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Publications of 2026
Occupational Vulnerability to AI-Driven Change: The Role of Skill Composition, Task Structure, and Psychosocial Buffers
Thinuri Welithotage, Behdin Nowrouzi-Kia
Background:
Automation risk is often framed as a question of which jobs can be automated. This perspective neglects how the structure of work itself shapes workers' vulnerability to AI-driven change. In occupational health research, job characteristics such as autonomy, task variety, and social interaction are known to influence worker well-being, yet are rarely incorporated into assessments of AI-related occupational risk.
Methods
To capture this complex vulnerability, this study distinguishes between Automation (AI) Exposure and Psychosocial Buffering capacity. We analyzed 664 U.S. occupations across 128 skill dimensions using K-means clustering, an unsupervised machine learning algorithm, to identify groups of occupations with similar skill profiles. AI Exposure was quantified using the Artificial Intelligence Occupation Exposure (AIOE) score, and the Psychosocial Buffer Index (PBI) captured protective job features relevant to occupational health. Principal Component Analysis (PCA) was used to examine the relationships among AI Exposure, PBI, and occupational skill composition.
Results
Five distinct occupational clusters emerged, systematically differentiating themselves in both AI exposure and buffering capacity. High AI exposure clusters varied in PBI, suggesting that structural job features can mitigate automation-related vulnerability, while low-exposure roles with limited buffering may still face occupational stress. PCA results revealed that AI exposure aligns with cognitive intensity, whereas PBI shows independent dispersion across the skill space.
Conclusions
These findings highlight that AI-related occupational risk is multi-dimensional and indicates the relation between automation potential and the job structure. This framework provides actionable insights for targeted interventions, including retraining, workflow redesign, and collaborative AI integration to support worker well-being in an AI-driven labor market.
Large Language Models for Clinical Data Extraction in Workplace Injury Rehabilitation: Protocol for a Retrospective Pilot Study of Accuracy, Fairness, and Methodological Considerations in Workers’ Compensation Medical Chart Review
Armaan Rehman Shah, Barbara Gorczyca Abel, Majid Komeili, Basem Gohar, Behdin Nowrouzi-Kia
Background:
Electronic medical charts within Workplace Safety and Insurance Board (WSIB) specialty programs contain rich but unstructured clinical and sociodemographic data essential for injury classification, treatment planning, and compensation decisions. Manual chart review is time-consuming, inconsistent, and susceptible to reviewer bias. Large language models (LLMs) extract complex information from unstructured clinical text, yet their application to workplace injury rehabilitation remains unexplored.
Objective:
This study will evaluate the accuracy, fairness, and methodological implications of using LLMs to extract clinical and rehabilitative information from WSIB medical charts at Trillium Health Partners (THP), Canada. We will assess model performance, examine algorithmic bias across demographic subgroups, and explore ethical implications for clinical decision-making and workplace compensation.
Methods:
We will conduct a retrospective review of 50 medical charts from the WSIB Back and Neck specialty program at THP, spanning January 2018 to December 2024. General-purpose models (Qwen3-VL-8B and InternVL3.5-8B) and domain-specific biomedical models (MedGemma-27B and LLaMA-3-Meditron-8B) will be evaluated off the shelf using zero-shot and few-shot prompting; the biomedical models will also be fine-tuned. Charts will be partitioned at the chart level into development, training, and held-out test sets, preventing leakage across purposes. Ground truth will be established by independent human annotation of all 50 charts, with interannotator agreement quantified using Cohen κ. The primary outcome is the macroaveraged F1-score across categorical variables on the held-out test set; secondary outcomes are the per variable F1-score, mean absolute error and root mean squared error for continuous variables, and span-level F1-score. Progression to the larger study requires a macroaveraged F1-score of at least 0.80, a pragmatic feasibility criterion; fairness and continuous-variable results are supporting outcomes. Algorithmic fairness will be examined using demographic parity and equalized odds across subgroups. A secure hybrid architecture will keep all identifiable personal health information within the THP infrastructure, with cloud compute restricted to transient processing.
Results:
This study was funded by the Data Sciences Institute at the University of Toronto in April 2025; the award supported protocol development and ended on April 30, 2026. As of August 12, 2026, neither had a research ethics application been submitted nor had any chart been accessed. Applications to the THP and University of Toronto research ethics boards are anticipated in late 2026, and no data will be retrieved or processed before approval from both boards. Contingent on approval and further funding, data collection is anticipated through 2027, analysis in late 2027 to early 2028, and results submitted for publication in 2028.
Conclusions:
This protocol describes the first systematic evaluation of LLM-based data extraction applied to workplace injury medical charts. Findings will inform best practices for the responsible, reproducible, and equitable integration of these tools into occupational health and workers’ compensation decision-making.
The DORQ framework: Digital online research using questionnaires — A structured methodological model for digital questionnaire-based health research
Gaurav Mittal, Vijay Kumar Chattu, Sujatha Alla, Behdin Nowrouzi-Kia, Riyaz Ahamed
Shaik, Anil Babu Payedimarri, Prakash Narayanan, Altay Dussypov, Sunil Thankam
Introduction:
Health Services and Global Health Research have relied heavily on digital/online survey-based
data collection as a consequence of the COVID-19 pandemic, and this approach will continue
to be used in future research. Currently, however, these digital/online survey-based studies face
numerous challenges in design (e.g., sample size), methodological issues (e.g., non-validated
or poorly documented methodology), and transparency in data integrity (e.g., threats to
confidentiality). Existing reporting guidelines for digital/online survey-based studies offer
several important points of guidance on research parameters; however, they do not provide an
integrated structure that assists researchers in successfully linking the methodological stages
and steps of the research process through to the manuscript reporting of the research results.
Objectives
To develop a structured methodological framework to support the design, conduct, and
reporting of digital, online questionnaire-based studies, grounded in real-world research
experience across diverse global contexts.
Methodology
The creation of the DORQ (Digital Online Research via Questionnaires) Framework was
driven by a systematic process informed by extensive participant experience and an
international, multidisciplinary working group that has collectively conducted numerous
previous digital/online survey-based studies, during which numerous recurring methodological
issues emerged. Each of these issues was systematically collated, analyzed, and organized into
overarching methodological domains and translated into practical, actionable decision points.
The resulting DORQ framework was refined by retrospectively applying these decision points
to previously completed digital/online survey-based studies, thereby improving the validity and
transparency of online survey implementation.
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Results
As the end-product of this process, the DORQ Framework consists of a dual-use structure: (a)
a checklist designed to help researchers develop and implement (DORQ – Conduct Checklist)
digital/online survey-based studies, and (b) a manuscript-aligned reporting checklist (DORQ –
Reporting Checklist) organized by standard paper sections. Each DORQ checklist aligns with
the structure of traditional reports; thus, the two checklists share a common framework,
ensuring that the conduct of the research and the resultant reports are transparent to users. The
DORQ Framework identifies six major methodical decision points: (1) inference; (2) sampling;
(3) equity; (4) consent/governance; (5) data integrity; and (6) reporting transparency. As such,
the Framework contributes to improving methodological defensibility, transparency, and
reproducibility in online survey-based research.
Conclusions
The DORQ Framework provides a foundational, ready-to-implement methodological resource
to support research using digital/online survey questionnaires. The explicit linkage of research
conduct to reporting, in conjunction with the inclusion of equity and integrity considerations
in decision-making, is a new aspect of the existing reporting guidelines. The DORQ
framework should support it as an effective remedial solution to recurring methodological
issues in individual researchers' experience with digital survey research.
Employment Trajectories of Patients with Systemic lupus erythematosus (SLE) and Factors Driving Transitions Between States
Javier Mencia-Ledo, Zahi Touma, Laura Whittall Garcia, Dafna Gladman, Behdin Nowrouzi-Kia
Objective
Systemic lupus erythematosus (SLE) significantly impacts employment capacity. This study aimed to investigate the impact of burden of disease activity, damage, and treatment on employment outcomes and transitions in patients with SLE.
Materials and Methods
Using data from a single center, we analyzed employment transitions, adjusted mean disease activity, and organ damage. Sankey diagrams helped visualize transitions between the categories. Multinomial logistic regression identified predictors of final employment status (employed, unemployed, disability benefit, retired, economically inactive, death while employed) for the disease activity and damage domains.
Results
Of 1,806 patients, limited transition was observed across employment categories. Of the 1155 ever employed, 398 patients (34.5%) permanently transitioned out of employment to disability benefits (n=82) or short-term sick leave (n = 71). Patients with disability showed high retention alongside significant health vulnerabilities, with the highest severe flare rates (0.3/year) and glucocorticoids use (47.8% on >30 mg/day), with a substantial proportion dying during follow-up. Early retirement was associated with malignancy, endocrine, and musculoskeletal damage (OR 2.51; 2.56; 1.47 respectively), while disability showed similar patterns with additional neuropsychiatric (OR 1.87) and renal damage (OR 1.89).
Conclusion
There is a lack of transitions between employment categories over the disease course, high persistence in the disability benefits and economically inactive categories and a low probability of re-entry after leaving the workforce. Neuropsychiatric and renal damage are key drivers of disability. Unemployed and disability-bound patients face the worst disease progressions, underscoring the need for early occupational intervention and an unmet need for novel therapeutic treatments.
Navigating long COVID: Integrated self-management, structural barriers, and patient-identified recommendations among marginalized populations and individuals with preexisting mental health conditions
Yunxi Piao, Thinuri Welithotage, Minahil Haq, De-Lawrence Lamptey, Victor E. Ezeugwu, Geoffrey Maina, Kimberly Flowers, Behdin Nowrouzi-Kia
Purpose
This qualitative study explored how adults living with long COVID, including persons from marginalized and visible minority groups, or individuals with preexisting mental health conditions, manage symptoms, navigate healthcare systems, and identify priorities for improving long COVID care and support.
Methods
We conducted semi-structured virtual interviews with 34 adults living in Canada with long COVID, drawn from marginalized/visible minority groups or with preexisting mental health conditions. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis. The results were reported per the COnsolidated criteria for REporting Qualitative research (COREQ) checklist.
Results
Four overarching themes were identified. (1) Personal Strategies for Well-Being and Daily Living (coordinated self-management, pacing, adapted routines); (2) Advocacy and Access Barriers (fragmented services, delayed care, persistent self-advocacy); (3) Clinical Awareness and Information Sharing (diagnostic uncertainty, symptom-based diagnosis, centralized information); (4) Social Support and Equitable Care Experiences (identity-based bias, reliance on social networks).
Conclusion
Participants managed integrated self-management systems while navigating structural gaps, credibility challenges, and inequities in care. Recommendations emphasized symptom-based diagnosis, coordinated pathways, pacing-centred rehabilitation, navigation support, and culturally informed services.
Health, Well-Being, Work Ability and Work Conditions Among EAP Non-Users in Canada and the U.S.: A Quantitative Cross-National Comparison Study
Chloe Hong Ki Lau, Javier Mencia-Ledo, Kishana Balakrishnar, Sana Siddiqui, Raihana Premji, Paula Allen, Marilyn Grand'Maison, Allison Kelly, Ali Bani-Fatemi, Behdin Nowrouzi-Kia
Background
Research on Employee Assistance Program (EAP) effectiveness has expanded in recent years, but comparative research across countries on people who have never used these services remains limited. Also, few studies have examined how low EAP usage relates to broader workplace factors and well-being.
Objectives
The present study aims to examine cross-national differences in health, well-being, and work conditions among working adults in Canada and the U.S. who have never used EAPs. Specifically, it explores (1) satisfaction with healthcare, work ability, and job demands; (2) quality of life; (3) self-reported happiness; and (4) key demographic and occupational factors.
Methods
This study employed a cross-sectional quantitative design, with adaptation from the international classification of function (ICF) framework. Data were collected through an 87-item online survey, including questions regarding demographic information and validated measures of psychological well-being (OHQ), quality of life (WHOQOL-BREF), and work ability (WAI). Participants included 179 employed adults (Canada: n = 78; U.S.: n = 101) with no prior experience of using EAP services. Data were analyzed using descriptive statistics, standardized between-country comparisons, exploratory subgroup analyses, and linear regression models.
Results
No significant national differences were found in overall quality of life or happiness. U.S. participants reported significantly higher overtime hours, while other between-country differences in income, work ability, physical health, and environmental quality of life were generally small or non-significant at the overall country level. Subgroup analyses revealed that socioeconomic factors (e.g., income, education) were stronger predictors of well-being in the U.S. while occupational factors (e.g., work ability, job demands) were more influential in Canada.
Conclusion
Cultural, economic, and structural differences between Canada and the U.S. shape how work and well-being interact across populations. Although overall well-being scores were similar between the two countries, differences emerged in predictors of well-being. These findings highlight the need for EAPs to adopt tailored strategies that address the specific needs of vulnerable subgroups within each national context.
An environmental scan of Indian children with mobility-related disabilities requiring assistive devices.
Javier Mencia Ledo, Kishana Balakrishnar, Stephanie Bao-Zhu Long, Lianne E. Gilmour, Elizabeth M. Campisi, Dinesh Krishna, Franzina Coutinho, Behdin Nowrouzi-Kia, Andrea L. Duncan
Context There is a severe shortage of assistive technology (AT) in low- and middle-income countries, where access is limited to only 3% of individuals, compared to 90% in high-income countries. Despite this disparity, there remains a critical lack of data on the prevalence of paediatric disability and the associated need for mobility devices. Aims This study aims to estimate the prevalence of children living with mobility-related disabilities in India and the proportion of them who would benefit from a mobility device. Subjects and Methods An environmental scan was carried out using scoping review methodology to synthesise available peer-reviewed and grey literature on paediatric disability in India. Data from the 2011 Indian Census and from the World Health Organization as of 2023 were used to derive population estimates. The current paediatric population with mobility-related disabilities was projected using prevalence estimates from cerebral palsy and other mobility-related disabilities. Finally, published distributions of the Gross Motor Function Classification System levels were used to determine the proportion of children likely to benefit from mobility devices. Results As of 2023, an estimated 3.28 million children in India were projected to be living with a mobility-related disability. Approximately 37.3% of them would likely benefit from a mobility device. Conclusions These findings reflect the need for mobility devices and improved access to paediatric AT among children with mobility-related disabilities in India. In addition, they inform rehabilitation professionals and AT vendors about the potential market size and unmet needs in this region.
Occupational interventions and their effects on work-related and mental health outcomes: A scoping review protocol
Behdin Nowrouzi-Kia, Hong Ki Chloe Lau, Sana Siddiqui, Raihana Premji, Grant Hamblin, Armaan Rehman Shah, R. Nicholas Carleton
Background
The well-being of individuals within their workplace (i.e., workplace mental health) has important implications for their productivity and mental health. The extensive literature on the effectiveness of individual workplace interventions does not yet include a comprehensive synthesis of occupational interventions delivered in workplace settings.
Objective
The proposed scoping review is designed to identify and categorize occupational interventions studied in the literature; and 2) map reported effects on work-related outcomes and mental health outcomes.
Methods
The review will examine five online databases to identify relevant articles: Embase, CINAHL, APA PsycINFO, MEDLINE, and Web of Science. The inclusion criteria will encompass peer-reviewed English-language studies published from 2005 to 2025, focusing on the effects of occupational interventions designed to improve workplace mental health. The results will support work participation among working adults.
Discussion
The review will examine the effects of current occupational interventions on workers’ mental health and well-being, as well as on work-related outcomes (e.g., work participation, productivity). The review results can inform researchers designing future studies assessing the effectiveness of occupational interventions on mental health and guide the development of new interventions.
Assessing burnout and occupational stress among racial and ethnic minority rehabilitation professionals during the COVID-19 pandemic: A qualitative study
Vijay Kumar Chattu, Emily King, Brydne Edwards, Sonia Nizzer, Aaron Howe, Edris Formuli, Kishana Balakrishnar, Behdin Nowrouzi-Kia
Homecare Rehabilitation Professionals (HcRPs) provide services including occupational therapy, physiotherapy, and speech-language therapy to clients in various settings. HcRPs experience burnout and occupational stress, which can significantly impact their participation and engagement at work. These experiences have increased since the onset of the COVID-19 pandemic. Data related to racial and ethnic disparities, burnout, occupational stress, and future policy implications were collected with the objectives to: 1) understand HcRPs’ experience of burnout, stress, and coping during the pandemic, and 2) explore HcRPs’ recommendations for optimizing service delivery during and/or after the pandemic. In this qualitative study, we conducted interviews with 10 HcRPs from racial and ethnic minorities. A thematic analysis was performed to analyze primary results, yielding three main themes: 1) Impact of HcRP’s race/ethnicity on patient-clinician interactions; 2) Reasons for burnout and emotional exhasution during the pandemic; and 3) Coping strategies and policy recommendations for improving productivity and service delivery. Participants faced racial discrimination from clients rather than their organization. Participants experienced occupational stress and emotional exhaustion, exacerbated by the pandemic. This empirical study documents inequities, challenges, and mitigation strategies among HcRPs. The findings provide evidence to support community-based organizations in fostering safe, cohesive, and inclusive working environments for HcRPs.
Comparing barriers to employee assistance program utilization in Canada and the United States using natural language processing and machine learning
Sana Siddiqui, Javier Mencia Ledo, Raihana Premji, Hong Ki Chloe Lau, Kishana Balakrishnar, Charlene Choi, Paula Allen, Allison Kelly, Marilyn Grand’Maison, Donia Obeidat, Ali Bani-Fatemi, Behdin Nowrouzi-Kia
Employee Assistance Program (EAP)s provide critical mental health support, yet utilization remains low in both Canada and the United States. Although qualitative studies have examined general barriers to EAP use, few have compared country-specific perceptions. This study explores barriers to EAP usage and explores potential differences in barriers between Canadian and American workers using natural language processing (NLP). This mixed-methods study, involving data transformation, included 30 semi-structured interviews with EAP-eligible employees (aged 18–65 years) in Canada and the US who had not previously used EAP services. Interviews were analyzed thematically using an inductive approach in alignment with Braun and Clarke’s Thematic Analysis. The qualitative portion of this study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. In Phase 2 of the study, a BERT-based NLP model was trained to classify qualitative quotes by country. In phase 1, three core themes were observed: (1) Structural, informational and systematic barriers influencing EAP accessibility and coverage; (2) Reluctance to use EAP services due to psychosocial and perceptual barriers; and (3) Service quality, scope and cultural relevance to those with multiple social identities. While most barriers were common across countries, US participants reported financial concerns exclusively. Comparatively, in the NLP analysis, financial accessibility and comprehensive support through diverse EAP offerings were important in classifying American quotes, while stigma, vulnerability, and fear of workplace judgement and perceived quality and cultural relevance of EAPs were important in classifying Canadian quotes. Although many barriers to using EAPs are shared, financial and perceptual differences exist between Canadian and American workers. EAPs may benefit from implementing country-specific strategies. This could include creating strategies reducing stigma and quality concerns in Canada, while addressing concerns about cost and alternative options in the United States. Further studies should focus on generalizability and explore sector-specific and longitudinal trends in EAP perceptions.
Assessing the antecedents behind after-hours work in teleworkers: a scoping review
Kishana Balakrishnar, Bao-Zhu Stephanie Long, Joyce Lo, Luke A Fiorini, Basem Gohar, Behdin Nowrouzi-Kia
Background
Since the start of the COVID-19 pandemic, telework arrangements have become increasingly prevalent, driven by benefits such as greater autonomy, reduced work-related stress, decreased commuting time and cost, and enhanced flexibility. Despite these advantages, teleworkers are more likely to engage in after-hours work, creating additional strain that may impact health and organizational outcomes.
Methods
A systematic search was conducted across seven online databases: Medline via OVID, Embase via OVID, APA PsycINFO via OVID, International Bibliography of Social Sciences via ProQuest, Sociological Abstracts via ProQuest, Business Source Premier via EBSCOhost, and CINAHL via EBSCOhost. Studies were included if they were empirical, peer-reviewed, published between 2010 and 2024, examined the antecedents of after-hours work, and focused on adults aged 18 to 65 engaged in telework. Descriptive thematic analysis was conducted to develop themes and sub-themes.
Results
Findings: A total of 17 studies were included in the review: 13 cross-sectional studies, three qualitative studies, and one longitudinal study. Using the Person–Environment–Occupation framework, three overarching themes were identified: (i) misalignment between personal capacities and occupational demands; (ii) environmental constraints that undermine healthy role balance; and (iii) occupational role strain in the context of remote work.
Conclusions
These findings may help to inform the development of targeted interventions that reduce cases of after-hours work among teleworkers and promote their overall health and well-being. Future research should examine these antecedents in non-Western contexts and explore the interplay between the individual, environmental, and occupational factors shaping after-hours work behaviors.
A qualitative study of lived experiences of underrepresented electrical workers using creative non-fiction
Zhiyang Shi, Donia Obeidat, Ali Bani-Fatemi, Aaron Howe, Behdin Nowrouzi-Kia
Objectives
Women, Indigenous peoples, racialized individuals, and persons with disabilities remain underrepresented in the electrical industry. This study explored the lived experience of underrepresented electrical workers related to their mental health and workplace integration.
Methods
A qualitative narrative design was employed. One-on-one interviews were conducted with eleven participants who self-identified as women, Indigenous peoples, racialized individuals, and/or persons with disabilities. Interview data were first analyzed using a narrative thematic approach and informed the development of creative non-fictional stories.
Results
Three stories were developed. Story 1 – “Asking for a ride: being a women electrician” illustrated the experiences of a woman apprentice who faced inadequate job site accommodations and sexism challenges in the workplace. Story 2 – “The lunch talk: Indigenous people and racialized individuals in the trade” highlighted the experiences of Indigenous and racialized participants who encountered language barriers and discriminatory comments. Story 3 – “Luke’s notes: living and working with disability” demonstrated the impacts of physical disability on the daily work of electrical workers, particularly in managing the physical demands and mental health strains.
Conclusions
Electrical workers from underrepresented groups experience persistent barriers to mental health and workplace integration, including a lack of accommodations, limited social support, and experiences of discrimination at the workplace. These individuals also reported challenges in seeking workplace support due to a “toughness” culture within the industry. Electrical employers should foster an inclusive organizational culture that prioritizes the health and psychosocial well-being of underrepresented workers.
Heat Exposure and Health Outcomes in Construction Workers: A Systematic Review and Meta-Analysis
Behdin Nowrouzi-Kia, Vijay Kumar Chattu, Thankam S. Sunil, Nancy Carnide, Heather Thomson, Raihana Premji, Aishvinigaa Sathananthan, Charlene Choi, Javier Mencia-Ledo
Climate change is becoming a recognized health concern in the scientific community, as heat exposure poses escalating health risks to outdoor occupational groups, particularly construction workers. Heat stress and climate change may lead to adverse physical health outcomes and reduced workability among construction workers. This systematic review and meta-analysis aimed to (1) examine the prevalence of physical health outcomes of construction workers in relation to heat exposure and (2) analyze the association between physical health outcomes of heat exposure and work performance by sex and age. Following the PRISMA guidelines and using a PICO framework, we conducted a comprehensive search across APA PsycINFO, MEDLINE, Embase, CINAHL, and Web of Science. Seventeen studies met our inclusion criteria. Outcomes were grouped into dehydration, heat-related illnesses (HRI), kidney function impairments, and heat-related deaths. Random-effects models were used for the meta-analysis, and subgroup analyses were performed using demographic variables. Pooled meta-analysis and heterogeneity statistics are only provided for the HRI outcome, as all other outcomes are only represented by single eligible studies. Dehydration demonstrated the highest single-study prevalence (0.97, 95% CI: 0.88, 1.00), contrasting with HRI pooled prevalence (0.40, 95% CI: 0.24, 0.58) and kidney function impairment single-study prevalence (0.17, 95% CI: 0.05, 0.39), which showed much lower estimates. High heterogeneity was present in the HRI symptoms category (I2 > 95%). Meta-regression revealed that males reported lower heat disorder prevalences in studies with both sexes (ß = −2.09, P = .049). Heat exposure significantly impairs the physical health of construction workers, particularly through dehydration and heat-related illnesses. Sex-responsive, psychological, and intervention-based studies are essential for protecting this vulnerable occupational group from accelerating climate change.
The impacts of climate change on occupational health and work among outdoor workers: A scoping review
Behdin Nowrouzi-Kia, Charlene Choi, Raihana Premji, Aishvinigaa Sathananthan, Kishana Balakrishnar, Alexia Haritos, Bao-Zhu Stephanie Long, Maryna Mazur, Ali-Bani Fatemi
Climate change has a significant impact on human health and productivity at work. Environmental changes, including extreme temperatures and natural disasters, contribute to psychological pressures and physical impairments which affect quality of life and well-being. This scoping review examines the effect of climate change on human health in occupational settings. A systematic search of MEDLINE, CINAHL, Embase, and PsycINFO identified empirical studies that analyzed the impacts of climate change on human health in relation to work. Eligible studies included employed individuals aged 18–65, peer-reviewed studies published between 2000 and 2024, and evidence linking climate change to occupational health outcomes. Studies underwent title, abstract, and full-text screening. The scoping review, registered with the Open Science Framework, includes 62 studies. Three overarching themes emerged: (1) climate change and mental health; (2) climate change and physical health; and (3) climate change and work. Research has demonstrated the association of psychological distress with extreme weather events, occupational stress, and anxiety among outdoor workers. Physical health risks associated with higher temperatures include chronic dehydration, heat-related illnesses, and other injuries. Climate change also negatively impacts work productivity, leading to increased labour shortages and subsequent economic losses. Climate change has complex effects on the physical and mental health of workers, with significant implications for productivity and safety in the workplace. Despite growing evidence, targeted interventions remain limited. Future studies should examine the long-term health consequences, develop standardized alleviation strategies, and implement policies to protect employees from climate-related occupational hazards.
Evaluating the Validity of the GM@W Survey: A Psychometric Study Across Gender and Industry
Javier Mencia-Ledo, Sana Siddiqui, Hong Ki Chloe Lau, Kishana Balakrishnar, André Luiz Fagundes Avila dos Santos, Ana Valentina Villarreal Galeano, Leyi Zhou, Michael Cooper, Gustavo S. Betini, Behdin Nowrouzi-Kia
Purpose
The National Workplace Psychological Health and Safety Standard (The Standard) recommends the use of a survey developed by Guarding Minds at Work (GM@W). However, its validity remains underexplored. This study has two objectives: (1) to evaluate the psychometric properties of the survey in assessing the Standard dimensions and (2) to examine validity across gender and industry.
Methods
A Confirmatory Factor Analysis (CFA) was conducted on data from the GM@W survey to evaluate the factor structure and validity of the 13 dimensions. Group comparisons by gender and occupational groups were assessed using t-tests and ANOVA tests.
Results
Across the 13 dimensions, most items demonstrated strong internal consistency and discriminant validity, with physical safety (r = 0.71) and organizational culture (r = 0.68) showing the highest internal consistency. While psychological competencies and physical safety were linked to positive mental health outcomes, challenges with workload management and balance remain prominent, especially for workers in healthcare and education. Group differences were observed, with women and workers in business, trades, and manufacturing reporting better psychosocial outcomes.
Discussion
While the GM@W tool demonstrated internal consistency and improved convergent validity compared to previous versions, significant model misfit was observed across all sectors. High latent correlations and frequent violations of the Fornell–Larcker criterion reveal substantial construct overlap and empirical redundancy. The findings suggest that while individual constructs are reliable, the 13-factor structure faces challenges in achieving empirical distinctiveness. Capturing the diverse psychosocial experiences of a national workforce within a single psychometric instrument remains a complex task.
Safeguarding the skilled trades: burnout, job satisfaction, and the risk of turnover in Ontario electricians
Maryam Shahzad, Javier Mencia Ledo, Mahdi Azarmi, Ali Bani-Fatemi, Behdin Nowrouzi-Kia
Skilled trades workers, including electricians, face unique occupational stressors and a persistent labour shortage that may contribute to burnout, job dissatisfaction, and heightened intention to leave (ITL). This cross-sectional study of 73 electricians aimed to assess the prevalence of burnout, job satisfaction, and ITL and to explore the relationships between these factors while accounting for sociodemographic and occupational characteristics. Burnout (measured using the Copenhagen Burnout Inventory), was prevalent (31.8%) but not independently associated with ITL. Higher job satisfaction (measured using an adapted NIOSH Generic Job Stress Questionnaire) was linked to lower ITL (OR = 0.58, 95% CI [0.34, 0.96]). Apprentice status significantly increased the odds of ITL (OR = 6.59, 95% CI [1.48, 38.47]). Findings suggest that job satisfaction is a protective factor against turnover intention, while apprentices are at a greater risk of ITL - underscoring the need for targeted retention and mental health strategies in the skilled trades.
Worker health and well-being in Ontario’s electrical sector: a quantitative study of occupational health outcomes
Donia Obeidat, Hong Ki Chloe Lau, Javier Mencia-Ledo, Sana Siddiqui, Avasa Sarawan, Zhiyang Shi, Raihana Premji, Aaron Howe, Ali Bani-Fatemi, Ali Asgary, Basem Gohar, Vijay Kumar Chattu, Geoffrey Maina, Thankam Sunil, Behdin Nowrouzi-Kia
Introduction: In Canada, Ontario’s shortage of electricians is linked to high physical demands and psychosocial stressors that may undermine worker well-being.
Methods: Using a Sustainable Development Goals (SDGs) informed lens, we conducted a cross-sectional online survey of self-employed electricians in Ontario (n = 188), assessing musculoskeletal symptoms (12-month), sleep quality, psychological distress, burnout (personal, work-related), and job satisfaction.
Results: Overall, 90.2% reported at least one musculoskeletal symptom in the past 12 months. Regression analyses revealed that sleep quality and years of experience significantly predicted psychological distress and burnout, with poorer sleep linked to higher personal and work-related burnout, greater psychological distress, and lower job satisfaction. More years of experience were associated with lower distress and burnout. Women reported higher psychological distress than men, highlighting inequality and discrimination in male-dominated trades. Apprentices experienced greater psychological distress [8.96 (SD = 8.29)] than non-apprentices [4.99 (SD = 6.59)], reflecting vulnerabilities associated with low wages, job insecurity, and a lack of support.
Discussion: These findings highlight the complex interplay of physical, psychological, and socio-structural factors in shaping electricians’ health. Targeted interventions are crucial for promoting sustainable and inclusive environments in the electrical industry.
Predicting burnout, anxiety and depression among Canadian healthcare professionals during the COVID-19 pandemic: a cross-sectional secondary analysis study
Kishana Balakrishnar, Bao-Zhu Stephanie Long, Raihana Premji, Charlene Choi, Aishvinigaa Sathananthan, Mandaakini Choppella, Maryna Mazur, Behdin Nowrouzi-Kia
This study aimed to identify the predictors of burnout, anxiety and depression among healthcare professionals during the COVID-19 pandemic. A secondary quantitative analysis of data from the Mental Health Research Canada (MHRC).
Setting Healthcare professionals across Canada during the COVID-19 pandemic.
Participants 1439 Canadian healthcare professionals. Data from MHRC, collected between April 2020 and January 2024, including sociodemographic factors and measures of burnout, anxiety and depression. In total, 1439 participants were included in the analysis. Women (OR: 2.25; 95% CI 1.46 to 3.48), younger workers (OR: 2.29; 95% CI 1.29 to 4.06) and mental health professionals (OR: 2.59; 95% CI 1.11 to 6.01) were more likely to experience burnout. Meanwhile, men (OR: 2.05; 95% CI 1.40 to 3.00), younger workers (OR: 8.58; 95% CI 4.12 to 17.86) and physicians (OR: 2.01; 95% CI 1.16 to 3.46) had an increased likelihood of being diagnosed with anxiety. Similar findings were obtained for depression, where men (OR: 1.74; 95% CI 1.18 to 2.56), young workers (OR: 5.22; 95% CI 2.68 to 10.18), physicians (OR: 2.11; 95% CI 1.22 to 3.64), visible minorities (OR: 2.29; 95% CI 1.55 to 3.38) and those with a physical impairment (OR: 4.79; 95% CI 2.55 to 8.97) were more likely to receive a diagnosis since the COVID-19 pandemic. These findings underscore the need for targeted clinical interventions among healthcare professionals during and beyond public health emergencies. Specifically, healthcare institutions should implement accessible mental health programmes, regular psychological assessments and workload management strategies for those who face increased vulnerabilities to mental health struggles.
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