Cameron A Mustard

Institute for Work and Health, Toronto, Ontario, Canada

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Publications (143)540.41 Total impact

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    Andrea Chambers, Cameron A Mustard, Jacob Etches
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    ABSTRACT: Background A number of jurisdictions have used regulation to promote the adoption of safety-engineered needles as a primary solution to reduce the risk of needlestick injuries among healthcare workers. Regulatory change has not been complemented by ongoing efforts to monitor needlestick injury trends which limits opportunities to evaluate the need for additional investment in this area. The objective of this study was to describe trends in the incidence of needlestick injuries in Ontario prior to and following the establishment of regulation to promote the adoption of safety-engineered needles. Methods An observational study of needlestick injuries obtained from two independent administrative data sources (emergency department records for the treatment of work-related disorders and workers' compensation claims) for a population of occupationally-active adults over the period 2004–2012. Results Comparing the year prior to the regulation being established (2006) to three years after the regulation came into effect (2011), needlestick injury rates in the health and social services sector that were captured by workers’ compensation claims declined by 31% and by 43% in the work-related emergency department records. Rates of workers’ compensation claims associated with needlestick injuries declined by 31% in the hospital sector, by 67% in the long-term care sector and have increased by approximately 1% in nursing services over the period 2004–2012. Conclusions Two independent administrative data sources documented an overall reduction in needlestick injuries in the province of Ontario following a regulatory requirement to adopt safety-engineered needles; however, a substantial burden of occupational needlestick injuries persists in this setting.
    BMC Health Services Research 04/2015; 15(1). DOI:10.1186/s12913-015-0798-z · 1.66 Impact Factor
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    ABSTRACT: Background The objective of this study was to examine individual, occupational, and workplace level factors associated with time loss following a similar injury.Methods Seven thousand three hundred and forty-eight workers’ compensation claims that did not require time off work were matched with up to four claims that required time off work on the event, nature, and part of body injured as well as injury year. Conditional logistic regression models examined individual, occupational, and workplace level factors that were associated with the likelihood of not requiring time off work.ResultsEmployees from firms with higher premium rates were more likely to report no time loss from work and workers in more physically demanding occupations were less likely to report no time loss from work. We observed no association between age or gender and the probability of a time loss claim submission.Conclusions Our results suggest that insurance costs are an incentive for workplaces to adopt policies and practices that minimize time loss following a work injury. Am. J. Ind. Med. © 2015 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 01/2015; 58(4). DOI:10.1002/ajim.22420 · 1.59 Impact Factor
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    ABSTRACT: Objectives. We describe trends in occupational and nonoccupational injury among working-age adults in Ontario. Methods. We conducted an observational study of adults aged 15 to 64 over the period 2004 through 2011, estimating the incidence of occupational and nonoccupational injury from emergency department (ED) records and, separately, from survey responses to 5 waves of a national health interview survey. Results. Over the observation period, the annual percentage change (APC) in the incidence of work-related injury was -5.9% (95% confidence interval [CI] = -7.3, -4.6) in ED records and -7.4% (95% CI = -11.1, -3.5) among survey participants. In contrast, the APC in the incidence of nonoccupational injury was -0.3% (95% CI = -0.4, 0.0) in ED records and 1.0% (95% CI = 0.4, 1.6) among survey participants. Among working-age adults, the percentage of all injuries attributed to work exposures declined from 20.0% in 2004 to 15.2% in 2011 in ED records and from 27.7% in 2001 to 16.9% in 2010 among survey participants. Conclusions. Among working-age adults in Ontario, nearly all of the observed decline in injury incidence over the period 2004 through 2011 is attributed to reductions in occupational injury. (Am J Public Health. Published online ahead of print December 18, 2014: e1-e6. doi:10.2105/AJPH.2014.302223).
    American Journal of Public Health 12/2014; 105(2):e1-e6. DOI:10.2105/AJPH.2014.302223 · 4.23 Impact Factor
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    ABSTRACT: Objective Work-related musculoskeletal disorders (MSDs) are the leading cause of work disability in the developed economies. The objective of this study was to describe trends in the incidence of MSDs attributed to work exposures in Ontario over the period 2004-2011. Methods An observational study of work-related morbidity obtained from three independent sources for a complete population of approximately six million occupationally active adults aged 15-64 in the largest Canadian province. We implemented a conceptually concordant case definition for work-related non-traumatic MSDs in three population-based data sources: emergency department encounter records, lost-time workers' compensation claims and representative samples of Ontario workers participating in consecutive waves of a national health interview survey. Results Over the 8-year observation period, the annual per cent change (APC) in the incidence of work-related MSDs was -3.4% (95% CI -4.9% to -1.9%) in emergency departments' administrative records, -7.2% (-8.5% to -5.8%) in lost-time workers' compensation claims and -5.3% (-7.2% to -3.5%) among participants in the national health interview survey. Corresponding APC measures for all other work-related conditions were -5.4% (-6.6% to -4.2%), -6.0% (-6.7% to -5.3%) and -5.3% (-7.8% to -2.8%), respectively. Incidence rate declines were substantial in the economic recession following the 2008 global financial crisis. Conclusions The three independent population-based data sources used in this study documented an important reduction in the incidence of work-related morbidity attributed to non-traumatic MSDs. The results of this study are consistent with an interpretation that the burden of non-traumatic MSDs arising from work exposures is declining among working-age adults.
    Occupational and Environmental Medicine 10/2014; 72(4). DOI:10.1136/oemed-2014-102442 · 3.23 Impact Factor
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    ABSTRACT: Background While companies talk about the importance of management and organizational initiatives, such as the presence of a strong safety culture or disability management system to promote good occupational health and safety (OHS) and disability management systems (DMS) there is little scientific evidence to support which leading indicators, among many, to use. There is little evidence on the distribution of disability management systems across industrial sectors and firm size, and whether disability policies and practices co-vary with businesses with strong safety cultures. Methods A random selection of organizations registered with the Workplace Safety and Insurance Board (WSIB) were recruited in collaboration with the Ontario Health and Safety Associations (HSA). The sample was representative of all sectors except forestry and mining. Participants completed an online questionnaire about their firms’ organizational policies and practices (OPP), using the organizational policies and practices questionnaire. The disability policy and practice (DPP) scale was measured with seven items. Firm survey data was linked to their WSIB claims data. Results A sample of over 1,900 firms completed an on-line questionnaire. The disability policy and practice (DPP) scale has strong internal consistency (α= 0.92) and test-retest reliability (ICC = 0.84), and reasonable structural validity (CHISQ=1462, df= 311, p< 0.0001, CFI= 0.93, TLI= 0.92, RMSEA (95% CI)= 0.048 (0.046, 0.051)). While it was expected that the DPP scale would co-vary with injuries and illnesses in a negative way, it was positive, suggesting that organizations with problematic workers compensation claims rates implement DPPs to redress these problems. How the DPP scale co-varies with the other OPP scales and by industrial sector will be reported. Conclusions This is the first study to report the variability in DPPs at the organizational level in a representative sample of firms in a jurisdiction. The DPP scale is shown to have high reliability and validity and may represent a useful leading indicator for jurisdictions interested in managing sustainable return to work. The DPP does not always co-vary in accordance with other OPP scales for managing occupational health & safety in an organization which has implications for benchmarking.
    3rd WDPI Conference: Implementing Work Disability Prevention Knowledge, Hyatt Regency Hotel, Toronto Canada; 09/2014
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    ABSTRACT: The aim of this study was to examine the risk of work injury associated with changes in shift schedules and identify whether work injury risks differ between men and women.
    Scandinavian Journal of Work, Environment & Health 09/2014; 40(6). DOI:10.5271/sjweh.3454 · 3.10 Impact Factor
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    ABSTRACT: Background The purpose of this study is to examine the risk of a work-injury absence and the likelihood of receiving compensation among partnered and lone mothers and fathers. Methods This study utilized data from an annual survey of Canadian residents. Logistic regression models examined the association between family status and the receipt of workers' compensation, and absences due to work-related injury or illnesses of 7 or more days. Results Being a lone mother was significantly associated with the risk of work-injury absence. Gender differences were observed for workers' compensation: mothers were half as likely as fathers to receive workers' compensation benefits, which may be attributed to differences in work experiences between men and women. Conclusions Findings may help in understanding whether some parental situations are more vulnerable than others and may contribute to identifying policies that could help workers sustain employment or return to work following an injury. (C) 2014 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 08/2014; 57(8). DOI:10.1002/ajim.22351 · 1.59 Impact Factor
  • Melanie Fortune, Cameron Mustard, Patrick Brown
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    ABSTRACT: Purpose: To assess the associations of occupational heat and cold-related illnesses presenting in emergency departments in south western Ontario, Canada, with daily meteorological conditions using Bayesian inference. Methodology: Meteorological and air pollution data for the south western economic region of Ontario were gathered from Environment Canada and the Ministry of Environment. Daily heat and cold-related emergency department visits clinically attributed to work from 2004 to 2010 were tabulated. A novel application of Bayesian inference on a flexible Poisson time series model was undertaken to examine linear and non-linear associations between average, regional meteorological conditions and daily morbidity rates, to adjust for relevant confounders and temporal trends, and to consider potential interactions. Results: Bilinear associations were observed between regional temperatures and morbidities resulting from extreme temperature exposures. The median increase in the daily rate of emergency department visits for heat illness was 75% for each degree above 22 degrees C (posterior 95% credible interval (Cl) relative rate=1.56-1.99) in the daily maximum temperature. Below 0 degrees C, rates of occupational cold illness increased by a median of 15% for each degree decrease in the minimum temperature (posterior 95% CI 0.80-0.91); wind speed also had a significant effect. Conclusions: The observed associations can inform occupational surveillance and injury prevention programming, as well as public health efforts targeting vulnerable populations. Methodologically, the use of Bayesian inference in time series analyses of meteorological exposures is feasible and conducive to providing accurate advice for policy and practice. (C) 2014 The Authors. Published by Elsevier Inc.
    Environmental Research 05/2014; 132C:449-456. DOI:10.1016/j.envres.2014.04.022 · 3.95 Impact Factor
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    ABSTRACT: To examine if age differences in the consequences of work injury are exacerbated when occupational physical demands are higher. A secondary analysis of workers' compensation claims in British Columbia (N = 373,672). Regression models examined the relationship between age and health care expenditures, days of wage replacement and the occurrence of long-term-disability following a work-related injury in occupations with lower and higher physical demands. Models were adjusted for individual and injury related covariates. Older age and higher occupational physical demands were associated with worse work-injury outcomes. The relationship between age and each outcome was not exacerbated when occupational physical demands were higher compared to when they were lower. Counter to our hypotheses age differences in health care expenditures were smaller among women in more demanding occupations. In this study, we found no evidence that the relationship between age and the consequences of work injury is exacerbated when physical occupational demands are high. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 04/2014; 57(4). DOI:10.1002/ajim.22303 · 1.59 Impact Factor
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    Melanie Fortune, Cameron Mustard, Patrick Brown
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    ABSTRACT: Purpose To assess the associations of occupational heat and cold-related illnesses presenting in emergency departments in south western Ontario, Canada, with daily meteorological conditions using Bayesian inference. Methodology Meteorological and air pollution data for the south western economic region of Ontario were gathered from Environment Canada and the Ministry of Environment. Daily heat and cold-related emergency department visits clinically attributed to work from 2004 to 2010 were tabulated. A novel application of Bayesian inference on a flexible Poisson time series model was undertaken to examine linear and non-linear associations between average, regional meteorological conditions and daily morbidity rates, to adjust for relevant confounders and temporal trends, and to consider potential interactions. Results Bilinear associations were observed between regional temperatures and morbidities resulting from extreme temperature exposures. The median increase in the daily rate of emergency department visits for heat illness was 75% for each degree above 22 °C (posterior 95% credible interval (CI) relative rate=1.56–1.99) in the daily maximum temperature. Below 0 °C, rates of occupational cold illness increased by a median of 15% for each degree decrease in the minimum temperature (posterior 95% CI 0.80–0.91); wind speed also had a significant effect. Conclusions The observed associations can inform occupational surveillance and injury prevention programming, as well as public health efforts targeting vulnerable populations. Methodologically, the use of Bayesian inference in time series analyses of meteorological exposures is feasible and conducive to providing accurate advice for policy and practice.
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    ABSTRACT: Reducing health inequalities has become a major public health priority internationally. However, how best to achieve this goal is not well understood. Population health intervention research has the potential to address some of this knowledge gap. This review argues that simulation studies can produce unique evidence to build the population health intervention research evidence base on reducing social inequalities in health. To this effect, the advantages of using simulation models over other population health intervention research methods are discussed. Key questions regarding the potential challenges of developing simulation models to investigate population health intervention research on reducing social inequalities in health and the types of population health intervention research questions that can be answered using this methodology are reviewed. We use the example of social inequalities in coronary heart disease to illustrate how simulation models can elucidate the effectiveness of a number of 'what-if' counterfactual population health interventions on reducing social inequalities in coronary heart disease. Simulation models are a flexible, cost-effective, evidence-based research method with the capacity to inform public health policy-makers regarding the implementation of population health interventions to reduce social inequalities in health.
    Journal of epidemiology and community health 12/2013; 68(4). DOI:10.1136/jech-2013-202756 · 3.29 Impact Factor
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    ABSTRACT: To estimate the contribution of preexisting chronic conditions on age differences in health care expenditures for the management of work-related musculoskeletal injuries in British Columbia. A secondary analysis of workers' compensation claims submitted over the 5-year period between January 1, 2002 and December 31, 2006 (N=55,827 claims among men and 32,141 claims among women). Path models examined the relationships between age and health care expenditures, and the extent to which age differences in health care expenditures were mediated by preexisting chronic conditions. Models were adjusted for individual, injury, occupational, and industrial covariates. The relationship between age and health care expenditures differed for men and women, with a stronger age gradient observed among men. Preexisting osteoarthritis and coronary heart disease were associated with elevated health care expenditures among men and women. Diabetes was associated with elevated health care expenditures among men only, and depression was associated with elevated health care expenditures among women only. The percentage of the age effect on health care expenditures that was mediated through preexisting chronic conditions increased from 12.4% among 25-34-year-old men (compared with 15-24 y) to 26.6% among 55+-year-old men; and 14.6% among 25-34-year-old women to 35.9% among women 55 and older. The results of this study demonstrate that differences in preexisting chronic conditions have an impact on the relationship between older age and greater health care expenditures after a work-related musculoskeletal injury. The differing prevalence of preexisting osteoarthritis, coronary heart disease, and to a lesser extent diabetes (among men) and depression (among women) across age groups explain a nontrivial proportion of the age effect in health care expenditures after injury. However, approximately two thirds or more of the age effect in health care expenditures remains unexplained.
    Medical care 11/2013; 52(1). DOI:10.1097/MLR.0000000000000017 · 2.94 Impact Factor
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    ABSTRACT: Relatively little attention has been paid to understanding and addressing the potential health-related barriers faced by older workers to stay at work. Using three representative samples from the Canadian Community Health Survey, we examined the relationship between seven physical chronic conditions and labour market participation in Canada between 2000 and 2005. We found that all conditions were associated with an increased probability of not being able to work due to health reasons. In our adjusted models, heart disease was associated with the greatest probability of not working due to health reasons. Arthritis was associated with the largest population attributable fraction. Other variables associated with not being able to work due to health reasons included older age, female gender and lower educational attainment. We also found particular combinations of chronic conditions (heart disease and diabetes; and arthritis and back pain) were associated with a greater risk than the separate effects of each condition independently. The results of this study demonstrate that chronic conditions are associated with labour market participation limitations to differing extents. Strategies to keep older workers in the labour market in Canada will need to address barriers to staying at work that result from the presence of chronic conditions, and particular combinations of conditions.
    Ageing and Society 11/2013; 34(10):1730-1748. DOI:10.1017/S0144686X13000457 · 1.23 Impact Factor
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    ABSTRACT: This study aims to examine the extent to which a greater prevalence of pre-existing chronic conditions among older workers explains why older age is associated with longer duration of sickness absence (SA) following a musculoskeletal work-related injury in British Columbia. A secondary analysis of workers' compensation claims in British Columbia over three time periods (1997-1998; 2001-2002, and 2005-2006), the study comprised 102 997 and 53 882 claims among men and women, respectively. Path models examined the relationships between age and days of absence and the relative contribution of eight different pre-existing chronic conditions (osteoarthritis, rheumatoid arthritis, hypertension, coronary heart disease, diabetes, thyroid conditions, hearing problems, and depression) to this relationship. Models were adjusted for individual, injury, occupational, and industrial covariates. The relationship between age and length of SA was stronger for men than women. A statistically significant indirect effect was present between older age, diabetes, and longer days of SA among both men and women. Indirect effects between age and days of SA were also present through osteoarthritis, among men but not women, and coronary heart disease, among women but not men. Depression was associated with longer duration of SA but was most prevalent among middle-aged claimants. Approximately 70-78% of the effect of age on days of SA remained unexplained after accounting for pre-existing conditions. Pre-existing chronic conditions, specifically diabetes, osteoarthritis and coronary heart disease, represent important factors that explain why older age is associated with more days of SA following a musculoskeletal injury. Given the increasing prevalence of chronic conditions among labor market participants (and subsequently injured workers) moderate reductions in age differences in SA could be gained by better understanding the mechanisms linking these conditions to longer durations of SA.
    Scandinavian Journal of Work, Environment & Health 10/2013; 40(2). DOI:10.5271/sjweh.3397 · 3.10 Impact Factor
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    ABSTRACT: The study sought to identify gender differences in work-related repetitive strain injuries (RSI), as well as examine the degree to which non-work factors such as family roles interact with gender to modify RSI risk. Another aim is to examine whether there are potential provincial differences in work-related RSI risk. The 2003/2005 Canadian Community Health Survey included over 89,000 respondents who reported working in the past 12 months. Separate multi-level models for men and women were used to identify the correlates of work-related RSIs. Women reported sustaining more work-related RSIs than men. Also, having one or more children in the household was associated with lower work-related RSI risk for females. Both men and women in British Columbia reported higher work-related RSI rates than in Ontario. Gender contributes to RSI risk in multiple and diverse ways based on labor market segregation, non-work exposures, and possibly biological vulnerability, which suggests more tailored interventions. Also, the provincial differences indicate that monitoring and surveillance of work injury across jurisdictions can assist in province-wide prevention and occupational health and safety evaluation. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 10/2013; 56(10). DOI:10.1002/ajim.22195 · 1.59 Impact Factor
  • Peter M Smith, Cameron A Mustard
    Canadian Medical Association Journal 10/2013; 185(14):1251. DOI:10.1503/cmaj.113-2135 · 5.81 Impact Factor
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    ABSTRACT: BACKGROUND: This study describes the association between unemployment and cause-specific mortality for a cohort of working-age Canadians. METHODS: We conducted a cohort study over an 11-year period among a broadly representative 15% sample of the non-institutionalized population of Canada aged 30--69 at cohort inception in 1991 (888,000 men and 711,600 women who were occupationally active). We used cox proportional hazard models, for six cause of death categories, two consecutive multi-year periods and four age groups, to estimate mortality hazard ratios comparing unemployed to employed men and women. RESULTS: For persons unemployed at cohort inception, the age-adjusted hazard ratio for all-cause mortality was 1.37 for men (95% confidence interval (CI): 1.32-1.41) and 1.27 for women (95% CI: 1.20-1.35). The age-adjusted hazard ratio for unemployed men and women was elevated for all six causes of death: malignant neoplasms, circulatory diseases, respiratory diseases, alcohol-related diseases, accidents and violence, and all other causes. For unemployed men and women, hazard ratios for all-cause mortality were equivalently elevated in 1991--1996 and 1997--2001. For both men and women, the mortality hazard ratio associated with unemployment attenuated with age. CONCLUSIONS: Consistent with results reported from other long-duration cohort studies, unemployed men and women in this cohort had an elevated risk of mortality for accidents and violence, as well as for chronic diseases. The persistence of elevated mortality risks over two consecutive multi-year periods suggests that exposure to unemployment in 1991 may have marked persons at risk of cumulative socioeconomic hardship.
    BMC Public Health 05/2013; 13(1):441. DOI:10.1186/1471-2458-13-441 · 2.32 Impact Factor
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    ABSTRACT: This study sought to examine provincial variation in work injuries and to assess whether contextual factors are associated with geographic variation in work injuries. Individual-level data from the 2003 and 2005 Canadian Community Health Survey was obtained for a representative sample of 89,541 Canadians aged 15 to 75 years old who reported working in the past 12 months. A multilevel regression model was conducted to identify geographic variation and contextual factors associated with the likelihood of reporting a medically attended work injury, while adjusting for demographic and work variables. Provincial differences in work injuries were observed, even after controlling for other risk factors. Workers in western provinces such as Saskatchewan (adjusted odds ratio [AOR], 1.30; 95% confidence interval [CI], 1.09-1.55), Alberta (AOR, 1.31; 95% CI, 1.13-1.51), and British Columbia (AOR, 1.46; 95% CI, 1.26-1.71) had a higher risk of work injuries compared with Ontario workers. Indicators of area-level material and social deprivation were not associated with work injury risk. Provincial differences in work injuries suggest that broader factors acting as determinants of work injuries are operating across workplaces at a provincial level. Future research needs to identify the provincial determinants and whether similar large area-level factors are driving work injuries in other countries.
    Annals of epidemiology 05/2013; 23(5):260-6. DOI:10.1016/j.annepidem.2013.03.008 · 2.15 Impact Factor
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    ABSTRACT: To estimate the direct and indirect pathways between education and diabetes. We examined the relative contribution of eight different pathways between education and diabetes incidence over a 9-year period in Ontario, Canada. Our data source was respondents (35-60 years of age) to the 2000-2001 Canadian Community Health Survey individually linked with physician and hospital administrative data. Our sample contained 11,899 participants with no previous diagnosis of diabetes. The direct and indirect effects of education level on incident diabetes were estimated using Aalen additive hazard models. Not having completed secondary education was associated with 120 extra diabetes cases per 10,000 men per year and 43 additional diabetes cases per 10,000 women per year, compared with having Bachelors education or higher. Body mass index accounted for 13 of the 120 extra diabetes cases among men, and 24 of the 43 additional diabetes cases for women. Of the mediating pathways examined in this paper, body mass index was the pathway through which the largest number of diabetes cases was mediated among men and women. A substantial number of excess diabetes cases among respondents with lower education levels, in particular among men, were not mediated through any of the eight pathways examined.
    Annals of epidemiology 03/2013; 23(3):143-9. DOI:10.1016/j.annepidem.2012.12.012 · 2.15 Impact Factor
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    ABSTRACT: Objective To examine the role of pain experiences in relation to work absence, within the context of other worker health factors and workplace factors among Canadian nurses with work-related musculoskeletal (MSK) injury. Methods Structural equation modeling was used on a sample of 941 employed, female, direct care nurses with at least one day of work absence due to a work-related MSK injury, from the cross-sectional 2005 National Survey of the Work and Health of Nurses. Results The final model suggests that pain severity and pain-related work interference mediate the impact of the following worker health and workplace factors on work absence duration: depression, back problems, age, unionization, workplace physical demands and low job control. The model accounted for 14 % of the variance in work absence duration and 46.6 % of the variance in pain-related work interference. Conclusions Our findings support a key role for pain severity and pain-related work interference in mediating the effects of workplace factors and worker health factors on work absence duration. Future interventions should explore reducing pain-related work interference through addressing workplace issues, such as providing modified work, reducing physical demands, and increasing job control.
    Journal of Occupational Rehabilitation 01/2013; 23(4). DOI:10.1007/s10926-012-9408-7 · 2.80 Impact Factor

Publication Stats

3k Citations
540.41 Total Impact Points

Institutions

  • 2006–2015
    • Institute for Work and Health
      Toronto, Ontario, Canada
  • 2002–2014
    • University of Toronto
      • • Faculty of Medicine
      • • Department of Family and Community Medicine
      Toronto, Ontario, Canada
  • 2013
    • Queen's University
      • Department of Community Health and Epidemiology
      Kingston, Ontario, Canada
  • 2005–2008
    • McMaster University
      • • Department of Economics
      • • Department of Clinical Epidemiology and Biostatistics
      Hamilton, Ontario, Canada
    • Institute for Clinical Evaluative Sciences
      Toronto, Ontario, Canada
  • 1994–2004
    • University of Manitoba
      • • Department of Community Health Sciences
      • • Manitoba Centre for Health Policy
      • • Faculty of Medicine
      Winnipeg, Manitoba, Canada
  • 1999
    • St. Boniface Hospital Research
      Winnipeg, Manitoba, Canada
  • 1994–1999
    • Health Sciences Centre Winnipeg
      Winnipeg, Manitoba, Canada
  • 1998
    • Statistics Canada
      • Division of Health Analysis
      Ottawa, Ontario, Canada
  • 1995
    • The University of Winnipeg
      Winnipeg, Manitoba, Canada