Work Disability Duration Among Mobile Workers: Does Intraprovincial Mobility Matter as Much as Interprovincial Mobility?

OBJECTIVE: The aim of the study is to compare work disability duration of intraprovincially and interprovincially mobile workers with nonmobile workers in British Columbia, Canada. METHODS: Workers' compensation claims were extracted for workers injured between 2010 and 2019. Employer and residential postal codes were converted to economic regions to define nonmobile, intraprovincially, and interprovincially mobile workers. Quantile regression models using matched cohorts were used to estimate differences in work disability days at different percentiles of the distribution. RESULTS: Compared with nonmobile workers, both mobile worker groups had longer work disability durations, particularly interprovincially mobile workers. Differences persisted in injury-stratified models and were partially or fully attenuated in some industry-stratified models. CONCLUSIONS: Workers' compensation systems, employers, and healthcare providers may need to tailor specific interventions for mobile workers who are from out-of-province as well as traveling between regions in the province.

Fishing safely during COVID-19 in Newfoundland and Labrador, Canada: Making it happen.

Globally, fisheries have been the site of multiple documented outbreaks of COVID-19. Existing studies point to the threat posed by the pandemic to livelihoods and health among migrant industrial fishery workers, small-scale fish harvesters, and fishing communities. They show the pandemic enhanced safety, economic, social and political layers of vulnerability in fisheries, while also showcasing examples of resilience. Case studies of COVID-19 response provide an opportunity to explore how existing organizational structures, leadership and networks in fisheries can enable the rapid co-development of customized strategies for fishing safely during large-scale global disruptions such as pandemics. This article contributes to our understanding of governance and fishing safety in small-scale fisheries during the early pandemic, examining the response of small-scale fisheries in the Canadian province of Newfoundland and Labrador. These seasonal fisheries successfully opened with regulator approval after a short delay and operated without documented COVID-19 outbreaks during 2020. Findings draw from key informant interviews with a safety sector association and union leader, complemented with insights from an anonymous online survey of small-scale harvesters. Interviews capture the organizational processes and resources mobilized to rapidly co-develop the COVID-19 Safe Work Practice Guideline. Online survey findings indicate that fifty-nine percent of respondents (crew and skippers) had no COVID-19-related concerns while fishing in 2020; older harvesters and owner-operators were significantly more likely to indicate concerns. When asked about the relative practicality of listed COVID-19 precautions, respondents commonly identified sanitization, reduced interactions with shore workers, social distancing, protection equipment, modifications to eating/rest areas, and reduced crew as impractical. These assessments are generally consistent with those of the interviewed leaders and the Guideline approach. This suggests the co-developed Guideline provided tailored and practical COVID-19 prevention strategies. Pre-existing governance structures and networks can help address small-scale fisheries vulnerabilities to pandemics by supporting co-development of organizational resources and evidence-informed prevention strategies.

Differences in workers' compensation claim rates for within-province and out-of-province workers in British Columbia, Canada, 2010-2017.

BACKGROUND: Little is known about the work-related injury and illness risk of out-of-province workers. This study examines whether there are differences in work-related injury and illness claim rates between within-province and out-of-province workers in British Columbia (BC), Canada. METHODS: Workers' compensation claim data for injuries and illnesses in BC from 2010 to 2017 were linked with denominator data from Statistics Canada. Multivariable negative binomial regression estimated the claim rate ratio (RR) and 95% confidence intervals (CI) for out-of-province workers with all, health care-only (HCO), short-term disability, long-term disability, and fatality (SLF), and serious injury (SI) claims, compared to within-province workers. RESULTS: Compared to within-province workers, out-of-province workers had a lower total claim rate (RR: 0.54, 95% CI: 0.52-0.57), adjusting for sex, age, industry sector, and year. Differences in rates differed by claim type, with the largest differences for HCO claims (RR: 0.49, 95% CI: 0.47-0.52) and smallest differences for SI claims (RR: 0.85, 95% CI: 0.78-0.92). Sex-stratified models showed larger differences for males than females, with older female out-of-province workers having elevated SI claim rates. Industry-specific models showed that, even in sectors with high proportions of out-of-province workers' claims, these workers have lower claim rates than within-province workers. CONCLUSIONS: Out-of-province workers generally have lower claim rates than within-province workers. The overall duration of work exposure, and underreporting or underclaiming, are factors that may explain these lower claim rates. Understanding the determinants and differences of these claim rates may improve the administration and adjudication of claims while also identifying where further prevention measures may be merited.

Do differences in work disability duration by interjurisdictional claim status vary by industry and jurisdictional context?

OBJECTIVES: To examine whether differences in work disability duration between out-of-province and within-province workers differed by industry and jurisdictional context. METHODS: Workers' compensation data were used to identify comparable lost time, work-related injury and musculoskeletal disorder claims accepted in six Canadian jurisdictions between 2006 and 2015. Out-of-province workers were identified as workers who filed claims in a different provincial jurisdiction to their province of residence. Coarsened exact matching was used to match out-of-province workers with within-province workers based on observable characteristics. Quantile regression models were used to estimate differences in cumulative disability days paid between out-of-province workers and within-province workers at different percentiles in the disability distribution, adjusting for confounders. RESULTS: Compared with within-province workers, out-of-province workers were paid more disability days even after matching and adjusting on observable characteristics. Differences between the two groups of workers were observed for short-duration, medium-duration and long-duration claims (differences of 1.57, 6.39, 21.42, 46.43 days at the 25th, 50th, 75th and 90th percentiles, respectively). Industry-specific models showed that differences were largest in construction, transportation and warehousing, and mining, quarrying and oil and gas extraction. Jurisdiction-specific models showed that differences were largest in the western provinces where out-of-province workers were concentrated in those sectors. CONCLUSIONS: Out-of-province workers are a vulnerable group with respect to risk of longer work disability duration. Workers' compensation systems, employers and healthcare providers may need to tailor specific interventions for these types of workers, particularly those employed in resource economy-dependent regions that are far from their regions of residence.

A scoping review to identify strategies that work to prevent four important occupational diseases.

BACKGROUND: Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts. METHODS: To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants. RESULTS: We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity. CONCLUSIONS: This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.

The neglected millions: the global state of aquaculture workers' occupational safety, health and well-being.

A scoping project was funded by the Food and Agriculture Organization in 2017 on the health and safety of aquaculture workers. This project developed a template covering basic types of aquaculture production, health and safety hazards and risks, and related data on injuries and occupational ill health, regulations, social welfare conditions, and labour and industry activity in the sector. Profiles using the template were then produced for key aquaculture regions and nations across the globe where information could be obtained. These revealed both the scale and depth of occupational safety and health (OSH) challenges in terms of data gaps, a lack of or poor risk assessment and management, inadequate monitoring and regulation, and limited information generally about aquaculture OSH. Risks are especially high for offshore/marine aquaculture workers. Good practice as well as barriers to improving aquaculture OSH were noted. The findings from the profiles were brought together in an analysis of current knowledge on injury and work-related ill health, standards and regulation, non-work socioeconomic factors affecting aquaculture OSH, and the role of labour and industry in dealing with aquaculture OSH challenges. Some examples of governmental and labour, industry and non-governmental organisation good practice were identified. Some databases on injury and disease in the sector and research initiatives that solved problems were noted. However, there are many challenges especially in rural and remote areas across Asia but also in the northern hemisphere that need to be addressed. Action now is possible based on the knowledge available, with further research an important but secondary objective.

Scoping Global Aquaculture Occupational Safety and Health.

Objectives: In 2017 the Food and Agriculture Organization (FAO) Committee on Fisheries committed to prioritize occupational safety and health issues in aquaculture (AOSH). An international team was established to synthesize OSH knowledge concerning more than 19 million, often vulnerable, aquaculture workers found globally.Methods: The study was conducted as a desktop scoping exercise using both peer-reviewed and gray literature and the knowledge and expertize of an international panel. Collated information used a standard proforma. Panel members developed draft national and regional AOSH profiles outlining occupational hazards contributing to occupational injuries, diseases, and known solutions. These were work-shopped and refined after gathering additional information and used to compile the first global scoping review report on AOSH.Results: Synthesized results revealed multiple hazards, significant global knowledge gaps and some successful and unsuccessful global, national and industry-specific AOSH policies, practices and standards along the primary supply chain, in marine and freshwater contexts. Some constructive initiatives by the International Labor Organization (ILO) and FAO, industry, labor and civil society groups in a range of employment and geographical settings and across diverse populations of workers were identified.Conclusion: Global commitment to AOSH should be given the same focus as product quality, biosecurity, food safety and environmental sustainability in the sector. This needs development and implementation of integrated AOSH actions appropriate for diverse settings especially in low and middle-income countries encompassing greater uptake of international codes, better risk assessment and OSH management, adoption of technological innovations, effective OSH regulation and enforcement, adequate resources, training and information.

Organization of work in the agricultural, forestry, and fishing sector in the US southeast: implications for immigrant workers' occupational safety and health.

BACKGROUND: There is widespread agreement that work organization is an important element of occupational safety and health, but the health effects of many aspects of work organization are likely to vary considerably across different sectors of work and geographies. METHODS: We examined existing employment policies and work organization-related research relevant specifically to immigrant workers in the Agriculture, Forestry, and Fishing (AgFF) Sector of the US workforce focusing, when possible, on the southeastern US. RESULTS: A number of specific aspects of work organization within AgFF subsectors have been described, but most of this literature exists outside the purview of occupational health. There are few studies that directly examine how attributes of work organization relevant to the AgFF Sector affect workers', much less immigrant workers', occupational health exposures and outcomes. CONCLUSIONS: In contrast to the broader literature, research linking occupational health outcomes to work organization in the AgFF Sector is limited and weak. A systematic program of research and intervention is needed to develop strategies that eliminate or substantially mitigate the deleterious health effects of occupational exposures whose origins likely lie in the organization of AgFF work.

Identification of crab proteins that elicit IgE reactivity in snow crab-processing workers.

BACKGROUND: The expanding snow crab-processing industry has resulted in increased numbers of workers at risk of occupational allergy. OBJECTIVE: Our study is to identify relevant allergenic proteins in cooked snow crab meat (CM) and crab water (CW) used for cooking for improved remediation, diagnosis, and treatment. METHODS: Extracts were prepared from CM extracts, CW extracts, and an air-filter collection near the crab cooker. Of the 207 workers, 24 with the highest IgE antibody reactivity to CM and CW extracts, as determined by using RASTs, were tested for reactivity to nitrocellulose membranes containing CM and CW proteins separated with SDS-PAGE. A 3-serum pool was similarly incubated against nitrocellulose-bound proteins from air samples collected near the crab cooker. RESULTS: Of the 207 sera tested, 27 and 39 sera exhibited positive IgE antibody reactivity (>or=2%) to CM and CW extracts, respectively. Twenty-two of 24 sera with the highest RAST activity (>or=3.5% binding) demonstrated IgE binding to multiple proteins (13.6-50 kd). A majority of the sera reacted to 4 proteins: 79% and 71% to a 34.0-kd protein, 79% and 42% to a 25-kd protein, 67% and 71% to an 18.5-kd protein, and 75% to a 14.4-kd protein in both CM and CW extracts, respectively. The pool of IgE-positive sera blotted against the air-filter extract reacted to 14.4-, 18.5-, 34.0-, 43.2-, and 50-kd proteins present in both crab extracts. CONCLUSION: Four major IgE-reactive proteins were identified in CM extracts, CW extracts, and air-filter eluate. Analysis of any potential association of protein reactivity with disease suggested crab proteins at 34.0 and 14.4 kd might be more relevant.

Gender and snow crab occupational asthma in Newfoundland and Labrador, Canada.

Fish and shellfish processing employs many thousands of people globally, with shellfish processing becoming more important in recent years. Shellfish processing is associated with multiple occupational health and safety (OHS) risks. Snow crab occupational asthma (OA) is work-related asthma associated with processing snow crab. We present a gender analysis of findings from a 3-year multifaceted study of snow crab OA in Newfoundland and Labrador, Canada. The study was carried out in four snow crab processing communities between 2001 and 2004. An anonymous survey questionnaire on knowledge, beliefs, and concerns related to processing snow crab administered to 158 workers attending community meetings at the start of the research found that women were significantly more likely than men to associate certain health problems, especially chest tightness, difficulty breathing, and cough, with crab processing (P<0.001). Worker health assessments carried out with 215 processing workers (187 current/28 former; 120 female/95 male) found that female participants were more likely to be diagnosed as almost certain/highly probable snow crab OA and allergy (P=0.001) and to be sensitized to snow crab (P=0.01) than male participants. Work histories from the health assessments were used to classify processing jobs as male or female. Allergen sampling (211 allergen samples: 115 area, 96 personal breathing zone) indicated that the plant areas where these male jobs were concentrated were associated with lower levels of aerosolized crab allergens (the agents responsible for OA to snow crab) than areas associated with female jobs. This difference was statistically significant in the two plants with poor ventilation (p<0.001 and P=0.017 for these plants). A gender analysis of work history data showed that female health assessment participants were likely to have worked longer processing snow crab than males (5 years versus 3.5 years, respectively). Cross-referencing of work history results with allergen sampling data for male and female job areas showed a gender difference in median cumulative exposures (duration of exposure x level of exposures) for health assessment participants. Health assessment participants with estimated higher median cumulative exposures were more likely to receive a diagnosis of almost certain/highly probable OA and allergy. Semistructured interviews with 27 health assessment participants (24 female/ 3 male) with a diagnosis of almost certain/highly probable or possible snow crab OA indicated that these workers can experience substantial quality of life impacts while working and that they seek to reduce the economic impact of their illness by remaining at their jobs as long as possible. Indications of selection bias and other study limitations point to the need for more research exploring the relationship between the gender division of labor and knowledge, beliefs, and concerns about snow crab processing, as well as gender differences in prevalence, quality of life, and socioeconomic impact.

Prevalence of crab asthma in crab plant workers in Newfoundland and Labrador.

OBJECTIVES: The aim of the study was to determine the prevalence of snow crab sensitisation and occupational asthma. STUDY DESIGN: Prevalence study of symptoms, pulmonary function testing and allergy testing to crab was conducted in four crab plants of different design in Newfoundland and Labrador, Canada. METHODS: Plants workers in four crab plants were interviewed and offered skin testing, RAST, pulmonary function testing and peak flow monitoring before and during crab processing. RESULTS: 38% (n=78) had atopy. 18% (n=39) had certain or highly probable crab asthma. The prevalence of sensitisation in different crab plants varied from 50% (n=19) to 15% (n=16) and the prevalence of certain or highly probable crab asthma varied from 50% (n=19) to 9% (n=3). CONCLUSION: Crab asthma and sensitisation to snow crab is a major health problem for snow crab plant workers in Newfoundland and Labrador.

Knowledge, attitudes and beliefs regarding crab asthma in four communities of Newfoundlad and Labrador.

OBJECTIVES: This study was conducted to learn from snow crab plants workers and others involved in the industry their knowledge and beliefs of health issues and potential solutions. STUDY DESIGN: This is a survey in four communities with different crab plant designs in Newfoundland and Labrador, Canada. METHODS: At the start of a meeting to discuss crab asthma participants were requested to complete the questionnaire. RESULTS: 65% of 196 participants believed there were health problems associated with crab plants. 85% have heard of crab asthma. Almost 80% identified correctly the major symptoms of crab asthma as difficulty breathing, chest tightness and cough. Only 74% of workers did not know that workers with crab asthma were eligible for workers' compensation. 55% of those surveyed had heard of crab asthma from crab plant workers and only 26% from their doctor or nurse. If they had breathing problems, 73% would see their local doctor, and 51% a specialist and 51% their nurse. CONCLUSION: The majority of participants believed that there were health problems associated with crab plants. The majority of crab plant workers could identify symptoms of crab asthma correctly. Many do not know that those with crab asthma can obtain workers' compensation. Most of them learn of crab asthma from other workers but would seek treatment from their doctor.