The workplace is the site of 18 to 28% of serious injuries suffered by Canadian adults. In Ontario, while most WSIB claims involve no or little lost time, nearly 15,000 injured workers a year have a recognized permanent impairment. However the current worker’s compensation system fails to track what happens to these workers in the long term, despite mounting evidence that the consequences of occupational injury resulting in permanent disability have been generally underestimated.
The contribution of recently published research in the Canadian Journal of Public Health (v.105, no.5, 2014) “Long-term Mortality Risk in Individuals with Permanent Work-related Impairment” has been hailed by John McKinnon (Injured Workers’ Consultants) as “a wake-up call for Ontario to take a closer look at the impact of workplace injuries” – and make meaningful changes to address identified needs.
Permanent injury & work disability
The study, led by Institute for Work & Health (IWH) scientist Heather Scott-Marshall, explored the impact on life expectancy of “work disability” – defined as the difficulty workers with permanent impairments face staying in the labour market, due to challenges coping with the physical, psychological and emotional effects of injury, or to stigma and discrimination limiting employment opportunities.
Using data from Statistics Canada and the WSIB, the 19-year follow-up study (summarized in IWH newsletter At Work no. 79, Winter 2015) compared mortality risks in two control groups, pairing each individual in a sample of 19,000 Ontarians with work-related permanent injuries (minor to severe) with up to 10 non-injured persons having similar characteristics (age, gender, income etc). Researchers reported that the markedly higher risks for those with permanent impairments peaked a decade or more after injury, and were slightly higher for women than men.
Comparing pre- and post-injury employment income, the study found work disability to be a significant determinant factor in increased risk for those with permanent impairments. Age at injury also played a role, those in the 25-39 age range having a higher likelihood of premature death. Scott-Marshall suggested that “this again probably ties into work disability and the fact that younger people may have greater difficulty getting back to work,” with further research to throw more light on the findings.
Feedback and follow-up
Jean Lian’s feature article “Spiralling Down” (OHS Canada, June 25, 2015) details responses to the study. Several emphasize the significant levels of mental health problems resulting from permanent injury and from interactions with the workers’ compensation system. Injured worker activist Steve Mantis (Centre for Research on Work Disability Policy) notes the study validates lived experiences, and calls for more individualized support to help injured workers in critical times remain active and healthy mentally, physically and emotionally.
IWC’s McKinnon draws attention also to the snowballing effects of permanent disabling work injury on all aspects of health and quality of life, with injured worker poverty clearly a factor in early death.
On issues of work disability, advocates have long called for real followup on what actually happens to injured workers and return to work, including those “deemed” to be employed. IWH president Cameron Mustard considers the key message of the Scott-Marshall study “is to create opportunities for people with disabilities,” noting the need to further address employer discrimination and protect workers’ compensation programs in providing economic security to injured workers. John McKinnon repeats the call for more long-term monitoring to achieve positive outcomes:
The fall from being a proud worker happens much more quickly for injured workers than it did 30 years ago,” he observes. “We can do better.”
Ballantyne, P. et al. 2015 Mar 17. “Poverty Status of Worker Compensation Claimants with Permanent Impairments.” Critical Public Health: 1-18
O’Hagan, Fergal T. et al. 2012. “Mental Health Status of Ontario Injured Workers with Permanent Impairments.” Canadian Journal of Public Health 103(4): 303-308