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Background: It has been suggested that total knee replacement is being performed in people with less-severe osteoarthritis. We aimed to determine whether there were differences in the presurgery profile, symptoms and disability of 2 cohorts who underwent total knee replacement over a 10-year period. Methods: Patients aged 18-85 years undergoing primary total knee replacement for osteoarthritis at 1 of 4 sites in Toronto and Strathroy, Ontario, were recruited in a cohort study during 2006-2008 (cohort 1) and 2012-2015 (cohort 2). Patients undergoing unicompartmental or revision arthroplasty were excluded. Demographic and health (body mass index [BMI], comorbidity) variables and osteoarthritis severity, as assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the disability component of the Late-Life Function and Disability Instrument (LLFDI-D), were collected before surgery. We calculated proportions, means and standard deviations with 95% confidence intervals (CIs) for all data. We constructed density plots by tertile score for the WOMAC pain and physical function subscales and the LLFDI-D limitation scale. Results: There were 494 patients in cohort 1 and 251 patients in cohort 2. There were no differences in age, sex, education, living status, BMI, comorbidity, pain severity or disability between the cohorts based on overlapping 95% CIs and the density plots. More patients in cohort 1 than in cohort 2 were single (176 [35.6%], 95% CI 32.5%-41.1% v. 63 [25.1%], 95% CI 20.3%-31.0%). Patients in cohort 2 reported less limitation in higher-demand activities than did those in cohort 1 (mean score on LLFDI-D 62.3 [95% CI 60.7-63.9] v. 59.2 [95% CI 58.2-60.2]). Interpretation: The patient profile and reported osteoarthritis severity were similar in 2 cohorts that had total knee replacement over a 10-year period. This suggests that increasing total knee replacement volumes over this period likely were not driven by these factors. [ABSTRACT FROM AUTHOR]

Objectives. We describe trends in occupational and nonoccupational injury among working-age adults in Ontario. Methods. We conducted an observational study of adults aged 15 to 64 over the period 2004 through 2011, estimating the incidence of occupational and nonoccupational injury from emergency department (ED) records and, separately, from survey responses to 5 waves of a national health interview survey. Results. Over the observation period, the annual percentage change (APC) in the incidence of work-related injury was –5.9% (95% confidence interval [CI] = –7.3, –4.6) in ED records and –7.4% (95% CI = –11.1, –3.5) among survey participants. In contrast, the APC in the incidence of nonoccupational injury was –0.3% (95% CI = –0.4, 0.0) in ED records and 1.0% (95% CI = 0.4, 1.6) among survey participants. Among working-age adults, the percentage of all injuries attributed to work exposures declined from 20.0% in 2004 to 15.2% in 2011 in ED records and from 27.7% in 2001 to 16.9% in 2010 among survey participants. Conclusions. Among working-age adults in Ontario, nearly all of the observed decline in injury incidence over the period 2004 through 2011 is attributed to reductions in occupational injury. [ABSTRACT FROM AUTHOR]

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 a medically attended work injury, 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. [Copyright &y& Elsevier]