Workers Compensation Board Research Articles

Carpal tunnel syndrome among Manitoba workers: Results from the Manitoba Occupational Disease Surveillance System.

Carpal tunnel syndrome (CTS) is associated with occupational high-force repetitive tasks and vibration. This project examines the relationship between CTS and work to: (1) identify jobs and industries with increased CTS risk; (2) explore whether there is a sex difference in the risk of CTS after controlling for occupation; and (3) determine whether any observed relationships persist after excluding Workers Compensation Board (WCB) accepted time-loss CTS claims. We linked 95.5% of time-loss WCB claims from 2006 to 2019 to provincial administrative health data. The cohort included 143,001 unique person-occupation combinations. CTS cases were defined as at least two medical claims for (ICD-9 354) within a 12-month period or a surgical claim for CTS from 2 years before the WCB claim to 3 years after. WCB accepted CTS time-loss claims not identified by the medical claims were also included. A total of 4302 individuals (3.0%) met the CTS definition. Analysis revealed that the hazard ratios (HRs) of CTS vary considerably with occupation. Sex-based differences in CTS risks were observed, both in low- and high-risk occupations. In many occupations with increased HR, the HR remained elevated after excluding accepted time-loss WCB cases. The risk of developing CTS varied with occupation. Job titles with ergonomic risk factors had higher risks than those with lower exposures. This finding remained after eliminating time-loss compensated WCB cases, suggesting that all cases of CTS in high risk jobs are not identified in WCB statistics. Female workers in some job titles had excess CTS cases compared to male workers within the same job title.

Characterizing worker compensation claims in long-term care and examining the association between facility characteristics and severe injury: a repeated cross-sectional study from Alberta, Canada

BackgroundDespite the physical demands and risks inherent to working in long-term care (LTC), little is known about workplace injuries and worker compensation claims in this setting. The purpose of this study was to characterize workplace injuries in LTC and to estimate the association between worker and organizational factors on severe injury.MethodsWe used a repeated cross-sectional design to examine worker compensation claims between September 1, 2014 and September 30, 2018 from 25 LTC homes. Worker compensation claim data came from The Workers Compensation Board of Alberta. LTC facility data came from the Translating Research in Elder Care program. We used descriptive statistics to characterize the sample and multivariable logistic regression to estimate the association between staff, organizational, and resident characteristics and severe injury, measured as 31+ days of disability.ResultsWe examined 3337 compensation claims from 25 LTC facilities. Less than 10% of claims (5.1%, n = 170) resulted in severe injury and most claims did not result in any days of disability (70.9%, n = 2367). Most of the sample were women and over 40 years of age. Care aides were the largest occupational group (62.1%, n = 2072). The highest proportion of claims were made from staff working in voluntary not for profit facilities (41.9%, n = 1398) followed by public not for profit (32.9%, n = 1098), and private for profit (n = 25.2%, n = 841). Most claims identified the nature of injury as traumatic injuries to muscles, tendons, ligaments, or joints. In the multivariable logistic regression, higher staff age (50–59, aOR: 2.26, 95% CI 1.06–4.83; 60+, aOR: 2.70, 95% CI 1.20–6.08) was associated with more severe injury, controlling for resident acuity and other organizational staffing factors.ConclusionsMost claims were made by care aides and were due to musculoskeletal injuries. In LTC, few worker compensation claims were due to severe injury. More research is needed to delve into the specific features of the LTC setting that are related to worker injury.

Midterm outcomes of autologous bridging of rotator cuff tears with an autologous tendon patch (TEAR patch)

Large and massive rotator cuff tears and tears after failed surgical repair are a challenging clinical problem with different treatment options. The purpose of the study was to evaluate the mid-term outcomes following rotator cuff repair (RCR) with autologous hamstring tendon graft bridging (TEAR patch) with the hypothesis, that outcomes would be reasonable and complication rates low. This is a retrospective case series study of patients who underwent open RCR using a TEAR patch from June, 2015 to March, 2019. evidence of cuff tear arthropathy, advanced fatty infiltration, moderate to severe arthropathy and workers compensation board or litigation involved. Clinical outcome measures: Constant score (CS), Disabilities of Arm, Shoulder and Hand score (DASH), Simple Shoulder Test (SST), Subjective Shoulder Value (SSV), range of motion (ROM) and manual muscle test (MMT) for forward elevation, abduction, external and internal rotation, patient satisfaction, willingness to do the operation again. Radiographic outcome measures: MRI, ultrasound and radiographs: Graft integrity and acromiohumeral distance (AHD). 44 patients were followed (89%) for ≥ 2 years (45 shoulders, mean age 60.3 years (48-76), mean follow-up 4.3 years (2-6)). All clinical outcome measures (CS, DASH, SST, SSV, ROM, and MMT) demonstrated significant improvement except active external and internal rotation. At 2 years follow-up, the mean patient satisfaction was high (12.2 out of 15 points) and 33 of 38 patients (73.3%) would do the operation again. A perfect graft integration was observed in n=30 (66.7%) a small gap in n=7 (15.6%), a retear in n=3 (7%) and a complete failure of the tendon patch in n=5 (11%) patients. Graft integrity was strongly correlated with the postoperative AHD (r=0.599 , p=0.001 ) and the gain in AHD (r=0.599 , p=0.001) but not with ROM or PROM's or patient satisfaction. Four patients required revision surgeries (three due to deep infection and one for poor function and pain). Mid-term clinical and radiographic outcomes following RCR with graft bridging using a TEAR patch were reasonable. The procedure resulted in improved shoulder function and a high level of patient satisfaction. The revision rate is acceptable in view of the specific patient group and treatment alternatives. The described technique of the TEAR patch can be a valuable alternative to existing methods and a novel autograft source for rotator cuff surgeries that need bridging of a tendon defect.

Effects of sex and age on work-related upper extremity musculoskeletal disorders in Ontario, Canada.

Effective targeting of workplace upper extremity musculoskeletal disorder (MSD) prevention strategies requires the identification of demographic groups most at risk. Workers' compensation data provides an effective means of surveillance of MSDs at the population level. The primary purpose of this study was to identify the effects of age and sex on rates of tendon injuries of the wrist and hand, carpal tunnel syndrome (CTS), epicondylitis, and soft tissue shoulder injuries in Ontario, Canada between 2000-2019 using workers' compensation data from the Association of Workers Compensation Boards of Canada (AWCBC). Age and sex specific rates of lost-time injury claims from the four identified injury categories as well as "non-specific" upper extremity MSDs which did not fit into the four categories were calculated by standardizing injury claim totals with "at-risk" population estimates from the Canada Labour Force Survey. A multiple regression analysis was used to analyze the effects of age and sex on rates of specific injury claims. Statistically significant age and sex effects were identified for rates of claims from tendon injuries of the wrist and hand, CTS, and shoulder injuries, while only age effects were significant for epicondylitis. Between 2000-2019, rates of claims from the four injury categories studied and the magnitude of the age and sex effects declined substantially over time. Detailed surveillance of workplace ergonomic hazards in Ontario workplaces is needed to determine what is causing rates of upper extremity claims to decline.

Acute myocardial infarctions identified in the Manitoba Occupational Disease Surveillance System: A linkage of worker's compensation and provincial health data.

The purpose of this study was to identify jobs and industries that may be associated with increased or decreased risk of myocardial infarction. We linked provincial health care data with Workers Compensation Board (WCB) of Manitoba claims data to create the Manitoba Occupational Disease Surveillance System (MODSS). Workers were eligible for inclusion in this study if their WCB claim listed an occupation, their claim could be linked to health data, they had an accepted non-acute myocardial infarction (AMI) compensation time loss claim and were free of a recent (<1 year) AMI diagnosis at the start of disease follow-up. AMI cases were identified as the most-responsible diagnosis in the hospitalization file (ICD-9 410 or ICD-10 I20). Cases were included if they occurred after the WCB record injury date until end of coverage, either through moving out of province, reaching age 65, death, or the end of the study period (March 1, 2020). We identified 1880 incident AMIs amongst 150,022 claims recorded in the MODSS (1.25%). A number of industries and occupations were found to have higher and lower AMI rates. Care providers and educational, legal, and public protection support occupations had a lower hazard ratio (HR; 0.64; 95% confidence interval [CI]: 0.44-0.92) compared to the overall cohort. Female chefs and cooks, and male butchers and bakers had elevated AMI HRs. Both male and female transport and heavy equipment operators and related maintenance occupations had increased HRs (1.48; 95% CI: 1.30-1.67). Often male and female workers employed in the same occupations had congruent AMI risks, but this was not always the case. The linkage of a WCB data set with provincial health claims data led to the identification of a number of occupations with elevated risks of AMI in Manitoba. This was most notable in the transportation industry. Identifying work areas with increased risk of AMIs could lead to targeted educational efforts and potential workplace modifications to lower this risk.

Developing Intercultural Competence in a Complex Organizational Structure: A Case Study Within Quebec’s Workers’ Compensation Board

Background: Wanting to offer culturally sensitive services to a diverse population, rehabilitation counsellors employed by a workers’ compensation board (WCB) in a Canadian province asked the researchers to provide them with support to develop their intercultural competencies. A collaborative research design was suggested as a potential way to make full use of experiential knowledge. This article presents an action research approach in which study participants were also active in the development of new knowledge and sought to become key players in organizational change.Objective: The objective of this article is to present the steps involved in the co-construction of an intercultural communication support tool and to describe the mechanisms and structure put in place to develop the tool.Methodology: A working group (WG), a steering committee (SC) and a validation group (VG) were created, and each met on a regular basis over approximately 18 months. Several methodological approaches and data collection tools were used: participant observation charts, diaries, an “intercultural situation” workshops.Results: A total of 28 people participated in the project, in addition to the three researchers. The study showed the importance of integrating three dimensions—the individual, collective, and organizational—into the definition of intercultural competence. It soon became evident in our study that a self-reflection process grounded in a collective learning approach was the core component of the entire process of developing intercultural competencies. This finding went well beyond the production of any materials (practical guides, checklists, and supporting documents) that resulted from this process.

Statistical Inference for Periodic Self-Exciting Threshold Integer-Valued Autoregressive Processes.

This paper considers the periodic self-exciting threshold integer-valued autoregressive processes under a weaker condition in which the second moment is finite instead of the innovation distribution being given. The basic statistical properties of the model are discussed, the quasi-likelihood inference of the parameters is investigated, and the asymptotic behaviors of the estimators are obtained. Threshold estimates based on quasi-likelihood and least squares methods are given. Simulation studies evidence that the quasi-likelihood methods perform well with realistic sample sizes and may be superior to least squares and maximum likelihood methods. The practical application of the processes is illustrated by a time series dataset concerning the monthly counts of claimants collecting short-term disability benefits from the Workers’ Compensation Board (WCB). In addition, the forecasting problem of this dataset is addressed.

Determining the influence of the Workers Compensation Board of Manitoba's opioid policy on prescription opioid use amongst WCB recipients.

BackgroundOpioid medications are commonly used by Workers Compensation Board (WCB) claimants following workplace injuries. The purpose of this study is to describe the impact of an opioid management policy on opioid prescriptions amongst a WCB‐covered population compared to changes in the use of these medications in the general population of a Canadian province.MethodsWe linked WCB claims data from 2006 to 2016 (13,155 claims, 11,905 individuals) to Manitoba provincial health records and compared opioid use amongst this group to 478,606 individuals aged 18–65. Linear regression was performed to examine the change over time in number of individuals being prescribed opioids for various durations and dosages of 50 or more, and 120 or more morphine equivalents (ME)/day for both the WCB and Manitoba population.ResultsWCB claimants totaled 2.5% of Manitoba residents aged 18–65 who were prescribed opioids for non‐cancer pain. After the introduction of the opioid use policy for the WCB population in November 2011, the number of people prescribed opioids declined 49.4% in the WCB group, while increasing 10.8% in the province as a whole. The number of individuals using 50 ME/day or more declined 43.1% in the WCB group and increased 5.8% in the province.ConclusionsOpioid management programs organized by a compensation board can lead to a substantial reduction in the prescription of opioid medications to a WCB client population, including individuals who were prescribed higher doses of these medications when compared with general trends in the community.

Structural and Molecular Characteristics of Axons in the Long Head of the Biceps Tendon

ObjectivesAlthough the long head of the biceps tendon (LHBT) is a major source of shoulder pain, the innervation is not sufficiently documented. Thus, the present study aimed to characterize structural and molecular features of nervous elements in the LHBT.MethodsThe proximal part of eleven LHBTs was harvested intraoperatively. There were 8 female and 3 male specimens. Age ranged from 66 to 86 years. For structural analyses, nervous elements were viewed in the transmission electron microscope. For molecular characterization, we used a series of neuronal markers: This included general neuronal markers [antibodies against neurofilament and protein gene product 9.5 (PGP9.5)] as well as specific neuronal markers[antibodies against myelin basic protein (MBP), calcitonin gene related product (CGRP), substance P (SP), tyrosine hydroxylase (TH), and growth associated protein 43 (GAP43)]. Anti‐neurofilament and anti PGP9.5 visualized the overall innervation. Anti‐MBP visualized myelination, anti‐CGRP and anti‐SP nociceptive fibers, anti‐TH sympathetic nerve fibers, and anti‐GAP43 nerve fibers during development and regeneration. Immunolabelled sections were analyzed in the confocal laser scanning microscope.All procedures performed in this study were approved by the local medical ethics committee (Austrian workers compensation boards’ research ethics committee and institutional review board of the Medical University of Vienna, No. 06/2017) and in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all persons included in this study.ResultsWe show that the LHBT contains unmyelinated as well as myelinated nerve fibers which group in nerve fascicles and follow blood vessels. Many myelinated and unmyelinated axons exhibit molecular features of nociceptive nerve fibers. Another subpopulation of unmyelinated axons exhibits molecular characteristics of sympathetic nerve fibers. Unmyelinated sympathetic fibers and unmyelinated nociceptive fibers express proteins that are found during development and regeneration.ConclusionPresent findings show that the LHBT of aged persons is richly innervated. The occurrence of growth protein GAP43 in nociceptive nerve fibers supports the hypothesis that in‐growth of nociceptive fibers is the source of chronic tendon pain.

Examining the impact of occupational health and safety vulnerability on injury claim reporting in three Canadian provinces.

The workers' compensation system covers wages and health care costs associated with work-related injuries or illnesses. We explore if dimensions of occupational health and safety vulnerability are associated with differences in reporting work-related injuries to workers' compensation boards (WCBs). We examined data from adults reporting physical workplace injuries requiring time off or health care. We explored relationships between exposure to nine hazards, risk from inadequate policies and procedures, inadequate occupational health and safety (OHS) awareness, inadequate empowerment, and reporting to provincial WCBs. Odds ratios (ORs) were calculated to assess risk from dimensions of workplace vulnerability for not reporting an injury to WCBs. Of 326 participants, 64% did not report injuries to WCBs. Reporting was higher among those with hazardous workplace exposures compared to those without (40% vs 22%, P = .01), lower among those with inadequate policy and procedures and inadequate awareness protections. Inadequate OHS awareness protection was related to not reporting to WCBs in logistic regression models. Women, those working part-time, workers in education, health, and public administration, and non-unionized workers were less likely to report injuries (nonsignificant), while workers with postgraduate educations were significantly less likely to report an injury compared to referent (OR = 3.89, 95% CI: 1.57-9.62). A general lack of knowledge about OHS rights and responsibilities was associated with low levels of reporting. This suggests there is a knowledge deficit among some workers, possibly amenable to joint efforts to increase rights and responsibilities related to OHS with the dissemination of information about rights to workers' compensation.

Obstructive Sleep Apnea Severity and the Risk of Occupational Injury: A Prospective Observational Cohort.

To determine whether patients with obstructive sleep apnea (OSA) are at increased risk of occupational injury (OI) METHODS: Working patients (aged 18 to 65 who reported more than 10h of work per week) who were referred to the University of British Columbia Sleep Laboratory for suspected OSA for polysomnogram (PSG) were recruited from 2003 to 2011. Patients completed an extensive survey the night of their PSG. Validated OI was obtained by linking patient data to Workers Compensation Board Claims Data. 1109 workers were studied; mean age was 47.1years, median AHI was 15.0/h, median BMI was 30kg/m2, 70.2% were male and 29% of patients worked in physical or manual related occupations. 78 patients (7.03%) suffered 140 OI in the 5years after PSG. In a multivariate logistic regression model, OSA severity [defined as a log(AHI + 1)] was a significant predictor of OI (p = 0.04) after controlling for age, sex, BMI, and physical or manual related occupations. Patients with moderate and severe OSA had approximately two times the odds of an OI compared to patients without OSA (OR 1.99, 95% CI 0.96-4.44 and 2.00, 95% CI 0.96-4.49 for moderate and severe OSA groups, respectively). In this prospective study, OSA severity was independently associated with an increased risk of OI.

Total disability days in interprovincial and home-province workers injured in Alberta, Canada: A mixed-methods study with matched-pair analysis of compensation data and participant interviews.

Workers moving between states or provinces to find employment are reported to take longer to return to work after the injury. The Alberta Workers Compensation Board (WCB) identified all workers from four Canadian Atlantic provinces who sustained a work injury in Alberta resulting in greater than 5 total temporary disability days (TTDDays) from January 2015 to June 2017. Each was matched on sex, age, and injury date with an Alberta claimant also with greater than 5 TTDDays. WCB information extracted included employment, injury, cost and place of treatment, and modified work. Cox regression identified factors associated with TTDDays. Semi-structured interviews were also undertaken. Two-hundred forty pairs were identified and 60 interviews completed. Those from the Atlantic provinces had more TTDDays (median 63 days) than Alberta (median 22 days) with an unadjusted hazard ratio (HR) 0.50 (95% confidence interval [CI], 0.42-0.61). When adjusted for all factors, the HR moved closer to unity (HR = 0.62; 95% CI, 0.50-0.76). Total health care costs were the strongest predictor, with modified work, injury type, and claim status also explanatory factors. Among the Atlantic workers, leaving Alberta for treatment was strongly related to a lower likelihood of ending wage replacement (HR = 0.45; 95% CI, 0.32-0.62). Participants in the interview study emphasized the importance of returning to the family after injury and the financial difficulties of maintaining a second home with reduced income after the injury. The higher costs of wage replacement associated with extended time off work may be inherent to the practice of employing out-of-province workers for jobs for which there is a shortage of local labor.

Do patients receiving workers' compensation who undergo arthroscopic rotator cuff repair have worse outcomes than non-recipients? Retrospective case-control study.

We compared preoperative and postoperative measures among workers' compensation board (WCB) recipients and non-recipients and determined the impact of WCB receipt on the 1- and 2-year outcomes of rotator cuff repair. We retrospectively reviewed patients with full-thickness rotator cuff tears who underwent arthroscopic repair between September 2011 and September 2014. Patients were divided into two groups based on WCB status: WCB recipients and non-recipients. All patients returned for follow-up functional evaluations at 1 and 2 years after the operation. Four outcome measures were evaluated: visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), and range of motion (ROM). Seventy patients (38 males, 32 females) were evaluated, 20 of whom were WCB recipients. At 1 year after the operation, ASES, UCLA, and VAS scores as well as abduction ROM (Abd-ROM) had improved significantly in both groups. However, non-recipients showed significantly greater improvement than did WCB recipients in ASES, UCLA, and VAS scores and in forward flexion ROM and Abd-ROM ( p = 0.000, 0.009, 0.002, 0.046, and 0.020, respectively). However, at 2 years after the operation (after the end of WCB), there were no significant differences in any clinical outcome between WCB recipients and non-recipients ( p = 0.057, 0.106, 0.075, 0.724, and 0.787, respectively). Although workers' compensation recipients who underwent arthroscopic rotator cuff repair had worse outcomes while receiving WCB benefits, the outcomes were similar after WCB benefits ended.

Effects of the New York State Workers Compensation Board Medical Treatment Guidelines on Return to Work.

Examine the association between New York State Workers' Compensation Medical Treatment Guidelines (Guidelines) adherence and return-to-work after occupational low back injuries. Assess adherence to Guidelines by examining diagnostic and treatment utilization. Retrospective chart review of cases. Outcomes of interest were lost time duration and diagnostic/treatment utilization rates. Time to event analyses performed using Kaplan-Meier plots and Cox proportional hazard model. Care received after implementation of Guidelines resulted in decreased lost time. Treatment rates were consistent, while diagnostic imaging use was inconsistent with Guidelines recommendations. Guidelines use positively influenced return-to-work after acute occupational low back injuries. Inconsistencies in following Guidelines were observed for diagnostic tests, having a potential paradoxical effect on lost time. Further studies are necessary to test for additional hypotheses.

Perceived Role and Expectations of Health Care Providers in Return to Work.

Purpose Health care providers (HCPs) play an important role in return to work (RTW) and in the workers' compensation system. However, HCPs may feel unsure about their responsibilities in the RTW process and experience difficulty making recommendations about RTW readiness and limitations. This study examines the ways in which HCPs and case managers (CMs) perceive HCPs role in the RTW process, and how similarities and differences between these views, in turn, inform expectations of HCPs. Methods In-depth interviews were conducted with 69 HCPs and 34 CMs from 4 provinces. Data were double coded and a thematic, inductive analysis was carried out to develop key themes. Findings The main role of HCPs was to diagnose injury and provide patients with appropriate treatment. In addition, the majority of HCPs and CMs viewed providing medical information to workers' compensation board (WCB) and the general encouragement of RTW as important roles played by HCPs. There was less clarity, and at times disagreement, about the scope of HCPs' role in providing medical information to WCB and encouraging RTW, such as the type of information they should provide and the timelines for RTW. Conclusion Interviews suggest that different role expectations may stem from differing perspectives of HCPs and the CMs had regarding RTW. A comprehensive discussion between WCB decision-makers and HCPs is needed, with an end goal of reaching consensus regarding roles and responsibilities in the RTW process. The findings highlight the importance of establishing clearer role expectations.

Model selection for time series of count data

Selecting between competing statistical models is a challenging problem especially when the competing models are non-nested. An effective algorithm is developed in a Bayesian framework for selecting between a parameter-driven autoregressive Poisson regression model and an observation-driven integer valued autoregressive model when modelling time series count data. In order to achieve this a particle MCMC algorithm for the autoregressive Poisson regression model is introduced. The particle filter underpinning the particle MCMC algorithm plays a key role in estimating the marginal likelihood of the autoregressive Poisson regression model via importance sampling and is also utilised to estimate the DIC. The performance of the model selection algorithms are assessed via a simulation study. Two real-life data sets, monthly US polio cases (1970–1983) and monthly benefit claims from the logging industry to the British Columbia Workers Compensation Board (1985–1994) are successfully analysed.

Measurement properties of instruments assessing permanent functional impairment of the spine: a systematic review protocol

IntroductionPermanent functional impairment (PFI) of the spine is a rating system used by compensation authorities, such as workers compensation boards, to establish an appropriate level of financial compensation for persistent...

The Role of Healthcare Providers in Return to Work

International research has generated strong evidence that healthcare providers (HCPs) play a key role in the return to work (RTW) process. However, pressure on consultation time, administrative challenges and limited knowledge about a patient's workplace can thwart meaningful engagement. Aim: Our study sought to understand how HCPs interact with workers compensation boards (WCBs), manage the treatment of workers compensation patients and navigate the RTW process. Method: The study involved in-depth interviews with 97 HCPs in British Columbia, Manitoba, Ontario and Newfoundland and Labrador and interviews with 34 case managers (CMs). An inductive, constant comparative analysis was employed to develop key themes. Findings: Most HCPs did not encounter significant problems with the workers compensation system or the RTW process when they treated patients who had visible, acute, physical injuries, but faced challenges when they encountered patients with multiple injuries, gradual-onset or complex illnesses, chronic pain and mental health conditions. In these circumstances, many experienced the workers compensation system as opaque and confusing. A number of systemic, process and administrative hurdles, disagreements about medical decisions and lack of role clarity impeded the meaningful engagement of HCPs in RTW. In turn, this has resulted in challenges for injured workers (IWs), as well as inefficiencies in the workers compensation system. Conclusion: This study raises questions about the appropriate role of HCPs in the RTW process. We offer suggestions about practices and policies that can clarify the role of HCPs and make workers compensation systems easier to navigate for all stakeholders.

Costs of productivity loss due to occupational cancer in Canada: estimation using claims data from Workers\u2019 Compensation Boards

IntroductionCancer is a leading cause of illness globally, yet our understanding of the financial implications of cancer caused by working conditions and environments is limited. The goal of this study is to estimate the costs of productivity losses due to occupational cancer in Canada, and to evaluate the factors associated with these costs.MethodsTwo sources of data are used: (i) Individual level administrative claims data from the Workers Compensation Board of Nova Scotia; and (ii) provincial aggregated cancer claims statistics from the Association of Workers Compensation Boards of Canada. Benefits paid to claimants are based on actuarial estimates of wage-loss, but do not include medical costs that are covered by the Canadian publicly funded healthcare system. Regional claims level data are used to estimate the total and average (per claim) cost of occupational cancer to the insurance system, and to assess which characteristics of the claim/claimant influence costs. Cost estimates from one region are weighted using regional multipliers to adjust for system differences between regions, and extrapolated to estimate national costs of occupational cancer.Results/DiscussionWe estimate that the total cost of occupational cancer to the Workers’ Compensation system in Canada between 1996 and 2013 was $1.2 billion. The average annual cost was $68 million. The cancer being identified as asbestos related were significantly positively associated with costs, whereas the age of the claimant was significantly negatively associated with costs. The industry type/region, injury type or part of body affected by cancer were not significant cost determinants.ConclusionGiven the severity of the cancer burden, it is important to understand the financial implications of the disease on workers. Our study shows that productivity losses associated with cancer in the workplace are not negligible, particularly for workers exposed to asbestos.

The cost and distribution of firefighter injuries in a large Canadian Fire Department.

There is limited data available regarding the cost of firefighter injuries. This information is necessary to develop targeted injury prevention strategies. To categorize the cost of injuries filed in 2012 by firefighters from a from a large department by job duty, injury type, body part affected, and the general motion pattern employed at the time of injury. Data were taken from reports filed by CFD personnel and claims filed with the Workers' Compensation Board (WCB) of Alberta between January 1, 2012 and December 31, 2012. Of the 244 injuries reported, 65% were categorized as sprains and strains, the most frequent of which affected the back (32%). The total cost of all claims was $555,955; 77% were sprain/strain-related. Knee and back injuries were most costly ($157,383 and $100,459). Categorized by job duty, most sprains/strains (31%) were sustained while attending to fire station responsibilities, although physical training was associated with the highest costs (34%). Fireground operations were attributed to 18% of sprains/strains and 16% of costs. Lifting injuries were more frequent (23%) and costly (20%) than all injuries. The most common and costly injuries occurred while attending to fire station-related responsibilities and during physical training.