UPFRONT | Roundup POLICY Research aims to identify gender differences in injury and health risks A Toronto scientist has launched a five-year re-search program on gen-der-related factors that af-fect differences in work injury risks, return-to-work and illnesses between male and female workers. Peter Smith, a scientist at the Institute for Work and Health, will focus on issues such as: why men and women face different injury risks, whether they face different challenges in re-turning to work post-injury, and how work stress and chronic disease affect men and women differently. “This new research knowledge will help shape the development of gender-and sex-sensitive policies and practices to improve the health of all working Cana-dians,” Smith said, stressing that although the terms, gender and sex, are typically interchanged, there is a difference between them. “Gender” refers to so-cially constructed roles, relationships, behaviours and other traits attributed as “male-like” or “fe-male-like,” while “sex” pertains to the biological and physical characteristics such as hormones, genes, physiology and anatomy. It is important to distin-guish between these two dimensions, he said. “They represent different pathways through which differences between men and women are created. In addition, the policy inter-vention responses to male and female differences will differ depending on whether the differences are ‘gender’ based or ‘sex’ based.” Smith’s research will also aid health-care providers in understanding where differ-ences may exist between genders with respect to care recommendations. Smith said the area of gender difference with re-spect to the interaction be-tween health-care providers and injured workers is cur-rently not well investigated. “We do know from stud-ies focusing on general conditions, such as back pain and knee osteoarthri-tis, which are not specifi-cally work-related, that men and women receive differ-ent recommendations even when they have the same condition,” Smith said. He cited a study in On-tario on physical recom-mendations for two patients – one male and one female – with moderate knee oste-oarthritis which found that physicians were twice as likely to recommend sur-gery to the male patient. This could potentially be attributed to unconscious or conscious stereotyping among doctors about gen-der/sex differences in who is more likely to benefit from surgery or will be sup-ported in their recovery, he said. “These differences might also be due to the way men and women describe their symptoms; previous studies have suggested women use a more narrative style and men use a more direct and factual style.” Over the next five years, Smith’s research will exam-ine the factors that mediate the relationship between gender/sex and return-to-work outcomes, and iden-tify situations where gender/ sex moderates the relation-ship between variables and return-to-work outcomes. INJURY PREVENTION Ontario’s work-related MSDs declining: study Work-related musculoskeletal disorders are dropping in Ontario along with other more traumatic job-related injuries, a study by the Institute for Work & Health (IWH) revealed. The report, “Time trends in musculoskeletal disorders attrib-uted to work exposures in Ontario using three independent data sources, 2004-2011,” was pub-lished online by Occupational and Environmental Medicine. Led by IWH president Cameron Mustard, the study tracks the inci-dence of work-related non-trau-matic musculoskeletal disorders (MSDs) and other work injuries in Ontario between 2004 and 2011 www.canadianchiropractor.ca using three independent sources of information. All three sources show a decline in both work-related MSDs and traumatic work injuries over the eight-year period. Workers’ compensation lost-time claim records show a 48.2 per cent decline in non-traumatic, work-related MSDs and a 39.4 per cent decline in traumatic work-re-lated injuries. Emergency depart-ment treatment records show a 16.3 per cent decline in MSDs and a 30.2 per cent decline in other work injuries. And a Statistics Canada national health survey shows a 40.7 per cent decline in MSDs and 45.1 per cent decline in other work injuries. “The study focuses on MSDs separately from other work injuries because they represent the largest disability burden among working adults in developed economies,” said Mustard. MSDs include sprains and strains of the neck, back, shoul-ders, elbows, wrists, knees and other joints and connective tissue of the musculoskeletal system as a result of awkward, forceful and/or repetitive movements and pos-tures. Over the past 10 years in Ontario, sprains and strains have consistently been the leading type of work injury, representing 40 per cent of all lost-time claims in 2013, according to the Workplace Safety and Insurance Board 2013 statistical report. The study cannot say if declining injury rates can be attributed to deliberate efforts by workplaces and health and safety system part-ners (e.g. governments, health and safety associations) to reduce inju-ry risk. However, “the study does suggest that efforts to prevent MSDs are proving to be as effective as efforts to prevent traumatic work-related injuries,” said Mustard. “The constant change and renewal in workplace equip-ment and machinery might have played a role by reducing the amount of lifting, pulling and reaching at work.” December 2014 Canadian Chiropractor 11
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