2019-12-05

1

Gender differences in injuries

attributed to workplace violence in

Ontario 2002 – 2015

Peter Smith

ETFO Workplace Violence Symposium

December 3rd 2019

Who we are

The Institute for Work & Health is a not-for-profit research organization based in Toronto, Canada

We conduct and share research to protect and improve the health of working people. Our research is carried out in two broad domains:

1. preventing work-related injury and illness through studies of workplace programs and practices, prevention policies and the health of workers at a population level, and

2. improving the health and recovery of injured workers through research on treatment, return to work, disability prevention and management, and compensation policies

Our research is valued by policy-makers, workers and workplaces, clinicians, and occupational health, safety and disability management professionals

www.iwh.on.ca 2

2019-12-05

2

Male/female differences in time trends for incidence of injuries attributed to workplace violence in Ontario, including differences by sector.

Current capacity to monitor workplace violence events and evaluate prevention activities in education.

For today

www.iwh.on.ca 3

The exercise of physical force by a person against a worker, in a workplace, that causes or could cause physical injury to the worker,

An attempt to exercise physical force against a worker, in a workplace, that could cause physical injury to the worker,

A statement or behaviour that it is reasonable for a worker to interpret as a threat to exercise physical force against the worker, in a workplace, that could cause physical injury to the worker.

Source: Ontario Occupational Health and Safety Act

www.iwh.on.ca 4

Workplace violence under the Ontario Occupational

Health and Safety Act

2019-12-05

3

Bill 168 (June 15, 2010)

Requires all employers to have policies and programs in place to deal with workplace violence, workplace harassment and domestic violence that may occur in the workplace.

Employers are required to:

Have procedures in place for workers to report incidents

Investigate incidents of workplace violence, harassment or threats of violence

Give workers information about the policies and programs

www.iwh.on.ca 5

Workplace violence in Ontario

Why take a gender/sex sensitive approach to workplace violence?

www.iwh.on.ca 6

2019-12-05

4

www.iwh.on.ca 7

The 12 most sex/gender segregated occupations in

Canada in 1987 and 2015

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1987 2015

Construction (M)

Contractors/Supervisor (M)

Other Trades (M)

Transport/Equipment (M)

Trades Helpers (M)

Protective Services (M)

Childcare/Home Supp (F)

Health Professionals (F)

Other Health Care (F)

Finan/Secret/Administ (F)

Primary Industry (M)

Natural/Appl Sciences (M)

www.iwh.on.ca 8

Rates of workplace violence per 1,000 persons. Overall and by sub-

groups of violence (N = 27,643). GSS 2009 and 2014.

8.1

1.6

6.86.6

1.4

14.0

6.77.7

11.8

2.4

0

2

4

6

8

10

12

14

16

All workplaceviolence

Sexual assault Physical assault Male perpetrator Female perpetrator

Men Women

Lanthier et al, 2018

2019-12-05

5

A "lost time" claim is created when a worker suffers a work-related injury/disease which results in

being off work past the day of accident

loss of wages/earnings, or

a permanent disability/impairment.

A "no lost time" claim results from a work-related injury where no time is lost from work, other than on the day of accident, but where health care is required. The health care costs resulting from the injury are paid by the WSIB

www.iwh.on.ca 9

Workers’ compensation claims in Ontario

Source: https://www.wsib.ca/en/operational-policy-manual/decision-making/types-claims0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Assaults (left)

Non-Assaults (right)

www.iwh.on.ca 10

Number of lost-time claims accepted in Ontario. Assaults

versus non-assaults. 2002 to 2018

139% relative

increase

35% relative

decrease

Source: WSIB By The Numbers

2019-12-05

6

WPV requiring health care

WPV leading to injury

Physical assault

Attempted assaults

Threats to exercise physical force

WPV leading to

time off work

www.iwh.on.ca 11

Objectives

To estimate trends in injuries attributed to workplace violence at the population level over the period 2002 to 2015, for men and women in Ontario

Examine male/female differences in workplace violence within industry sectors

www.iwh.on.ca 12

Gender differences in injuries attributed to workplace

violence in Ontario: 2002 – 2015

2019-12-05

7

Workers’ Compensation Data (WSIB) Emergency Visit Data (NACRS)

Eligibility

One or more days of wage replacement (other

than DOI). Assessed for work-relatedness.

Workplace covered by WSIB (approx. 65% of

labour market)

Responsibility for payment (filled in by treating

HCP) is WSIB

Time period 2002 to 2015 2004 to 2014

Definition of Workplace

violence

Based on event (CSA-Z795): Assaults and

violent acts (6.*)Assault: Based on ICD-10 codes (X92-Y09)

Denominator Estimated from the Labour Force Survey* Estimated from the Labour Force Survey

Other relevant

information recordedAge, sex, occupation, industry, tenure Age, sex

Number 21,228 (1,516 per year) 13,245 (1,204 per year)

www.iwh.on.ca 13

Sources of WPV surveillance at the population level in

Ontario

www.iwh.on.ca 14

2019-12-05

8

www.iwh.on.ca 15

Lost time injury incidence rates (per 1000 FTEs) due to violence or aggression, stratified by sex.

Ontario 2002 to 2015

Blue = Female claims

Purple = Male claims

Green = Male ED visits

Orange = Female ED visits

NACRS_M

NACRS_F

WSIB_M

WSIB_F

0.0

0.2

0.4

0.6

0.8

2002 2004 2006 2008 2010 2012 2014

Year

Vio

lenc

e In

jury

Rat

e (p

er 1

000

FTE

S)

60%

13%

-4%

35%

1.30*

0.73*

1.86*

1.00

www.iwh.on.ca 16

Lost-time injury incidence rates (per 1,000 FTEs) due to violence or aggression by sector. Ontario 2002 to 2015

2019-12-05

9

Lost-time injury incidence rates (per 1,000 FTEs) due to

violence or aggression, by sector and sex. Ontario 2002 to 2015

Edu_M

Edu_F

0

1

2

3

2002 2004 2006 2008 2010 2012 2014

Year

Vio

lenc

e In

jury

Rat

e (p

er 1

000

FTE

S)

Education

Health_M

Health_F

0

1

2

3

2002 2004 2006 2008 2010 2012 2014

Year

Vio

lenc

e In

jury

Rat

e (p

er 1

000

FTE

S)

Health Care

Other_M

Other_F

0

1

2

3

2002 2004 2006 2008 2010 2012 2014

Year

Vio

lenc

e In

jury

Rat

e (p

er 1

000

FTE

S)

Other IndustriesEducation Health Care Other Industries

www.iwh.on.ca 17 www.iwh.on.ca 18

Lost-time injury incidence rates (per 1,000 FTEs) due to violence

or aggression, by sector and sex. Ontario 2002 to 2015

2019-12-05

10

www.iwh.on.ca 19

Are the differences in trends only due to differences in

reporting?

Metric Avg Ann Perc Change

Women

Lost-time claims due to workplace violence 2.79

Lost-time claims not due to workplace violence -5.88

ED visits due to violence – work-related 2.69

ED visits due to violence – not work-related -0.37

Men

Lost-time claims due to workplace violence 0.15

Lost-time claims not due to workplace violence -6.67

ED visits due to violence – work-related -0.48

ED visits due to violence – not work-related -2.160

100

200

300

400

500

600

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Other occupations in education sector

Elementary and Secondary School TeacherAssistants

Elementary School and Kindergarten Teachers

www.iwh.on.ca 20

Number of lost-time claims due to violence or

aggression in the education sector by occupation

2019-12-05

11

0

100

200

300

400

500

600

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Other

Mental disorders or syndromes

Other traumatic injuries and disorders

Multiple traumatic injuries and disorders

Intracranial injuries

Surface wounds and bruises

Traumatic injuries to muscles, tendons, ligaments, joints, etc

www.iwh.on.ca 21

Number of lost-time claims due to violence or

aggression in the education sector by nature of injury

www.iwh.on.ca 22

Current capacity to monitor workplace violence

events and evaluate prevention activities in

education

2019-12-05

12

The first step to reducing workplace violence is to understand how often it occurs.

Unless we know how much it occurs, how can we tell if primary prevention is effective?

www.iwh.on.ca 23 www.iwh.on.ca 24

Comparison of estimates of workplace violence by data source.

Rate per 1,000 FTEs (workers). Circa 2009 to 2014

10.80

7.20

0.40 0.24 0.41

0.00

2.00

4.00

6.00

8.00

10.00

12.00

GSS (any) GSS (phys) CCHS (activity lim) CIHI (ED pres) WSIB (LTC)

An assault can be anything from being hit, slapped,

grabbed or knocked down, to being shot, or beaten.

This can also include forced sexual activity and

unwanted sexual touching or grabbing. In this incident,

were you assaulted in any physical or sexual way?

2019-12-05

13

www.iwh.on.ca 25

Comparing self-reported assault among nurses to workers’

compensation claims rates in health care (2005). Per 100 workers/FTEs

43.6

27.9 28.4

0.2 0.10

5

10

15

20

25

30

35

40

45

50

Men Women Ontario Men Women

2005 National Survey of the Work and Health of

Nurses2004-06 LTC rate estimates for

health care industry

“During the past 12 months, did you

experience a physical assault from a

patient? from someone other than a

patient while working?”

51%

37%

26%

17%

8% 8%4% 5%

0%

10%

20%

30%

40%

50%

60%

www.iwh.on.ca 26

Consequences of workplace violence in six hospitals in

Ontario. 2017. Most serious incident (N = 419)

Smith et al in progress

2019-12-05

14

Bill 168 (June 15, 2010)

Requires all employers to have policies and programs in place to deal with workplace violence, workplace harassment and domestic violence that may occur in the workplace.

Employers are required to:

Have procedures in place for workers to report incidents

Investigate incidents of workplace violence, harassment or threats of violence

Give workers information about the policies and programs

www.iwh.on.ca 27

Workplace violence in Ontario

www.iwh.on.ca 28

Reporting of different types of WPV to the hospital

reporting system (six Ontario Hospitals, N = 1,323)

23.7%13.8%

8.5%

30.8%

34.6%

27.6%

45.5%51.6%

63.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Physical Assaults Attempted Assaults Threats

All Events Reported Some events reported No Events reported

2019-12-05

15

32%

44%

29%

18%

48%42%

55% 53%

44%

79%

89%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

www.iwh.on.ca 29

Proportion reporting to the hospital system by WPV subgroups

40%

32%30%

24% 23%22% 20% 20% 20%

12% 12%

8% 8%5%

4%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

All Red = 62%

All Black = 54%

All Purple = 25%

www.iwh.on.ca 30

Main reason for not reporting to the hospital system.

Multiple responses allowed.

2019-12-05

16

Rates of workplace violence (that results in ED visits or lost-time claims) are increasing in Ontario.

The largest increase in lost-time claims for violence or aggression is among women in education sector

Key messages (1)

www.iwh.on.ca 31

To understand the burden of workplace violence and to assess prevention efforts we need to develop better systems for the surveillance of workplace violence.

All workplaces a required to collect information on WPV events that occur

However, these systems are unevenly implemented

‒ In six Ontario hospitals only 33% of WPV events were reported to the hospital system

Key messages (2)

www.iwh.on.ca 32

2019-12-05

17

www.iwh.on.ca 33

The Institute for Work & Health operates with the support of the Province of Ontario.

The views expressed in this document are those of the authors and do not necessarily reflect those of the Province of Ontario.

www.iwh.on.ca 34

Acknowledgements

2019-12-05

18

Sign up online for our monthly e-alerts, our quarterly newsletter,

event notifications and more: iwh.on.ca/subscribe

Follow @iwhresearch on Twitter:

twitter.com/iwhresearch

Connect with us on LinkedIn:

linkedin.com/company/institute-for-work-and-health

Subscribe to our YouTube channel:

youtube.com/iwhresearch

Keep up on evidence-based practices from IWH

www.iwh.on.ca 35 www.iwh.on.ca36