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Regarding lower back pain, Radauceanu et al. (2019[28]) showed that lower back MSDs in parcel delivery workers were related to working time driving, cargo loading more than 3 kg/package, awkward postures, and increased demand for delivery work. The reports of pain in this region were also described by Sobti et al. (1997[30]), 39 % of the 3,920 retired male postal service workers presented low back pain positively related to high stature and loads lifting greater than 25 kg for more than 20 years.

Regarding the L5-S1 segment, bending postures were observed, especially in container parcel removal and vehicle loading activities. In the analyzed employee group, the greater the height, the greater the angular values of anterior lumbar flexion in the activities of cargo destination and code bar reading. Working in bending postures is a risk factor for lower back pain (Miller and Fathallah, 2006[24]; DeBeeck and Hermans, 2000[6]; Lotters et al., 2003[20]). This risk was observed in England postal workers due to parcel lifting (Sobti et al., 1997[30]).

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Example: A postal clerk was required to stand at a counter to serve customers for most of her eight-hour shift. During her pregnancy she developed severe pelvic pain caused by relaxed joints that required her to be seated most of the time due to instability. Her manager provided her with a stool that allowed her to work comfortably at the height of the counter.

[151] Mayorga v. Alorica, Inc., 2012 WL 3043021, at *6 (S.D. Fla. July 25, 2012) (unpublished) (denying defendant's motion to dismiss where plaintiff claimed impairments related to her pregnancy included premature uterine contractions, irritation of the uterus, increased heart rate, severe morning sickness, severe pelvic bone pains, severe back pain, severe lower abdominal pain, and extreme headaches). Several recent district court decisions that have concluded that impairments related to pregnancy are not disabilities have been based either on a lack of any facts describing how the impairment limited major life activities, or on the incorrect application of the more stringent requirements for establishing that an impairment constitutes a disability that existed prior to the effective date of the ADA Amendments Act (ADAAA). See Wanamaker v. Westport Board of Education, 899 F. Supp. 2d 193 (D. Conn. 2012) (plaintiff did not allege facts that would demonstrate that the spinal injury, transverse myelitis, she suffered in childbirth substantially limited a major life activity); Selkow v. 7-Eleven, Inc., 2012 WL 2054872 (M.D. Fla. June 7, 2012) (without acknowledging the ADAAA, which applied at the time of plaintiff's termination, the court held that plaintiff presented no evidence to withstand summary judgment on whether her weakened back constituted the type of "severe complication" related to pregnancy required to establish a disability); Sam-Sekur v. Whitmore Group, LTD, 2012 WL 2244325 (E.D.N.Y. June 15, 2012) (relying on case law pre-dating the ADAAA, the court held that "temporary impairments, pregnancies, and conditions arising from pregnancy are not typically disabilities," but allowed the pro se plaintiff to amend her complaint to allege facts concerning the duration of her chronic cholecystitis, which required removal of her gall bladder, and how the condition was linked to pregnancy).

Next Steps: During their March 2023 meeting, Prime Minister Justin Trudeau and President Joe Biden affirmed ashared commitment to disrupting each link of the illicit production and distribution of deadly synthetic opioids, such as fentanyl, including by preventing the importation of illicit precursor chemicals and continuing to lead efforts to address the synthetic drug crisis on the global stage.

Officials agreed to priority areas for strengthened cooperation over the next year to disrupt the illicit opioid supply chain and advance public health cooperation. In 2024, Canada and the United States will work to further strengthen their bilateral counternarcotics partnership by exploring ways to increase information sharing among law and border enforcement agencies as well as postal services; advance precursor chemical and synthetic opioid supply chain interdiction efforts; explore additional joint operational activities; and continue public health collaboration to ensure that Canadians and Americans who use substance have stigma-free access to appropriate recovery and harm-reduction resources, pain management and drug checking services.

About 3-7 days after surgery most patients are off their strong pain medications, particularly narcotics. Ideally these drugs should be discontinued once postop discomfort becomes more "manageable" or more tolerable since their prolonged use is linked to constipation, lethargy, and even longer recovery. be457b7860