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New research findings on risks of occupational stress injury among Canadian first responders and frontline healthcare workers

March 22, 2021 
By FFIC Staff

March 22, 2021, Toronto — The Public Services Health & Safety Association (PSHSA), in partnership with Dr. Bill Howatt and the Conference Board of Canada, developed a non-diagnostic screening tool for assessing occupational stress injury (OSI) risks among first responders and frontline healthcare workers in Canada.

First responders and nurses are exposed to significant events or critical incidents outside what can be considered normal. Many factors can contribute to an individual’s vulnerability to increased OSI risk, including moral conflict, physical fatigue and chronic work-related stress. A mental injury can result in lost time at work and decreased productivity, or increase the risk for disability and mental duress. If not dealt with properly, it can lead to mental illness such as depression, addictive behaviours and post-traumatic stress disorder.

In 2020, 620 individuals in Canada – primarily first responders – completed the Occupational Stress Injury Resiliency (OSIR) Index screening tool. The OSIR Index generates a predictive resiliency score where individuals are grouped into four vulnerability profiles from high to low risk for OSI. The tool predicted important outcomes for mental health, physical health and the workplace, such as absenteeism. Based on this study, there is significant evidence that the OSIR Index is a reliable and valid tool that employers and employees can use to screen for occupational stress injury risk.

Key findings:

  • The higher a respondent’s OSIR Index score, the lower their risk for negative mental health outcomes (e.g., general mental outlook score), health outcomes (e.g., sick days, feeling unwell at work) and workplace outcomes (e.g., motivation at work).
  • Respondents who reported higher OSIR Index scores had lower presenteeism and absenteeism (due to illness) levels than those with lower scores.
  • Respondents who reported lower OSIR Index scores were more vulnerable to experiencing psychosocial hazards (e.g., stress, fatigue, burnout).
  • Correlations were found between the OSIR Index score and workplace outcomes such as motivation, short-term disability time off and workers’ compensation claims.
  • Employer supports, employer perceptions and employee behaviour factors were all identified as important for the prevention of OSI risks.
  • On average, respondents fell into the Concern vulnerability profile. The Concern profile ranges from 79 to 93, and the average OSIR Index score was 92 out of a possible score of 160.

While significant efforts have been made to understand the prevalence of PTSD and mental health disorders among first responders in Canada, a gap remains in understanding what preventative actions employers and workers can take to reduce the risk of mental harm. Employers and workers have recognized that they need support in targeting prevention efforts and identifying what factors might have the most significant impact on prevention programming.

“To promote mental health and prevent mental harms in first responders it is beneficial to have an early detection strategy in place designed to detect cognitive and emotional vulnerabilities,” said Dr. Howatt in a press release. “PSHSA’s OSIR tool is designed to support first responders and employers with early detection that can facilitate proactive steps, as well be used by employers to evaluate current programs and policies.”

This tool could help organizations reduce occupational stress injuries by targeting investments in more focused ways. Employers can select supports and provide tailored resources to employees based on their OSIR Index risk. Additionally, employees can use the tool to monitor risk and initiate services when needed.

“We wanted to build a tool to help first responders and healthcare workers understand their vulnerability to occupational stress injuries and help workplaces identify specific actions to prevent OSI risk,” says Glenn Cullen, CEO and COO at PSHSA, in a news release. “Our collaboration with Dr. Howatt and the Conference Board of Canada has enabled us to develop a resource that has the potential to make a significant impact for first responders and healthcare workers in Ontario.”

To learn more about the development of the screening tool, the methodology used and the research findings, download the complete issue briefing at

PSHSA will be launching pilots in select workplaces to further test and validate the tool’s use at the organizational level, and will continue to work closely with public safety and healthcare stakeholders to determine how these findings can be best applied to support mental injury harm prevention efforts in these sectors.

For more information on this research and to participate in upcoming pilots, please contact: Amanda Allan, manager of marketing and communications for the PSHSA at


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