Education workers, including teachers, educational assistants, and other support staff, have highly demanding jobs characterized by long working hours, heavy workloads, and emotional demands (1). These working conditions take a toll, and as a profession, teachers are known to have comparatively poor physical health and psychological wellbeing (2, 3). This matters in several ways. The health challenges of education workers may be difficult to navigate in themselves, potentially leading to high levels of absenteeism (4) and leaving the profession. Employers may find it challenging to meet their responsibilities for workplace health when the general level of distress is high. Finally, educational workers are central in the care of children. The difficulties faced by education workers may, in turn pose greater challenges to meet their needs.

The study was approved by the University of Guelph's Research Ethics Board (REB# 20-06-002). This prospective cross-sectional study is a part of a larger undertaking that examined the impacts of the pandemic on Ontarian education workers. We used the STROBE checklist to ensure quality and accuracy when preparing this study (10). We examined the functional activities of education workers across Ontario, Canada, during the second pandemic wave, which began in in Ontario in the fall of 2020. The survey was disseminated between October 2020 and January 2021 via Qualtrics (11), with one follow-up email sent in December 2020. At the time of this study, Ontarian education workers were asked to return physically to the workplace following school closures in the spring of 2020 until the summer holidays. In some schools, teachers used a hybrid teaching model where they simultaneously taught students in person and others virtually.

We define education workers as unionized employees in the public education sector ranging from kindergarten to secondary. They include teachers, educational assistants, supply teachers, early childhood educators, administrative staff, and support workers who provide specialized services, including psychology, social work, and communicative supports. Eligible participants included those employed during the first wave of the pandemic and have returned to work during the second wave. We partnered with provincial unions, who agreed to disseminate the questionnaire on our behalf. Specifically, the survey links were disseminated from the executive to the district levels. Next, district leaders disseminated the survey links to their local members.

Participation was purely voluntary, and our anonymous survey could be completed in either English or French. Informed consent was obtained at the beginning of the survey. We collected demographic information, including age, gender, marital status, occupational groups, and employment status (i.e., permeant vs. contract, part-time vs. full-time). Participants also identified if they received accommodations from their employer due to physical or psychological disability.

We examined the perceived impact of the pandemic on functional activities of education workers in Ontario, Canada using the WHODAS 2.0 SF. The WHODAS 2.0 SF addresses difficulties due to health conditions; it provides a measure of disability under the ICIDH-2 framework in which disabilities arise when difficulties with form or function prevent desired levels of participation in society. Disability measured in this way reflects both relatively objective and reliable difficulties workers face. It also provides some guidance as to the levels of accommodation, which could potentially be required as a matter of policy.

To our knowledge, this is the first study to explore this area among education workers. Cross-sectional surveys are inherently limited in their capacity to investigate cause and effect. However, the salience of COVID-19 and related public health measures gives confidence that participants can generally attribute changes in their functional capacity to this period. Overall, education workers perceived that their capacities for functional activities have worsened since the pandemic.

A key finding in the present study is that there are associations between how individuals perceived the impact of COVID-19 and functional activity ratings. These associations were evident across all six domains, an essential consideration for school employers, policymakers, and rehabilitation researchers. Several reasons could explain how the pandemic influenced functional activities. For instance, it could be due to the challenges of setting boundaries between work and home life (16). While most Ontario workers were physically at work, there is naturally more reliance on technology to complete day-to-day tasks, including meetings and the stress of the hybrid model. Thus, we suspect that establishing boundaries between work and home duties is a contributor. Furthermore, with the COVID restrictions, it is unsurprising to find challenges in domains such as participation and getting along. However, what is critical from a policy and employment perspective is that the impact of COVID-19 falls most strongly on people who have pre-existing functional limitations. Therefore, planning for these difficulties and review of accommodations should be given some priority in the future.

The pandemic restrictions might have reduced mobility among some participants, especially older adults. Specifically, with prolonged inactivity and increased stress, mobility could be affected due to reduced muscle activity (17). Furthermore, factors such as fear of contamination, limited in-person socialization, and closures of fitness facilities could have affected education workers' mental wellbeing. Poor mental health and functional limitations potentially reinforce each other. This is concerning since depression and anxiety symptoms have negative implications across all six domains (6), and teachers' mental health is clearly at risk. These are important considerations and contribute to our understanding of the impact of COVID-19 on education workers' physical and mental wellbeing. It is also important to consider the potential long-term impact of the restriction measures on functional activities, including physical and cognitive impairments, because functional difficulties that are not addressed may in turn lead to difficulty managing disability and increased health care costs (18).

Older employees (i.e., ≥45) were more likely to have difficulties in mobility than younger employees. However, older age decreased the odds of adverse outcomes for some WHODAS domains. They were less likely to report difficulties learning new tasks (cognition) and maintaining friendships (getting along). While evidence suggests that older education workers had more difficulties adapting to some aspects of their jobs, such as technology, they were more eager to advance their knowledge than younger employees (19). Notably, younger participants were more likely to be impacted by COVID-19. This could be due to poorer coping abilities to deal with the consequences of the pandemic despite having more access to social support (6).

Age as a continuous variable produced relatively similar results as dichotomizing age, although the correlations were relatively weak. This is because increased or decreased risk is not entirely linear. Specifically, significant changes in scores changes were more visible in older age groups instead of a steady change in score year by year.

Our results revealed that women were more likely to have difficulties taking care of household responsibilities than men. Some evidence suggests that women tend to be more involved in household chores than men (20). However, a recent meta-analysis revealed that gender differences in work-life conflict are generally small (21). Another possible explanation could be the gender difference in the likelihood of reporting physical or psychosocial symptoms. Specifically, while men and women could exhibit similar symptoms, women were more likely to report their symptoms than men (22).

Individuals requiring accommodations were more likely to have difficulties in all functional areas. This could be due to difficulties managing their health and are often affected by work-related aspects such as stress, high workload, hostile interpersonal relationships, and dealing with strangers (23). While Ontario schools are compliant with the Accessibility for Ontarians with Disabilities Act (24), these workers are particularly vulnerable to negative treatment in the workplace, while issues around adequate resources and accessibility remain problematic pre-pandemic (25). We also found that employees requiring accommodations were more likely to be affected by their health problems. We suspect that the pandemic has likely exacerbated these concerns due to limited training or sufficient resources.

This study offers insight into the perceived impact of COVID-19 on functional activities in educational workers in Ontario, Canada. Overall, employees perceived worse functional activities since the pandemic. Furthermore, those requiring accommodations have worse functional outcomes. Despite provincial mandates to support those with disabilities, more research is required to understand the needs of education workers requiring accommodations within the context of the pandemic. Older participants had poorer mobility outcomes; however, they appeared to have better coping skills in learning new tasks and maintaining friendships. Furthermore, women had greater odds of experiencing difficulties in maintaining household responsibilities. Based on the results, we suspect that restrictions to reduce the spread of the virus have contributed to mobility, getting along, participation, and life activities. Also, due to the restrictions, we suspect that poorer mental health outcomes also affect one's abilities in all six domains. Based on these findings, we suggest that policymakers incorporate a health promotion lens to support their employees, including tailored support for employees requiring accommodations.

The datasets presented in this article are not readily available because of ethical restrictions. Requests to access the datasets should be directed to the corresponding author.

The studies involving human participants were reviewed and approved by Stephen P. Lewis, University of Guelph. The patients/participants provided their written informed consent to participate in this study.

Material preparation and data collection were performed by FS, BG, BN-K, RB, and JC. Analysis was performed by BG, FS, and BO. The first draft of the manuscript was written by FS. All authors edited subsequent versions of the manuscript. All authors contributed to the study's conception and design, read, and approved the final manuscript.

The Centre for Research in Occupational Safety and Health funded the article processing charge of this manuscript.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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