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Purpose This study aimed to understand age differences in wage-replacement duration by focusing on variations in the relationship across different periods of follow-up time. Methods We used administrative claims data provided by six workers' compensation systems in Canada. Included were time-loss claims for workers aged 15-80 years with a work-related injury/illness during the 2011 to 2015 period (N = 751,679 claims). Data were coded for comparability across cohorts. Survival analysis examined age-related differences in the hazard of transitioning off (versus remaining on) disability benefits, allowing for relaxed proportionality constraints on the hazard rates over time. Differences were examined on the absolute (hazard difference) and relative (hazard ratios [HR]) scales. Results Older age groups had a lower likelihood of transitioning off wage-replacement benefits compared to younger age groups in the overall models (e.g., 55-64 vs. 15-24 years: HR 0.62). However, absolute and relative differences in age-specific hazard rates varied as a function of follow-up time. The greatest age-related differences were observed at earlier event times and were attenuated towards a null difference across later follow-up event times. Conclusions Our study provides new insight into the workplace injury/illness claim and recovery processes and suggests that older age is not always strongly associated with worse disability duration outcomes. The use of data from multiple jurisdictions lends external validity to our findings and demonstrates the utility of using cross-jurisdictional data extracts. Future work should examine the social and contextual determinants that operate during various recovery phases, and how these factors interact with age.

BACKGKROUND: Traffic-related trauma is an important contributor to morbidity and mortality in Canada, especially among children and young adults. Comparing exposure-based injury rates between travel modes and jurisdictions is a valuable tool towards improving safety. METHODS: We used injury data from the British Columbia Motor Vehicle Branch, trip diary data from the Metro Vancouver transportation authority, and population and provincial travel data from the Census to calculate crude fatality and injury rates for motor vehicle occupants, bicyclists, and pedestrians. We used three different denominators: population; person-trip; and distance travelled. RESULTS: Motor vehicle occupants had the lowest fatality rates using exposure-based denominators: 9.6 per 100 million person-trips and 0.97 per 100 million km. Bicyclists and pedestrians had similar fatality rates using one denominator (13.8 vs. 14.7 per 100 million person-trips, respectively), but bicyclists had a lower rate using the other (2.60 vs. 7.37 per 100 million km). For injuries, pedestrians had the lowest rate and bicyclists the highest using the person-trip denominator, whereas motor vehicle occupants had the lowest rate using the distance denominator, and bicycling and walking had similar rates. CONCLUSIONS: Risks of driving, walking and bicycling in British Columbia were similar to their risks in the United States. The injury and fatality rates for these three travel modes were intermediate compared to much higher rates among US motorcyclists and much lower rates among US bus passengers. Data improvements would enable transportation trauma rate calculations for Canada as a whole and for other modes of travel (transit, motorcycling).

Despite variation in Canadian privacy laws between provinces and territories, increasing legislative protection of personal privacy has imposed restrictions on health research across the country. The effects of these restrictions on patient recruitment include increased study costs, durations, and decreased participation rates. Low participation rates can jeopardize the validity of research findings and the accuracy of measures of association by introducing non-response, or participation bias. We constructed simulations to assess potential effects of non-response bias on the accuracy of measures of association in a hypothetical case-control study. Small biases that alter the probability of selecting an exposed case can lead to dramatic inflation or attrition of the odds ratio (OR) in case-control studies. ORs are more unstable and subject to error when the true probability of selecting an exposed case is greater, such that strong positive associations are subject to error even at low levels of bias. Well-powered, population-based epidemiological research is a cornerstone of public health. Therefore, when weighing the benefits of protecting personal privacy, the benefits of valid and robust health research must also be considered. Options might include special legislative treatment of health research, or the use of an “opt-out” (vs. the current “opt-in”) construct for consent in confidential research.

Background Widely varying crash circumstances have been reported for bicycling injuries, likely because of differing bicycling populations and environments. We used data from the Bicyclists’ Injuries and the Cycling Environment Study in Vancouver and Toronto, Canada, to describe the crash circumstances of people injured while cycling for utilitarian and leisure purposes. We examined the association of crash circumstances with route type. Methods Adult cyclists injured and treated in a hospital emergency department described their crash circumstances. These were classified into major categories (collision vs. fall, motor vehicle involved vs. not) and subcategories. The distribution of circumstances was tallied for each of 14 route types defined in an earlier analysis. Ratios of observed vs. expected were tallied for each circumstance and route type combination. Results Of 690 crashes, 683 could be characterized for this analysis. Most (74%) were collisions. Collisions included those with motor vehicles (34%), streetcar (tram) or train tracks (14%), other surface features (10%), infrastructure (10%), and pedestrians, cyclists, or animals (6%). The remainder of the crashes were falls (26%), many as a result of collision avoidance manoeuvres. Motor vehicles were involved directly or indirectly with 48% of crashes. Crash circumstances were distributed differently by route type, for example, collisions with motor vehicles, including “doorings”, were overrepresented on major streets with parked cars. Collisions involving streetcar tracks were overrepresented on major streets. Collisions involving infrastructure (curbs, posts, bollards, street furniture) were overrepresented on multiuse paths and bike paths. Conclusions These data supplement our previous analyses of relative risks by route type by indicating the types of crashes that occur on each route type. This information can guide municipal engineers and planners towards improvements that would make cycling safer.

Background The aim of this study was to estimate use of helmets, lights, and visible clothing among cyclists and to examine trip and personal characteristics associated with their use. Methods Using data from a study of transportation infrastructure and injuries to 690 adult cyclists in Toronto and Vancouver, Canada, we examined the proportion who used bike lights, conspicuous clothing on the torso, and helmets on their injury trip. Multiple logistic regression was used to examine associations between personal and trip characteristics and each type of safety equipment. Results Bike lights were the least frequently used (20% of all trips) although they were used on 77% of trips at night. Conspicuous clothing (white, yellow, orange, red) was worn on 33% of trips. Helmets were used on 69% of trips, 76% in Vancouver where adult helmet use is required by law and 59% in Toronto where it is not. Factors positively associated with bike light use included night, dawn and dusk trips, poor weather conditions, weekday trips, male sex, and helmet use. Factors positively associated with conspicuous clothing use included good weather conditions, older age, and more frequent cycling. Factors positively associated with helmet use included bike light use, longer trip distances, hybrid bike type, not using alcohol in the 6 hours prior to the trip, female sex, older age, higher income, and higher education. Conclusions In two of Canada’s largest cities, helmets were the most widely used safety equipment. Measures to increase use of visibility aids on both daytime and night-time cycling trips may help prevent crashes.