Injuries in Long Term Care – By the Numbers

April 2, 2014 | News

As remarked on recently in the news, if you were to look at the injury claims data for long term care, caring for others seems to be hazardous for your health. A story run in the Leader Post last year identified the health care sector as “…one of the most dangerous industries…” to work in. Although this article dealt with the health care sector in Saskatchewan, the same trends are present in British Columbia.

SpineB.C.’s long term care sector has one of the highest injury claims rates within the health care industry. In 2013 the sector had an overall injury rate of 9.6 per 100 person years, with a serious injury rate of 3.6 per 100 person years1. This compared to a province-wide average of 2.3 and 0.8, respectively, and an acute care average of 4.0 and 1.5, respectively – or more than double the acute care sector injury rate and more than quadruple the provincial average1.

In 2013, over 120 000 work days were lost due to injury among B.C. long term care workers1. This compares with just under 111 000 work days lost among acute care workers – a sector that employs more than twice the number of individuals employed in long term care1.

Beyond the significant intangible costs, there are very real financial costs associated with workplace injuries. From an injured individual’s perspective, a workplace injury means a loss of income and unplanned medical costs. Even with assistance from third-party insurers, an injured individual experiences a great deal of financial stress when faced with time off work. From an employer’s perspective, costs include higher WorkSafeBC premiums, legal costs, costs of backfilling an absence or hiring and training a replacement, regulatory fines, investigation costs, and higher insurance fees.

From a sector-wide perspective, provincial injury claim payouts alone cost $23 million in 20131. Of the nearly $83 million paid out in injury claims in the health and social services industry, long term care accounted for over 27% of all claim costs in 20131. When compared to the health and social services industry average, long term care employers pay the most in WorkSafeBC base rate premiums, at over three times the average.

In terms of injuries among B.C. long term care workers, back injuries are the most common (30.3%), followed by shoulders (13.0%), and wrist/fingers/hand (11.2%). These figures closely match the injuries reported in the acute care sector1.

shoulderHowever, workplace injuries are not a foregone conclusion. There are several examples of organizations that have had success in addressing this issue. Participating facilities in the Alberta Continuing Care Association’s injury reduction pilot programs saw a reduction in injury claims of 64%2.

A study by Vredenburgh (2002) of safety management practices in hospitals found that front-end involvement in new hire training practices to be particularly effective in preventing injuries3. Similarly, a hospital pilot project that targeted musculoskeletal injuries in nursing staff saw nearly a 50% reduction in injuries over a two-year period. This program employed a train-the-trainer approach to enable a core group of “safety champions” comprised of frontline staff (e.g. LPNs, RNs) to identify high-risk resident handling scenarios, develop techniques to address those scenarios, and deliver hands-on training to the nursing staff 4.

Other studies have also found a link between staff engagement in addressing safety concerns and safer work environments. A systematic review conducted by Yassi et al. (2013) identified that joint occupational health and safety committees that have management support, access to training, and are empowered to proactively identify and develop solutions to safety issues can have a significant impact on reducing injuries in the workplace 5. Similarly, Nahrgang et al. (2011) found that frontline staff engagement was positively related to the greater adoption of workplace safety practices 6.

Overall, musculoskeletal injuries in the long term care sector is a significant issue. In addition to an ethical and moral obligation to keep our workplaces safe, the financial costs associated with high injury claim rates present a strong justification for the sector to prioritize injury reduction among its workers. Cooperation between management and frontline staff is a key component of successful safety initiatives. In addition, workplaces that emphasize engagement are also associated with higher worker job satisfaction and better client care3,4,5,6. Leveraging frontline staff to identify issues and work with management to create solutions is therefore a powerful tool in addressing high injury rates among long term care workers.

B.C. Long Term Care Snapshot in 2013


Long Term Care

Health and Social Services Sector

Claims paid:

$23 million (total)

$83 million (total)

Overall injury rate:

9.6 / 100 person-years

3.8 / 100 person-years (avg.)

Serious injury rate:

3.6 / 100 person-years

1.4 / 100 person-years (avg.)

WorkSafeBC base rate:

$2.50 / $100 payroll

$0.83 / $100 payroll (avg.)


body part affected

Data Source:

WorkSafeBC. Industry Safety Information Centre. Retrieved from, March 31, 2014.


1 WorkSafeBC. Industry Safety Information Centre. Retrieved from, March 31, 2014.

2 Background: Seniors Care and Work Place Safety. Retrieved from, March 31, 2014

3 Vrendenburgh, A. (2002). Organizational safety: Which management practices are most effective in reducing employee injury rates? Journal of Safety Research, 33, 2, 259-276.

4 Garrett, R., Perry, A. (1996). A safer way to move patients. Occupational Health and Safety, 65, 9, 60-65.

5 Yassi, A., Lockhart, K., Sykes, M., Buck, B., Stime, B., Spiegel, J. (2013). Effectiveness of joint health and safety committees: A realist review. American Journal of Industrial Medicine, 56, 4,424-438.

 6 Nahrgang, J., Morgeson, F., Hofmann, D. (2011). Safety at work: A meta-analytic investigation of the link between job demands, job resources, burnout, engagement, and safety outcomes. Journal of Applied Psychology, 96, 1, 71-94.