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British Columbia's outsourced hospital workers : an occupational health and safety perspective Siganporia, Pearl


Cleaners and Food Service Workers (CFSW) form a large yet understudied occupation group within the healthcare sector in terms of their occupational health and safety concerns. Four health regions in British Columbia (BC), Canada have outsourced these services. Evidence suggests an association between outsourced labor and higher risks of injury due to different standards of occupational health and safety. The purpose of this study was to investigate the impact of outsourcing on the health and safety outcomes and experiences among outsourced healthcare CFSWs compared to non-outsourced healthcare CFSWs. Two studies were conducted as part of this mixed-methods project. Study 1 was a quantitative assessment of injury rates, average days lost per claim and average costs per claim among CFSWs in hospitals that outsourced support services and those that did not, between two periods - pre (2001-2003) and post outsourcing (2005-2008). Study 2 was a qualitative study where twenty semi-structured telephone interviews with outsourced and non-outsourced CFSWs from five health authorities were conducted. Results indicate a decrease in incidence rate ratios (IRR) of injury rates post outsourcing for CFSW at outsourced facilities (Cleaners IRR =0.79, CI=0.57, 1.09; FSW IRR = 0.65, CI=0.57, 1.10), although the 95% CI estimates include ‘1’, indicating possibility of no difference between the two exposure periods. The IRR of average days lost per injury showed a decrease post outsourcing for CFSW at outsourced facilities (Cleaners IRR=0.81, CI=0.66, 0.99; FSW IRR=0.80, CI=0.50, 1.28), although the 95% CI estimates included ‘1’ for FSWs. Average costs per claim for outsourced cleaners were shown to decrease significantly (p<0.05) post outsourcing. No differences were seen in emergent themes from the interviews between outsourced and non-outsourced workers except for injury reporting. Workers at outsourced facilities indicated possible underreporting of injuries in their interviews. The study outcomes suggest a change in claims outcomes and experiences among outsourced workers with decreases in IRR of injury rates and days lost per claim and costs per claim, possibly due to underreporting of injuries among outsourced workers. This study provides preliminary evidence of the association between outsourcing and occupational health and safety and future research is warranted.

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