Geographic variation in work injuries: a multilevel analysis of individual-level data and area-level factors within Canada

Ann Epidemiol. 2013 May;23(5):260-6. doi: 10.1016/j.annepidem.2013.03.008.

Abstract

Purpose: This study sought to examine provincial variation in work injuries and to assess whether contextual factors are associated with geographic variation in work injuries.

Methods: 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 an activity limiting work injury [corrected], while adjusting for demographic and work variables.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Occupational / statistics & numerical data*
  • Adult
  • Canada / epidemiology
  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • Incidence
  • Injury Severity Score
  • Logistic Models
  • Male
  • Middle Aged
  • Multilevel Analysis
  • Occupational Health / statistics & numerical data
  • Risk Factors
  • Rural Population
  • Socioeconomic Factors
  • Urban Population
  • Workplace / statistics & numerical data*
  • Wounds and Injuries / classification
  • Wounds and Injuries / epidemiology*
  • Young Adult