Injuries In Canada Research Articles

Unemployment and Personal Income Loss After Traumatic Brain Injury

Employment and personal income loss after traumatic brain injury is a major source of postinjury stress and a barrier to societal reintegration. The magnitude of labor market ramifications following traumatic brain injury remains largely unknown. To quantify the 3-year postinjury labor market consequences following traumatic brain injury in Canada. To also estimate the incurred national labor market cost over the study period. This retrospective quasi-experimental, pan-Canadian observational cohort study used linked administrative health and federal taxation data obtained between 2007 and 2017. Mixed-effects difference-in-difference regressions were constructed to estimate the annualized magnitude of the personal income and employment loss during each of the 3 years following injury, respectively, relative to preinjury baseline. Participants included tax-filing adult (19 to 61 years old) traumatic brain injury survivors. Traumatic brain injury. Coprimary outcomes were personal income loss and the proportion of newly unemployed individuals per annum. Secondary objectives were to quantify income and employment loss within mild, moderate, and severe traumatic brain injury subgroups. A total of 18 050 patients with traumatic brain injury between 2007 and 2017 were identified (mean age, 38.0 [SD, 12.4] years; 13 360 male [74.0%]), each of whom was followed up with for 3 consecutive fiscal years. Mean income was CAD $42 600 (US $31 083) in the fiscal year prior to injury and 82% were employed at time of injury. The adjusted mean loss of personal income was CAD $7635 (US $5650) in the first year after injury (Y+1) and CAD $5000 (US $3700) in the third year after injury (Y+3) relative to uninjured controls. In each of the 3 postinjury years, 7.8% individuals were newly unemployed compared with the preinjury baseline. The adjusted average personal income loss for mild, moderate, and severe traumatic brain injury subgroups were CAD $3354 (US $2482), CAD $6750 (US $4995), and CAD $17 375 (US $12 859), respectively, at Y+3; the proportion of unemployed individuals increased by 5.8%, 9.2%, and 20% across the same groups at Y+3 after injury relative to preinjury baseline. The estimated total reduction in personal income aggregated over the 3 postinjury years for the affected participants was CAD $588 million (US $435 million). This work represents national cohort data quantifying the labor market implications of traumatic brain injury. These results may be used to inform economic evaluations and social service resource allocation.

What was the impact of COVID-19 restrictions on unintentional injuries, in Canada and globally? A scoping review investigating how lockdown measures impacted the global burden of unintentional injury.

Injuries are among the leading causes for hospitalizations and emergency department (ED) visits. COVID-19 restrictions ensured safety to Canadians, but also negatively impacted health outcomes, including increasing rates of certain injuries. These differences in trends have been reported internationally however the evidence is scattered and needs to be better understood to identify opportunities for public education and to prepare for future outbreaks. A scoping review was conducted to synthesize evidence regarding the impact of COVID-19 restrictions on unintentional injuries in Canada, compared to other countries. Studies investigating unintentional injuries among all ages during COVID-19 from any country, published in English between December 2019 and July 2021, were included. Intentional injuries and/or previous pandemics were excluded. Four databases were searched (MEDLINE, Embase, Web of Science, SPORTDiscus), and a gray literature search was also conducted. The search yielded 3,041 results, and 189 articles were selected for extraction. A total of 41 reports were included from the gray literature search. Final studies included research from: Europe (n = 85); North America (n = 44); Asia (n = 32); Oceania (n = 12); Africa (n = 8); South America (n = 4); and multi-country (n = 4). Most studies reported higher occurrence of injuries/trauma among males, and the average age across studies was 46 years. The following mechanisms of injury were reported on most frequently: motor vehicle collisions (MVCs; n = 134), falls (n = 104), sports/recreation (n = 65), non-motorized vehicle (n = 31), and occupational (n = 24). Injuries occurring at home (e.g., gardening, home improvement projects) increased, and injuries occurring at schools, workplaces, and public spaces decreased. Overall, decreases were observed in occupational injuries and those resulting from sport/recreation, pedestrian-related, and crush/trap incidents. Decreases were also seen in MVCs and burns, however the severity of injury from these causes increased during the pandemic period. Increases were observed in poisonings, non-motorized vehicle collisions, lacerations, drownings, trampoline injuries; and, foreign body ingestions. Findings from this review can inform interventions and policies to identify gaps in public education, promote safety within the home, and decrease the negative impact of future stay-at-home measures on unintentional injury among Canadians and populations worldwide.

‘There’s no club, absolutely nothing’: Experiences of parents of Veterans living with illnesses and injuries in Canada

LAY SUMMARY Parents of Veterans are often excluded from literature or programs surrounding military and Veteran families. Parents can play an important role in their adult child’s life following an operational stress injury. Little research has been done to look at how supporting an adult child may affect the parents. Parents of Canadian Armed Forces Veterans were interviewed to discuss their experiences supporting an ill or injured adult child. Parents reported taking on many additional responsibilities and often feel worried, guilty, and lost. These demands impacted their own health, well-being, finances, jobs, and relationships. They described feeling forgotten and betrayed by the lack of support and programs available for them. It is important that all parents are given the support and programs required, demonstrating a need for more in-depth explorations of what families of Veterans experience and need in Canada.

Network analysis of multimorbidity and health outcomes among persons with spinal cord injury in Canada.

Multimorbidity, defined as the coexistence of two or more health conditions, is common in persons with spinal cord injury (SCI). Network analysis is a powerful tool to visualize and examine the relationship within complex systems. We utilized network analysis to explore the relationship between 30 secondary health conditions (SHCs) and health outcomes in persons with traumatic (TSCI) and non-traumatic SCI (NTSCI). The study objectives were to (1) apply network models to the 2011-2012 Canadian SCI Community Survey dataset to identify key variables linking the SHCs measured by the Multimorbidity Index-30 (MMI-30) to healthcare utilization (HCU), health status, and quality of life (QoL), (2) create a short form of the MMI-30 based on network analysis, and (3) compare the network-derived MMI to the MMI-30 in persons with TSCI and NTSCI. Three network models (Gaussian Graphical, Ising, and Mixed Graphical) were created and analyzed using standard network measures (e.g., network centrality). Data analyzed included demographic and injury variables (e.g., age, sex, region of residence, date, injury severity), multimorbidity (using MMI-30), HCU (using the 7-item HCU questionnaire and classified as "felt needed care was not received" [HCU-FNCNR]), health status (using the 12-item Short Form survey [SF-12] Physical and Mental Component Summary [PCS-12 and MCS-12] score), and QoL (using the 11-item Life Satisfaction questionnaire [LiSAT-11] first question and a single item QoL measure). Network analysis of 1,549 participants (TSCI: 1137 and NTSCI: 412) revealed strong connections between the independent nodes (30 SHCs) and the dependent nodes (HCU-FNCNR, PCS-12, MCS-12, LiSAT-11, and the QoL score). Additionally, network models identified that cancer, deep vein thrombosis/pulmonary embolism, diabetes, high blood pressure, and liver disease were isolated. Logistic regression analysis indicated the network-derived MMI-25 correlated with all health outcome measures (p <0.001) and was comparable to the MMI-30. The network-derived MMI-25 was comparable to the MMI-30 and was associated with inadequate HCU, lower health status, and poor QoL. The MMI-25 shows promise as a follow-up screening tool to identify persons living with SCI at risk of having poor health outcomes.

A Look at Spinal Cord Injury in Canada: Rick Hansen Spinal Cord Injury Registry (RHSCIR) - 2021 SCI Data Summary.

The Rick Hansen Spinal Cord Injury Registry (RHSCIR) is a prospective registry of individuals who sustain a spinal cord injury (SCI) from 18 acute and 14 rehabilitation (rehab) Canadian hospitals specializing in SCI care. The data summary provides demographic and clinical details on 1148 people with either a traumatic spinal cord injury (tSCI) or a nontraumatic spinal cord injury (ntSCI) who were treated at a RHSCIR hospital in 2021. Information about the patient demographics, cause and severity of injury, care pathway, length of hospital stay, secondary complications, and social impacts after SCI were included. Data from the summary can provide researchers, healthcare providers, and decision makers with knowledge and evidence that may support strategies to improve SCI care services within their institutions.

Incidence and prevalence of traumatic spinal cord injury in Canada using health administrative data.

Incidence and prevalence data are needed for the planning, funding, delivery and evaluation of injury prevention and health care programs. The objective of this study was to estimate the Canadian traumatic spinal cord injury (TSCI) incidence, prevalence and trends over time using national-level health administrative data. ICD-10 CA codes were used to identify the cases for the hospital admission and discharge incidence rates of TSCI in Canada from 2005 to 2016. Provincial estimates were calculated using the location of the admitting facility. Age and sex-specific incidence rates were set to the 2015/2016 rates for the 2017 to 2019 estimates. Annual incidence rates were used as input for the prevalence model that applied annual survivorship rates derived from life expectancy data. For 2019, it was estimated that there were 1,199 cases (32.0 per million) of TSCI admitted to hospitals, with 123 (10% of admissions) in-hospital deaths and 1,076 people with TSCI (28.7 per million) were discharged in Canada. The estimated number of people living with TSCI was 30,239 (804/million); 15,533 (52%) with paraplegia and 14,706 (48%) with tetraplegia. Trends included an increase in the number of people injured each year from 874 to 1,199 incident cases (37%), an older average age at injury rising from 46.6 years to 54.3 years and a larger proportion over the age of 65 changing from 22 to 38%, during the 15-year time frame. This study provides a standard method for calculating the incidence and prevalence of TSCI in Canada using national-level health administrative data. The estimates are conservative based on the limitations of the data but represent a large Canadian sample over 15 years, which highlight national trends. An increasing number of TSCI cases among the elderly population due to falls reported in this study can inform health care planning, prevention strategies, and future research.

Severity of All-Terrain Vehicle–Related Injuries by Age in Canada, 2002-2019

Rates of pediatric hospitalizations following an injury while riding an all-terrain vehicle (ATV) are increasing. Few studies have compared the rates of severe injuries among children, adolescents, and adults. To investigate whether younger ATV riders are at risk for more severe ATV-related injuries. This cross-sectional study was conducted using administrative data from hospitals in 9 provinces in Canada. Participants included patients admitted to hospitals with ATV-related injuries between 2002 and 2019. Statistical analysis was performed from June 2020 to September 2021. The primary exposure was age younger than 16 years. Comparison groups were youths aged 16 to 20 years and adults aged 21 years and older. The main outcomes of interest were death, spinal cord injury, and an Injury Severity Score (ISS) greater than 25. Secondary outcomes were less severe injuries, including head injuries, crush type injuries, and fractures. Among 52 745 patients with complete data, 15% were youths younger than 16 years, 13% were youths aged 16 to 20 years, 82% were male, and 47% lived in rural areas. After adjusting for covariates, the odds of dying were higher among youths aged 16 to 20 years (adjusted odds ratio [aOR], 1.64; 95% CI, 1.04-2.60) compared with those younger than 16 years. Youths aged 16 to 20 years also had higher odds of spinal cord injury (aOR, 2.72; 95% CI, 1.80-4.20) and an injury severity score greater than 25 (aOR, 1.63; 95% CI, 1.36-1.96) compared with youths 16 years of age or less. Sex-specific analyses revealed these associations were greater for male youths aged 16 to 20 years (spinal cord injury: aOR, 3.81; 95% CI, 1.38-11.10, and dying in a hospital: aOR, 4.37; 95% CI, 1.19-21.02) than female youths aged 16 to 20 years. In this cross-sectional study of patients hospitalized for ATV injuries in Canada, youths aged 16 to 20 years and adults aged 21 years and older were at an increased risk of death and severe injuries compared with youths younger than 16 years. The increased risk of death and severe injuries was most evident among male patients.

The effect of recreational cannabis legalization on rates of traffic injury in Canada.

To measure the impact of Canada's recreational cannabis legalization (RCL) in October 2018 and the subsequent impact of the COVID-19 lockdowns from March 2020 on rates of emergency department (ED) visits and hospitalizations for traffic injury. An interrupted time series analysis of rates of ED visits and hospitalizations in Canada recorded in population-based databases from January/April 2010 to March 2021. ED visits in Ontario and Alberta and hospitalizations in Ontario, Alberta, British Columbia, Prairies [Manitoba, Saskatchewan], and Maritimes [Nova Scotia, New Brunswick, Newfoundland, Prince Edward Island]. Cases Monthly counts of presentations to the ED or hospital for motor vehicle injury or pedestrian/cyclist injury, used to calculate monthly rates per 100,000 population. An occurrence of one or more International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD-10-CA) code for motor vehicle injury (V20-V29, V40-V79, V30-39, V86) and pedestrian/cyclist injury (V01-V09, V10-V19) within the National Ambulatory Care Reporting System and Discharge Abstract Database. There were no statistically significant changes in rates of ED visits and hospitalizations for motor vehicle or pedestrian/cyclist injury after RCL after accounting for multiple testing. After COVID-19, there was an immediate decrease in the rate of ED visits for motor vehicle injury that was statistically significant only in Ontario (level change ß = -16.07 in Ontario, 95% confidence interval [CI] -20.55 to -11.60, p=0.000; ß = -10.34 in Alberta, 95% CI -17.80 to -2.89, p=0.008; alpha of 0.004) and no changes in rates of hospitalizations. Canada's recreational cannabis legalization (RCL) did not notably impact motor vehicle and pedestrian/cyclist injury. The rate of emergency department visits for motor vehicle injury decreased immediately after COVID-19, resulting in rates below post-RCL levels in the year after COVID-19.

Fatal and non-fatal firearm-related injuries in Canada, 2016–2020: a population-based study using three administrative databases

BackgroundFirearms are a substantial cause of injury-related morbidity and mortality in Canada and globally, though evidence from contexts other than the USA is relatively limited. We examined deaths, hospitalizations and emergency department (ED) visits due to firearm-related injuries in Canada to identify population groups at increased risk of fatal and non-fatal outcomes.MethodsWe conducted a population-based study using three national administrative databases on deaths, hospitalizations, and ED visits. ICD-10 codes were used to identify firearm-related injuries from January 1, 2016, through December 31, 2020. Fatal and non-fatal firearm injuries were classified as suicide/self-harm, homicide/assault, unintentional, undetermined or legal intervention injuries. We analyzed the data with counts, rates and proportions, stratified by sex, age group, province/territory, and year.ResultsOver the 5-year period, we identified 4005 deaths, 3169 hospitalizations, and 2847 ED visits related to firearm injuries in various jurisdictions in Canada. Males comprised the majority of fatal and non-fatal injury cases. The highest rates of fatal and non-fatal firearm injuries were among 20- to 34-year-olds. The leading cause of fatal firearm injuries was self-harm (72.3%). For non-fatal firearm hospitalizations and ED visits, assault (48.8%) and unintentional injuries (62.8%) were the leading causes of injury. Rates varied by province and territory.ConclusionsOur results showed that males comprised the majority of fatal and non-fatal firearm injuries in Canada. The rates of both fatal and non-fatal firearm injuries were highest among the 20- to 34-year-old age group. This comprehensive overview of the epidemiology of firearm injuries in Canada provides baseline data for ongoing surveillance and policy evaluation related to public health interventions.

Fall Risk Factors in Community-Dwelling Older Adults: An Umbrella Review Protocol

BACKGROUND: Falls are among the leading cause of accidental injury in Canada, with one in three older adults experiencing a fall each year. This leads to disability, long-term pain, loss of independence, reduced quality of life, mental health challenges, and increased mortality risk. Alongside these injuries, falls are a growing national public health concern given their direct cost of over $2 billion a year. Further, with an aging Canadian population, the prevalence and incidence of falls are expected to increase at a rapid rate. A large body of literature has identified risk factors that contribute to falls in older adults, however, to date this literature has been disjointed and often groups together fall risks for different populations. To address these limitations, this review will aim to summarize the evidence identifying risk factors for falls in community-dwelling older adults (60 years).&#x0D; &#x0D; METHODS: We searched seven databases (Medline, Embase, CINAHL, Cochrane Library, PsychINFO, Ageline) for articles that: are systematic reviews (including scoping reviews), include a population of community dwelling older adults (60 years), and report modifiable and non-modifiable factors that have shown to increase the risk for falls in prospective studies. Multiple independent reviewers will screen titles, abstracts, and full text articles, and perform data extraction and quality assessment. Risk factors will be synthesized narratively. Wherever possible, findings will be grouped according to the International Classification of Functional Disability (ICF).&#x0D; &#x0D; ANTICIPATED IMPACT: Given the substantial amount of research conducted in this area, we anticipate that the identified risk factors for falls will cover a wide breadth. Further, our results will identify the risk factors that are of the utmost importance to consider when undertaking fall prevention efforts.

Allied Interpreters: Exploring the Role Perception and Ethics of Uncertified Interpreters Supporting Migrant Agricultural Workers in British Columbia

Uncertified interpreters enable migrant agricultural workers in Canada’s Seasonal Agricultural Worker Program to access key resources and connect with community. Through providing a range of services, including support work and advocacy, interpreters assist migrant workers at risk of exploitation and injury in Canada. This article explores how uncertified interpreters navigate the power dynamics between migrant workers, interpreters, and other actors. Moreover, this article investigates how uncertified interpreters perceive their role and the ethical values that guide their communicative methods. This study’s research findings show that interpreters may adopt a pro-worker role perception as they gain knowledge of the disempowerment experienced by migrant workers. Arising from this role perception, interpreters may also adopt pro-worker ethical values that renounce interpreter neutrality in favour of accessibility and an explanatory communication style. Ultimately, this article contends that uncertified interpreters may reject some traditional interpretation guidelines to adopt a role perception, ethical framework, and communicative style perceived to be more well-suited to supporting migrant farm workers in British Columbia.

Where to start? Injury prevention priority scores for traumatic injuries in Canada.

Background:Given limited resources for injury prevention, it is essential to determine which mechanisms of injury to target to provide the most benefit to the largest proportion of the population. We developed objective, evidence-based injury prevention priority scores (IPPSs) for the Canadian population across 4 prevention perspectives: mortality, injury severity, resource use and societal cost.Methods:We performed a retrospective cohort study of all injuries in Canada from 2009/10 to 2013/14. Hospital admissions were obtained from the Discharge Database, and deaths from the Statistics Canada Canadian Vital Statistics Death Database. For each mechanism of injury, we calculated an IPPS as a balanced measure of injury frequency and 1) mortality rate, 2) median 1 – ICISS (Injury Severity Score derived from the International Statistical Classification of Diseases and Related Health Problems, 10th revision, enhanced Canadian version), 3) median cost per hospital stay or 4) median potential years of life lost (PYLL), providing a ranking of mechanisms of injury in priority order. The IPPS by definition has a mean of 50 and a standard deviation of 10. The higher the IPPS, the higher the priority for injury prevention.Results:A total of 694 535 injuries were identified over the study period. The most frequent mechanism of injury was falls (391 068 [56.3%]). The overall mortality rate was 0.09 deaths/injured person, the median 1 – ICISS was 0.017, the median cost was $5217, and the median PYLL was 0. The mechanisms with the 3 highest IPPSs were falls (75), self-harm (67) and drowning (66) for mortality; falls (77), drowning (70) and suffocation (61) for severity; falls (80), suffocation (63) and fire (60) for resource use; and falls (72), assault (62), and firearms and legal interventions (59 in both cases) for societal cost.Conclusion:This study produced IPPSs for traumatic injuries in Canada that provide objective and quantifiable methods for identifying mechanisms of injury to target for specific prevention initiatives. Preventing falls would provide the most benefit to the largest proportion of Canadians and should be prioritized in injury-prevention policy.

Basketball vs. Hockey-The Changing Face of Sport-Related Injuries in Canada.

To characterize and compare the incidence of basketball-related, soccer-related, and hockey-related injuries over a 10-year period. Cohort analysis of sport-related injuries using multiple Ontario healthcare databases. Emergency department visits in Ontario, Canada. Any patient who sustained musculoskeletal injuries sustained while playing basketball, soccer, or hockey between 2006 and 2017 were identified. Sport of injury, age, sex, rurality index, marginalization status, and comorbidity score. Annual Incidence Density Rates of injury were calculated for each sport, and significance of trends was analyzed by assessing overlap of 95% confidence intervals. One lakhs eighty five thousand eighty hundred sixty-eight patients (median age: 16 years, interquartile range 13-26) received treatment for sport-related injuries (basketball = 55 468; soccer = 67 021; and hockey = 63 379). The incidence of basketball-related and soccer-related injuries increased from 3.4 (3.3-3.5) to 5.6 (5.5-5.7) and 4.4 (4.3-4.5) to 4.9 (4.8-5) per 10 000 person years, respectively, whereas the incidence of hockey-related injuries decreased from 4.7 (4.6-4.8) to 3.7 (3.6-3.8). Patients with basketball injuries were more marginalized (3.01 ± 0.74) compared with patients with soccer and hockey injuries (2.90 ± 0.75 and 2.72 ± 0.69, respectively). Accurate regional epidemiologic information regarding sports injuries can be used to guide policy development for municipal planning and sport program development. The trends and demographic patterns described highlight general and sport-specific injury patterns in Ontario. Populations with the highest incidence of injury, most notably adolescents and men older than 50, may represent an appropriate population for injury risk prevention.

P.057 Multidisciplinary Care for Optimal Management of Complex Nerve Injuries In Canada

Background: Recent advances in management of peripheral nerve injuries is leading to a paradigm shift in the treatment of Canadian patients. Multi-disciplinary care models provide diagnostic, surgical and rehabilitative consultations within a single clinical encounter. Involvement of allied health care professionals has been shown to improve outcome. The purpose of this study was to ascertain the distribution and composition of multidisciplinary teams, and identify regional disparities. Methods: Representatives from clinics across Canada were invited to participate in a survey at the Annual Canadian Peripheral Nerve Symposium in London, Ontario in November 2019, with telephone follow up. Results: Delegates from 17 programs responded to the survey (12 academic centre and 5 community setting). Program provides electrodiagnostic testing, neuromuscular, rehabilitation and surgical assessment. Access to the following services was reported: occupational therapy=53% (9/17), physiotherapy 29% (5/17), research assistant=17% (3/17), social work=12% (2/17), mental health=6% (1/17). Conclusions: Complex nerve injury clinics are being established throughout Canada. Allied health care and research support are limited in many multi-disciplinary complex nerve injury programs. There is variable access, likely resulting in disparities in patient care across Canada. This data will be valuable for lobbying for resources for resources to improve the care of these complex patients.

Cost-utility analysis of transcranial direct current stimulation therapy with and without virtual illusion for neuropathic pain for adults with spinal cord injury in Canada

Objective To undertake a cost-utility analysis comparing virtual illusion (VI) and transcranial direct current stimulation (tDCS) combination therapy, tDCS alone and standard pharmacological care in Ontario, Canada from a societal perspective over a three-month time horizon. Design Cost-utility analysis using Markov model methods Setting Community setting in Ontario, Canada. Participants Individuals with spinal cord injury and neuropathic pain (NP) resistant to pharmacological therapy. Interventions Virtual illusion and transcranial direct current stimulation, transcranial direct current stimulation alone and standard pharmacological therapy. Outcome Measures Incremental costs, quality adjusted life years (QALY) and incremental cost effectiveness ratio Results The incremental cost effectiveness ratio of VI and tDCS therapy cost is $3,396 per QALY (2020 Canadian dollars) when compared to standard care. The incremental cost per QALY of tDCS therapy alone is $33,167. VI and tDCS therapy had lower incremental costs (−$519) and higher incremental QALYs (0.026) compared to tDCS alone. From a public healthcare payer perspective, there is a 74% probability that VI and tDCS therapy and 54% probability that tDCS alone would be cost effective at a $50,000 per QALY willingness-to-pay threshold. Our findings remained relatively robust in various scenario analyses. Conclusion Our findings suggest that at three-months after therapy, VI and tDCS combination therapy may be more cost effective than tDCS therapy alone. Based on conventional health technology funding thresholds, VI and tDCS combination therapy merits consideration for the treatment of NP in adults with spinal cord injuries.

The Impact of Adverse Employment and Working Conditions on the Risk of Workplace Injury in Canada.

BackgroundEmployment standards (ES) include having a regular payday, regular breaks, the right to paid sick or vacation time, and paid wages. Inadequate ES contribute to the labour market vulnerability of workers; however, they are not typically considered to be risk factors for workplace injury. In a sample of Canadian workers, we examine the risk of injury associated with inadequate ES, independent of, and combined with inadequate workplace protections from workplace hazards.MethodsData from 2,803 adults working 15 hours or more/week in workplaces with at least five employees were analysed. We explored associations between exposure to workplace hazards with inadequate protections [termed occupational health and safety (OHS) vulnerability] and inadequate ES on workplace injury (physical or mental injury; injury requiring time off). Additive interaction models were used to examine the independent and combined effects of these exposures.ResultsOccupational health and safety vulnerability and inadequate ES were independently associated with increased injury outcomes. Adjusted models showed an additive relationship for all injury outcomes between OHS vulnerability and inadequate ES. Statistically significant superadditive relationships were observed for physical injury risk with policy and procedure vulnerability plus inadequate ES [synergy index (S) 1.50, 95% CI: 1.13–2.00] and for overall OHS vulnerability plus inadequate ES (S 1.53, 95% CI: 1.16–2.02), suggesting a combined effect greater than independent effects.ConclusionOccupational health and safety vulnerability and inadequate ES are independently associated with workplace injury. For certain injury outcomes, the combined effect of OHS vulnerability and inadequate ES is greater than the independent effects of each individual exposure.

Prevalence of tanning equipment use among Canadians.

The objective of this study was to collect prevalence estimates of indoor tanning usage and associated injuries in Canada. The rapid response component of the 2019 Canadian Community Health Survey collected data on the use of tanning equipment in the previous 12months, including reasons for use, frequency/duration of use, precautions taken and adverse reactions or injuries. The 2019 research findings were as follows, an estimated 3.0% (95% CI: 2.5-3.4%) of Canadians reported that they had used indoor tanning equipment in the past year. Among users, 71.1% (95% CI: 63.9-78.3%) were female and females aged 18-34 were significantly more prevalent users compared to females aged 45 or older. The prevalence of indoor tanning was higher among people without a university degree; however, there were no differences in prevalence by household income or region. Most users indicated they used indoor tanning equipment within a tanning salon (75.3%: 95% CI: 69.1-81.6%) and the most common reason for usage was to develop a "protective" base tan (72.1%: 95% CI: 65.2-78.9%). Over one third (39.2%: 95% CI: 31.1-47.2%) of all users reported 10 or more sessions in the past year. The prevalence of indoor UV tanning usage is declining in Canada. Similar to results in 2014, the majority of users continue to be female, with a large number in the 18 to 34 age group.

Family Members' Perspectives on Family and Social Support Available to Suicidal Patients, and Health Systems' Interactions and Responses to Suicide Cases in Alberta: Protocol for a Quantitative Research Study.

BackgroundSuicide is a major cause of preventable death globally and a leading cause of death by injury in Canada. To support people who experience suicidal thoughts and behaviors and to ultimately prevent people from dying by suicide, it is important to understand individual and familial experiences with the health care system.ObjectiveWe present the protocol for a study, the objective of which is to explore how people who died by suicide, and their family members, interacted with the health care system.MethodsThis is a quantitative research study. Data will be collected through a self-administered paper-based or online survey of the family member of patients who died by suicide. The sample size was calculated to be 385 (margin of error ±3%).ResultsData collection will start in October 2020 and results will be available by March 2021. We expect the results to shed light on the experiences of individuals who died by suicide and their family members with the health care system. The study has received ethical clearance from the Health Ethics Research Board of the University of Alberta (Pro00096342).ConclusionsOur study may inform practice, policy, and future research. The findings may shape how members of the health care system respond to people who are at risk of suicide and their families.International Registered Report Identifier (IRRID)PRR1-10.2196/19112

Association of Severe Trauma With Work and Earnings in a National Cohort in Canada

Traumatic injury disproportionately affects adults of working age. The ability to work and earn income is a key patient-centered outcome. The association of severe injury with work and earnings appears to be unknown. To evaluate the association of severe traumatic injury with subsequent employment and earnings in long-term survivors. This is a retrospective, matched, national, population-based cohort study of adults who had employment and were hospitalized with severe traumatic injury in Canada between January 2008 and December 2010. All acute care hospitalizations for severe injury were included if they involved adults aged 30 to 61 years who were hospitalized with severe traumatic injury, working in the 2 years prior to injury, and alive through the third calendar year after their injury. Patients were matched with unexposed control participants based on age, sex, marital status, province of residence, rurality, baseline health characteristics, baseline earnings, self-employment status, union membership, and year of the index event. Data analysis occurred from March 2019 to December 2019. Changes in employment status and annual earnings, compared with unexposed control participants, were evaluated in the third calendar year after injury. Weighted multivariable probit regression was used to compare proportions of individuals working between those who survived trauma and control participants. The association of injury with mean yearly earnings was quantified using matched difference-in-difference, ordinary least-squares regression. A total of 5167 adults (25.6% female; mean [SD] age, 47.3 [8.8] years) with severe injuries were matched with control participants who were unexposed (25.6% female; mean [SD] age, 47.3 [8.8] years). Three years after trauma, 79.3% of those who survived trauma were working, compared with 91.7% of control participants, a difference of -12.4 (95% CI, -13.5 to -11.4) percentage points. Three years after injury, patients with injuries experienced a mean loss of $9745 (95% CI, -$10 739 to -$8752) in earnings compared with control participants, representing a 19.0% difference in annual earnings. Those who remained employed 3 years after injury experienced a 10.8% loss of earnings compared with control participants (-$6043 [95% CI, -$7101 to -$4986]). Loss of work was proportionately higher in those with lower preinjury income (lowest tercile, -18.5% [95% CI, -20.8% to -16.2%]; middle tercile, -11.5% [95% CI, -13.2% to -9.9%]; highest tercile, -6.0% (95% CI, -7.8% to -4.3%]). In this study, severe traumatic injury had a significant association with employment and earnings of adults of working age. Those with lower preinjury earnings experienced the greatest relative loss of employment and earnings.

Agriculture-related Injuries: Discussion in Canadian Media

ABSTRACT Objectives: This study examined news media reporting on farm injuries in Canada for the occurrence of prevention messages and factors related to whether an event was reported in more than one article. Methods: This study used a media database maintained by the Canadian Agricultural Safety Association (CASA), which stores publicly available news media reports of agricultural injuries and fatalities in Canada. Media reports were obtained for the years 2010 through 2017. Reports were coded as whether they reported a fatal or non-fatal injury, age and gender of those affected, urban or rural media, as well as whether they involved machinery, or were in French. Logistic regression was used to determine which variables predicted an event being reported more than once, and whether a report included a prevention message. Results: The database identified 856 relevant articles. Only 6.3% of the articles included a prevention message, and 34.7% were duplicate articles. Fatal injuries were more likely to be reported in multiple articles (odds ratio: 2.44). There was also significant variation in the occurrence of multiple reports across the years of the study. Prevention messages were more likely to occur when at least one child or female victim was involved in an event. However, only year of publication remained significantly associated with the occurrence of a prevention message in multivariable regression (odds ratio: 0.85). Conclusion: Prevention messages are rare in media reporting of farm injuries and are decreasing over time. Improved reporting is needed to aid in farm injury prevention.