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Background: Work-related injuries and diseases have a significant impact on workers and their families, society, and the economy. There is a gap in the literature regarding the structures, content, quality, and outcomes of international occupational health systems serving injured and ill workers. This global round table was an attempt to elucidate, evaluate, and identify areas needing improvement. Methods: International occupational health professionals were identified via chain/snowball sampling and asked to answer five questions designed to evaluate the structures, processes, and outcomes of the workers' compensation systems in each country. Findings: Areas for improvement identified during this round table included timely access, reducing the impact of liability and eligibility determinations on access to medical care, equitable access to care, and the accuracy of reporting. Canada had successfully utilized a virtual approach to care for the geographically remote worker. Conclusions: International workers' compensation structures are designed to ensure timely access to quality care and services. Financial incentives optimize the safety of the working environment. There remain areas for improvement. Resources are limited, especially within the public health systems, which may delay care and affect quality. Informal and remote workers often do not have the same access to care. Occupational Health Services (OHS) and national reporting databases exist throughout the world but may not accurately capture data on informal, self-employed, small business, migrant, and remote workers. [ABSTRACT FROM AUTHOR]

Much correctional work is generally misunderstood by the mainstream media and many public circles as solely punitive and authoritative, which has fueled many politicized outcomes for correctional policy, practice and intervention. Reasonably, critical criminological discourse is steered primarily by the perspectives and voices of prisoners and victims. Yet this privileging leaves many questions remaining about how correctional workers in the contemporary era negotiate their complex duties of both prisoner care and accountability. Drawing on data garnered from open-ended survey responses of provincial and territorial correctional employees (n = 876) in Canada, we explore how Canadian correctional workers balance their emotional and occupational framework and perspectives with integrity. Informed through a lens of emotional labour, we find that many Canadian correctional workers recognize the need for, and gap in, prisoner care, mental health and rehabilitation, while also problematizing the shift and decline in prisoner accountability, which they believe jeopardizes both correctional worker and prisoner safety. We discuss the implications our findings present in relation to questions of power and control in prison spaces. [ABSTRACT FROM AUTHOR]

Workplace violence against nurses is a significant global occupational health problem, with incidents of violence increasing in frequency since the COVID-19 pandemic began. In this article, we provide a review of recent legislative amendments meant to bolster workplace safety in health care in Canada, analyze legal cases where nurses were the victims of violence, and discuss what these legal reforms and decisions reveal about how nurses' work is treated within the Canadian legal system. Under criminal law, the limited number of cases we could find with oral or written sentencing decisions show that, historically, the fact a victim was a nurse was not always considered an aggravating factor on sentencing. Recent legislative amendments make this a specified aggravating factor and it is important to track the impact of these amendments when judges exercise their discretion in sentencing. Under employment law, it appears that, despite the government's efforts to increase the deterrence factor under legislation with significantly increased fines for employers who fail to protect their employees from injury, courts remain reluctant to impose such sanctions. In these cases, it is also important to track the impact of harsher penalties. We conclude that combating the widespread normalization of workplace violence in health care, and specifically against nurses, is acutely needed to help ensure that these ongoing legal reforms aimed at improving the safety of health workers are effective. [ABSTRACT FROM AUTHOR]

Background: Endoscopic percutaneous tracheostomy (PT) is a safe technique that is performed frequently by otolaryngologists and intensivists. New challenges have been identified in order to maintain the safety of this procedure during the COVID-19 pandemic. A novel approach, using a modified demistifier canopy, was developed during the first wave of the pandemic and implemented for 17 consecutive percutaneous tracheostomies in order to enhance procedural safety. Methods: A protocol was developed after performing a literature review of tracheostomy in COVID-19 patients. A multidisciplinary tracheostomy team was established, including the departments of otolaryngology, critical care, and respiratory therapy. Simulation was performed prior to each PT, and postoperative debriefings were done. Results: A protocol and technical description of PT using a modified demistifier canopy covering was written and video documented. Data were collected on 17 patients who underwent this procedure safely in our tertiary care hospital. There were no procedure-related complications, and no evidence of COVID-19 transmission to any member of the health care team during the study period. Conclusion: As patients continue to recover from COVID-19, their need for tracheostomy will increase. The technique described provides a safe, multidisciplinary method of performing PT in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background : Although studies have assessed the impact of occupational risk factors on the health of law enforcement officers (LEO's), few have involved (LEO's) as informants in ways that allow their points of view to be heard directly. Thus, the objective of this study is to explore the occupational health, safety, and wellness (OHSW) concerns of (LEO's). Methods : (LEO's) working in Quebec, Canada were invited to answer an open-ended question regarding their OHSW concerns. Using a multi-stage content analysis, the collected answers were analyzed and coded by two members of the research team to identify the most recurrent concerns of (LEO's). Findings : Five themes relating to the OHSW concerns of (LEO's) were identified, namely, the work schedule, occupational stress, work equipment, workplace health promotion, and operational risks. Furthermore, our analyses highlighted differences in the concerns of (LEO's) based on their level of experience and sex. Conclusions/Application to Practice : This study addresses a gap in the literature on the OHSW concerns from the perspective of (LEO's). Overall, our results support that the work schedule and occupational stress associated with law enforcement are the two most recurrent concerns of (LEO's). Thus, the results of this study further stress the need for police organizations to implement strategies and policies, which could mitigate the deleterious effects of these hazards on the overall wellness of (LEO's). [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers exposure to antineoplastic drugs can lead to adverse health effects. Guidelines promote the safe handling of antineoplastic drugs, but no safe exposure limit was determined. Regular surface sampling contributes to ensuring workers safety. Methods: A cross-sectional monitoring is conducted once a year with voluntary Canadian centers, since 2010. Twelve standardized sampling sites were sampled. Samples were analyzed by high performance mass coupled liquid chromatography. The limits of detection (in ng/cm2) were: 0.001 for cyclophosphamide and gemcitabine; 0.3 for docetaxel and ifosfamide; 0.04 for 5-fluorouracil and paclitaxel; 0.003 for irinotecan; 0.002 for methotrexate; 0.01 for vinorelbine. Results: The surfaces from 109 centers were sampled between 01/01/2020–18/06/2020. Twenty-six centers delayed their participation because of the COVID-19 pandemic. 1217 samples were analyzed. Surfaces were frequently contaminated with cyclophosphamide (34% positive, 75th percentile 0.00165 ng/cm2) and gemcitabine (16% and <0.001 ng/cm2). The armrest of patient treatment chairs (84% to at least one drug), the front grille inside the biological safety cabinet (BSC) (73%) and the floor in front of the BSC (55%) were frequently contaminated. Centers that prepared ≥5000 antineoplastic drugs annually had higher concentration of cyclophosphamide on their surfaces (p < 0.0001). Contamination measured on the surfaces was reduced from 2010 to 2020. Conclusions: This large-scale study showed reproducible long term follow up of the contamination of standardized sites of Canadian centers and a reduction in surface contamination from 2010 to 2020. Periodic surface sampling help centers meet their continuous improvements goals to reduce exposure as much as possible. The COVID-19 pandemic had a limited impact on the program. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses' sources of distress is important when planning interventions to support them. Purpose: To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic. Design: Qualitative descriptive component within a larger mixed-methods study. Participants and research context: Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis was used to analyze the data. Ethical considerations: The study was approved by the ethics committee at the researchers' university in eastern Canada. Results: A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families' grief, (3) our safety, and (4) futility of care. Many nurses' stories also focused on the organizational preparedness of their institutions and concerns over their own safety. Discussion: Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed. Conclusion: Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses' well-being. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, breast imaging must be performed using safe practices. Balancing the need to avoid delays in the diagnosis of breast cancer while avoiding infection requires careful attention to personal protective equipment and physical distancing and vigilance to maintain these practices. The Canadian Society of Breast Imaging/Canadian Association of Radiologists guideline for breast imaging during COVID-19 is provided based on priority according to risk of breast cancer and impact of delaying treatment. A review of the best practices is presented that allow breast imaging during COVID-19 to maximize protection of patients, technologists, residents, fellows, and radiologists and minimize spread of the infection. The collateral damage of delaying diagnosis of breast cancer due to COVID-19 should be avoided when possible. [ABSTRACT FROM AUTHOR]

Background: Exposure to traumatic events is an occupational hazard with potential adverse psychological consequences. Previous research has focused mainly on urban practice settings; therefore, this study explored the distressing experiences encountered by rural/remote nurses and their perception of organizational support. Methods: Thematic analyses were conducted on open-ended data from a pan-Canadian survey of 3,822 regulated nurses, where 1,222 nurses (32%) reported experiencing an extremely distressing health care incident within the past 2 years. Among the respondents, 804 nurses (65%) reported that they did not receive psychological support from the organizations leadership following incidents. Findings: Three main themes regarding distressing events were: (a) involvement in profound events of death/dying, traumatic injury and loss, (b) experiencing or witnessing severe violence and/or aggression, and (c) failure to rescue or protect patients/clients. Three themes were identified regarding perceptions of organizational support including: (a) feeling well supported in the work setting with debriefing and reliance on informal peer support, (b) lack of acknowledgement and support from leaders on the nature and impact of distressing events, and (c) barriers influencing access to adequate mental health services in rural/remote settings. Conclusion/Application to Practice: Findings suggest that rural/remote nurses rely on informal, peer supports; there is a lack of organizational understanding of the potential risks to their psychosocial health and safety. They require more accessible, structured, appropriate, and timely supports within these settings. Increased understanding of the psychological hazards will assist organizations to establish workplace policies and practices designed to protect and support rural/remote nurses. [ABSTRACT FROM AUTHOR]

Introduction: The performance of tracheotomy is a common procedural request by critical care departments to the surgical services of general surgery, thoracic surgery and otolaryngology - head & neck surgery. A Canadian Society of Otolaryngology – Head & Neck Surgery (CSO-HNS) task force was convened with multi-specialty involvement from otolaryngology-head & neck surgery, general surgery, critical care and anesthesiology to develop a set of recommendations for the performance of tracheotomies during the COVID-19 pandemic. Main body: The tracheotomy procedure is highly aerosol generating and directly exposes the entire surgical team to the viral aerosol plume and secretions, thereby increasing the risk of transmission to healthcare providers. As such, we believe extended endotracheal intubation should be the standard of care for the entire duration of ventilation in the vast majority of patients. Pre-operative COVID-19 testing is highly recommended for any non-emergent procedure. Conclusion: The set of recommendations in this document highlight the importance of avoiding tracheotomy procedures in patients who are COVID-19 positive if at all possible. Recommendations for appropriate PPE and environment are made for COVID-19 positive, negative and unknown patients requiring consideration of tracheotomy. The safety of healthcare professionals who care for ill patients and who keep critical infrastructure operating is paramount. [ABSTRACT FROM AUTHOR]

Objectives: The National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) was released in 2013. The objectives of this study were to 1) estimate the proportion of Canadian employers who were aware of the Standard, 2) examine the extent to which the Standard has been implemented, and 3) describe perceived barriers to implementing the Standard in Canadian organizations.Methods: A cross-sectional survey in Canadian employers was conducted between February 2015 and January 2017. A random sample of Canadian employers was selected, and the individuals who were knowledgeable about the occupational health policies of the organizations were interviewed by telephone. The participants answered questions about the awareness, implementation, perceived effects, and barriers to implementation. Descriptive statistics and chi-square tests were used to characterize the results.Results: A total of 1010 companies participated in the study. Overall, 17.0% reported that they were aware of the Standard; 1.7% and 20.3% reported that their organizations had implemented the entirety or elements of the Standard, respectively; and 71.4% of participants believed that elements of the Standard would be implemented within the next year. The perceived effects associated with implementation of the Standard included increased job satisfaction and employee retention while the greatest barrier to implementing the Standard was the belief that psychological health and safety are irrelevant in the workplace.Conclusions: Many Canadian employers are still unaware of the Standard's existence; however, most Canadian employers are positively inclined toward the Standard in its potential to help employee productivity and job satisfaction. [ABSTRACT FROM AUTHOR]

When an article similar to this one was published in Canada, it reflected primarily knowledge derived from firsthand experience in several provinces and territories, and empirical research in Ontario and British Columbia. Since that article was published in 2013, this new article reflects my research on recent publications in the United States on Workers’ Compensation. The article begins by explaining the damaging and overwhelming significance of experience rating. To enhance an understanding of current situations, the article then explains the legal history of Occupational Health & Safety and Workers’ Compensation. Then the role of physicians is discussed, particularly the difficulties they often have in distinguishing questions of law from questions of medicine. The article then deals with how decisions are made in the claims department of a Workers’ Compensation Board and by appeals tribunals. The practice of actuaries is explained, including the problems that their role creates. The limited role of judicial review is then mentioned, and finally the significance of the North American Free Trade Agreement and the World Trade Organization. The article concludes with conclusions and comments. [ABSTRACT FROM PUBLISHER]

This commentary responds to the recent critique by Weinstock and Slatin [1] of our systematic review on the effectiveness of occupational safety and health (OSH) training conducted jointly by the Institute for Work & Health (IWH) in Canada and the National Institute for Occupational Safety and Health (NIOSH) in the United States [2, 3]. We address misunder-standings of our perspectives on training, especially empowerment training, and the evaluation of such training. [ABSTRACT FROM AUTHOR]

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Worker health and safety training is an important part of occupational health and safety programs. In the United States, governments, unions, employers, university programs, and health and safety advocacy organizations make training available. This article considers training effectiveness research conducted and supported by the National Institute for Occupational Safety and Health (NIOSH), and some done in collaboration with the Institute for Work and Health (Canada). Differing perspectives regarding the purpose of worker health and safety training are reviewed and critiqued. We assert that a focus on changing the working behaviors of workers exposed to hazardous conditions is less appropriate and scientifically rigorous than a focus on helping workers establish the power to reduce and eliminate workplace hazards. For training to lead to a decrease in morbidities and fatalities related to hazardous exposures, it needs to be integrated with workers' attainment of such power. [ABSTRACT FROM AUTHOR]

Scholars and practitioners from multiple perspectives, including developmental science, sociology, business, medicine, and public health, have considered the implications of employment for young people. We summarize a series of meetings designed to synthesize information from these perspectives and derive recommendations to guide research, practice, and policy with a focus on young worker safety and health. During the first three meetings, participants from the United States and Canada considered invited white papers addressing developmental issues, public health data and findings, as well as programmatic advances and evaluation needs. At the final meeting, the participants recommended both research and policy directions to advance understanding and improve young worker safety. [ABSTRACT FROM AUTHOR]

This piece describes involvement and reflections by Dave Bennett in three areas: 1) union education at the Canadian Labour Congress (CLC) from the late 1970s onwards; 2) insights regarding how the CLC moved into health and safety education in the early 1980s; and 3) further thoughts on how the CLC moved from health and safety into environmental protection education in the early 1990s, and consequent changes in the perspective adopted by health and safety courses. There are two types of critical comment on these educational processes, one which examines the educational dilemmas at the time, with an evaluation of the decisions reached, and the other a retrospective view of the educational process as a result of reflective hindsight. [ABSTRACT FROM AUTHOR]

The last few years have seen increasing interest in the development of joint labor-management health and safety committees. The U. S. Occupational Safety and Health Administration has been experimenting with the committees as a substitute for governmental enforcement. Despite this interest in and experimentation with the committees, there have been few studies of health and safety committees- Ignored during this recent increase in worker participation in health and safety through joint labor-management committees and in the few studies has been the Canadian experience. In this article, the author reviews the history and experience of joint labor-management committees in selected Canadian provinces, examines factors which have an impact on their effectiveness, and concludes with a review of lessons from the Canadian experience. [ABSTRACT FROM AUTHOR]

This article is an empirically based theoretical essay that reports findings from a study of the organizational basis of major industrial accidents and hazards in Canada. The purpose of the article is to demonstrate the importance and usefulness of integrating a variety of approaches to understanding the organizational basis of industrial accidents.
The article draws on previous empirical research on organizationally based accidents in Canada (Gephart, 1984, 1987, 1992, 1993; Gephart & Steier, 1989; Gepahrt, Steier, & Lawrence, 1990). We briefly summarize the method or approach to theoretical grounding that was used in these studies. The importance of the intagrative, micro- and macrotheoretical perspective is then illustrated by applying it to specific case studies of accidents, particularly fatal accidents in the ski industry and the oil and gas industry. [ABSTRACT FROM AUTHOR]

Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset in the end of 2019. Amongst the most impacted are the elective medical and surgical services in order to conserve resources to care for COVID-19 patients. As the number of infected patients decrease across Canada, elective surgeries are being restarted in a staged manner. Since Otolaryngologists – Head & Neck Surgeons manage surgical diseases of the upper aerodigestive tract where the highest viral load reside, it is imperative that these surgeries resume in a safe manner. The aim of this document is to compile the current best evidence available and provide expert consensus on the safe restart of rhinologic and skull base surgeries while discussing the pre-operative, intra-operative, and post-operative care and tips. Risk assessment, patient selection, case triage, and pre-operative COVID-19 testing will be analyzed and discussed. These guidelines will also consider the optimal use of personal protective equipment for specific cases, general and specific operative room precautions, and practical tips of intra-operative maneuvers to optimize patient and provider safety. Given that the literature surrounding COVID-19 is rapidly evolving, these recommendations will serve to start our specialty back into elective rhinologic surgeries over the next months and they may change as we learn more about this disease. [ABSTRACT FROM AUTHOR]