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Prince SA, Lang JJ, Betancourt M, Toigo S, Roberts KC. Sedentary time at school and work in Canada. Can J Public Health 2024; 115:343-355. [PMID: 38277123 PMCID: PMC11006642 DOI: 10.17269/s41997-023-00835-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/02/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES High levels of sedentary time (ST) are associated with poor physical and mental health. Given that Canadians spend a large portion of their days at school and work, they may be important targets for reducing ST. Our objectives are to estimate the daily amount of school and work ST among Canadians, examine differences by subgroups, and determine associations with health. METHODS Using the 2020 Canadian Community Health Survey Healthy Living Rapid Response module (N = 5242), the amount of time spent sitting while at school and work was estimated among youth (12-17 years) and adults (18-34 and 35-64 years). Differences by sociodemographics and 24-Hour Movement Guideline adherence were assessed with independent t-tests. Associations between school and work ST and health indicators were assessed using adjusted logistic regression. RESULTS Canadian youth aged 12-17 years and adults aged 18-34 years reported an average of 4.5 and 5.2 h/day of school ST, respectively. Adults 18-34 years and 35-64 years reported an average of 3.9 and 4.0 h/day of work ST, respectively. School and work ST differed within several subgroups. Among adults 18-34 years, higher school ST was associated with a reduced odds of 'excellent/very good' mental health, whereas higher work ST was associated with a greater likelihood of reporting 'excellent/very good' general health. CONCLUSION Canadian youth and working-age adults report an average of 4-5 h/day sedentary at school or work. This is the first study estimating school and work ST in a representative sample of Canadians and will aid in increasing awareness of setting-specific behaviours to better inform targeted interventions including addressing inequalities in ST.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Marisol Betancourt
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Stephanie Toigo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Karen C Roberts
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
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Toigo S, Katzman DK, Vyver E, McFaull SR, Iynkkaran I, Thompson W. Eating disorder hospitalizations among children and youth in Canada from 2010 to 2022: a population-based surveillance study using administrative data. J Eat Disord 2024; 12:3. [PMID: 38167164 PMCID: PMC10763198 DOI: 10.1186/s40337-023-00957-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Eating disorders (EDs) are severe mental illnesses associated with significant morbidity and mortality. EDs are more prevalent among females and adolescents. Limited research has investigated Canadian trends of ED hospitalizations prior to the COVID-19 pandemic, however during the pandemic, rates of ED hospitalizations have increased. This study examined rates of ED hospitalizations among children and youth in Canada from 2010 to 2022, by sex, age, province/territory, length of stay, discharge disposition and ED diagnosis. METHODS Cases of ED hospitalizations among children and youth, ages 5 to 17 years, were identified using available ICD-10 codes in the Discharge Abstract Database from the 2010/11 to 2022/23 fiscal years. The EDs examined in this study were anorexia nervosa (F50.0), atypical anorexia nervosa (F50.1), bulimia nervosa (F50.2), other EDs (F50.3, F50.8) and unspecified EDs (F50.9). Both cases of total and first-time ED hospitalizations were examined. Descriptive statistics and trend analyses were performed. RESULTS Between 2010/11 and 2022/23, 18,740 children and youth were hospitalized for an ED, 65.9% of which were first-time hospitalizations. The most frequent diagnosis was anorexia nervosa (51.3%). Females had significantly higher rates of ED hospitalization compared to males (66.7/100,000 vs. 5.9/100,000). Youth had significantly higher rates compared to children. The average age of ED hospitalization was 14.7 years. Rates of ED hospitalizations were relatively stable pre-pandemic, however during the pandemic (2020-2021), rates increased. INTERPRETATION Rates of pediatric ED hospitalizations in Canada increased significantly during the pandemic, suggesting that there may have been limited access to alternative care for EDs or that ED cases became more severe and required hospitalization. This emphasizes the need for continued surveillance to monitor how rates of ED hospitalizations evolve post-pandemic.
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Affiliation(s)
- Stephanie Toigo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada.
| | - Debra K Katzman
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Ellie Vyver
- Section of Adolescent Medicine, Department of Pediatrics, Alberta Children's Hospital and University of Calgary, Calgary, Canada
| | - Steven R McFaull
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada
| | - Ithayavani Iynkkaran
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada
| | - Wendy Thompson
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada
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Varin M, Champagne A, Venugopal J, Li L, McFaull SR, Thompson W, Toigo S, Graham E, Lowe AM. Trends in cannabis-related emergency department visits and hospitalizations among children aged 0-11 years in Canada from 2015 to 2021: spotlight on cannabis edibles. BMC Public Health 2023; 23:2067. [PMID: 37872564 PMCID: PMC10591397 DOI: 10.1186/s12889-023-16987-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Cannabis poisonings among children are of public health concern. Existing evidence from the US and from four provinces in Canada (Quebec, Ontario, Alberta, British Columbia) indicate an increase in pediatric cannabis-related poisonings since the legalization of cannabis. This study evaluates trends in cannabis-related poisoning pediatric emergency department (ED) visits and hospitalizations in Canada and addresses a gap in literature by describing trends and context around cannabis edible-related poisoning cases using data from a Canadian sentinel surveillance system. METHODS Mixed-methods using data from two administrative data sources and one injury/poisoning sentinel surveillance system to estimate age-specific rates of cannabis-related poisonings ED visits (Ontario and Alberta), edible-related events (sentinel surveillance Canada), and hospitalizations (Canada with the exception of Quebec) among children between the ages of 0 to 11 from 2015/2016 to 2021. Annual absolute changes were calculated to quantify the magnitude of change between each age-specific rate. Joinpoint regression was used for trend analysis. A thematic analysis was completed to gain a better understanding of cannabis edible-related poisoning cases in the ED. RESULTS The pediatric age-specific rates for cannabis-related poisoning ED visits (average annual percent change (AAPC) Ontario: 98.2%, 95% CI: 79.1, 119.2; AAPC Alberta: 57.4%, 95% CI: 36.7, 81.2), hospitalizations (AAPC: 63.4%, 95% CI: 42.0, 87.9) and cannabis edible-related events (AAPC: 122.8%, 95% CI: 64.0, 202.6) increased significantly from 2015 to 2021. Almost half of all pediatric edible-related events involved gummy edible products (48.8%, n = 143). Based on the thematic analysis, 88% cannabis edible-related events were attributed to inadvertent ingestion due to access to such products or lack of safe storage practices. CONCLUSION Age-specific rates of cannabis-related poisoning ED visits (Ontario and Alberta) and hospitalizations (Canada with the exception of Quebec) have increased since cannabis legalization, with the largest increase in rates occurring from 2019 to 2020. A similar increase in the rate of cannabis edible-related cases from sentinel surveillance data underscores the importance of monitoring this outcome. Public health messaging and national public health promotion strategies targeted towards raising awareness on the risks associated with consuming illegal cannabis and safe storage of cannabis could help mitigate cannabis poisonings among children.
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Affiliation(s)
| | | | | | - Le Li
- Public Health Agency of Canada, Ottawa, ON, Canada
| | | | | | | | - Eva Graham
- Public Health Agency of Canada, Ottawa, ON, Canada
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Toigo S, McFaull SR, Thompson W. Impact of substance-related harms on injury hospitalizations in Canada, from 2010 to 2020. Health Promot Chronic Dis Prev Can 2023; 43:130-138. [PMID: 36924466 PMCID: PMC10101041 DOI: 10.24095/hpcdp.43.3.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
INTRODUCTION Injuries continue to be a leading cause of death and contribute significantly to hospitalizations each year in Canada. Substance use has been associated with an increase in intentional and unintentional injuries, resulting in hospitalizations. This study examines trends in injury hospitalizations with a co-occurring substance diagnosis, to quantify the burden of injuries and identify at risk populations. METHODS We analyzed Discharge Abstract Database data between 2010/11 and 2020/21, for clinical and demographic information about hospital discharges across Canada. We used ICD-10 codes to identify injury hospitalizations with co-occurring substance diagnostic codes, by injury intent and substance type. Rates, proportions, age-specific rates and age-standardized rates were calculated, trends quantified using average annual percent change and results stratified by sex and age group. RESULTS From 2010/11 to 2020/21, unintentional injuries accounted for over half of all substance-related injury hospitalizations. Substance-related injuries accounted for 12% of total injury hospitalizations over this period. Overall, substance-related injury hospitalizations with co-occurring use of stimulants, opioids, cannabinoids and alcohol increased significantly among males and females. Unintentional substance-related, injury hospitalizations were more common later in life, and intentional substancerelated injuries were more common among adolescents and young adults. CONCLUSION These results highlight key demographic groups with higher rates of substance-related injury hospitalizations that would benefit from targeted prevention efforts.
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Toigo S, Pollock NJ, Liu L, Contreras G, McFaull SR, Thompson W. Fatal and non-fatal firearm-related injuries in Canada, 2016-2020: a population-based study using three administrative databases. Inj Epidemiol 2023; 10:10. [PMID: 36788597 PMCID: PMC9930327 DOI: 10.1186/s40621-023-00422-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/05/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Firearms are a substantial cause of injury-related morbidity and mortality in Canada and globally, though evidence from contexts other than the USA is relatively limited. We examined deaths, hospitalizations and emergency department (ED) visits due to firearm-related injuries in Canada to identify population groups at increased risk of fatal and non-fatal outcomes. METHODS We conducted a population-based study using three national administrative databases on deaths, hospitalizations, and ED visits. ICD-10 codes were used to identify firearm-related injuries from January 1, 2016, through December 31, 2020. Fatal and non-fatal firearm injuries were classified as suicide/self-harm, homicide/assault, unintentional, undetermined or legal intervention injuries. We analyzed the data with counts, rates and proportions, stratified by sex, age group, province/territory, and year. RESULTS Over the 5-year period, we identified 4005 deaths, 3169 hospitalizations, and 2847 ED visits related to firearm injuries in various jurisdictions in Canada. Males comprised the majority of fatal and non-fatal injury cases. The highest rates of fatal and non-fatal firearm injuries were among 20- to 34-year-olds. The leading cause of fatal firearm injuries was self-harm (72.3%). For non-fatal firearm hospitalizations and ED visits, assault (48.8%) and unintentional injuries (62.8%) were the leading causes of injury. Rates varied by province and territory. CONCLUSIONS Our results showed that males comprised the majority of fatal and non-fatal firearm injuries in Canada. The rates of both fatal and non-fatal firearm injuries were highest among the 20- to 34-year-old age group. This comprehensive overview of the epidemiology of firearm injuries in Canada provides baseline data for ongoing surveillance and policy evaluation related to public health interventions.
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Affiliation(s)
- Stephanie Toigo
- Injury Surveillance, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada.
| | - Nathaniel J. Pollock
- grid.415368.d0000 0001 0805 4386Injury Surveillance, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1S 5H4 Canada
| | - Li Liu
- grid.415368.d0000 0001 0805 4386Injury Surveillance, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1S 5H4 Canada
| | - Gisèle Contreras
- grid.415368.d0000 0001 0805 4386Injury Surveillance, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1S 5H4 Canada
| | - Steven R. McFaull
- grid.415368.d0000 0001 0805 4386Injury Surveillance, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1S 5H4 Canada
| | - Wendy Thompson
- grid.415368.d0000 0001 0805 4386Injury Surveillance, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1S 5H4 Canada
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Wang C, Toigo S, Zutrauen S, McFaull SR, Thompson W. Injuries among Canadian children and youth: an analysis using the 2019 Canadian Health Survey on Children and Youth. Health Promot Chronic Dis Prev Can 2023; 43:98-102. [PMID: 36794826 PMCID: PMC10026611 DOI: 10.24095/hpcdp.43.2.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This work provides an overview of injury patterns in Canadian children and youth aged 1 to 17 years. Self-reported data from the 2019 Canadian Health Survey on Children and Youth were used to calculate estimates for the percentage of Canadian children and youth who experienced a head injury or concussion, broken bone or fracture, or serious cut or puncture within the last 12 months, overall and by sex and age group. Head injuries and concussions (4.0%) were the most commonly reported, but the least likely to be seen by a medical professional. Injuries most frequently occurred while engaging in sports, physical activity or playing.
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Affiliation(s)
- Chinchin Wang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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Toigo S, McFaull SR, Thompson W. Hospital discharges for substance-related injuries before and during the COVID-19 pandemic: a descriptive surveillance study using administrative data. CMAJ Open 2023; 11:E54-E61. [PMID: 36693656 PMCID: PMC9876582 DOI: 10.9778/cmajo.20220164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and associated behavioural changes have contributed to an increase in substance-related hospital discharges, and has altered the injury epidemiology landscape in Canada. We sought to evaluate hospital discharges for substance-related injuries during the pandemic compared with prepandemic and to identify subpopulations that have been greatly affected by substance-related injuries during the first year of the pandemic. METHODS We compared data on hospital discharges in Canada from before the pandemic (March 2019-February 2020) with discharges during the first year of the pandemic (March 2020-February 2021) using the Discharge Abstract Database. We identified discharges for substance-related injuries using codes from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. We calculated percent changes, age-standardized rates and age-specific rates of discharges for substance-related injuries. RESULTS Hospital discharges for substance-related injuries increased by 7.1% during the first year of the pandemic. Discharges for intentional injuries decreased by 6.3%, whereas unintentional substance-related injuries increased by 15.1% during this period. Male patients accounted for 95.6% of the increase in hospital discharges for substance-related injuries during the first year of the pandemic. We observed a percent increase among discharges for injuries related to alcohol, opioid, cannabinoid, hallucinogen, tobacco, volatile solvents, other psychoactive substances and polysubstance use. INTERPRETATION We observed an increase in hospital discharges for substance-related injuries during the first year of the COVID-19 pandemic, compared with the same time period before the pandemic. This work will provide useful insight into the ongoing management of the COVID-19 pandemic, as well as future policy and health care planning related to substance use in Canada.
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Toigo S, Jacques M, Razek T, Rajda E, Omelon S, Dankoff F, Tohme R, Lefebvre P, Deckelbaum DL. Fit Testing Retrofitted Full-Face Snorkel Masks as a Form of Novel Personal Protective Equipment During the COVID-19 Pandemic. Disaster Med Public Health Prep 2021; 16:1-16. [PMID: 33926606 PMCID: PMC8209433 DOI: 10.1017/dmp.2021.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 12/26/2022]
Abstract
Objective: Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the COVID-19 pandemic, resulting in fractures in the functionality of healthcare systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for healthcare workers during infectious disease outbreaks.Methods: A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on healthcare workers at the McGill University Health Centre between April-June 2020. Historical fit test results, using medical-grade respirators, for healthcare workers were also analyzed.Results: During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator.Conclusions: The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing healthcare workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.
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Affiliation(s)
- Stephanie Toigo
- Research Institute of the McGill University Health Center, Montréal, Canada
| | - Michel Jacques
- Department of Occupational Health and Safety, McGill University Health Center, Montréal, Canada
| | - Tarek Razek
- Research Institute of the McGill University Health Center, Montréal, Canada
- Department of Trauma Surgery, Montreal General Hospital, McGill University Health Center, Montréal, Canada
| | - Ewa Rajda
- Research Institute of the McGill University Health Center, Montréal, Canada
- Divisions of Infectious Diseases and Medical Microbiology, McGill University Health Centre, Montréal, Canada
| | - Sidney Omelon
- Department of Mining and Materials Engineering, McGill University, Montréal, Canada
| | - Frederic Dankoff
- Department of Emergency Medicine, McGill University Health Center, Montréal, Canada
| | - Rami Tohme
- Department of Infrastructure and Biomedical Engineering, McGill University Health Center, Montréal, Canada
| | - Patricia Lefebvre
- Department of General Support, Administration, and Performance, McGill University Health Center, Montréal, Canada
| | - Dan L Deckelbaum
- Research Institute of the McGill University Health Center, Montréal, Canada
- Department of Trauma Surgery, Montreal General Hospital, McGill University Health Center, Montréal, Canada
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