Are rural healthcare workers at more risk? Comparing the occupational health and safety experience of rural and urban healthcare workers in British Columbia, Canada

This study examined whether healthcare workers (HCWs) are at higher risk of experiencing occupational injury in rural settings compared to urban ones. Incidents of occupational injuries resulting in compensated claims by the workers’ compensation system over a one year period for two health regions (one urban, one rural) in British Columbia, Canada, were compared. Incidents were extracted from a standardized operational database and productive hours were obtained from payroll data. Detailed analysis adjusted for relevant demographic and occupational variables was conducted using Poisson regression modeling with Generalized Estimating Equations. Multivariate models adjusted for age, gender, occupation and sub-sector (acute, long term and community care) found that compared to their urban counterparts, rural HCWs were 1.74 (95% confidence interval: 1.59, 1.91) times at risk for all injuries; 1.78 (1.58, 2.00) times for musculoskeletal injuries; 1.58 (1.06, 2.35) times for aggression injuries; 3.06 (2.33, 4.03) times for needlestick injuries; and 2.18 (1.66, 2.87) times as likely to have experienced allergy/irritations injuries. As rural HCWs are experiencing higher rates of workplace injuries, occupational health and safety policies developed in the urban context should not be applied to rural settings without considering the unique challenges they face.