Grant round-up: Emerging issues and innovative prevention approaches seen in latest IWH projects

Newly funded projects at the Institute for Work & Health include research on accommodating chronic, episodic conditions, measuring workplace cannabis use and integrating OHS and health promotion

Published: October 5, 2018

Researchers at the Institute for Work & Health (IWH) are constantly on the lookout for emerging work health issues and innovative approaches to preventing occupational injury and work disability. Three new studies featured below, taken from among the grants awarded to the Institute in the period between June 2017 and August 2018, are a few examples.

Addressing accommodation and communication barriers across different chronic conditions

At first glance, chronic health conditions such as depression and Crohn’s disease, arthritis and anxiety, or HIV and multiple sclerosis seem to have very little in common. They differ in their causes and symptoms; they usually involve very different treatment and management strategies.

Yet these conditions do have at least one thing in common: they are often invisible, episodic and unpredictable. People living with these conditions can be in good health for considerable periods of time, but then experience debilitating symptoms for bouts of uncertain duration. As such, these individuals can encounter difficulties asking for workplace support and accommodation—or even disclosing their health condition. This may lead to them being misperceived by managers and co-workers as lacking motivation or not being up to the task, which further marginalizes them in the workplace.

Institute for Work & Health Associate Scientific Director and lead investigator Dr. Monique Gignac speaks at the launch of the "Accommodating and communicating about episodic disabilities (ACED)" project. Photos: Sara Macdonald

In a large, five-year project jointly funded by the Social Sciences and Humanities Research Council (SSHRC) and the Canadian Institutes of Health Research (CIHR), IWH Senior Scientist and Associate Scientific Director Dr. Monique Gignac is leading a team to examine accommodation and communication challenges faced by people with episodic, chronic conditions. One of the project’s objectives is to develop evidence-based tools, resources and training to help workers living with these conditions access the support they need without giving up their privacy, says Gignac.

A feature of this project is the involvement of diverse health charities as partners. Their participation reflects an innovative perspective on workplace accommodation challenges—one that sees past the specific diseases and their particular symptoms to focus instead on the common experiences of people living and working with these conditions.

Partners and researchers meet at the September 2018 launch of the "Accommodating and communicating about episodic disabilities (ACED)" project. From left: Aaron Thompson, medical director of occupational disease, Workplace Safety and Insurance Board; Jordan Friesen, national director, workplace mental health, Canadian Mental Health Association; and Sarah Jenner, executive director, Mindful Employer.

It’s a wonderful opportunity to collaborate, says Kate Lee, vice-president of research and patient programs for Crohn’s and Colitis Canada, one of the partner organizations on the project. The commonality of these conditions—the fact that they’re chronic, episodic and invisible—is what brings us together. And it’s what we need to talk about, not necessarily the specific symptoms.

For individuals with multiple sclerosis, asking for workplace supports can be a complex challenge, as symptoms can be so unpredictable when they do flare. We’re excited to see what support we can provide to individuals with these issues—such as how to talk to their supervisors about their disease, says Abidah Shamji, manager of government relations at the MS Society of Canada. But I’m also interested in developing supports for the workplaces themselves. We haven’t understood enough about what happens on the workplace side of things. How can we use research like this to have the most effective conversations?

And for mental illness, growing public awareness of the issue means that now, more than ever, managers and supervisors need tools and resources to support workers with these conditions, says Jordan Friesen, national director of workplace mental health at the Canadian Mental Health Association. “Employers are starting to recognize their responsibilities in supporting employees with mental illness, but the conversations around how to manage and support these employees are still challenging,” he says. “The knowledge and skills to do so are still lacking.”

The project, called Accommodating and communicating about episodic diseases (ACED), gets underway this fall. Other partner organizations include the Great-West Life Centre for Mental Health in the Workplace, Mindful Employer Canada, the Ontario Ministry of Labour, Realize Canada, the Arthritis Society and the University of Toronto.

Partners and researchers meet at the September 2018 launch of the Accommodating and communicating about episodic disabilities (ACED) project. Back row, from left: Mary Ann Baynton, program director at Great-West Life Centre for Mental Health in the Workplace; Dr. Peter Smith, senior scientist at Institute for Work & Health; Dr. Ron Saunders, adjunct scientist at IWH. Front row, from left: Kimberly McGinnis, MS ambassador, Multiple Sclerosis Society of Canada; Helen Anderson, senior manager of education services, The Arthritis Society; and Tammy Yates, executive director, Realize Canada.

Understanding behaviour and attitudes related to at-work cannabis use 

On October 17, 2018, Canada legalizes the use of cannabis for non-medical purposes. This major policy change has raised concerns among workplace parties about potential implications for workplace productivity and occupational health and safety (OHS). One key concern is the lack of evidence upon which workplaces can build effective policies and prevention approaches. Indeed, researchers know virtually nothing about the current magnitude of cannabis use in Canadian workplaces—including use during work, on breaks and in the hours prior to beginning a work shift—let alone how use patterns might change following legalization.

A research project by the Institute seeks to fill that knowledge gap by gathering pan-Canadian data on cannabis use at work, as well as workers’ perceptions of, and attitudes towards, such use. As part of the study, a team co-led by IWH Post-Doctoral Fellow Dr. Nancy Carnide and IWH Senior Scientist and Associate Scientific Director Dr. Peter Smith surveyed more than 2,000 people across a wide range of industries and occupations.

The team asked respondents about their cannabis use at work prior to legalization, their intentions to use cannabis in the workplace following legalization, their current reasons for use and the expected effects of that use in the workplace, their knowledge of cannabis effects, their perceptions of risk and consequences of workplace use, as well as their perceptions of workplace cannabis norms and workplace cannabis availability. The researchers are now analyzing the data, and findings are expected later this year. Funding for the study, called Toking 9 to 5: Clearing the haze on cannabis consumption in Canadian workplaces, comes from a CIHR Catalyst Grant.

It’s important to us to examine not just actual at-work cannabis use, but also attitudes about such use,” says Carnide. “The legalization of recreational cannabis will likely change social norms and perceptions of risk around cannabis use. Studies elsewhere have shown a link between cannabis use and risk perception, so it’s important to capture in data any change in attitudes about cannabis use at work.” The survey was conducted in the months leading up to legalization and can thus provide a pre-legalization baseline for future research examining the impact of this change.

Get early findings at an IWH Speaker Series presentation

Developing guidance on integrating OHS and health promotion programs at work

Employers in Canada are required to provide OHS programs and activities to prevent worker exposure to job-related risks and hazards. Some voluntarily offer workplace health promotion programs that help workers improve their health through individual behaviour changes such as exercising or having a healthy diet. Research has started to show that OHS and health promotion programs can provide greater benefits to workers’ overall health and well-being when they’re blended together. This approach has been popularized through initiatives such as the U.S. National Institute of Occupational Safety and Health’s Total Worker Health™ program.

However, Canadian employers lack guidance as to how to develop and implement integrated OHS and health promotion strategies that are appropriate for our distinct labour and health-care contexts. A new study led by IWH Mustard Post-Doctoral Fellow Dr. Avi Biswas sets out to fill that gap.

The study, funded by the Alberta OHS Futures research grants program, begins with an environmental scan to identify research for various approaches to integrating OHS and workplace health promotion, as well as the barriers and facilitators of the approaches. The team will then work with stakeholder partners, including the Alberta Cancer Prevention Legacy Fund, Energy Safety Canada and the Graham Lowe Group, on a consensus-building process to identify guiding principles that can be used by workplaces in Alberta and Canada to integrate OHS and health promotion activities.

We expect to be able to offer recommendations to employers, with concrete steps to implement, says Biswas. He adds that he hopes this study forms the first phase of a multiphase project, an outcome of which would potentially be a workplace scorecard and assessment tools for an integrated approach,  based on this study’s recommendations.