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Occupational injuries in inter-provincial workers in Alberta: a

feasibility study with focus on Newfoundland.

A report submitted to OHS Futures

Grant reference: 095202154 Work Injuries

December 2016

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Contents

Title Page

List of figures and tables 3

Background 4

Approach 1 Rules and practices for filing compensation claims and to investigate

provinces’ practices when jurisdictional issues are contradictory or unclear 5

Appendix 1.1 Interjurisdictional Agreement on Workers' Compensation:

relevant provisions 10

Approach 2 Investigation of data sources that may allow documentation of work injuries

and the calculation of rates 14

Appendix 2.1 C1040 form used by Alberta WCB to elicit and record election of

out-of-province workers to claim from Alberta 26

Approach 3 Establishing a cohort of workers to determine conditions of work and reporting

practices. 28

Conclusions and recommendations 39

Appendix 1: Proposal submitted to OHS Futures 41

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List of figures and tables

Figure Page

Figure 1: Injury in Alberta reported to the WCB 30

Tables

Table 2.1: Claims in Alberta 2013-2015 by province of residence and time loss due to injury 16

Table 2.2: Claims in Alberta 2013-2015 by province of residence, by sex, age and industry 16

Table 2.3A: Alberta residents that worked in Alberta, 2012 by age, sex, and industry type 17

Table 2.3B: NL residents that worked in Alberta, 2012 18

Table 2.4: WCB claim rates by sex and province of residence 19

Table 2.5: Rate for time loss in WCB claims by sex and province of residence 19

Table 2.6: Regression of time loss by province, sex & industry 21

Table 2.7: Regression of time loss by province and age: male construction workers. 22

Table 2.8: Missing data in WBC claims (2013) by province of residence 24

Table 3.1: Characteristics of workers recruited 29

Table 3.2 Work injury in Alberta by time settled in the province 31

Table 3.3: Reportable and reported injuries by time in Alberta 32

Table 3.4: Presence of factors requiring report by time in Alberta 32

Table 3.5: Relation between reportable characteristics and report of an injury 33

Table 3.6: Participants’ reasons for not reporting the injury 34

Table 3.7: Job characteristics of job at baseline by time in Alberta 35

Table 3.8: Injuries in the present job at baseline by industry group. 36

Table 3.9: Relation between job characteristics and injury in present job at baseline 36

Table 3.10: Success of recruitment method 37

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Background

In October 2014, a funding application (included as Appendix 1) was submitted to Alberta’s Occupational

Health and Safety (OHS) Futures research funding program. This was approved for funding for 10

months from February 2015. The period for completion was subsequently extended (with no change in

funding) to October 30th 2016.We are now providing a final report on work completed during this 21-

month funding period.

The phase of work reported here is of a feasibility study to explore ways in which valid and useful data

might be obtained to allow the following questions to be addressed in a full proposal. It is important to

recognize that these were not the objectives of the phase reported here, which simply sought to determine

how far such a substantive study might be possible and useful. We will return to this question in the final

section of this report.

The objectives of a full study, based on feasibility results, were preliminarily identified as follows:

1) How many work-related injuries are there in inter-provincial workers in Alberta?

2) Can injury rates be estimated and compared with injury rates in Alberta residents?

3) Do differences in work demands/environments /contractual arrangements (as well as demographic

factors) explain some or all of any observed differences in rates?

4) Are injuries reported to the Alberta Workers’ Compensation Board a complete (or, if incomplete, an

unbiased) reflection of injuries in out-of-province workers?

5) Is it possible to estimate the health care costs (in Alberta or the home province) resulting from work-

related injury, whether or not recognized by the appropriate workers’ compensation board?

6) Can conclusions about work-related injury be extended to either short or long latency occupational

disease?

For the feasibility study, we used three approaches to collect information that would increase our

understanding of the context in which injuries in inter-provincial workers could be assessed, through

workers’ compensation board statistics or in other ways. The three approaches were as follows:

1) Documenting rules and practices for filing workers’ compensation claims in Alberta and the

provinces of incoming workers (Newfoundland and Labrador (NL) and Ontario).

2) Investigating data sources that would allow us to document injuries and estimate rates.

3) Establishing a cohort of workers to determine conditions of work and reporting practices.

The next three sections report on the context, methods and findings of each approach.

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Approach 1

Rules and practices for filing compensation claims and to investigate provinces’ practices when

jurisdictional issues are contradictory or unclear.

Katherine Lippel, University of Ottawa, CRC in OHS Law

Methods: We interviewed spokespersons for the WSIB (in writing), the WCB of Alberta and the

Newfoundland and Labrador board, Workplace NL, and gathered relevant documentation including

legislation, agreements, policy documents, and arbitration decisions.

We studied the most recent version of the Interjurisdictional agreement on workers' compensation, as

amended on November 20th, 2012, in force since January 1st, 2014 in order to determine provisions that

allow us to identify the workers' compensation board, or boards, that could have jurisdiction on an

accident or disease claim based on events taking place in Alberta (see Appendix 1.1).

The purpose of this aspect of the study was to determine whether statistics from Alberta's WCB involving

workers injured in Alberta would be sure to include all workers injured in Alberta regardless of place of

residence. We did not explore issues relating to occupational disease incurred from exposures in Alberta

in our interviews. Section 7 of the interprovincial agreement shows the complexity of trying to explore

these issues when exposures in multiple provinces occur. It is also of note that Québec opted out of the

provision governing occupational diseases as of 2005. Given the complexity of the process, we restricted

our interviews to issues relating to injury sustained in Alberta.

There appear to be quite a few cases in which a claim for an injury incurred in Alberta will be filed in

Ontario, but this is less evident if the worker is a resident of Newfoundland and Labrador because of the

wording of the workers' compensation legislation in that jurisdiction. When a worker opts to file a claim

in Ontario for an injury sustained in Alberta, the costs will be incurred by Alberta, by virtue of s. 9 of the

interprovincial agreement, but it is unclear whether this is reflected in the claims statistics of the AWCB.

In this report, we have focused on claims that are not filed in Alberta for injuries incurred in Alberta.

In the case of Newfoundland and Labrador, we received detailed information (statistics) regarding claims

adjudicated by Workplace NL for workers injured in Newfoundland but having their 'current claims

address' outside NL but we do not have information about workers, if any, injured in Alberta who were

compensated in Newfoundland.

In the case of Ontario, WSIB responses confirm that information regarding the place where the accident

occurred is not available, so that we do not know how many of the 2,146 allowed lost time claims

managed by the WSIB for accidents that occurred outside of Ontario for the years 2011 through 2015

occurred in Alberta.

What follows is an overview of the jurisdictional issues raised when a worker who resides in either

Ontario or Newfoundland and Labrador is injured in Alberta.

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Injuries sustained in Alberta will normally lead to a claim in Alberta

In principle, if an employment injury is sustained in Alberta while the worker is employed by an

employer with an account with the Alberta WCB, or who should have had an account with the Alberta

WCB, then the worker has the right to claim compensation from the Alberta WCB. Our informants

confirmed this, and confirmed that if the employer were doing business in Alberta without having an

account, this would not jeopardize the worker's right to claim for an injury sustained in Alberta.

According to our informants, the requirement to have an account in Alberta appears to be very broad,

broader than in B.C., for example.

"Interviewer: Okay, just to be clear, I’m from Newfoundland I’m working for a company from

Newfoundland. I’m a welder. They operate welders in Newfoundland and they get a contract in Alberta.

They come out with my crew. They’re all Newfoundlanders and I’m injured here. Whether or not the

employer actually pays premiums in Alberta…

Respondent 1: Would have to in that case, because you’ve just said they’ve come to Alberta to work.

[...] So our legislation, which is the employer part (...), they would be required to have an account here.

Respondent 2: Because their operations are here.

Respondent 1: They’re operating here. It wouldn’t be carried over. For example, say, we don’t need

you to have an account because you have an account in Nova Scotia. We have very clear rules to say,

“Look, you’re doing business in Alberta. During this period of time you actually need to have an

account.” Some provinces, like specifically BC, has a special rule that says if it’s any more than six days

(I think it’s six days) we don’t have that rule. You’re doing business here. Clearly you have an account

here. "

The employer also has the obligation to report all accidents that require medical attention (not simply first

aid) or that lead to the worker losing work time (time loss).

Exception: Inter-provincial transport workers

Special rules apply to interprovincial transport because compensation boards in Canada have agreed to

apply the Alternative Assessment Procedure for Interprovincial Transport, which provides for particular

rules governing assessments of employers in that industry. Workers may claim either in the jurisdiction

where they are injured or the jurisdiction where they reside, according to the Fact Sheet for workers

produced by the AWCB1:

Exception: residents of Ontario

In some cases, a worker who is eligible for benefits in Alberta may have an option to file a claim in

another province. This is clearly true in Ontario, for example. Our WSIB key informant directed us to

written policy:

"A.2a) OPM document #15-01-08, “Out of Province”, sets out under what conditions, Ontario workers

injured while employed outside the province of Ontario, may claim benefits under the Workplace Safety

and Insurance Act (the WSIA).

1 https://www.wcb.ab.ca/assets/pdfs/workers/WFS_AAP_Interprovincial_Transportation.pdf

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Specifically:

• A worker who is an Ontario resident, and whose usual place of employment is in Ontario, is

automatically covered for up to six months while temporarily working outside Ontario.

• A worker may be required to work part of the time in a jurisdiction other than Ontario. Where

the worker is employed outside Ontario up to 6 months or more with an approved extension (considered

upon application from the employer), and the employer is not carrying on an assessable business in that

jurisdiction, the worker's right to claim compensation for a work-related injury is limited to Ontario. If the

employer operates an assessable business in other jurisdictions, the worker has a right to claim under the

laws of either the jurisdiction where injured, or Ontario.

• An Ontario resident worker injured outside the province may be entitled to claim benefits in

more than one jurisdiction. While [a] worker in this circumstance has a choice of claiming benefits in

more than one jurisdiction, they can only claim benefits in one. The worker must complete and submit an

election, if electing to claim benefits from the Ontario WSIB. The board where the claim is filed

adjudicates the claim according to its own laws and policies.

OPM document #15-01-09, “Entitlement in Ontario and Other Jurisdictions, provides further guidelines

regarding a worker’s right to elect to claim in Ontario and other jurisdictions."

Interview data from Ontario confirms that some claims made for accidents taking place in Alberta are

considered to be Ontario claims under certain conditions. The WSIB confirmed to us that

"the WSIB manages claims for Ontario residents injured in Alberta and in other provinces or out of the

country. According to the WSIB’s published statistics, “By the Numbers 2015”, there were 2,146 allowed

lost time claims managed by the WSIB for accidents that occurred outside of Ontario for the years 2011

through 2015. The WSIB does not break down this number of claims outside of Ontario by accident

location specific to a particular province and/or country."

Section 20 of the WSIA outlines the election process when a worker can claim for an injury occurring

outside of Ontario.

Exception: residents of Newfoundland

The Alberta WCB confirmed that the only circumstances in which a claim for injury sustained in Alberta

could be made in the province in which the worker resided, such as Newfoundland, would be if the injury

employer had an account with the workers' compensation board of the workers' home province, and if

there was "a connection to employment" with the employer in the home province.

The Workplace Health, Safety and Compensation Act2 of Newfoundland and Labrador has a provision on

interprovincial issues that appears to be more narrow than the provision and policy in Ontario. Section 51

of the Newfoundland and Labrador legislation states:

Injury outside province

2 RSNL 1990 c. @11.

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51. (1) Notwithstanding section 48, where an employer carries on a business in the province that has a

substantial connection with the province and an injury occurs out of the province to a worker who is

employed by that employer, the worker or his or her dependents are entitled to compensation in the same

manner as if the injury had occurred in the province, unless the worker or his or her dependents are

entitled to compensation under the law of the place where the injury occurred.

(2) In a case where compensation is payable in respect of an injury occurring out of the province, where

the employer has not fully reported to the commission the wages of the worker who sustains the injury,

the employer is, except where he or she may be relieved by the commission, liable for the full amount or

capitalized value of the compensation and the payment of that amount may be enforced in the same

manner as the payment of an assessment may be enforced.

The ordinary reading of s. 51(1) suggests that no option would be available to a Newfoundland resident if

he or she were "entitled to compensation under the law of the place where the injury occurred." Given

that our respondents in Alberta clearly stated that accidents occurring in Alberta give the worker the right

to coverage in Alberta, it appears that a Newfoundland resident would not have the option of filing a

claim in Newfoundland. We also examined Workplace Health, Safety and Compensation Commission of

Newfoundland and Labrador Policy on Out-of-Province Coverage, which does suggest that cases that

would not meet the legislative criteria as described above could be "considered on an individual basis".

So while it is highly unlikely that a claim eligible for compensation in Alberta would nonetheless be filed

in Newfoundland it is not impossible. This might be an academic point, given the opinion of our

informants as to what would be the most likely scenario for non-resident workers injured in Alberta.

Practical considerations would make it likely that the claim would be filed with the WCB of Alberta.

Practical considerations

The key informants suggested that in those cases where an option was available, it was likely that the

worker would opt for a claim in Alberta:

"Most of the time (and I’ll use that term loosely because I don’t have any facts or percentages to base on

it), but basically they would often choose to elect in Alberta solely because financially they’ll receive

more money because of our compensation rate, differences between the provinces[...]. We have different

maximums as, let’s just say, Nova Scotia does. So they might say, “That’s ridiculous.” But the other part

of it that people forget, and especially our own claim owners, is they’ll say, “Well, why would I even

offer it in Nova Scotia?” Well, the reason being is because often it’s, if they’re living in Nova Scotia, they

can access treatment providers, their family, their support system, all of their resources are in Nova

Scotia. So why wouldn’t I want to be home and get treatment in Nova Scotia? So therefore of course I’m

going to elect – I don’t really care what the financial differences are. I know I’m staying in Nova Scotia. "

Conclusion

Except for accidents sustained by workers employed in interprovincial transport, which are governed by

particular rules, occupational injury occurring in Alberta will normally be included in the statistics of the

AWCB, regardless of the residence of the worker. This seems highly likely in the case of workers from

Newfoundland and Labrador, because the legislation there does not appear to allow for an option

(election) by those workers if they have coverage in Alberta, although policy does suggest exceptions are

possible. Ontario's legislation does allow for an election and some clearly exercise that option and file in

Ontario. No conclusions can be drawn with regard to occupational diseases attributable to exposure in

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Alberta given the possibility of exposures in many provinces and the complexity of rules governing those

situations (s. 7 of the Interprovincial Agreement).

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Appendix 1.1 Interjurisdictional Agreement on Workers' Compensation: relevant

provisions

Does not apply:

3.2

Personal coverage for working employers, directors and executive officers of a corporation,

partners in a partnership, proprietors, or independent operators, unless coverage is in force in

both the jurisdiction of residence or usual employment and the one in which the work is

undertaken or performed;

Election by Beneficiary

4.1 Where there may be entitlement to benefits in more than one jurisdiction, the beneficiary

shall be required by the Adjudicating Board to elect not to claim from other jurisdictions if the

claim is accepted, and the Adjudicating Board shall advise the other jurisdictions where the

claim could be made, of the election, adjudication and disposition of the claim.

SECTION 6. BENEFITS IN KIND

Benefits by Administering Board 6.1 Where a beneficiary has left the jurisdiction of an Adjudicating Board and taken up

temporary or permanent residence in the jurisdiction of an Administering Board, the

Administering Board shall, at the request of the Adjudicating Board, provide or procure and pay

for such benefits in kind to the beneficiary as are authorized by the Adjudicating Board.

Refund by Adjudicating Board 6.2 The amount paid according to subsection 6.1 shall be refunded in full by the Adjudicating

Board on completion of the services, or on such other terms, as agreed between the two Boards,

according to need and circumstance.

SECTION 7. OCCUPATIONAL DISEASES

Definitions 7.1 In this section:

a) “Contributing Board” means a Board

i) In whose jurisdiction a worker has had occupational exposure which has contributed to the

development of the occupational disease, and

ii) Which has agreed to implement section 7, and

iii) May include an Adjudicating Board.

b) “Contributing exposure” means occupational exposure in the jurisdiction of a Contributing Board.

c) “Occupational disease claim” means a claim made by a person who is either a worker suffering

from an occupational disease, or the dependant of a deceased worker whose death was attributable to

an occupational disease.

Election 7.2 Where there may be entitlement to benefits in more than one jurisdiction in respect of an

occupational disease claim, the person making the occupational disease claim shall be required by the

Adjudicating Board to elect not to claim from other Contributing Boards if the claim is accepted, and

the Adjudicating Board shall advise the other jurisdictions where the claim could be made, of the

election, adjudication and disposition of the claim. If the claim is denied by the Adjudicating Board,

the occupational disease claim may be made to the Board in another jurisdiction in which the worker

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has occupational exposure. The election shall be made on a form similar to Appendix B.

No Reimbursement 7.3 A Contributing Board shall adjudicate each occupational disease claim and pay the full costs of

the claim without reimbursement from any other Board, if the claim and the full costs of the claim

would be allowable based solely on exposure within the jurisdiction of that Board.

Partial Exposure with Contributing Board 7.4 If a claim is registered with a Contributing Board, and it cannot allow the claim pursuant to

subsection 7.3, than the Board shall have regard to all contributing exposure and shall:

a) Adjudicate the claim if 30% of the total contributing exposure occurred in the jurisdiction of that

Board; or

b) If paragraph (a) does not apply, the Board shall either adjudicate the claim or refer the claim to

another Board for adjudication so that the Board which adjudicates claim is

i) The Board where the claim is registered, if no contributing exposure is 30% or more of the total

contributing exposure;

ii) The Board where the longest contributing exposure occurred, if one or more Boards has at least

30% or more of the total contributing exposure; or

iii) The Board where the most recent exposure occurred, if the longest contributing exposures over

30% are equal.

Acceptance of Determination by Adjudicating Board 7.5 The Contributing Boards shall accept the allowance of an occupational disease claim by the

Adjudicating Board under subsection 7.4.

Contribution Request by Adjudicating Board 7.6 A Contributing Board which has adjudicated and paid the full costs of a claim for occupational

disease, while another Contributing Board, where the claim was originally submitted, did not apply

the rules provided for under subsection 7.4, can ask for a reimbursement under the rules provided by

subsection 7.7.

Sharing of Costs 7.7 Where subsection 7.4 applies, the costs of the occupational disease claim shall be shared by the

Contributing Boards as follows:

a) The Adjudicating Board shall apportion among the Contributing Boards the financial

responsibility for the occupational disease claim according to the duration of exposure in the

jurisdictions of the Contributing Boards in which the worker had occupational exposure;

b) The Adjudicating Board shall invoice each Contributing Board quarterly, not in advance, for its

share of the costs of the claim for the past quarter of the year,

c) Each Contributing Board receiving an invoice shall pay the full amount of the invoice within sixty

(60) days of receipt, subject only to the maximum amount of benefits payable according to its

Statutory Authority.

Exposure in months 7.8 For the purpose of this section, exposure shall be calculated in months of occupational exposure,

rounded up.

Costs must exceed $5,000 7.9 Subsection 7.7 applies only to occupational disease claims in which the total costs exceed

$5,000.00.

Disablement 7.10 Subject to subsection 7.11, any condition which is treated by a Board as a disablement, but

which is defined in this Agreement as an “occupational disease” shall be treated for the purposes of

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this Agreement as an occupational disease.

Section 7 does not apply 7.11 This section does not apply to claims for occupational chronic stress, occupational chronic pain,

or occupational noise-induced hearing loss. Existing arrangements among Boards concerning the

compensation of claims for occupational noise-induced hearing loss shall continue.

Effect of No Election 7.12 If an Adjudicating Board allows a claim and pays benefits without an election being made in

accordance with subsection 7.2, the Contributing Boards are not responsible for any costs of the

claim.

Effective Date 7.13 Section 7 shall commence on January 1, 1998 for all new claims registered after January 1,

1998. [Note: section 7 is effective for Ontario as of June 25 2001 and does not apply to Québec as of

February 8th 2005].._ _

SECTION 8. AGGRAVATION OR WORSENING OF A DISABILITY

Subsequent Employment 8.1 Where a worker who has been, or is, in receipt of benefits from one jurisdiction, and who has

taken up employment in another jurisdiction, claims that his or her condition has recurred,

worsened, or been aggravated as a result of his or her employment in that jurisdiction, the Board

in that jurisdiction shall adjudicate the new claim and award additional benefits to which the

worker is entitled and pay the full cost of such benefits and related services as are provided for

by its Statutory Authority or policy, and shall advise the other Board upon request.

Not from subsequent employment 8.2 Where the recurrence, worsening or aggravation of the condition did not result from the

subsequent employment, the Board in that jurisdiction shall refer all pertinent information to the

original adjudicating Board for adjudication and the provisions of this Agreement shall apply in

respect of administrative co-operation.

SECTION 9. GENERAL COST REIMBURSEMENT GUIDELINES

Accident Board Responsible 9.1. Where benefits are provided by an Adjudicating Board to a beneficiary, and the injury, or a

fatality resulting from the injury, occurred in another jurisdiction where the beneficiary is

eligible to claim benefits, the cost of benefits provided by the Adjudicating Board shall be borne

by the Board in the jurisdiction in which the injury occurred.

Amount of Reimbursement 9.2. Reimbursements shall either cover the full amount of all payments made by the adjudicating

Board on a claim, or the portion of that full amount requested by the adjudicating Board for

reimbursement subject only to any policy or statutory limitations. This includes the capitalized

costs established on a claim, where both the adjudicating and reimbursing Boards employ a

process of capitalizing future costs. Reimbursement in such cases shall be limited to the extent

that the reimbursing Board would have itself capitalized the costs had it administered the claim.

SECTION 11. ASSESSMENTS - GENERAL PRINCIPLES

Assessment by Boards 11.1 When this Part applies, as a general principle, each Board agrees to assess those employers

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who are liable to pay assessments for the work performed by their workers in that Board's

jurisdiction only.

Assessment Rates 11.2 Such assessments shall be levied according to the policy of the Adjudicating Board at the

assessment rate for the industry in which the employer's operations are classified in each

jurisdiction in which the employer is subject to assessment.

SECTION 16. DISPUTE RESOLUTION

Exclusive Jurisdiction of Adjudicating Board 16.1 Each Adjudicating Board has the exclusive jurisdiction to determine all matters arising

under its Statutory Authority and the action or decision of the Adjudicating Board on such

matters is final and conclusive. This decision-making authority cannot be delegated to any other

Board.

Dispute Resolution 16.2 In the event of a dispute arising between jurisdictions, the Boards in dispute shall undertake

negotiations in good faith to reach a decision. Such negotiations shall originally be conducted by

the staff involved by correspondence and telephone. Failing an agreement, senior representatives

of each Board to the dispute shall address the issues, with the goal of reaching a fair and

reasonable conclusion.

Referral to IJA Coordinator 16.3 Should the dispute remain unresolved, each Board shall refer the dispute to the

interjurisdictional coordinator appointed by their respective Boards for further review and

discussion. If the coordinators fail to resolve the issues to their mutual satisfaction, they may

agree to the appointment of one or more coordinators from other Boards to mediate the dispute.

Note special provisions for trucking and exclusion of Québec from the disease provision, s. 7, as

of 2005.

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Approach 2

Investigation of data sources that may allow documentation of work injuries and the calculation of

rates.

Nicola Cherry with the collaboration of Michael Haan, Western University.

As discussed under Approach 1, an insurable injury that happens to a worker as defined in the Workers'

Compensation Act of Alberta is eligible to be compensated by the Alberta Workers’ Compensation

Board. Injuries that involve more than just first aid, that result in time off (other than on the day of the

injury), or that result in either temporary or permanent work accommodations are required to be reported

by the employer. The legal review did not uncover any loophole in such reporting: those employed as

casual staff or through a contractor are as fully covered as those permanently employed or on long term

contracts. As such, if every injury were reported, Alberta WCB claim records would be a complete record

of injuries in Alberta accepted as work related, regardless of the home province of the worker. If

reporting is less than complete, however, and out-of-province workers are disproportionately less likely to

report an injury, WCB records would be a biased reflection of injury rates for these out-of-province

workers.

To estimate rates, we need both numerator data (the number of injuries reported to the WCB) and

denominator data (the number of people from each province working in Alberta). As discussed below it

only proved possible to obtain denominator data for two provinces, Alberta and NL, and this section

concentrates on injuries in people with Newfoundland and Labrador as their home.

We are grateful to the Alberta WCB for the considerable work they did in ensuring that the numerator

(injury) data were as accurate and complete as possible. In Alberta, since 2013, workers from out of

province who have a work injury in Alberta are invited to complete a form (a C1040, included as

appendix 2.1 to this section) in which they specify whether they are planning to claim in Alberta or in

some other jurisdiction. The day such a form is received it is immediately scanned and entered into the

claim record. If a case worker later becomes aware that the claimant’s home address is out of province a

C1040 will be completed at that point and included in the record.

For this project the Alberta WCB first identified all records of reported injuries from 2013-2015 for which

a C1040 had been scanned and we examined the distribution of these by Province. For the three years of

interest 25145 claims were reported to be for out of province workers (as reported on the C1040) with a

further 584 (2.3%) for whom a C1040 was reported but the province shown as Alberta. Each of these 584

was investigated individually by WCB staff, with just under half (287/584) being found to be truly from

out-of-province workers. Reasons for rejecting the 297 ‘false’ C1040 records were varied but a recurrent

error was the mistaken recoding of a C1040 for cases that were a federal claim.

It was felt likely that the true C1040 for which Alberta had been recorded as home province would arise

largely from those for whom home province had been recognized late into the claim, with the initial data

entry not being updated when a late C1040 was received. As such it seemed possible that the out-of-

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province workers missed in the initial coding were those with more serious time loss claims. The impact

of excluding those coded in error as Alberta is examined below.

At our request the Alberta WCB then provided information on all WCB claims in Alberta for 2013-2015,

including details of the worker (age, sex), the industry (2 digit codes of the North America Industry

classification (NAIC)) and the days (if any) lost from work as a result of the injury, as well as the

province of residence. Only accepted claims were included.

Denominator data was obtained, through Dr. Michael Haan, from Statistics Canada. The data were taken

from a linked longitudinal T1-T4 tax file. T1s are the main tax return that individuals must submit on an

annual basis, whereas the T4 is the employer issued supplement given to all wage-salary employees. T1s

contain postal code information, which allowed us to identify an individual’s province of residence. Box

10 of the T4 contains the province where the majority of the work was completed. The combination of

the two pieces of information enabled us to identify people whose home was in NL but the majority of

whose work was in Alberta, together with those whose home was in Alberta and also the majority of

whose work was in Alberta.

There were some limitations with both the numerator and denominator data. First, the most recent

denominator data available was 2012 and the earliest Alberta WCB data with reliable province of

residence data was 2013. Within the WCB data it was possible for one individual to have multiple claims

within the year and there were many records with missing data (26% missing industry; 5% missing sex;

1% missing age). Because we did not have the claim number for those with the ‘late identified’ C1040

data we were unable to correct the province for these 287 but have been able to calculate (below) the

likely impact of not correcting. In the denominator data there were again some (although fewer) with

unknown industry and cells with <10 people were censored. In the analysis the censored data were

replaced by a constant (2 for women; 20 for men) that maintained marginal totals: we were not able to

ascertain why the replacement for men had to be >10. Further, although those included had all worked in

Alberta at some point during the year under study, the amount of time spent in Alberta was not recorded.

Finally, it did not prove possible within the timescale of the project to get denominators for provinces

other than Alberta and NL.

Table 2.1 is a summary by province of residence of the total Alberta WCB claims over 3 years, by time

lost as a result of the injury. The difference in lost time differs very significantly between provinces (Chi

square=1448 with 4 df) with Alberta residents having the lowest proportion of no time loss injuries

(82.8%) and NL the highest (91.0%). The data in this table have not been corrected for the 287 coded as

Alberta but apparent from the C1040 to be living elsewhere. The proportion with time loss injuries in this

subsample of 287 was greater than in the out-of- province workers recorded in the initial data set, with

only 71% of NL residents and 52% of those from other provinces having a claim that did not involve loss

of time from work. However, adjustment for these ‘late C1040’ province changes made negligible

difference overall. It increased the proportion with time loss in workers from NL from 8.78% to 8.98%,

those from other provinces from 12.53% to 12.93% and marginally decreased the proportion with time

loss in claimants resident in Alberta from 17.19% to 17.17%. Because of the very minor impact, and the

laboriousness of the hand correction, the remainder of the analysis reported here is carried out using the

WCB data as initially supplied.

16

Table 2.1: Claims in Alberta 2013-2015 by province of residence and time loss due to injury

Time loss (days) None 1 ≤ 28 >28 Total

N % N % N % N %

Alberta 340361 82.8 53475 13.0 17185 4.2 411021 100

NL 1278 91.2 48 3.4 75 5.4 1401 100

Other provinces 20770 87.5 1369 5.8 1605 6.8 23744 100

Total 362409 83.1 54892 12.6 18865 4.3 436166 100

The characteristics of those making claims in Alberta differed sharply by province (Table 2.2). Those

claimants who were resident outside Alberta were more likely to be male and much more likely to be

employed in oil and gas or construction. Those from NL were less likely to be in the youngest age group

(18-25 years) and their mean age (40.5 years) was some 2 years greater than those from Alberta (38.5

years) or other provinces (37.9 years). Given that sex, age and industry have all been related to risk of

injury, it was evidently desirable to adjust for these in calculating rates.

Table 2.2: Claims in Alberta 2013-2015 by province of residence, by sex, age and industry

Percentage with Characteristic* Alberta NL Other Total

% male 67.6 88.5 85.0 68.5

% ≤ 25 years old 21.3 15.6 24.0 21.5

% employed in oil, gas, construction 21.9 70.7 55.5 23.7

* Missing values excluded

The data obtained from Statistics Canada to use as denominators for the rate calculations are shown for

Alberta in table 2.3A and for NL residents working in Alberta in Table 2.3B. These give figures, by sex

age and industry for people from Alberta and NL working in Alberta in 2012. To calculate claim rates, we

considered just claims from 2013 with 584 claims from NL workers in Alberta and 143020 claims from

Albertans for injuries in Alberta.

17

Table 2.3A: Alberta residents that worked in Alberta, 2012 by age, sex, and industry type (data from Statistics Canada)

Male Female

Industry Group NAICS codes 18-25 26-35 36-45 46-55 >55 18-25 26-35 36-45 46-55 >55

Agriculture, forestry, fishing

and hunting

11 2341 2604 2339 2641 2649 1198 1084 1365 1801 1942

Oil , Mining and Gas 21 11206 24025 20267 20791 10078 2966 7444 6626 7068 3046

Utility 22 1467 3418 3282 4011 1849 717 1528 1321 1351 463

Construction 23 27476 35867 25435 26030 17296 4784 7154 6111 6705 3651

Manufacturing 31-33 10988 20847 22693 22800 12945 3383 6923 7312 7623 3506

Wholesale and Retail trade 41, 44-45 33447 30455 27490 28784 21747 37255 26872 25025 28029 18230

Transportation and warehousing 48-49 4971 10445 11832 14861 9490 2147 5683 6001 6479 3199

ICR-FIRE-BusMgmt services 51, 52, 53, 55,

56

6706 13139 11587 11779 9964 10215 15783 13819 16485 10552

Professional, scientific and

technical

54 6499 16899 15533 13877 10716 6471 13825 11690 11519 6828

Education and health 61 - 62 5777 12543 13523 14203 12865 21889 46140 45619 50620 34338

Accommodation and food

services

72 12368 11960 7203 5431 3968 21385 17143 10584 9065 5777

Other services 71, 81 17809 19708 16623 16733 15051 18049 20261 16949 16993 11807

Public administration 91 7495 14217 14708 17588 12332 8707 18461 18653 23163 13725

Unknown 1745 2978 2449 1859 1227 1849 3078 2525 1824 1004

18

Table 2.3B: NL residents that worked in Alberta, 2012 by age, sex, and industry type (data from Statistics Canada)

Male Female

Industry Group NAICS Codes 18-25 26-35 36-45 46-55 >55 18-25 26-35 36-45 46-55 >55

Agriculture, forestry, fishing

and hunting

11 . . 12 18 . . . . . .

Oil , Mining and Gas 21 233 392 455 362 192 19 9 16 17 12

Utility 22 . . . . . 0 0 0 0 0

Construction 23 668 1087 1276 1220 630 49 54 60 80 22

Manufacturing 31-33 29 36 43 36 27 . . . . .

Wholesale and Retail trade 41, 44-45 52 39 43 36 33 84 28 22 43 28

Transportation and warehousing 48-49 23 53 106 56 45 . . . . .

ICR-FIRE-BusMgmt services 51, 52, 53, 55,

56

37 25 36 38 24 16 . 12 23 13

Professional, scientific and

technical

54 66 106 103 62 36 11 12 17 12 .

Education and health 61 - 62 . . . . 10 23 29 14 18 13

Accommodation and food

services

72 22 30 33 73 73 86 37 51 142 90

Other services 71, 81 98 110 103 118 98 59 33 41 113 53

Public administration 91 . . . . . 13 . . . .

Unknown 10 19 12 15 . . 0 . . .

19

The crude injury rates by province and sex are shown in Table 2.4. The rates for men from NL are

roughly half that for Albertans, while the rates for women from NL are only slightly below those for

Alberta women.

Table 2.4: WCB claim rates by sex and province of residence

Alberta NL

Worked Claimed Rate Worked Claimed Rate

Male 907929 90656 9.98 8914 459 5.48

Female 812787 42008 5.17 1517 68 4.48

Total 1720716 132664 7.71 10431 527 5.05

Note: Inclusion of claims with missing sex would increase rates to 8.31 for Alberta residents

and 5.60 for NL residents.

The rates were then examined by time loss associated with the claim (table 2.5). As had been suggested

earlier (table 2.1) the rate of time loss injuries (and particularly those with a loss of time of 1-28 days)

was appreciably lower in those from NL.

Table 2.5: Rate for time loss in WCB claims by sex and province of residence

*using denominators from Table 2.4

**includes unknown sex

This observation was examined further in a regression analysis, using blogit within STATA. Odds ratios

were calculated, using a maximum likelihood estimator, with the unit of observation being the number of

claims within the number of workers in each cell of the table compiled by merging the claims data on sex,

injury, age and time loss, for Alberta and Newfoundland, with the detailed denominator data in table 2.3.

The analysis considered first all claims, adjusted for sex, age (in 5 groups as in Table 2.3) and industry

group (in the 13 groups as in table 2.3). The adjusted risk (Odds Ratio, OR) of any claim for a NL

resident was 0.43 (95% CI=0.39-0.48). The risk was then calculated just for men working in the

construction industry, the largest single group of NL workers in Alberta (as seen in Table 2.3 B). For this

Time Loss (days) None

1-28 days

>28 days

N rate* N rate* N rate*

Alberta

Male 75718 8.34 10859 1.20 4079 0.45

Female 32870 4.04 7299 0.90 1839 0.23

All** 118944 6.91 18158 1.06 5918 0.34

NL

Male 414 4.64 19 0.21 26 0.29

Female 61 4.02 3 0.20 4 0.26

All** 532 5.100 22 0.21 30 0.29

20

group, the OR associated with domicile in NL was even lower at 0.30 (95% CI 0.26-0.35). Simply

interpreted, this means that workers from NL had half (43%) the risk of an Albertan to have an injury

reported to the WCB while working in Alberta. For men in construction, adjusted only for age, the risk

was about a third.

The next stage was to estimate the risks associated with time loss, and these results are shown for all in

table 2.6 and for male workers in construction in table 2.7. The detailed results shown in table 2.6 are of

interest over and above the adjusted OR associated with the province of residence. As expected, men were

at higher risk than women of a WCB claim, with or without time loss. With no time loss, risk of a claim

decreased steadily with age, while the risk of a claim with time loss >28 days increased markedly in older

workers. For industry, the category against which risk of other industries was based was chosen to be

‘other services’ as this was well represented amongst both numerator and denominator data (table 2.3) for

both men and women. However, the relatively low claim rate in this group results in high ORs for other

industry groups. The order of risk by industry groups was not biased by this choice of comparison group

and it is evident that, even having adjusted for age, sex and province, the risk of a claim is high for work

in manufacturing, construction and transportation but relatively low in oil and gas. For male construction

workers (table 2.7), increasing age is again associated with decreasing risk for no time loss claims but

increasing risk with loss >28 days.

Tables 2.6 and 2.7 are included largely to support consideration of the possible reasons why inter-

provincial workers from NL have a lower risk of a claim than those from Alberta, even after adjustment

for sex, age and type of work. In this discussion, we will note particularly the disparity in odds ratios

between no time loss and time loss claims. For all workers (table 2.6) the OR associated with being an NL

resident is 0.49 for a no time loss claim, but much lower (0.18) with a loss of 1-28 days. Similarly, for

male construction workers (table 2.7) the risk for no time loss is 0.35 but for loss of 1-28 days it is 0.09.

21

Table 2.6: Regression of time loss by province, sex and industry: all claims

No time loss Loss ≤ 28 Days Loss > 28 Days Any time loss

Province OR 95% CI OR 95% CI OR 95% CI OR 95% CI

Alberta 1 − − 1 − − 1 − − 1 − −

NL 0.49 0.44-0.56 0.18 0.12-0.27 0.44 0.30-0.63 0.27 0.20-0.36

Sex

Female 1 − − 1 − − 1 − − 1 − −

Male 1.71 1.68-1.74 1.43 1.38-1.48 1.69 1.59-1.80 1.49 1.44-1.53

Age (years)

18 < 25 1 − − 1 − − 1 − − 1 − −

25 < 35 0.86 0.84-0.88 0.94 0.90-0.98 1.37 1.24-1.51 1.00 0.96-1.04

35 < 45 0.76 0.74-0.78 0.91 0.87-0.95 1.82 1.65-2.01 1.05 1.00-1.09

45 < 55 0.72 0.70-0.73 0.91 0.87-0.95 2.10 1.91-2.31 1.09 1.04-1.13

55+ 0.72 0.71-0.74 0.81 0.77-0.85 2.60 2.35-2.87 1.07 1.03-1.12

Industry (NAIC)

Agriculture 3.57 3.23-3.94 3.23 2.67-3.91 5.56 4.09-7.56 3.74 3.18-4.40

Oil & Gas 3.95 3.71-4.21 1.15 0.99-1.34 2.10 1.63-2.71 1.36 1.19-1.54

Utility 2.78 2.49-3.09 1.35 1.03-1.77 1.25 0.74-2.13 1.33 1.04-1.69

Construction 10.73 10.14-11.36 6.28 5.63-7.01 14.0 11.37-17.17 7.96 7.23-8.76

Manufacturing 13.91 13.14-14.73 7.39 6.62-8.26 7.23 5.83-8.97 7.38 6.69-8.14

Wholesale/Retail 6.17 5.83-6.53 6.23 5.60-6.93 6.01 4.88-7.41 6.22 5.66-6.84

Transportation 10.06 9.47-10.70 8.21 7.32-9.21 12.89 10.41-15.97 9.33 8.43-10.32

Finance & Insurance 4.19 3.94-4.47 3.54 3.14-4.00 4.72 3.76-5.92 3.80 3.42-4.23

Professional, Scientific &

Technical Services

0.83 0.75-0.90 0.36 0.28-0.45 0.52 0.35-0.76 0.39 0.32-0.48

Education & Health 7.28 6.87-7.71 7.71 6.93-8.58 6.45 5.22-7.96 7.47 6.79-8.21

Accommodation & Food

Services

4.35 4.07-4.63 5.37 4.78-6.03 5.50 4.36-6.93 5.45 4.91-6.04

Other Services 1 − − 1 − − 1 − − 1 − −

Public Administration 8.42 7.94-8.93 3.89 3.46-4.37 4.54 3.64-5.67 4.03 3.64-4.47

22

Table 2.7: Regression of time loss by province and age: male construction workers

No time loss Loss ≤ 28 Days Loss > 28 Days Any time loss

Province OR 95% CI OR 95% CI OR 95% CI OR 95% CI

Alberta 1 − − 1 − − 1 − − 1 − −

NL 0.35 0.30-0.41 0.09 0.47-0.61 0.36 0.23-0.57 0.19 0.13-0.28

Age (years)

18 < 25 1 − − 1 − − 1 − − 1 − −

25 < 35 0.89 0.85-0.94 0.91 0.81-1.01 1.34 1.12-1.61 1.02 0.92-1.11

35 < 45 0.77 0.73-0.81 0.75 0.66-0.85 1.78 1.48-2.13 1.00 0.90-1.11

45 < 55 0.59 0.56-0.63 0.66 0.58-0.75 1.72 1.43-2.07 0.92 0.83-1.02

55+ 0.77 0.72-0.82 0.55 0.47-0.64 1.94 1.60-2.36 0.88 0.78-0.96

23

Discussion of approach 2

To interpret these results, we consider first the questions we had identified for the potential substantive

study, for which this feasibility was set up as a preliminary step. The question of most relevance here was

the fourth: Are injuries reported to the Alberta Workers’ Compensation Board a complete (or, if

incomplete, an unbiased) reflection of injuries in out-of-province workers? If the results presented here

are a true reflection of injury experience on people from NL coming to work in Alberta, they imply that

such workers had less than half the risk of an injury resulting in a claim. Since the premise in setting up

the study was that interprovincial workers may be at greater risk of injury, we need to consider whether

these results might arise from some systematic bias or confounding. Of the two, confounding seems a less

likely explanation but would arise if, for example, workers from NL were assigned to jobs with less

inherent risk than Albertans of the same age and sex, working within the same industry. We do however

need to consider carefully the sources of bias that might lead to this result, recognizing that bias might

arise from the denominator data (the ‘at risk’ population), the numerator data (WCB claims as an

unbiased indicator of injury) or both.

The denominator reports the number of workers paid in Alberta during the year of observation (2012) by

their reported province of domicile in that year. In identifying such workers, it is not a requirement that

they were employed in Alberta throughout the whole 12 months. The first, and highly potent source of

bias, lies in the denominator: if workers from NL spent less hours during the year at work in Alberta, they

would have less time at risk of experiencing an occupational injury. If we accept the adjusted risk of 0.43

of a reported claim, this might be consistent with no difference in injury rates if the time at risk for the NL

workers was 0.43 of the time spent working in Alberta by those giving Alberta as their province of

residence. If those from Alberta work 12 months and those from NL work 5 months in Alberta, this

would be consistent with no difference in risk of injury and would wholly account for an observed 0.43

risk. While in a further, substantive, study it might be possible to estimate months worked in Alberta from

the T4 slips, for this report we have no clear indication of the extent to which this potential bias accounts

for the result.

There are also potential biases associated with the numerator. Thanks to the extensive work done by the

Alberta WCB in checking C1040 forms in which the province of residence appeared inconsistent, we can

be confident that claims attributed in error to residence in Alberta by out-of-province workers had only

the most minor effect on rates (see page 15 above). We know also that a substantial number of WCB

claims had missing data, particularly for industry, and that the proportion with missing data was higher

for those from NL (34.8%) compared with 27.0% for those resident in Alberta: this was largely a

reflection of the higher proportion of no time loss claims in those from NL. Within time loss category

there was little difference in the proportions with missing data and, for analyses taking account of time

loss, this is unlikely to have been an important source of bias (table 2.8).

24

Table 2.8: Missing data in WBC claims (2013) by province of residence

Alberta NL p=

N % with missing data N % with missing data

No Time Loss 118944 33.4% 532 36.7% 0.117 Loss 1-28 Days 18158 1.6% 22 4.5% 0.293

Loss > 28 Days 5918 1.5% 30 6.7% 0.072

Overall 143020 28.1% 584 33.9% 0.002

Of more concern is the very substantial difference in ORs associated with no time loss and time loss 1-28

days: ORs for longer time loss (>28 days) were similar to those with no time loss. It is possible that

selective factors would affect the length of time off work, given that an injury serious enough to warrant

time loss had occurred. It might be, for example, that those from Alberta had better access to

rehabilitation or modified work than those from NL (and so return to work sooner), or that those from NL

return home after injury and either had poorer access to rehabilitation or, because of distance, had been

less available to return to modified work. Such factors might tend to reduce the time off work for

Albertans and increase it for those from NL, even if the injury were identical. For this reason, we

considered next the disparity between the risk (OR) of no time loss claims (0.49 from table 2.6) and

claims with any time loss (0.27). There seem at least three possible ways to account for this difference in

risk. First, that those from NL are in jobs where the risk relative to those from Alberta is lower for more

severe (time loss) injuries than for no time loss injuries: given the concept of an injury pyramid where risk

of serious injury can be estimated from the number of minor injuries and near-misses, this line of

explanation seems unlikely. Second, it may be that having sustained an injury, those from Alberta and NL

behave differently, with those from NL continuing to work despite the injury and those from Alberta

electing to take time off work, perhaps because their conditions of employment are more favorable to

injury-related sick leave: the observed rebound in risk, with ORs for time loss >28 days being similar to

those with no time loss, may reflect, in part, a greater likelihood of more serious injury being detected and

reported, whether in an Alberta or NL resident. Third, since injuries must be reported if they involve time

off beyond the day of the injury (and high rates of reportable injury may be reflected in WCB premiums)

it might be that NL workers are more likely to be employed in circumstances in which injuries are under-

reported. From other sources (the WHAT-ME/WHAT-MEN studies) we know that less than half the

work injuries experienced by welders and electricians in the study are reported to the WCB. If this is

indeed the case more generally, there is at least a possibility that the difference in rates of time loss injury

reflects under-reporting.

Finally, it may be helpful to consider how many time loss injuries would be needed to make good the

apparent deficit. Of the 584 Alberta WCB claims in 2013 by people resident in NL, 52 (8.9%) were time

loss: for Albertans, 12.6% were time loss. Assuming the same proportion for those from NL this would

estimate 24 missing time loss claims (that is 32% of time loss claims were missing). To allow for

difference in age, sex and industry, we can obtain a second estimate from the computed odds ratios. If we

assume that the risk of a no time loss WCB claim (0.49) is wholly explained by the difference in time at

risk (working 5-6 rather than 12 months) we might, all other things being equal, expect to observe the

same risk (0.49) for time loss injuries. Under that assumption, we can calculate an expected 52 x

0.49/0.27=94 time-loss claims (that is 45% of time loss claims are missing).

25

Examination of WCB claim reporting by self-report of inter-provincial workers is the focus of the third

approach (below). In conclusion of this section there must be at least some doubt that injuries reported to

the Alberta Workers’ Compensation Board are a complete (or, if incomplete, an unbiased) reflection of

injuries in out-of-province workers. The deficit of time loss injuries in those from NL may suggest a bias

in reporting.

Note: As this final report was in the final stage of preparation the WCB kindly made available a further

data file from which duplicate claims had been removed, reducing the total numbers for residents in

Alberta by 4.5% and for those who were resident in NL by 4.2%. This may result in very minor changes

in estimates when the analyses are repeated for publication.

26

Appendix 2.1:

C1040 form used by Alberta WCB to elicit and record election of out-of-province workers to claim from

Alberta

27

28

Approach 3

Establishing a cohort of workers to determine conditions of work and reporting practices.

Nicola Cherry and Whitney Haynes

The prime objective of this part of the project was to explore whether, and how, a cohort of workers in

Fort McMurray might be established and, further, to determine whether it was possible to re-contact them

going forward. If this were possible, it would provide a research platform to both examine the extent (if

any) of differential injury reporting and identify modifiable work factors that might explain any excess

risk in inter-provincial workers or other vulnerable groups. The report of this feasibility phase focuses

first on the experiences of recruiting the cohort and then turns to examine whether the data here can

usefully illustrate the types of analysis that would be carried out in a more substantive study.

Recruitment

The initial recruitment plan, as outlined in the proposal, was to enroll 20 workers from NL and Alberta

and to identify, through focus groups, ways to recruit and retain workers. We then aimed to recruit a

further 100 participants, 50 from Alberta and 50 from Newfoundland. The 100 would be re-contacted

after 4 months to see if on-going participation would be possible. The anticipated ways of contacting

workers included through large employers, at airports, through social clubs and at walk-in clinics.

During the first months of the study we explored these and other options, initially with little success. Our

first move was to meet with the occupational physicians and other health professions who form a working

group within OSCA (the Oil Sands Community Association). Although they generally supported the

study they were not able to provide any active recruitment, although one occupational health department

did undertake to put up posters. The group felt that this project was closer to the remit of the Oil Sand

Safety Association (OSSA) rather than that of OSCA. Meetings with the Executive Director of OSCA

lead to a contact with the Director of the Personal Safety Collaborative Program at Keyano College, a

contact that eventually proved most fruitful.

Other leads were less helpful largely because, as we learnt with time, information that could be linked to

individual employers would not be forthcoming. This meant, for example, that those running chartered

flights or work camps did not feel able to collaborate. A visit to construction unions in Newfoundland

was of interest but was again not productive: many union members were probably working in Alberta but

not contracted to do so through the union. A campaign to put flyers and posters in cafes serving a

Newfoundland clientele in Fort McMurray was implemented, but without response. One unemployed

union member did come forward and spent time at the University going through the questionnaire and

helpfully talking about the difficulty of getting workers to admit to unreported injuries.

A breakthrough came through the collaboration of a colleague working part-time as director to a down-

town medical clinic that carried out pre-employment/pre-placement screening for many of the large oil

and gas (and other) companies. The staff there provided space and help in recruiting workers about to

start in a new position. By emphasizing that we did not want to know the name of any employer, we were

able to recruit subjects and to talk to them informally about the aims of the study. The first two days of

29

recruitment in effect served as a substitute for focus group work and, following review of the first 16

subjects, adjustments were made to the baseline questionnaire. Unexpectedly almost all identified Alberta

as their home province (even if they had been there only for a few months). Additional questions were

added to the revised questionnaire to enable us to be (somewhat) more precise about their status as inter-

provincial workers. We also elected to ask about the most recent work injury and not simply injuries in

the previous 12 months as initially planned. Recruitment at this clinic continued, with 68 subjects

eventually joining the cohort.

We were conscious that using this source alone would not give us a sufficient sample of the NL

component of the cohort or of those employed by a contractor, small company or through some more

casual arrangement. We next negotiated to recruit on a quiet evening at a social club run by and for

Newfoundlanders: 11 subjects were recruited by two of the team during a single evening.

After many months of negotiation and paperwork we were eventually given access to two further arenas

in which to recruit in March and April 2016. We obtained agreement to recruit in the Emergency

Department of the Fort McMurray hospital, looking not for occupational injuries but for people, off-shift

and without a family physician, who were attending for minor medical issues. This went smoothly and

resulted in 48 participants. Finally, and through the Keyano contact provided by OSSA, we were able to

recruit participants in a basic safety training course: all the major employers in the oil and gas industries

require potential recruits to have completed this, and a one-day course and certification was held 5

days/week. This source provided 13 recruits over 2 days. Finally, 16 ‘ad hoc’ participants completed the

questionnaire, largely on-line or, if they preferred, by telephone interview. Two of these approached the

team from work camps that the investigators had visited but had undertaken not to use as a source of

recruits. Others had heard of the study through friends or worked in the hospital and picked up leaflets

from the Emergency Department. In total, we recruited 151 subjects, employed in Fort McMurray at the

time of completing the baseline questionnaire. Some characteristics of those recruited are shown, broken

down by the time they had been in Alberta, in Table 3.1.

Table 3.1: Characteristics of workers recruited

Time in Alberta at

Baseline

N % male % married

or living as

married

% with

children at

home

% high

school

outside

North

America

% >45

years of

age

Non-resident 27 92.6 70.4 37.0 3.7 40.7

≤ 2 years 18 61.1 16.7 27.8 0.0 22.2

> 2 years 87 62.1 59.8 38.4 19.5 33.3

Born in Alberta 19 73.7 42.1 42.1 5.3 0.0

Total 151 68.9 37.1 37.1 12.6 29.1

Difference between

groups

p=0.009 p=0.001 p=0.812 p=0.008 p=0.001

In all 27 considered their home was not now Alberta, of whom 9 were from Ontario, 7 from the

Maritimes, 6 from NL, 3 from BC and 2 from Saskatchewan or Manitoba. However only 19 were born in

Alberta, leaving 105 who had moved to the Province since birth. Of these 19 had attended high school

30

outside North America. The province immediately prior to Alberta is known for all but the first 16

participants recruited. Of these 25 were from Ontario, 20 from NL, 14 from BC and 11 from the

Maritimes. The 18 who had been in Alberta for less than 2 years are perhaps of special interest, and might

be expected to have some of the work characteristics of interprovincial workers. The non-resident

workers, however were much more likely to be male, married and over 45 years.

Follow-up

Recruitment of subjects with all 151 baseline questionnaires, was completed on 29th April. On May 2nd

Fort McMurray was engulfed by wildfires. By this point, only 31 of the 151 participants had completed a

follow-up questionnaire. We chose to call a halt to any follow-up activity for 18 days from the start of the

fire but from May 21st we began again to try to contact people by phone, using a rapidly amended

questionnaire to ask also about their experiences during the fire and the effect on their employment.

These very interesting data on the effects on workers of the wildfire will be published but are not central

to the aims of the current study and are not addressed further in this report.

The fire was important for the study operations and affected the conclusions that could be drawn from the

follow-up in three ways: first, it reduced the period of risk of occupational injury for everyone (except

one fireman) caught up in the fire. No-one worked during the period of evacuation: even for those who

did return to the city there was no work for many during the first weeks and beyond. Some were paid

during this period, but not at risk of injury. Second, the follow-up was to examine work injuries in Fort

McMurray but, given the destruction, people looked for work elsewhere either in another province or

elsewhere in Alberta; third, with the whole population of the city moving away and homes being

destroyed, the re-contact details given at baseline were often immediately inapplicable. Although we had

taken the precaution of collecting long term family contacts where we could, this level of disruption was

not anticipated.

We were successful in completing follow-up questionnaires for 120/151 of those recruited at baseline. Of

the 31 not recruited, one was not approached because of difficulties at baseline, one was in jail and 2

refused to continue with the study. Of the remaining 27, we established that contact details were no longer

current for 8 and for a further 19 we were unable to make contact. As outlined in the proposal we wrote to

the last known address of each of these offering to pay $20 for a comment on why they had not

responded. Only one has, so far, taken up this offer, perhaps indicating that many more addresses are no

longer current.

Injuries at baseline

At baseline subjects were asked to tell us about their most recent work injury. In total 64/151 (42.4%) of

participants told us of an injury. Of these 53 were in Alberta but only 20 of these within the last 12

months. These are tabulated by time in the province at the date of the injury (table 3.2). As would be

expected, those longer in the province were more likely to have had an injury at some point in Alberta,

but importantly injuries in Alberta during the previous 12 months were unrelated to length of residence.

31

Table 3.2: Work injury in Alberta by time settled in the province

Home

Injury

Most recent Last 12 months

N n % n %

Home is another province 27 8 30 3 11

Alberta home <2 years 18 2 11 2 11

Alberta home >2 years 87 33 38 11 13

Born in Alberta 19 10 53 4 21

Total 151 53 35 20 13

p value p=0.03 p=0.77

In the light of the finding from Approach 2 of possible under-reporting of injuries leading to claims in

those from out-of-province, we next considered whether injuries in Alberta reported on the baseline

questionnaire were, according to the participants, reported to the Alberta WCB. Figure 1 plots the pattern

of reporting: workers resident outside the province and those recently arrived appear much less likely to

report. These data are also shown in the final columns of table 3.3. This table considers, in addition, the

reporting of injuries by whether the injury appeared to be reportable. Overall 54% of ‘reportable’ injuries

were reported but only 13% of those that appeared to be non-reportable. Within ‘reportable’ injuries those

from out of province, or recently arrived, appeared less likely to report although this trend, based on only

37, did not reach significance (p=0.167). Importantly, inspection of the table suggests that those from out

of province had a lower proportion of ‘reportable’ injuries.

Figure 1: Injury in Alberta reported to the WCB

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Table 3.3: Reportable and reported injuries by time in Alberta

Reportable injury Injury not reportable All injuries

Time in Alberta

at time of

injury

N % reported N % reported N % reported

< 2 years

(including non-

residents)

4 25.0 7 0.0* 12 9.1

2 < 6 years 9 44.4 3 33.3 12 41.7

≥ 6 years 16 62.5 3 0.0 19 52.6

Born in Alberta 8 62.5 2 50.0 10 60.0

Total 37 54.1 15 13.3 53 42.3

Linear Trend p=0.168 p=0.180 p=0.013

*No record of reporting (yes/no) for one subject.

As outlined earlier, an injury is reportable if it results in a death, if it involves consultation with a health

professional (beyond first aid), if it results in a temporary or permanent work modification or if it involves

time off work beyond the day of the injury. If an employer knows of an accident that is likely to result in

any of these, he is required to report it to the WCB within 72 hours. In Alberta, a health care provider is

also required to report to the WCB within 48 hours of providing assessment or treatment of a condition he

believes to be work related. The worker also needs to fill a reporting form, giving information about

himself and the injury. The information available on whether injury was reported or not is limited in this

study to the injured worker’s response to the question ‘was this injury reported to the WCB’.

Based on these reporting requirements for the employer the injuries described by non-residents and recent

arrivals were less likely to have the characteristics (other than time off work) that made them reportable

(table 3.4)

Table 3.4: Presence of factors requiring report by time in Alberta

% of injuries that were described as resulting in:

Time in

Alberta at time

of injury

N Modified

work

Consultation

with health

professional

Time off

work

One or more

factor

described

% % % %

< 2 years

(including non-

residents)

12 8.3% 33.3 25 33.3

2 < 6 years 12 25.0 50.0 41.7 75.0

≥ 6 years 19 36.8 78.9 26.3 84.2

Born in

Alberta

10 40.0 80.0 40.0 80.0

Total 53 28.3 62.3 32.1 69.8

Linear Trend p=0.065 p=0.006 p=0.707 p=0.009

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Consulting a health professional was strongly related to an injury being reported (table 3.5). Modified

work (as described by the participant) was less strongly related to an injury being reported and time off

work appeared to be unrelated, with those missing time from work being slightly less likely to say that the

injury was reported. Responses to this question, however, included 6 who were fired or quit as a result of

the injury: such time off would not necessarily trigger a WCB claim, unless the employer believed that

the injury would have been likely to result in time off, had the worker’s employment continued.

Inspection of the 10 cases with time off who did not report showed the following: four (with 6,7,14 and

150 days off work) said they did not report because they feared losing their job or being penalized, one

with 30 days off was self-employed and not covered, one with 10 days was paid by their employer to stay

at home, one with 5 days off said he didn’t know he should report (but quit his job for fear of more

injuries), one with 2 days off felt it was his own fault and two who took only one day beyond the day of

injury felt it was not serious enough to report.

Table 3.5: Relation between reportable characteristics and report of an injury

Injury reported

N % reported p =

Modified work

Yes 15 53.3 0.362

No 37 37.8

Health professional

consulted

Yes 33 60.6 0.000

No 19 10.5

Time off work

Yes 16 37.5 0.765

No 36 44.4

Any characteristic

Yes 37 54.1 0.012

No 15 13.3

The reasons given for not reporting are shown in Table 3.6. There is a marked and significant difference

between those from other provinces or who have recently arrived in Alberta and those more settled, with

the less settled workers being much more likely to report that the injury was not serious enough to warrant

reporting (p=0.02).

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Table 3.6: Participants’ reasons for not reporting the injury

Home is another province or

Alberta < 2 years

In Alberta >2 years

N % N %

Not bad enough* 8 89% 7 39%

No or little time off 1 11% 3 17%

Fear of losing job 0 - 4 22%

Paid me to stay home 0 - 1 6%

Didn’t know I should 0 - 1 6%

Felt own fault 0 - 1 6%

Self-Employed at the

time

0 - 1 6%

Total 9 100% 18 100%

* p=0.02

Note: 3 early participants with injuries were not asked the reason for not reporting

Job characteristics and injury.

People working in Alberta but with their home elsewhere reported work characteristics that differed from

those who called Alberta home. They worked more days without a break and were on schedules with

more ‘days on’ (table 3.7). They did not appear to work longer hours during a shift, with the study group

overall reporting a mean maximum of 12 hours. Those resident elsewhere were more likely to be in the

trades, to work for a contractor and to live in camp.

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Table 3.7: Job characteristics of job at baseline by time in Alberta

Time in Alberta at baseline questionnaire

Non-resident

≤2 years >2 years Born in

Alberta

Means P=

Maximum days

without a break

14.7 9.3 10.4 11.4 0.073

Scheduled*

days-on

16.2 7.8 9.0 8.1 0.000

Maximum*

hours worked

11.7 12.1 11.4 12.3 0.656

% Yes

Job in trades 63.0% 61.0% 47.1% 26.3% 0.065

Worked for a

contractor

74.1% 27.8% 34.9% 36.8% 0.002

Lived in camp 61.8% 5.9% 17.6% 14.7% 0.000

*Not asked for initial respondents

To obtain an unbiased estimate of the effect of such potentially modifiable factors on injury, a cohort

study was designed, to be tested for feasibility here and executed, if proved feasible, in a larger study. The

plan was to compare jobs at baseline in those who went on to have an injury and those who did not. Such

a comparison would be unbiased but could not usefully be carried out in the present feasibility study,

where only seven people reported injuries on the follow-up questionnaire, planned for 4 months after

baseline, but in practice completed after a mean of 25.9 weeks (6 months). The monthly rate of 12 (7/6)

was somewhat less than that for the 12 months before baseline 1.6/month (20/12).Correcting for the

number of respondents (151 at baseline, 120 at follow-up this gave only a small difference in

risk/month/respondent (1.10% at baseline, 0.97% at follow-up) the slightly lower rate possibly reflecting

work stoppage due to the fire. Of these seven post baseline injuries, only 2 were in the job held at baseline

with the other 5 workers having changed jobs, reflecting in part the impact of the fire. To illustrate the

type of crosstabulation that might precede a multivariate analysis of such data in a planned prospective

study, we have compared, in tables 3.8 and 3.9, those who reported, at baseline, that they had sustained an

injury in the job at baseline with those who had not had an injury in that job. It is important to note that

this comparison is biased: it excludes, as does the whole cross-sectional study, anyone who was injured in

the preceding months or years and who could not, or chose not, to continue to work in Fort McMurray. It

also excludes as injured workers those who had an injury in Alberta and had moved, because of the injury

or for another reason, to a different job and were now working in Fort McMurray in a job where they had

not been injured. Third, as we have seen in table 3.2, length of residence in Alberta is associated with

higher risk (reflecting the greater time at risk) of an injury.

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Twenty-seven of the participants reported at baseline that they had had an injury in their present job. Men

(18.3%) and women (17.0%) were equally likely to report such an injury. Those injured were very close

to the same age (38.2 years) as those without injury in the present job (37.6 years) but, as anticipated,

those injured had been longer on the job (51.7 months) than those not injured (30.3 months) (p=0.003),

confirming that the comparison was biased. The distribution of injuries varied significantly (Fisher’s

exact test p=0.05) between industry groups with the highest proportions seen in accommodation and food,

transportation and construction: the one worker in NAICS group 1 (agriculture and forestry) and the one

in manufacturing had also been injured (table 3.8).

Table 3.8: Injuries in the present job at baseline by industry group.

Industry Group NAICS codes N % injured in

present job

Agriculture, forestry, fishing

and hunting

11 1 100%

Oil , Mining and Gas 21 57 15.8%

Utility 22 0 -

Construction 23 26 19.2%

Manufacturing 31-33 1 100%

Wholesale and Retail trade 41, 44-45 6 0.0%

Transportation and

warehousing

48-49 9 22.2%

ICR-FIRE-BusMgmt services 51, 52, 53, 55, 56 7 14.3%

Professional, scientific and

technical

54 3 0.0%

Education and health 61 - 62 25 16.0%

Accommodation and food

services

72 5 60.0%

Other services 71, 81 8 0.0%

Public administration 91 3 33.3%

Total 151 17.9%

From table 3.9, which examines only the potentially modifiable factors (plus work in trades) shown in

table 3.7, it is evident that injury was not strongly related to any one factor. The mean maximum number

of days working without a break was somewhat higher (at 13.5 days) in those with an injury and those

with an injury were scheduled to work slightly more days at a stretch. They were marginally more likely

to be living in camp, but none of these differences approached significance. There was no difference in

the mean maximum number of hours worked nor in the proportion working in the trades. Those working

for a contractor were somewhat less likely to tell us about an injury.

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Table 3.9: Relation between job characteristics and injury in present job at baseline

Injured Not injured p=

Means

Maximum days without

a break

13.5 10.7 0.105

Scheduled days-on 12.0 9.7 0.179

Maximum hours 11.9 11.6 0.651

% Yes

Job in the trades 48.1% 49.2% 0.546

Worked for a contractor 33.3% 43.3% 0.395

Lived in camp 29.6% 21.0% 0.445

Again, in interpreting these tables, included for illustration only, it must be kept firmly in mind that they

are biased: only half of the reported injuries (27/53) were in the job at baseline and workers who quit or

were fired following an injury will be shown here as uninjured in their present job. They do not

demonstrate that injuries are unrelated to job demands, but rather that a prospective study is needed to

identify risk factors associated with jobs in which injuries occur.

Discussion of approach 3

The study was set up to determine whether it was feasible to recruit a cohort from Fort McMurray and to

establish if they would respond when contacted again. While it became clear that recruitment through

employers, unions or industry contractors (such as ‘open’ workcamps and down-town apartments) was

not productive, ways were found. The characteristics of workers recruited by each method are shown in

Table 3.10. The impression of the investigators was that the participant pool at the Emergency

Department and the technical college was closest to the needs of the study and this is supported by the

numbers in Table 3.10. These two sources had the highest proportion of non-resident workers living in

camp and with report of earlier injuries in Alberta. Despite being mainly recruited just days before the

fire, the follow-up rate for those from the Emergency Department and technical college was not

importantly lower. As large numbers of those at the pre-placement clinic were recruited at the point at

which they were undergoing drug and alcohol testing for safety sensitive jobs, they are perhaps not

representative of all Fort McMurray workers and, although their participation and description of injuries

in previous jobs was most valuable, such a clinic population would not be a first choice for recruiting a

prospective cohort. None of the 7 injuries at follow-up were in those recruited in the pre-placement clinic

or the social club.

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Table 3.10: Success of recruitment method

Place of

Recruitment

N % Non-

Resident

% Living

in camp

% Trade

work

% Alberta

injury

%

Responded

to follow-up

Pre-employment/

Placement clinic

63 9.5 6.3 50.8 22.2 79.4

NL Social Club 11 0.0 9.1 72.7 36.4 81.8

Emergency Room 48 29.2 41.7 41.7 54.2 77.1

Technical College

Safety Training

13 23.1 38.5 53.8 46.2 76.9

Online/ Phone 16 25.0 25.0 43.8 18.8 87.5

Total 151 17.9 22.5 49.0 35.1 79.5

Difference between

Methods

p=0.016 p=0.001 p=0.408 p=0.005 p=0.915

The results of the feasibility were a little unexpected. We have shown that those from out-of-province or

who had recently arrived, were no more likely to have experienced injuries in Alberta during the previous

12 months but they were overall less likely to report injuries to the WCB. Importantly, many of the

injuries described by those less settled in Alberta were rendered non-reportable because they choose not

to seek medical help or, for some, by quitting the job without reporting the injury to their employer. The

reasons for not seeking medical help may be complex: workers from outside the province may find

difficulty registering with a family physician, be based out of town without transport to attend a drop-in

clinic or emergency department, or be offered first aid by supervisors or other workers. In some instances,

workers told the study team that they chose to self-medicate to avoid getting on a black list with

contractors.

It is evident that the numbers from which to draw conclusions are small and that the results from

Approach 3 are not based on a representative random sample. The out-of-province workers formed a

lower proportion of respondents than we had hoped and NL is not strongly represented. Nevertheless, the

analysis reported here is useful in expanding the evidence from Approach 2: injury reporting patterns

appear to be different in those from out-of-province, with those living in the province over increasing

years developing patterns of reporting very close to those of workers born in Alberta.

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Conclusions and recommendations

The three parts of the project, presented here as Approaches 1, 2 and 3, were each essential to

understanding the data on injuries in inter-provincial workers. The documentation of rules and practices

for filing compensation carried out by Katherine Lippel as Approach 1 concluded that an occupational

injury occurring in Alberta will normally be included (if reported and the claim is allowed) in the Alberta

WCB statistics. There appears to be no circumstance in which an occupational injury sustained in Alberta

to a NL resident would be compensated in NL. The situation is less clear in Ontario, although most

Ontario resident workers employed in Alberta, aside from those working in interprovincial transport,

would be likely to be compensated there, particularly if they were earning a salary that was higher than

the maximum insurable earnings covered in Ontario (Alberta's ceiling is higher). Approach 2, which

considered only workers from NL injured in Alberta, was able to use the thorough review reported in

Approach 1 to be confident that it was highly unlikely that claims by workers from NL, injured in

Alberta, were being adjudicated in NL. Insofar as there were fewer than expected NL claims, this was not

simply a reflection of inter-provincial practice, but rather a real deficit. In the absence of data on the hours

during the year that each worker was at risk it was not possible to say whether the lower rate of claims,

particularly for male workers, was purely a reflection of less hours spent working in the province. The

even lower rate of loss-time claims is however puzzling, with some 32-45% of time loss claims ‘missing’

for the out of province and recent Albertans. While under-reporting is one possible explanation, it may

also be that those resident in Alberta enjoy better conditions of work, with time off for illness or injury

not constituting a threat to continued employment. Nevertheless Approach 3 confirmed, on small

numbers, that out-of-province workers were less likely to report an injury to the Alberta WCB and that

the worker’s own behavior, self-medicating and leaving the job rather than reporting the injury, also

played a part in ensuring that rates of time loss injuries remained low in those less settled in Alberta. The

contribution of modifiable features of work to increased rates of injury could not be demonstrated in the

feasibility phase, although the need for a prospective cohort to collect such data was demonstrated.

Were there to be interest in taking this forward, we can be very confident that a cohort of, say, 500

workers in Fort McMurray could be assembled, recruiting from the ED and technical college, over a

period of 6 months, spending 2 days/week in the field. If such a cohort were followed up for 12 months,

some 100 new injuries, occurring after baseline might be expected, estimating from the numbers in the

previous 12 months in the group assembled here. Given the fire and changing demands for work in Fort

McMurray there might be more transient and fewer well-settled workers in evidence in the next short

while: the intensity at which they are expected to work may have reduced, with fewer episodes of

extremely long periods of work without a break. Nevertheless, the present report does not convey great

confidence that the work demands, particularly long shifts over many days, experienced by

interprovincial workers is without injury risk or that the currently available information from Statistics

Canada can, together with data on WCB claims, adequately quantify any increased risk The outstanding

question on the hours of work in Alberta (i.e. months at risk) by someone in NL would be of importance

and interest if the Statistics Canada files could be interrogated further, to determine whether time working

out-of-province can be established from the T4 or other information. It would also be of considerable

interest to repeat the NL analysis for other provinces from which appreciable numbers come to work in

Alberta while maintaining their residence in their home province.

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We are conscious that 2 of the 6 questions for a substantive study (questions 5 and 6 on page 1) have not

been addressed in the body of the report. The question of the proportion of work-related health costs

covered by the provinces rather than the WCB is a huge one that we have not tackled systematically.

Certainly we heard anecdotes of people injured in Alberta and going home to another province in need of

medical care but without filing a claim, but at this point do not have recommendations as to how examine

further this involuntary cost sharing. Equally, we did not tackle in the feasibility study the extent to which

occupational disease, underestimated throughout Canada, could be approached in the same way as injury.

Our recommendation would be to concentrate on better understanding the issues raised here in relation to

injury before attempting to widen the scope.