Prevention

Need/Data

According to national AWCBC data, there were 592 occupational disease deaths in Canada vs. 312 traumatic fatalities in 2016, and the rate is increasing in most provinces. Plus the numbers don't reflect deaths in workplaces not covered by a compensation board; from diseases not recognized to be work-related; nor those that are simply not reported. And of course, there are thousands more debilitating but non-fatal illnesses and health impacts, including occupational deafness, dermatitis and asthma. Prevention is needed, and it is possible. It is all about recognizing the potential for harm and doing something about it.

The link between exposure and disease is often unclear medically, scientifically and practically, partly due to the literal and figurative “invisibility” of a hazardous substance and its delayed impact. Clearer data is needed to better identify patterns of disease incidence within occupations and workplaces. Adding occupational information to health data is seen as a key, but difficult to implement. In the meantime, known health hazards need to be identified and managed to minimize exposure and harm. This is the reason for WHMIS. It is critical to take it seriously, read labels and data sheets, reflect on product use in the workplace, and manage exposure to minimize the potential for harm.

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Prevention Basics

Public health identifies three levels of prevention which have occupational parallels: Primary (1) prevention is focused on preventing disease or injury at the source, before it can even occur, and is by the far the most effective. Secondary (2) prevention aims to raise awareness and catch symptoms early to reduce the impact (and spread) of a disease or injury through education, hazard communication and screening programs. Tertiary (3) prevention focuses on reducing the harm and impact of an illness or injury through facilitating treatment, ensuring income security, organizing accommodation, and supporting return to work, while increasing local and societal recognition (and eventual exposure control) through compensation documentation and associated costs.

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R.A.C.E. to Health

Eliminating or reducing harmful exposures requires a R.A.C.E. approach: Recognize the presence and existence of the hazard; Assess the potential for worker exposure and risk of harm; Control any exposure to eliminate or minimize risk; Evaluate solutions to be certain they're effective and/or improve hazard control. R.A.C.E. should be an ongoing continuous improvement cycle used in workplaces large and small, and will contribute to health, safety, productivity and sustainability.

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Control is the Goal

The main ways to control exposure in a workplace in descending order of effectiveness (commonly called the Hierarchy of Controls) are:

• Elimination (including substitution): to remove the hazard from the workplace, or replace hazardous materials, machines or processes with less harmful ones
• Engineering Controls: design or modification of plants, equipment, ventilation systems, and/or processes to isolate the source or the worker, or otherwise reduce exposure
• Administrative Controls: alteration of the way the work is done, including scheduling, timing, policies and rules, work practices (e.g. operating procedures, housekeeping, maintenance, and hygiene access) as well as education, training and coaching
• Personal Protective Equipment: equipment worn by individuals to reduce exposure such as contact with chemicals or exposure to noise. Often ineffective and unreliable, affected by many variables including fit, age, pace, training, comfort

Workplaces should regularly review the opportunity to move control of hazards up the hierarchy to optimize effectiveness and minimize exposure.

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Prioritize to Mobilize

Risk assessment is a systematic approach to identifying hazards and reducing exposure risks in a workplace in 3 or 4 steps, and can also be used for prioritization:

• Identify hazards and risk factors that have the potential to cause harm (hazard identification).
• Analyze and evaluate the risk associated with actual, probable or possible exposure to that hazard (risk analysis, and risk evaluation).
• Determine ways to eliminate the hazard(s), or control the risk(s) when the hazard cannot be eliminated (risk control).
• Assess for feasibility of implementation and potential effectiveness of control.
• Implement based on need and opportunity.
• Evaluate for effectiveness.

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Focus on Exposure

Occupational hygiene uses methods for exposure identification and management following the techniques of anticipation, identification, evaluation, and control. The goal is to identify solutions for eliminating or reducing the hazard, and monitoring to ensure no further harm occurs. Occupational exposure limits are a factor in this process. In general, an occupational exposure limit (OEL) represents the maximum airborne concentration of a toxic substance to which most (but not all) workers can be exposed over a period of time without suffering harmful consequences. However, many substances don't have an OEL, and the existing ones are often reduced based on new information, so it is important to strive for ALARA (as low as reasonably achievable) exposure where possible. Measurement of levels is ideal, but difficult to achieve and not always representative. Therefore other methods of understanding and managing any associated risks (e.g. control banding) can help.

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Comply and Protect

A key component in the reduction of harmful exposures is the development of (and compliance with) legislation and regulations, which are considered to be minimum standards for managing health and safety in the workplace. Ministries of Labour (MOL) are generally responsible for occupational health and safety legislation, and the development and updating of regulations and enforcement. Many provinces set occupational exposure limits (OELs) (e.g. Ontario's more than 725) for common hazardous biological and chemical substances as well as have broader general duty clauses. The scientific basis for OELs continues to evolve and hence there are regular reviews to determine whether they need to be updated. It is critical that workplace parties, especially small and medium-sized employers without professional staff, seek information and support to assist them in worker protection, including complying with and building on current and future legislation and regulations.

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Inform with WHMIS

WHMIS, the Workplace Hazardous Materials Information System, is the primary framework for providing health and safety information on hazardous products used, handled, or stored in Canadian workplaces. WHMIS is now aligned with the worldwide hazard communication system known as GHS – the Globally Harmonized System of Classification and Labelling of Chemicals for consistency and comprehension. However, the key pillars of the framework remain: hazard classification; labels with universally recognized hazard symbols and risk phrases; safety data sheets with detailed hazard, use and emergency response information; and regular mandatory training. In order to truly protect workers from hazardous exposures, WHMIS has to be enlivened in a workplace through engagement, dialogue and review at the floor, lab, safety committee and management levels. It is the best tool we have - let's use it!

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The Role of Compensation

Workers compensation is an insurance system meant to provide income security for workers, cost limitation for employers, and resource protection for healthcare. However, it plays a significant role in prevention. Literally, through the programs and initiatives it develops to educate, motivate and support employers, as well as the secondary role of supporting worker recovery and reintegration, and especially, the tertiary prevention role of accepted claims (and their costs) driving recognition of hazards and ultimately exposure elimination or control. Their claims data is relied upon heavily to identify patterns of injury and illness for strategic intervention and to measure improvement and validate success. Find compensation-related links and resources here.

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Ontario OHS System

This website is the product of a Strategic Opportunity allocation from the Ontario Ministry of Labour Prevention Office under the Occupational Disease priority. In Ontario, three inter-related entities have mandated responsibility for occupational health and safety: the Ministry of Labour, the WSIB, and the six health and safety associations (four sector-based, one worker training centre and an occupational health clinic network), along with three funded research centres.

Within each entity, there are a number of initiatives underway aimed at preventing occupational disease. However, in January 2017 a system-wide Occupational Disease Action Plan, involving eight approaches (Intelligence & Decision Support; Research & Data Management; Awareness; Advisory & Support Services; Education & Training; Enforcement & Monitoring; Programs; and Legislation & Regulations) was launched and continues to be implemented broadly and strategically, with a yearly review.

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(Inter) National Partners

While there is growing awareness of occupational diseases, preventing them remains a global challenge. National partners include the Canadian Centre for Occupational Health and Safety (CCOHS), Canada’s resource for the advancement of workplace health and safety, along with regulators and safety associations from other provinces.

Internationally, the World Health Organization’s Global Plan of Action on Workers’ Health called for improving the diagnosis, reporting and registration of occupational diseases and building capacities for estimating the occupational burden of diseases. WHO’s activities regarding occupational and work-related diseases include: carrying out estimates of the global burden of disease from major occupational risks, such as injuries, airborne exposures, carcinogens, ergonomic stressors, noise and other specific risks; and working with the International Labour Organization (ILO) to develop diagnostic and exposure criteria for occupational diseases and to enable primary and secondary health care providers to detect and report such diseases.

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