policies, act as risk factors.

Study explores provincial differences

There has long been evidence that workers in Canada’s western provinces have a higher incidence of workers’ compensation claims than workers in Ontario. What has not been clear from the administrative statistics of provincial workers’ compensation boards is why. Traditionally, however, risk of work injury is commonly thought to stem from a mix of personal and workplace-related factors.

For example, it is unclear the degree to which the higher risk among workers in the western provinces is due to the make-up of their workforces or their industry mix. Western provinces have historically had a higher proportion of employment in primary production sectors, such as forestry and oil and gas industries, which pose a higher risk of work injury. Ontario has a higher proportion of employment in financial and insurance services, which pose a lower risk. This study provides some insight into whether factors such as these affect provincial differences in work injury risk.

Using the 2003 and 2005 Canadian Community Health Survey (CCHS), researchers looked at 89,541 Canadians (ages 15 to 75 years) who had worked in the past year. Through the CCHS, these people were asked if they had been injured at work (excluding repetitive strain injuries) in the last 12 months seriously enough to limit their normal activities. Researchers looked at work injuries by personal and work-related factors (called individual-level factors), as well as area-level factors (determined by census division), and then looked to see how these factors were associated with work injury risk in the provinces in which respondents worked.

Risk factors operate at jurisdictional level

The study revealed that, taking all workers together across Canada, a higher incidence of work injury was associated with the following individual-level factors: being male, being under 55 (and especially between 25 to 34) years of age, being Canadian-born as opposed to an immigrant, working full-time, reporting medium or high job stress levels, working in a manual or mixed manual/non-manual occupation, and working in retail.

Area-level factors showed little or no association with work injury risk, according to the study. That is, an area’s socioeconomic status (household income, education levels, etc.), labour market status (unemployment rate, percentage of permanent jobs, etc.) and workplace characteristics (size of firms, degree of unionization) were not associated with risk of work injury.

Finally, provincial differences in work risk were found, even after taking individual and area-level factors into account, including industry mix. Workers in the western provinces were shown to be at higher risk of work injury compared to those in Ontario. Specifically, Saskatchewan showed 30 per cent higher risk compared with Ontario; Alberta, 31 per cent; and British Columbia, 46 per cent. Workers in Manitoba, Quebec and Atlantic Canada were at comparable risk of work injury.

Arguably, the key finding is this: Provincial differences in work injury risk persisted after taking into consideration individual characteristics and industry of employment. This finding of unexplained differences in provincial work injury risk points to the idea that factors affecting work injury are operating at a jurisdictional level.

We need to look beyond worker characteristics as risk factors to truly understand risk of work injury, says Breslin. We need to look at broader factors to assist in planning prevention efforts tailored to provincial needs.

Note: The online version of this article was updated in December 2013 to reflect the final findings reported in the May 2013 issue of the Annals of Epidemiology (doi:10.1016/j.annepidem.2013.03.008), in which the paper related to this research was published. In the final analysis, the researchers included "occupation type" (i.e. working in a non-manual, manual or mixed manual/non-manual occupation) as a variable. Including this variable changed the odds ratios slightly, and some statistically significant relationships were different than were initially reported. As a result, some of the risk-of-work-injury numbers associated with various factors changed slightly from those originally reported. These are included in the section above titled "Risk factors operate at jurisdictional level." The overall findings, however, did not change.

Source: At Work, Issue 70, Fall 2012: Institute for Work & Health, Toronto