Definitions

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The Canadian Community Health Survey (CCHS) contains detailed information about a single injury event for each respondent who reported having sustained at least one activity-limiting injury during the year before the interview.  If more than one such injury was reported, the focus was on the injury that the respondent identified as most serious.  CCHS interviewers instructed respondents to report injuries that were "serious enough to limit your normal activities."  Occupational injurywas defined as a "yes" response to the question, "(Not counting repetitive strain injuries), were you injured in the past 12 months?"  together with the response "working at a job or business" to the question, "Thinking about the most serious injury, what type of activity were you doing when you were injured?"  Injuries sustained while commuting were not considered to be work injuries in this analysis.   Respondents also provided information about their single, or most serious, injury that occurred during "sports or physical exercise," "leisure or hobby," "travel to or from work," "household chores, other unpaid work," "sleeping, eating, personal care," or "other activities."   

Body part injured was indicated in response to the question, "What part of the body was injured? (Multiple sites; Eyes; Head (excluding eyes); Neck; Shoulder/Upper arm; Elbow/Lower arm; Wrist; Hand; Hip; Thigh; Knee/Lower leg; Ankle/Foot; Upper back or upper spine; Lower back or lower spine; Chest (excluding back and spine); Abdomen or pelvis (excluding back and spine)." 

Type of injury was indicated in response to the question, "What type of injury did you have?  For example, a broken bone or burn. (Multiple injuries; Broken or fractured bones; Burn, scald, chemical burn; Dislocation; Sprain or strain; Cut, puncture, animal or human bite (open wound); Scrape, bruise, blister; Concussion or other brain injury; Poisoning; Injury to internal organs; Other)."

Those types of injuries that are usually more harmful (burn or scald, concussion, fracture, internal injury, multiple injuries) were defined as serious injuries.

Information abouttreatmentfor injury was ascertained in the questions, "Did you receive any medical attention from a health professional in the 48 hours following the injury?" and "Where did you receive treatment? (Doctor's office; Hospital emergency room; Outpatient clinic; Walk-in clinic; Appointment clinic; Community health centre/CLSC; At work; At school; At home; Telephone consultation only; Other.  Were you admitted to a hospital overnight?)." 

Job category was defined using the Standard Occupational Classification (SOC) 1991-Canada.  The SOC specifies 10 occupational categories:

• management occupations;
• business, finance and administrative occupations;
• natural and applied sciences and related occupations;
• health occupations;
• occupations in social science, education, government service and religion;
• occupations in art, culture, recreation and sport;
• sales and service occupations;
• trades, transport and equipment operators and related occupations,
• occupations unique to primary industry;
• occupations unique to processing, manufacturing and utilities.

For some of the analysis, the first six categories were combined into a "white-collar" category; the remaining four sectors were combined as a "blue-collar" category.  The occurrence of occupational injury within some individual occupations was examined for some categories (for instance, sales and service occupations).

Respondents indicating that they had had a job (including full- or part-time, seasonal or contract work, self-employment, baby-sitting or any other paid work) throughout, or during part of, the year were classified as having been employed in the past year.

To determine self-employment, respondents who had worked at a job or business at any time in the past 12 months were asked, "Are you an employee or self-employed?"

Hours worked per week was ascertained by asking, "About how many hours a week do you usually work at your job/business?  If you usually work extra hours, paid or unpaid, please include these hours."  For people who worked at more than one job during at least 26 weeks of the year, the usual number of hours worked per week was defined as the total hours worked at all jobs.  For those who worked at more than one job during fewer than 26 weeks of the year, the number of hours worked was based on their main job only.  For the analysis, the following categories of hours per week were used:  less than 35; 35 to 44; 45 to 79; 80 or more.

Type of shift was ascertained with the question, "Which of the following best describes the hours you usually work at your job/business? (Regular daytime schedule or shift; Regular evening shift; Regular night shift; Rotating shift; Split shift; On call; Irregular schedule)."  Respondents indicating that they worked a regular daytime schedule or shift were defined as working a regular daytime schedule; all others were combined into a category labeled "shift worker."

Physical work demands was defined using the question, "Thinking back over the past three months, which of the following best describes your usual daily activities or work habits? (Usually sit; Stand or walk quite a lot; Usually lift or carry light loads; Do heavy work or carry very heavy loads)."  A response of "Do heavy work or carry very heavy loads," was defined as "strenuous" activity; the other categories combined were defined as "light" activity.

Income was based on the respondent's total annual personal income (before taxes and deductions) from all sources, and for the analysis was categorized into the following groups:  less than $20,000; $20,000 to $39,999; $40,000 to $59,999; $60,000 or more.  Income data were missing for 6,683 (9%) of the 75,184 respondents included in the analysis (data not shown).  

Self-perceived work stress was measured by the question, "The next question is about your main job or business in the past 12 months.  Would you say that most days were (not at all stressful; not very stressful; a bit stressful; quite a bit stressful; extremely stressful)?"  For the regression, "not at all stressful" and "not very stressful" were combined; the other three responses were used as distinct categories.

Age groups were specified as follows:  18 to 24; 25 to 34; 35 to 44; 45 to 54; 55 to 64; and 65 to 75.    

Chronic conditions were assessed by asking respondents if they had specific conditions that had been diagnosed by a health professional and had lasted, or were expected to last, six months or more.  Data on the following conditions were used for this analysis:  diabetes, heart disease, stroke, high blood pressure, migraine, asthma, arthritis, bronchitis, chronic obstructive lung disease, epilepsy, gastric or intestinal ulcers, Crohn's disease, cataract, glaucoma, thyroid condition, fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivities.  Respondents were categorized as having 0 to 2, or 3 or more chronic conditions.

Respondents who indicated that they currently smoke every day were classified as daily smokers.

For bivariate analysis, alcohol consumption was categorized as: not one drink in past year; one or more drink(s) in past year but heavy drinking never, or at most monthly; heavy drinking not more than three times per month; heavy drinking at least weekly.  Heavy drinking was defined as consuming at least five drinks on one occasion.  For multivariate analysis, alcohol consumption was categorized into three groups:  no alcoholic drinks in past year; at least one alcoholic drink in past year, but less than weekly heavy drinking; weekly heavy drinking in past year. 

Educational attainment (household)was defined as "lower" if no household member reported education beyond secondary graduation, and "higher" if at least one household member's education exceeded secondary graduation.  

Personal stress was measured by the question, "Thinking about the amount of stress in your life, would you say that most days are:  not at all stressful; not very stressful; a bit stressful; quite a bit stressful; extremely stressful?"  Responses of "quite a bit" and "extremely" stressful were defined as "high personal stress;" the other categories were combined and defined as "low personal stress."

Racewas identified by the question, "People living in Canada come from many different cultural and racial backgrounds.  Are you:  White? Chinese? South Asian? Black? Filipino? Latin American? Southeast Asian? Arab? West Asian? Japanese? Korean? Aboriginal? Other?"  Race was categorized as White or visible minority (applied to all other groups).

Type of residence area was determined using the Statistical Area Classification Type, which classifies each census subdivision as a census metropolitan area (CMA), a census agglomeration (CA), a zone influenced by a CMA or CA, or the territories.  For this analysis, "urban or urban-influenced" areas were those that are within a CMA or CA and those that have been determined to be strongly or moderately influenced by a CMA or CA.  "Rural or remote" was applied to areas that have been determined to be weakly or not influenced by a CMA or CA, and the territories.

Body mass index (BMI) is a measure of weight adjusted for height, and is calculated by dividing weight in kilograms by height in metres squared.  The CCHS collected self-reports of height and weight, from which BMI was calculated for each respondent.  Using the body weight classification standards adopted by Health Canada,12 the following BMI categories were used in the analysis:

• Underweight:  less than 18.5
• Normal:  18.5 to 24.9
• Overweight:  25.0 to 29.9
• Obese:  30.0 or more