Podcast Title: Health and Safety to Go!

Episode #: 132  - Brain Injury Awareness: An Interview with Dr. Angela Colantonio

Introduction Welcome to Health and Safety to Go, broadcasting from the Canadian Centre for Occupational Health and Safety.

Host:  Hello and thank you for joining us. June is Brain Awareness Month and in recognition of this, today we are speaking with Dr. Angela Colantonio, the Director of the Rehabilitation Sciences Institute at the University of Toronto. Dr. Colantonio holds a Canadian Institutes for Health Research Chair in Gender, Work and Health with a focus on brain injury and is also a Senior Research Scientist at the Toronto Rehabilitation Institute/University Health Network, where she is currently leading the Acquired Brain Injury and Society team.

Thank you for joining us today Dr. Colantonio.

Angela: You’re welcome. Thank you for having me.

Host: Maybe you could get us started by explaining what a brain injury is exactly.

Angela: Well a brain injury has been defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force. Its typically caused by a jolt to the head or body, and the immediate effect of a brain injury can range from feeling dazed and confused, but not loosing consciousness to very serious injury with prolonged unconsciousness and even death.

Host: When we talk about brain injuries, I think that many of us are likely to think of concussions, and the concussions we often hear about are in sports and suffered by athletes when they are hit hard in the head or body. Outside of the sports arena, what can you tell us about brain injuries common in the workplace?

Angela: Brain injuries can occur anywhere and to anyone and yes, they do occur in the workplace, which may surprise some people, although technically professional sports is a workplace and an elite workplace.

Some causes of injuries to the brain in the civilian workplace context are:

Falls. These can include falls from elevation, such as falling off ladders, roofs, scaffolds and falls at the same level, which include falling on slippery floors, outside on slippery terrain, tripping on debris, articles on the ground.

Being struck by an object or a person can also cause a brain injury. This includes having objects falling from above one's head, being struck by a beam or machinery. It could also include assault such as health care worker being struck by a patient.

Motor vehicle crashes are a more obvious cause of brain injury and we have found that the transportation and storage sectors have among the highest rates of injury in Ontario.

Host: Perhaps you can tell us if brain injuries affect men and women differently, and if so, how?

Angela: Firstly, there has been a dramatic rise in the reporting of concussion injuries in Ontario over the last 10 years, approximately 250% and the same trend can be found in the United States.  Now this reporting is revealing that workplace injuries statistics for men and women are different and so is the severity of the injuries they typically experience.  We see that men represent almost all workplace injury fatalities and they also suffer more severe workplace injuries than women overall.

However, when more milder injuries are examined, such as concussion and they are included in statistics, women comprise over 40% of these workplace injuries. Now some of the highest brain injury rates are found across levels of severity in the government sector which includes education and healthcare and are among women.   The sectors where the injuries are almost exclusively among men are in construction and primary industries such as mining and forestry.

Host: How does this affect a worker’s return to work and workplace accommodation?

Angela: Our work has shown that breadwinner roles are important for both men and women. We found that women are more proactive in seeking treatment following a brain injury, but again can depend on the context.  And that overall returning to work is easier in workplaces that are not male dominated. Our studies show that for all participants, employer and co-worker relations were critically important in determining their successful return to work.

Overall workplace accommodation must take into account the nature and severity of the worker’s injury, the work environment, as well as the demands of the job. There are many types of brain injuries and the affect they have on an individual so there typically is not a ‘one size fits all’ accommodation solution.

There are a few things that can influence how a brain injury affects an individual such as previous head/brain injury, concussion, the areas of the brain affected, other injuries, pre-existing health conditions, age, the severity and possibly the mechanism.  For example, having an assault versus slip and fall may require different approach.

A few things to take into account are that on the surface people may look fine as there are no outward signs of injury. However, they may be experiencing headaches, problems with fatigue, moods, light, sleep, and noise sensitivity for instance.

Host: What would you say are the most important factors to consider for people returning to work after they have suffered a brain injury?

Angela:  Our studies have shown that workers rate support by friends and family, health care providers, and work accommodations as the most important factors in returning to work after a mild/moderate brain injury. Providing the best care possible to the injured worker requires careful consideration and planning when involving outside support and care.

Host: Before we wrap up today’s episode, is there anything else you want our listeners to know about brain injuries in the workplace?

Angela:  Its incredibility important to protect your brain, not to take risks, and also important not to reinjure oneself. Now any loss of consciousness is considered a critical injury and should be reported.  Co-workers and employers can be a great support to person’s affected, as both family and friends.  Our Lab also awards an employer award, to recognize employers who have accommodated a person with a brain injury.  And overall we wish to thank all our supporters, our funders, and partners in this area, including the Canadian Centre for Occupational Health and Safety.  As world persons who have lived experience of workplace injuries who have mentored us.

Host: Thank you for speaking with us today Dr. Colantonio. More information on traumatic brain injury as well as Dr. Colantonio’s work with the Acquired Brain Injury Research Lab can be found at www.abireresearch.utoronto.ca .

Thanks for listening everyone.