The psychosocial work environment among educators during the COVID-19 pandemic.

BACKGROUND: The education sector has been heavily impacted by COVID-19. While the impact on school-aged children has received much attention, less attention has focused on the experiences of educators. AIMS: To compare various dimensions of the psychosocial work environment and health outcomes between educators engaged in online learning to those engaged in in-person learning in the Canadian province of Ontario. METHODS: Responses from 5438 educators engaged in either online or in-person learning were collected between 23 November and 21 December 2020; three months after the start of the 2020/21 academic year in September 2020. Psychosocial outcomes included quantitative demands, work pace, predictability, role conflicts, and social support from supervisors and co-workers; assessed using an abbreviated version of the Copenhagen Psychosocial Questionnaire. Secondary outcomes included burnout and sleep troubles. Ordinary Least-Squares regression models examined adjusted mean differences in the levels of outcomes for respondents in in-person versus online learning, after adjustment for a variety of covariates. RESULTS: Compared to respondents engaged in in-person learning, respondents engaged in online learning reported less predictability, higher role conflicts and less support from supervisors and co-workers. Statistically significant differences in work pace, burnout and sleep troubles were also observed across learning modes, although these differences did not exceed previously suggested thresholds for minimum important differences. CONCLUSIONS: Important differences in the psychosocial work environment were observed between respondents engaged in in-person learning versus online learning. Addressing these differences is required, given the potential continued importance of online learning within the context of the COVID-19 pandemic and beyond.

Differential antibody responses to gliadin-derived indigestible peptides in patients with schizophrenia.

Gluten consumption has previously been implicated in the development of schizophrenia while an immunological link between gluten and schizophrenia was established by the detection of circulating antibodies against gliadin, a major component of wheat gluten. Several studies have reported an increase in circulating antibodies against native gliadin molecules that are unlikely to survive degradation in the digestive system. In this study, therefore, we measured plasma immunoglobulin G (IgG) and IgA antibodies against indigestible gliadin-derived peptide antigens using an in-house enzyme-linked immunosorbent assay (ELISA) among 169 patients with schizophrenia and 236 control subjects. We also examined the plasma levels of IgG and IgA antibodies against the mixture of native gliadins using commercially available ELISA kits. The results showed that patients with schizophrenia had the increased levels of plasma IgG against the γ-gliadin-derived fragment, namely AAQ6C, but decreased levels of plasma IgG against the α- and γ3-gliadin-derived antigens, as compared with control subjects. This study also demonstrated a uniform decrease in plasma IgA antibodies against gliadin-derived antigens. There was no significant difference in the levels of plasma antibodies against native gliadins between the patient group and the control group. Of eight gliadin-derived antigens tested, four showed a sensitivity of >20% against the specificity of ⩾95% for detection of their corresponding antibodies in plasma. These four tests may thus have a potential to serve as biomarkers for the identification of schizophrenia subgroups that may need an alternative therapy or precision treatment. Further investigation with clinical trials should be carried out to explore this possibility.

The demographic and contextual correlates of work-related repetitive strain injuries among Canadian men and women.

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

The psychosocial work environment and incident diabetes in Ontario, Canada.

BACKGROUND: Relatively few longitudinal studies have explored the relationship between psychosocial work conditions and diabetes incidence. Given the increasing global burden of diabetes this is an important area for public health research. AIMS: To examine the relationships between dimensions of the psychosocial work environment on the subsequent incidence of diabetes among men and women in Ontario, Canada over a 9 year period. METHODS: We used data from Ontario respondents (35 to 60 years of age) to the 2000-01 Canadian Community Health Survey linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. Our sample of actively employed labour market participants with no previous diagnoses for diabetes was followed for a 9 year period to ascertain incident diabetes. RESULTS: There were 7443 participants. Low levels of job control were associated with an increased risk of diabetes among women, but not among men. Counter to our hypotheses high levels of social support were also associated with increased diabetes risk among women, but not among men. No relationship was found between any psychosocial work measure and risk of diabetes among men. CONCLUSIONS: Given the increasing prevalence of diabetes worldwide, job control could potentially be an import ant modifiable risk factor to reduce the incidence of diabetes among female, but not among male, workers. More research is needed to understand the pathways through which low social support may protect against the development of diabetes.

Disability management outcomes in the Ontario long-term care sector.

INTRODUCTION: Optimal disability management practices supporting early and safe return-to-work involve the workplace adoption of formal policies and procedures to ensure the quality of disability management outcomes. In the Canadian province of Ontario, there are approximately 60,000 health care workers in 600 licensed facilities providing long-term residential care to approximately 75,000 elderly residents. Workers in this sector are exposed to high biomechanical demands arising from care-giving tasks and have a substantial risk of work-related disability. Over the period 2000-2006, many long-term care facilities in Ontario adopted disability management practices that encourage modified work arrangements. The objective of this study was to describe differences in modified work arrangements and disability outcomes in long-term care facilities in Ontario. METHODS: Measures of disability episode outcomes are described for a representative sample of 32 Ontario long-term care facilities for two consecutive years 2005 and 2006. Data were obtained from a questionnaire survey of facilities, a survey of a representative sample of caregivers and administrative records from the provincial workers' compensation agency. RESULTS: A total of 28,747 days of disability attributed to work-related conditions were experienced by 3,271 full-time equivalent staff in 2005 (28,034 days in 2006). Average total disability days were 922 per 100 full-time equivalent staff in 2005 and 889 per 100 full-time equivalent staff in 2006. Disability compensation expenditures, measured as wage replacement benefits received by disabled workers, were estimated to be $72,332 per 100 full-time equivalent staff in 2005 and $64,619 per 100 full-time equivalent staff in 2006. On average, approximately 60% of all disability days were managed by modified duty arrangements and the proportion of total disability days managed by modified duty arrangements for each facility was correlated between the two observation years. CONCLUSIONS: Across facilities, there was no evidence that modified duty arrangements were associated with lower disability compensation expenditures and there was mixed evidence that modified duty was associated with a lower burden of disability. In this setting, disability days managed by modified duty arrangements were not accurately documented in worker's compensation claim records.

Differential risk of employment in more physically demanding jobs among a recent cohort of immigrants to Canada.

OBJECTIVE: To examine the proportion of a recent cohort of immigrants to Canada who were working in jobs that were more physically demanding than those in which they worked before migration to Canada. DESIGN: Longitudinal cohort of immigrants to Canada with occupational position measured before and 2 and 4 years after arrival in Canada. SUBJECTS: Respondents to Statistics Canada's Longitudinal Survey of Immigrants to Canada (LSIC). The LSIC surveyed a representative sample of immigrants, aged 15 and older, who arrived in Canada between November 2000 and December 2001. For the purpose of this study, the sample was restricted to respondents who had worked before immigrating and were working when re-interviewed 2 (n = 4331) or 4 (n = 4238) years after arrival in Canada. MAIN OUTCOME: Employment in an occupation with higher physical demands than that employed in before arrival in Canada. RESULTS: Respondents with less proficiency at speaking English and family class or refugee applicants were the most likely to be employed in occupations with higher physical demands both 2 and 4 years after arrival in Canada. CONCLUSIONS: Employment in a more physically demanding occupation may pose particular risks of workplace injury. In this sample of immigrants to Canada, respondents with poorer English skills and refugees (factors that may increase this risk) were more likely to be employed in more physically demanding occupations. Greater attention to the prevention of workplace injuries among particular groups of new immigrants to Canada is required.

Trends in educational inequalities in smoking and physical activity in Canada: 1974-2005.

BACKGROUND: In Canada levels of smoking have decreased and levels of physical activity have increased over the last 20 years. However, little research has examined if educational inequalities in either of these important health determinants have changed. METHODS: A secondary analysis of Canadian population-based surveys from 1974 through to 2005 was conducted. The prevalence of both smoking and physical activity across educational groups for both men and women, as well as relative and absolute measures of inequality was estimated. RESULTS: Differences in both smoking and physical activity across educational groups in all surveys examined between 1974 and 2005 were found, with lower educational groups more likely to be heavy smokers and inactive in each survey. Both relative and absolute educational inequalities in smoking widened between 1974 and 2005 (relative concentration index (RCI) for smoking 10 plus cigarettes per day changed from -7.9 to -26.9 among men; and from -4.8 to -27.4 among women), with inequalities in physical activity narrowing between 1981 and 1996, then widening between 1996 and 2005 (RCI for inactivity -4.34 to -6.75 among men; -3.57 to -5.54 among women). In general, results among men and women did not differ substantially. CONCLUSIONS: It is unlikely that the widening educational inequalities in smoking and physical activity documented here reflect lower knowledge of the consequences of smoking and physical inactivity among lower educated groups. The results suggest more work needs to be done in both designing population health approaches that focus on equity and the creation of supportive environments that provide equal opportunities for behaviour change for all educational groups in Canada.

Comparing the risk of work-related injuries between immigrants to Canada and Canadian-born labour market participants.

OBJECTIVES: To examine the burden of work-related injuries among immigrants to Canada compared to Canadian-born labour force participants. METHODS: Using data from the 2003 and 2005 Canadian Community Health Surveys (n = 99,115), two nationally representative population samples, we examined the risk of self-reported, activity limiting work-related injuries among immigrants with varying time periods since arrival in Canada. Models were adjusted for hours of work in the last 12 months as well as various demographic and work-related variables. RESULTS: Immigrant men in their first 5 years in Canada reported lower rates of activity limiting injuries compared to Canadian-born respondents. Surprisingly, the percentage of injuries that required medical attention was much higher among recent immigrants compared to Canadian-born respondents, resulting in an increased risk of activity limiting injuries requiring medical attention among immigrant men compared to Canadian-born labour force participants. No excess risk was found among female immigrants compared to Canadian-born female labour market participants. CONCLUSIONS: Immigrant men in their first 5 years in Canada are at increased risk of work-related injuries that require medical attention. A similar risk is not present among immigrant women. Further, given differences in the number of activity limiting injuries requiring medical attention across immigrant groups, we believe this excess risk among immigrant men may be underestimated in the current data source. Future research should attempt to fully capture the barriers faced by immigrants in obtaining safe employment, the number of injuries that are sustained by immigrants while working, and the consequences of these injuries.

Examining the relationships between job control and health status: a path analysis approach.

OBJECTIVE: To examine the pathways through which job control affects health status; to examine if the effects of job control on health status are attenuated by including other measures associated with lower socioeconomic status, and to examine if the relationship between job control and health status is consistent across socioeconomic status groups. DESIGN: A prospective observational cohort study over eight years (1994-2002). PARTICIPANTS: 4886 Respondents aged 25-60 years, who were non-self-employed labour force participants, working more than 20 hours per week, without physical or mental limitations restricting the type or amount of work they could do at baseline. After longitudinal attrition, the remaining study sample was 3411 (87% of the original study sample who did not die or become pregnant during the survey period). MAIN RESULTS: Low job control in 1994 was associated with worse than expected self-rated health in 2002, both directly and indirectly via a lower physical activity level in 1996. Adjustment for other factors associated with low socioeconomic status did not attenuate these relationships to a large extent. No differences were found in the effects of job control on physical activity or health status between socioeconomic groups (high and low education and high and low household income). CONCLUSIONS: The inclusion of other factors associated with lower socioeconomic status did not attenuate the direct and indirect effects of job control on health status. The finding that low job control is associated with lower physical activity levels deserves further investigation, given the increasing concern about rising levels of obesity in the developed world.

Time allocation between work and recreation and the associated injury risks among young people.

PROBLEM: The purpose of this study was to examine the relationship between overall risk of injury and time use patterns between work and active recreation among adolescents and young adults. METHODS: Using a representative sample of 9,795 Canadians aged 15-24 years, a multivariate logistic regression on the likelihood of any medically attended injury was conducted, including sociodemographic, individual, and time factors. RESULTS: Young people who engaged in a combination of high work and high activity hours were twice as likely to sustain a medically attended injury compared to those who worked low hours, but did not participate in any recreational activity. Those respondents who were not in school had a 43% increase in injury risk compared to full-time students. SUMMARY: Our findings suggest that injury risk was not a simple function of fatigue and cumulative exposure time. Our findings suggest the importance of considering time use and the associated injury risk tradeoffs. IMPACT ON INDUSTRY: Relevant to state and federal work safety policy makers, our findings suggest the importance of understanding where youth might otherwise spend their time if constraint were placed on their employment opportunities, and the associated injury risk tradeoffs must be taken into consideration.

Age-social stratification designs had a negligible impact on income-mortality associations.

OBJECTIVES: Age-social stratification has been used to offset socioeconomic status (SES) misclassification due to cohort effects. This study was to evaluate whether age-income stratification designs generate comparable income-mortality associations as those whose income rankings are based on absolute thresholds. STUDY DESIGN AND SETTING: Using self-reported income as our SES variable, and mortality as our outcome measure, the impact of age-social stratification was examined in two distinct cohorts: one with acute myocardial infarction (AMI) (n=3,138), and the second free of cardiovascular disease (n=15,115). Age-adjusted income-mortality associations were compared between age-social stratification techniques, which used "age-relative" income thresholds and "absolute" income thresholds whose ranks were independent of patient age. RESULTS: In both cohorts, crude mortality inversely correlated with age and income. Techniques using "age-relative" income thresholds yielded similar adjusted odds ratio for mortality as did those that used "absolute" income threshold methods (differences in adjusted odds ratios [+/-95% confidence interval (CI)] between "absolute" and "age-relative" classifications for highest vs. lowest income tertiles: -0.05 [-0.24, 0.12] among patients with AMI and 0.05 [-0.03, 0.13] among patients without cardiovascular disease). CONCLUSION: More complex designs incorporating age-social stratification techniques generate similar income-mortality associations as more simplified approaches, which classified SES using absolute income thresholds.

Young people and work injuries: an examination of jurisdictional variation within Canada.

OBJECTIVE: The purpose of this study was to identify risk factors of work injuries among Canadian adolescents and young adults and to examine provincial differences in work injury rates. METHODS: Information on work and injuries were obtained from a representative sample of 14 541 Canadians aged 15-24 years. Respondents reported medically attended, work related injuries in the past 12 months, work hours, and type of occupation. A multivariate logistic regression on likelihood of work injury included demographic and work variables, as well as province of residence. RESULTS: Even when factors expected to vary by province such as occupation were statistically controlled, Saskatchewan youth were about twice as likely to be injured at work compared to Ontario youth. Type of job was a major correlate of injury risk, with all jobs showing higher risk than administrative clerical jobs. Even with type of job controlled, visible minorities, students, and 15-17 year olds had a reduced likelihood of work injury than their counterparts. CONCLUSIONS: Many young Canadians sustain work injuries that have clear medical costs and potential long term health consequences. Individual level explanations for youth's increased risk for workplace injuries (for example, inexperience or developmental factors) need to be supplemented with a better understanding of the broader social, economic, and political factors across jurisdictions.

Healthcare use before and after a workplace injury in British Columbia, Canada.

OBJECTIVES: There is growing evidence that occupational injuries influence workers' emotional and physical wellbeing, extending healthcare use beyond what is covered by the Workers' Compensation Board (WCB). METHODS: The authors used an administrative database that links individual publicly funded healthcare and WCB data for the population of British Columbia (BC), Canada. They examined change in service use, relative to one year before the injury, for workers who required time off for their injuries (lost time = LT) and compared them to other injured workers (no lost time = NLT) and individuals in the population who were not injured (non-injured = NI). RESULTS: LT workers increased physician visits (22%), hospital days (50%), and mental healthcare use (43% physician visits; and 70% hospital days) five years after the injury, relative to the year before the injury, at a higher rate than the NI group. For the NLT workers, the level of increased use following the injury was between that of these two groups. These patterns persisted when adjusting for registration in the BC Medical Service Plan (MSP) and several workplace characteristics. CONCLUSIONS: Although the WCB system is the primary mechanism for processing claims and providing information about workplace injury, it is clear that the consequences of workplace injury extend beyond what is covered by the WCB into the publicly funded healthcare system.

Childhood and early adult predictors of risk of incident back pain: Ontario Child Health Study 2001 follow-up.

Musculoskeletal disorders of the back and spine are a leading cause of disability in working-age populations. There is limited information on the potential consequences of childhood socioeconomic and health status on the risk of incident back pain in early adulthood. The authors describe factors associated with having had a first episode of back pain during the past year in the Ontario Child Health Study, a prospective cohort study of children who were aged 4-16 years at the time of enrollment in 1983 and were resurveyed in 2001. Respondents reporting a first episode of back pain (n=143) were compared with respondents who had never experienced back pain (n=896). The annual incidence of a first episode of back pain in this sample of young adults was 74.7/1,000. Following adjustment for age, sex, childhood conditions, childhood health status, and measures of early adult health, behavior, socioeconomic status, and work environment, the risk of incident back pain was associated with both low (odds ratio (OR)=1.86, 95% confidence interval (CI): 1.14, 3.03) and moderate/high (OR=1.85, 95% CI: 1.07, 3.02) levels of psychological distress, current heavy smoking (OR=1.85, 95% CI: 1.10, 3.10), lower levels of parental education in childhood (OR=1.72, 95% CI: 1.06, 2.80), and emotional or behavioral disorders in childhood (OR=1.87, 95% CI: 1.02, 3.41). The associations of low childhood socioeconomic status and childhood emotional and behavioral disorders with risk of incident back pain in early adulthood are important findings with implications for better understanding the etiology of soft-tissue disorders.

Examining the associations between physical work demands and work injury rates between men and women in Ontario, 1990-2000.

AIMS: To describe the decline in injury rates between 1990 and 2000 within occupations stratified across three levels of physical demands and gender, adjusting for industry, in Canada's largest province. METHODS: Records of injury compensation claims were obtained from the Ontario Workplace Safety & Insurance Board. The population likely to be insured by the Ontario Workplace Safety & Insurance Board was estimated from Statistics Canada's Labour Force Survey. Injury rates were calculated by three broad levels of physical demands, separately for men and women. RESULTS: Injury rates decreased across each grouping of lower physical demands at work for both men and women, with the largest absolute differences in manual occupational groups (high physical demands). Occupations classified as manual (high physical demands) and mixed (moderate physical demands) showed larger differences in injury rates between genders than did non-manual (low physical demands), although the directions of these differences were not always consistent across different natures of injury classification. CONCLUSIONS: The absolute reduction in injury rates in Ontario between 1990 and 2000 was dominated by the reduction in injury rates for men and women in manual and mixed occupations. However, not all types of injury have declined to the same extent. A large proportion of differences in injury rates between men and women can be attributed to the differential labour force participation across occupations and industries, as well as the differential tasks within occupational groups.

Gender differences in socioeconomic inequality in mortality.

OBJECTIVES: There is uncertainty about whether position in a socioeconomic hierarchy confers different mortality risks on men and women. The objective of this study was to conduct a systematic review of gender differences in socioeconomic inequality in risk of death. METHODS: This research systematically reviewed observational cohort studies describing all cause or cause specific mortality for populations aged 25-64 in developed countries. For inclusion in the review, mortality had to be reported stratified by gender and by one or more measures of socioeconomic status. For all eligible studies, five absolute and six relative measures of the socioeconomic inequality in mortality were computed for male and female populations separately. RESULTS: A total of 136 published papers were reviewed for eligibility, with 58 studies deemed eligible for inclusion. Of these eligible studies, 20 papers published data that permitted the computation of both absolute and relative measures of inequality. Absolute measures of socioeconomic mortality inequality for men and women generally agreed, with about 90% of studies indicating that male mortality was more unequal than female mortality across socioeconomic groups. In contrast, the pattern of relative inequality results across the 20 studies suggested that male and female socioeconomic inequality in mortality was equivalent. CONCLUSIONS: Inferences about gender differences in socioeconomic inequality in mortality are sensitive to the choice of inequality measure. Wider understanding of this methodological issue would improve the clarity of the reporting and synthesis of evidence on the magnitude of health inequalities in populations.

Socioeconomic status, drug insurance benefits, and new prescriptions for inhaled corticosteroids in schoolchildren with asthma.

BACKGROUND: Low-income children with asthma are less likely to receive inhaled corticosteroid prescriptions that can prevent asthma morbidity. OBJECTIVE: To determine whether the receipt of inhaled corticosteroids in children with asthma is related to household socioeconomic status and type of drug insurance. DESIGN: Using population-based prescription and health care data from Manitoba, a cohort study of the determinants of receiving new prescriptions for inhaled corticosteroids was conducted in children treated with asthma drugs. PARTICIPANTS: School-aged children (n = 12 481) receiving asthma prescriptions from January 1995 to March 1996 but no inhaled corticosteroid prescriptions in the initial 6-month period. MAIN OUTCOME MEASURES: Household socioeconomic and drug insurance predictors of the probability of receiving a new inhaled corticosteroid prescription from July 1995 to March 1998, following adjustment for disease and health care utilization factors. RESULTS: In comparison with higher-income children insured through a provincial cost-sharing drug plan, the adjusted likelihood ratio for a new inhaled corticosteroid prescription was 0.88 (95% confidence interval, 0.80-0.97) in low-income children insured through the same drug plan and 0.82 (95% confidence interval, 0.76-0.88) in children receiving prescriptions at no charge through provincial income assistance or First Nations benefits programs (Winnipeg, Manitoba). CONCLUSION: Independent of asthma severity, type of drug insurance, or health care utilization patterns, low-income children with asthma are significantly less likely to receive inhaled corticosteroid prescriptions.

Income-based drug benefit policy: impact on receipt of inhaled corticosteroid prescriptions by Manitoba children with asthma.

BACKGROUND: Drug benefit policies are an important determinant of a population's use of prescription drugs. This study was undertaken to determine whether a change in a provincial drug benefit policy, from a fixed deductible and copayment system to an income-based deductible system, resulted in changes in receipt of prescriptions for inhaled corticosteroids by Manitoba children with asthma. METHODS: Using Manitoba's health care administrative databases, we identified a population-based cohort of 10,703 school-aged children who met our case definition for asthma treatment before and after the province's drug benefit policy was changed in April 1996. The effects of the program change on the probability of receiving a prescription for an inhaled corticosteroid and on the mean number of inhaled corticosteroid doses dispensed were compared between a group of children insured under other drug programs (the comparison group) and 2 groups of children insured under the deductible program: those living in low-income neighbourhoods and those living in higher-income neighbourhoods. All analyses were adjusted for a measure of asthma severity. RESULTS: For higher-income children with severe asthma who were covered by the deductible program, the probability of receiving an inhaled corticosteroid prescription and the mean annual number of inhaled corticosteroid doses declined after the change to the drug policy. A trend toward a decrease in receipt of prescriptions was also observed for low-income children, but receipt of prescriptions was unaltered in the comparison group. Before the policy change, among children with severe asthma, the mean annual number of inhaled corticosteroid doses was lowest for low-income children, and this pattern persisted after the change. Among children with mild to moderate asthma, those covered by the deductible program (both low income and higher income) were less likely to receive prescriptions for inhaled corticosteroids than those in the comparison group, and this difference was statistically significant for the higher-income children. INTERPRETATION: The change to an income-based drug benefit policy was associated with a decrease in the use of inhaled corticosteroids by higher-income children with severe asthma and did not improve use of these drugs by low-income children.

Relationship between health services outcomes and social and economic outcomes in workplace injury and disease: data sources and methods.

BACKGROUND: Understanding the mediating role of health care in mitigating social, economic and occupational role disability is a complex task. METHODS: No single method of research will be successful in addressing all elements of this NORA research priority area. In this paper, we argue that research methods are needed which have the following components: (1) the detailed measurement of therapeutic intervention and the impacts of this intervention on clinical and functional health status using study designs which rule out competing explanations, (2) a longitudinal follow-up component which measures social, economic, and occupational role function following the conclusion of therapy, and (3) a commitment to execute studies across multiple settings to observe the variations in health care and in social and occupational role function that arise as a result of differences in labor market factors and employer and government policies. CONCLUSIONS: More comprehensive portraits of the longitudinal trajectory of individual workers, social, economic and occupational role function following an occupational injury or illness will have significance for a large number of policy sectors.

Comparison of expert-rater methods for assessing psychosocial job strain.

OBJECTIVES: This study tested the reliability and validity of industry- and mill-level expert methods for measuring psychosocial work conditions in British Columbia sawmills using the demand-control model. METHODS: In the industry-level method 4 sawmill job evaluators estimated psychosocial work conditions at a generic sawmill. In the mill-level method panels of experienced sawmill workers estimated psychosocial work conditions at 3 sawmills. Scores for psychosocial work conditions were developed using both expert methods and applied to job titles in a sawmill worker database containing self-reported health status and heart disease. The interrater reliability and the concurrent and predictive validity of the expert rater methods were assessed. RESULTS: The interrater reliability and concurrent reliability were higher for the mill-level method than for the industry-level method. For all the psychosocial variables the reliability for the mill-level method was greater than 0.90. The predictive validity results were inconclusive. CONCLUSIONS: The greater reliability and concurrent validity of the mill-level method indicates that panels of experienced workers should be considered as potential experts in future studies measuring psychosocial work conditions.