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Outdoor workers are exposed to many hazards, including solar ultraviolet radiation (UVR). Identifying, reporting, analyzing and tracking the exposures or health outcomes of outdoor workers have not generally been formally considered. This article aims to summarize the best practices/strategies for creating an occupational sun exposure or skin cancer surveillance system for outdoor workers and to understand the key barriers and facilitators to the development of such a system. For the design of a successful occupational safety and health (OSH) surveillance system five occupational surveillance strategies are summarized: exposure registry, disease registry, disease screening/medical surveillance, sentinel event surveillance, and disease surveillance via data linkage. Ten key considerations are identified, including identifying a clear goal, a defined target population and stakeholder involvement, five critical barriers are highlighted including underreporting and funding, and five vital facilitators are recognized including communication/collaboration and a simple reporting process.

Objective We investigated long-term economic impacts of respirable crystalline silica (RCS) removal interventions in the construction at the societal level. Methods We estimated costs and benefits of two RCS exposure interventions, use of "respirators" and "wet method," over a 30-year time period. We identified economic impacts of the interventions under four different scenarios. Results Under current practices, we estimated that approximately 125 lung cancer cases attributable to RCS exposure would arise in 2060. Under the full exposure removal scenario, we estimated there would be 53 new cases. Over the 30-year time period, the estimated cumulative averted cases are 787 and 482 for respirators and wet method, respectively, which amount to net benefits of $422.13 and $394.92 million. Conclusions Findings provide important information for policymakers seeking to reduce the economic burden of occupational lung cancer in society.

Environmental radon has been examined as a risk factor for neurodegenerative diseases in a small number of previous studies, but the findings have been inconsistent. This study aims to investigate the association between occupational radon exposure and neurodegenerative disease in a cohort of male miners with work experience in multiple ore types in Ontario, Canada.Radon exposure (1915-1988) was assessed using two job-exposure matrices (JEM) constructed from using historical records for 34,536 Ontario male miners. Neurodegenerative outcomes were ascertained between 1992 and 2018. Poisson regression models were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI) between cumulative radon exposure in working level months (WLM) and each neurodegenerative outcome.Levels of cumulative radon exposure showed variability among cohort members with a mean of 7.5 WLM (standard deviation 24.4). Miners in uranium mines or underground jobs had higher levels and more variability in exposure than workers in non-uranium work or surface jobs. Compared to the reference group (radon 1 WLM), increased rates of Alzheimer's (RR 1.23, 95% CI 1.05-1.45) and Parkinson's disease (RR 1.43, 95% CI 1.08-1.89) were observed among workers with1-5 WLM and5-10 WLM, respectively, but not among higher exposed workers (10 WLM).This study did not observe a positive monotonic dose-response relationship between cumulative radon exposure and Alzheimer's or Parkinson's disease in Ontario mining workers. There was no association observed with motor neuron disease.

OBJECTIVES: We estimated associations between respirable aluminum exposure through McIntyre Powder (MP), a fine-sized aluminum and aluminum compound powder, and neurological disease in a retrospective cohort of mining workers from Ontario, Canada. Outcomes included Alzheimer’s disease, Alzheimer’s with other dementias, Parkinson’s disease, parkinsonism, and motor neuron disease. METHODS: The cohort was created by linking a database of mining workers’ work history to healthcare records. This analysis included 36 826 male miners potentially exposed to MP between 1943 and 1979, followed up for disease diagnosis between 1992 and 2018. Exposure was assessed using two approaches, self-reported and historical records. Neurological diseases were ascertained using physician billing and hospital discharge records. Poisson regression models were used to estimate associations between MP exposure and neurological outcomes using incidence rate ratios (RR) and 95% confidence intervals (95% CI). RESULTS: Exposure to self-reported MP was associated with an elevated incidence rate of Parkinson’s disease (RR 1.34, 95% CI 1.14–1.57). The rate of Parkinson’s disease appeared to increase with the duration of exposure assessed by historical records. Having ever been exposed to MP was positively associated with an elevated rate of Alzheimer’s with other dementias (RR 1.12, 95% CI 1.06–1.19) but not Alzheimer’s disease alone. CONCLUSION: This study found that miners who were exposed to MP (respirable aluminum) had elevated rates of Parkinson’s disease. The rate of Parkinson’s disease appeared to increase with the duration of exposure assessed by historical records.

Silicone passive samplers were assessed for measuring personal exposure to 37 flame retardants at three Quebec e-waste recycling facilities. Silicone brooches (n = 45), wristbands (n = 28), and armbands (n = 9) worn during a ∼8 h work shift accumulated detectable amounts of 95-100% of the target compounds. Brooch concentrations were significantly correlated with those from active air samplers from which we conclude that the brooches could be used to approximate inhalation exposure and other exposures related to air concentrations such as dermal exposure. The generic sampling rate of the brooch (19 ± 11 m3 day-1 dm-2) was 13 and 22 times greater than estimated for home and office environments, respectively, likely because of the dusty work environment and greater movement of e-waste workers. BDE-209 concentrations in brooches and wristbands were moderately and significantly (p < 0.05) correlated with levels in blood plasma; organophosphorus esters in brooches and wristbands were weakly and insignificantly correlated with their metabolite biomarkers in post-shift spot urine samples. Silicone brooches and wristbands deployed over a single shift in a dusty occupational setting can be useful for indicating the internal exposure to compounds with relatively long biological half-lives, but their use for compounds with relatively short half-lives is not clear and may require either a longer deployment time or an integrated biomarker measure.

Objectives In recent years, nail salons have become more abundant than ever. The majority are small businesses, often employing immigrant women. Nail technicians have many exposures at work including chemical, biological, physical, and ergonomic hazards but few data exist on their symptoms or occupational health and safety practices, particularly in the Canadian context. The aim of this study was to learn about nail technicians, their work, and their health and safety practices. Methods Nail technicians were recruited from nail salons in Toronto, Ontario. Participants completed an anonymous survey with questions about demographics, work tasks, workplace health and safety practices, and symptoms (skin, respiratory, and musculoskeletal). Results A total of 155 nail technicians (95% female) participated in the survey. The majority of nail technicians performed manicures (99%) and pedicures (96%) and applied shellac polishes (86%). Only a third (34%) applied acrylic artificial nails. The reported use of personal protective equipment (PPE) was very high; 88% reported using a mask at work and 96% reporting using gloves. The most common symptoms reported by technicians were neck (44%) and back pain (38%). Skin and respiratory symptoms were less common with 6% of technicians reporting cough, 8% wheeze, and 5% a current rash. Technicians working over 30 h per week reported more neck pain (52 vs. 32%, P = 0.02). Technicians who reported using shellac polishes were more likely to report a runny nose (25 vs. 0%, P = 0.01). Conclusions Nail technicians in Toronto, Canada are experiencing work-related symptoms. Musculoskeletal symptoms were the most common symptoms reported. Much of the focus on nail salons and health has been on chemical exposures, but ergonomic hazards should not be overlooked. Efforts to increase knowledge and improve occupational health in nail salons should include information on multiple possible workplace hazards and how to reduce impacts of exposure.

The complete evaluation of the carcinogenicity of cobalt, antimony compounds, and weapons-grade tungsten alloy will be published in Volume 131 of the IARC Monographs., [Excerpt] In March, 2022, a Working Group of 31 scientists from 13 countries met remotely at the invitation of the International Agency for Research on Cancer (IARC) to finalise their evaluation of the carcinogenicity of nine agents: cobalt metal (without tungsten carbide or other metal alloys), soluble cobalt(II) salts, cobalt(II) oxide, cobalt(II,III) oxide, cobalt(II) sulfide, other cobalt(II) compounds, trivalent antimony, pentavalent antimony, and weapons-grade tungsten (with nickel and cobalt) alloy. For cobalt metal and the cobalt compounds, particles of all sizes were included in the evaluation. These assessments will be published in Volume 131 of the IARC Monographs.1 Cobalt metal and soluble cobalt(II) salts were classified as “probably carcinogenic to humans” (Group 2A) based on “sufficient” evidence for cancer in experimental animals and “strong” mechanistic evidence in human primary cells. Cobalt(II) oxide and weapons-grade tungsten alloy were classified as “possibly carcinogenic to humans” (Group 2B) based on “sufficient” evidence in experimental animals. Trivalent antimony was classified as “probably carcinogenic to humans” (Group 2A), based on “limited” evidence for cancer in humans, “sufficient” evidence for cancer in experimental animals, and “strong” mechanistic evidence in human primary cells and in experimental systems. Cobalt(II,III) oxide, cobalt(II) sulfide, other cobalt(II) compounds, and pentavalent antimony were each evaluated as “not classifiable as to its carcinogenicity to humans” (Group 3).[...]

Background Health care workers (HCWs) have been recognized as being at higher risk for coronavirus disease 2019 (COVID-19) infection; however, relevant factors and magnitude have not been clearly elucidated. Aim This study was aimed to describe COVID-19 infections among hospital employees at a large tertiary care hospital located in Ontario, Canada from March to July 2020, towards better understanding potential risk factors. Methods Data on all HCWs with either a positive COVID test or a high-risk exposure from March to July 2020 were analyzed. HCWs with positive COVID test results and high-risk exposures were described. Those who developed COVID-19 following high-risk exposure were compared to those who did not. Data were also analyzed to determine trends over time. Results Over the period of observation, 193 staff (2% of total working staff) had a positive COVID-19 test. Incidence of HCW infections closely followed community incidence. Overall, 31% of COVID-19 cases were deemed occupationally acquired. Of these, 41% were acquired from a patient, with the remainder (59%) from fellow staff. Over the same period, 204 staff were identified as having a high-risk exposure. The majority of exposures (55%) were patient-associated, with the remaining (45%) resulting from staff-to-staff contact. Overall, 13% went on to develop COVID-19. Of these cases, 58% were patient-associated and 42% were a result of staff-to-staff transmission. Conclusions HCWs are at risk for work-related COVID-19. Given the number of infections attributed to staff–staff transmission, greater attention could be paid to implementing prevention measures in non-clinical areas.

Objectives Research on asbestos-related disease (ARD) has traditionally focused on groups with well-recognized, consistently high exposure. Contemporary exposure to asbestos occurs more intermittently, for example during maintenance of asbestos-containing materials (ACM). The Ontario Asbestos Workers Register (AWR) was established in 1986 to track asbestos exposure. This study reports on the risk of ARD among workers in the AWR. Methods Overall 33,490 AWR registrants were included. Data were linked probabilistically with administrative health databases (1986–2018) to identify cases of ARD. Workers were followed until diagnosis, death, age 100, last contact with the health system, or end of study, whichever occurred first. Incidence rates were compared to the general population using standardized incidence ratios (SIRs). Associations between ACM exposure and ARD were estimated using Poisson regression. Results Overall 26,401(79%) AWR registrants were linked to health data; 97% were male. The mean age at cohort entry was 36 years. The most common industries represented were construction (61%), manufacturing (20%) and education (10%). Among men and women rates were markedly increased for mesothelioma [M:SIR 6.55(95% CI=5.34–7.96); W:SIR 19.3(3.87–56.3)] and pulmonary fibrosis [M:SIR 13.8(11.9–15.9); W:SIR 9.15(2.46–23.4)]. The risk of asbestosis was also elevated, but did not reach statistical significance among women [M:SIR 11.1(9.46–12.9); W:SIR 1.21(0.02–6.75)]. Among men and women, rates of COPD and lung cancer were elevated, but few cases were observed among women. Compared to workers with 238 hours had increased rates of lung cancer [RR 1.3(1.07–1.57)], mesothelioma [RR 3.13(1.94–5.06)], asbestosis [RR 3.31(2.33–4.71)], COPD [RR 1.34(1.22–1.48)], and pulmonary fibrosis [RR 1.86(1.34–2.58)]. Conclusion Exposure to asbestos in construction and building maintenance continues to contribute to ARD incidence. Though a Canadian ban on asbestos use in new products is encouraging, it is likely to have minimal impact on ARD resulting from construction activities, where exposure to existing ACM will persist.

Introduction: Diesel engine exhaust (DEE) is a known carcinogen and a common occupational exposure in Canada, particularly within construction. The use of diesel-powered equipment in the construction industry is widespread, but little is known about DEE exposures and occupational disease in this work setting. The objective of this study was to characterize and identify key determinants of DEE exposure at construction sites in Ontario. Methods: Diesel particulate matter (DPM) measurements were taken from workers employed on seven infrastructure construction worksites in Ontario. Full-shift personal air samples were collected from workers using a constant-flow pump and SKC aluminum cyclone with 37-mm quartz fibre filters in an open-faced cassette. Samples were analyzed for elemental carbon (EC), a surrogate of DEE exposure, following NIOSH method 5040. Exposures were compared to recommended health-based limits, including the Dutch Expert Committee on Occupational Safety (DECOS) limit (1.03µg/m3 respirable EC) and the Finnish Institute of Occupational Health (FIOH) recommendation (5µg/m3 respirable EC). A determinants of exposure model was constructed. Results: In total, 126 DPM samples were collected, ranging from

Exposure of e-waste workers to eight halogenated and five organophosphate ester flame retardant chemicals (FRs) was studied at a Canadian e-waste dismantling facility. FR concentrations were measured in air and dust samples collected at a central location and at four work benches over five-24 hour periods spanning two weeks. The highest concentrations in air from workbenches were of BDE-209 (median 156 ng m−3), followed by Tris(2-chloroethyl) phosphate (TCEP, median 59 ng m−3). Dust concentrations at the workbenches were higher than those measured at the central location, consistent with the release of contaminated dust during dismantling. Dust concentrations from the workbenches were also dominated by BDE-209 (median 96,300 ng g−1), followed by Triphenyl phosphate (TPhP, median 47,000 ng g−1). Most FRs were in coarse particles 5.6–18 μm diameter and ~30% were in respirable particles (

Background We estimated the proportion and number of female breast cancer cases in Canada attributable to night shift work, a probable cause of breast cancer. Methods Levin's equation was used to calculate population attributable fractions (PAFs) among Canadian women who ever worked night/rotating shifts from 1961 to 2000, accounting for labor turnover and survival to the year 2011. The calculated PAFs were applied to 2011 Canadian breast cancer incidence statistics to obtain the number of attributable cases. Results Approximately 1.5 million women ever worked night/rotating shifts during 1961-2000 and survived to 2011. The PAFs ranged from 2.0% (95% confidence interval [CI]: 1.4-6.2) to 5.2% (95% CI: 3.7-13.6), and 470 to 1200 incident breast cancer cases in 2011 were likely due to shift work, of which 38% would have been diagnosed among women in health-related occupations. Conclusions More research is needed to increase the certainty of this association, but current evidence supports workplace-based prevention.

Rationale: Given that approximately 15% of new-onset adult asthma cases originate because of exposures in the workplace, there is a need for systematic and ongoing monitoring of risk among workers. Objectives: To characterize the risk of new-onset adult asthma among workers in Ontario. Methods: We used 575,379 provincial accepted time-loss workers' compensation claimants data linked to physician billing data. Workers aged 15 to 65 years with a nonasthma compensation claim between January 1, 2002, and December 31, 2013, were eligible for inclusion. Cohort entry corresponded to the date of the claim. The case definition required two or more records for asthma within a 12-month period, within a 3-year time window after cohort entry. A 3-year washout period preceding cohort entry was used to exclude prevalent cases. Workers at risk of new-onset adult asthma were followed from cohort entry date to date of diagnosis, emigration, age 65 years, death, or end of study period. Cox regression models were used to generate birth year- and sex-adjusted hazard ratios (HRs) by occupation, industry, and exposures identified using a job exposure matrix. Sex-stratified risk estimates were also generated. Results: Increased risks were detected among well-recognized groups, including bakers (HR, 1.60; 95% confidence interval [CI], 1.22-2.09) and painters and decorators (HR, 1.67; 95% CI, 1.23-2.28). In the job exposure matrix analysis, flour and isocyanates were associated with increased risk of asthma. Concrete finishers (HR, 1.93; 95% CI, 1.12-3.32) and shipping and receiving clerks (HR, 1.21; 95% CI, 1.03-1.43) also showed elevated risk, whereas results varied across woodworker groups. Decreased risks were detected for nursing and farming groups. Conclusions: This practical data linkage approach was successful for examining associations across hundreds of jobs. Unexpected and previously unrecognized findings deserve further investigation and emphasize the importance of an ongoing system to guide research as well as prevention.

Objectives Diesel engine exhaust (DEE) is a known lung carcinogen and a common occupational exposure in Canada. The use of diesel-powered equipment in the construction industry is particularly widespread, but little is known about DEE exposures in this work setting. The objective of this study was to determine exposure levels and identify and characterize key determinants of DEE exposure at construction sites in Ontario. Methods Elemental carbon (EC, a surrogate of DEE exposure) measurements were collected at seven civil infrastructure construction worksites and one trades training facility in Ontario using NIOSH method 5040. Full-shift personal air samples were collected using a constant-flow pump and SKC aluminium cyclone with quartz fibre filters in a 37-mm cassette. Exposures were compared with published health-based limits, including the Dutch Expert Committee on Occupational Safety (DECOS) limit (1.03 µg m−3 respirable EC) and the Finnish Institute of Occupational Health (FIOH) recommendation (5 µg m−3 respirable EC). Mixed-effects linear regression was used to identify determinants of EC exposure. Results In total, 149 EC samples were collected, ranging from Conclusions This study provides data on current DEE exposure in Canadian construction workers. Most exposures were above recommended health-based limits, albeit in other jurisdictions, signifying a need to further reduce DEE levels in construction. These results can inform a hazard reduction strategy including targeted intervention/control measures to reduce DEE exposure and the burden of occupational lung cancer.

BACKGROUND: Occupational skin disease (OSD) is a common health issue in the food processing sector. However, risk factors for OSD are suspected to differ according to the nature of the operation. OBJECTIVE: To ascertain if the risk factors for OSD vary depending on the type of food processing operation, namely meat processing vs. a commercial bakery. METHODS: Participants were asked to answer questions regarding workplace exposures and the current skin condition of their hands. Bivariate analyses were conducted to identify differences between the two participating operations. RESULTS: The meat processing workers were more likely to have wet work exposure, used hand sanitizer more often and changed their gloves more frequently. These findings from meat processing represented a statistically significant difference compared to the commercial bakery workers. Also, workers from meat processing reported more severe skin symptoms. CONCLUSIONS: Risk factors for OSD apparently differ between types of food processing operations. Differences in the nature of skin symptoms were also found between the two participating operations. It is therefore suggested that future studies examining OSD within the food processing sector should evaluate this health effect based on the nature of operations rather than the sector as a whole.

Objective To assess the prevalence and determinants of sun protection behaviours among outdoors workers at work and leisure in Alberta, Canada. Methods We collected outdoor workers' demographics, skin cancer risk factors, job information, and sun habits at work and leisure using self-completed questionnaires. For both settings, we compared use of specific behaviours and modelled determinants of sun protection behaviour scores. Results At work, wearing a sleeved shirt (81% often/always) and hat (73%) were most prevalent, while seeking shade (12%) and applying sunscreen (36%) were least prevalent. Workers had higher sun protection scores at work than leisure. Hours spent outdoors was a strong determinant for both models. Additional leisure model predictors were eye colour, sex, skin type, and job group. Conclusions Differences in behaviours across settings were observed and should be considered when developing solar UVR exposure reduction initiatives.

Background From 1943 to 1980, some underground gold and uranium workers in Ontario, Canada were required to inhale aluminum dust daily for silicosis prevention. This study explored the perceived personal impact of aluminum dust exposure for some Northeastern Ontario workers. Methods This qualitative descriptive study included 16 respondents who participated in individual semi-structured interviews. All respondents were Northeastern Ontario workers who were exposed to aluminum dust prophylaxis for at least one year. Interviews were transcribed verbatim and analyzed thematically. Results Themes that emerged included: 1) compulsory exposure, 2) hesitancy to complain, 3) feelings of betrayal, and 4) concerns about health impact and dying. Conclusion Exposed workers perceived that their long-term health was impacted on a personal level. The results will contribute to the literature about workplace aluminum dust exposures and to better inform workers and companies about exposure impact and management of aluminum dust.

Solar ultraviolet radiation is one of the most common occupational carcinogens in Canada and is responsible for approximately 5,556 non-melanoma skin cancers per year. A large part of these cases are preventable by reducing solar ultraviolet radiation exposure. In this study, investigators estimated the potential economic impacts of different solar ultraviolet radiation reduction interventions among construction workers, as they are one of the largest at-risk occupational groups. Investigators performed an economic evaluation from a societal perspective, by comparing incremental costs in relation to incremental benefits achieved by two interventions-use of personal protective equipment by all exposed individuals and use of shade structure wherever and whenever feasible. Interventions costs were estimated for 2020-2050, and benefits with a 10-year delay, i.e., for the period 2030-2060. Economic evaluation estimates were reported by intervention costs, total costs of non-melanoma skin cancers cases averted, incremental cost per avert case, return on investment, and the break-even point. Various sensitivity analyses were undertaken with key parameters. Our findings indicate that if the rising trend of incidence continues, cases will be double in 2060, whereas by using personal protective equipment or shade structure, with the best-case scenario of full ultraviolet radiation removal, would result in 6,034 and 2,945 cases averted over 30 years, respectively. This translates into a total of $38.0 and $20.5 million of averted costs (all monetary values represented in 2017 Canadian dollars). Under this scenario investigators expect that by 2060, for every dollar invested in personal protective equipment and shade structures, $0.49 and $0.35 will be returned, respectively. Findings also suggested that under a conservative scenario, prevention of non-melanoma skin cancer cases by personal protective equipment and shade structures resulted in $5,812 and $7,355 incremental costs, respectively, over the 30-year period. This study provides important insights for decision makers about the potential impacts of solar ultraviolet radiation reduction interventions in the construction sector and other sectors with substantial outdoor work. Our estimates also can raise awareness of the importance of solar ultraviolet radiation reduction interventions.

Objectives To use the recently developed Ontario Mining Exposure Database (OMED) to describe historical silica exposure in the Ontario metal mining industry and identify predictors of historical silica exposure. Methods Personal respirable crystalline silica (RCS) data for metal mines were extracted from OMED and included both individual and summary measures, where multiple exposure measurements (n > 1) were aggregated and entered as a single exposure value (n = 1). Data were stratified by sample location (underground/surface) for analysis. Monte Carlo simulation was used to simulate individual measures from the summary measures. A fixed effects multiple linear regression model was used to assess the effects of commodity (ore mined), sample year, source of exposure data, and occupational group on RCS concentration. Parameter estimates (β), standard errors, and 95% upper and lower confidence intervals were reported. Results The OMED contained 12 995 silica measurements. After limiting to RCS measurements in metal mines, and measures with sufficient information for analysis, 2883 RCS measurements collected from 1974 to 1991 remained, including 2816 individual and 67 summary measurements. In total, 321 individual RCS measurements were simulated from the 67 summary measures. The analysis database contained 2771 (12% simulated) underground measurements and 366 surface measurements (0% simulated). In the underground group, an overall geometric mean (GM) of 0.05 [geometric standard deviation (GSD) 3.09] mg m−3 was estimated with a 6% annual decrease over time. In this group, the commodity with the highest average RCS level was zinc mines (GM = 0.07 mg m−3) and the lowest was iron mines (GM = 0.01 mg m−3). In the surface group, an overall GM of 0.05 (GSD 3.70) mg m−3 was estimated with an 8% decreased over time. In this group, the commodity with the highest average RCS level was gold mines (GM = 0.07 mg m−3) and the lowest was zinc mines (GM = 0.03 mg m−3). In both groups, company collected data had lower estimated RCS compared with regulator collected data. Conclusions Historical RCS levels decreased over time. Mean measurements exceeded the American Conference of Governmental Industrial Hygienists current health-based threshold limit value (0.025 mg m−3). The main predictors of exposure were commodity, source of exposure data, and sample year. However, low R2 and high GSD values suggest additional predictors of RCS exposures in Ontario’s metal mines exist that were unavailable in OMED.

Background Training and education may be effective strategies for the prevention of work-related contact dermatitis. While there is some information in the literature related to skin-specific training experiences, there is very little information available on workers’ preferences related to content and format and to barriers and facilitators to training. Objectives To understand workers’ experiences and preferences for workplace training and barriers and facilitators to training. Methods Following ethics approval, 24 patients with work-related contact dermatitis participated in semi-structured interviews obtaining information on training experiences, perceived training effectiveness, desired training characteristics, and barriers and facilitators to training. An inductive thematic analysis was used to identify themes. Results Though many workers had received general workplace health and safety training, none reported training about skin exposure and disease prevention. Examples of what the workers perceived as good training included first aid training, while Workplace Hazardous Materials Information System training was felt to be ineffective. Desired content of training for preventing skin exposures included information on the hazards, short- and long-term health impacts, and potential symptoms and personal protective equipment. They desired multi-modal presentation (e.g. in-person and online supplement), hands-on training with visual content and suggested the use of personal stories and negative messaging. Training that could be applied outside the workplace was also valued. Barriers and facilitators to implementation included factors related to the training program itself, the organization, and the regulatory landscape. Conclusions These findings can help to shape more effective workplace training programs for skin protection.

Objectives The nail salon industry has seen significant growth in recent years. Nail technicians provide manicures, pedicures and apply artificial nails; tasks that expose them to chemicals, including acrylates that are known skin and respiratory sensitizers. This paper reports on potential skin exposure to acrylates among nail technicians in Toronto, Canada. Methods Hand skin wipes were collected after (i) the application of artificial nails, (ii) the application of ultraviolet cured gel nail polish, and (iii) deliberate contact with nail polish. Surface wipes were collected from work areas and surfaces contaminated with known products. Wipe samples were analysed for eight acrylates: methyl acrylate (MA), ethyl acrylate (EA), methyl methacrylate (MMA), ethyl methacrylate (EMA), 2-hydroxyethyl acrylate (HEA), 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate (HPMA), and ethylene glycol dimethacrylate (EGDMA) by gas chromatography with mass spectrometry. Results Thirty-five wipe samples were collected. No acrylates were detected in skin samples (n = 8) or work surfaces (n = 6). However, MMA, EMA, EA, HEMA, and HPMA were detected in the samples of surfaces contaminated with known products. MMA was detected in 28% of products tested. HEMA and HPMA were detected where deliberate contact with nail polish occurred. Conclusions These results confirm that acrylates are present in nail products. However, no acrylates were detected in skin wipes. MMA, a chemical prohibited for use in cosmetics in Canada, was detected in nail polishes. Nail technicians should continue to employ safe work practices that reduce the probability of skin contact with acrylates and other chemicals.

BackgroundThe Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada by linking a cohort of workers with data created from Workplace Safety and Insurance Board (WSIB) claims to administrative health databases. The aim of this study was to use ODSS to identify high-risk industry and occupation groups for lung cancer in Ontario.MethodsWorkers in the WSIB lost time claims database were linked to the Ontario Cancer Registry using subjects’ health insurance numbers, name, sex, birthdate and death date (if applicable). Several occupations and industries known to be at increased risk were outlined a priori to examine whether ODSS could replicate these associations. Age-adjusted, sex-stratified Cox proportional hazard models compared the risk of lung cancer within one industry/occupation versus all other groups in the cohort. Workers with a lung cancer diagnosis prior to cohort entry were excluded for analysis, leaving 2 187 762 workers for analysis.ResultsDuring the 1983 to 2014 follow-up, 34 661 workers in the cohort were diagnosed with lung cancer. Among expected high-risk industries, elevated risks were observed among workers in quarries/sand pits and construction industries for both sexes, and among males in metal mines, iron foundries, non-metallic mineral products industries and transportation industries. Excess risk was also observed among occupations in drilling/blasting, other mining/quarrying, mineral ore treating, excavating/grading/paving, truck driving, painting, bus driving and construction.ConclusionsThis current surveillance system identified several established high-risk groups for lung cancer and could be used for ongoing surveillance of occupational lung cancer in Ontario.

Electronic waste (e-waste) is a global public health challenge. E-waste recycling workers may be exposed to chemical, physical, ergonomic, and psychosocial hazards. This review provides an overview of recent research on occupational exposures in e-waste recycling and work-related health effects that can impact e-waste workers. E-waste workers are exposed to a variety of chemicals including metals, particulates, persistent organic compounds, and flame retardants. Exposure varies according to job task with higher exposures observed for dismantling and burning e-waste. Exposure to job stress and physical hazards (e.g., noise) also occurs. Many studies have measured workers’ exposure in the e-waste recycling industry; fewer have investigated health effects. Biological measures were reported more often than external exposure measures. In order to protect workers, efforts are required to better understand exposures and their health effects. Removing hazardous materials from electronic equipment and reducing e-waste production would benefit workers, communities, and the environment.

Objective Exposure to radon causes lung cancer. The scope and impact of exposure among Canadian workers have not been assessed. Our study estimated occupational radon exposure in Canada and its associated lung cancer burden. Methods Exposed workers were identified among the working population during the risk exposure period (1961–2001) using data from the Canadian Census and Labour Force Survey. Exposure levels were assigned based on 12,865 workplace radon measurements for indoor workers and assumed to be 1800 mg/m3 for underground workers. Lung cancer risks were calculated using the Biological Effects of Ionizing Radiation (BEIR) VI exposure-age-concentration model. Population attributable fractions were calculated with Levin’s equation and applied to 2011 Canadian lung cancer statistics. Results Approximately 15.5 million Canadian workers were exposed to radon during the risk exposure period. 79% of exposed workers were exposed to radon levels 3 and 4.8% were exposed to levels > 150 Bq/m3. We estimated that 0.8% of lung cancers in Canada were attributable to occupational radon exposure, corresponding to approximately 188 incident lung cancers in 2011. Conclusions The lung cancer burden associated with occupational radon exposure in Canada is small, with the greatest burden occurring among those exposed to low levels of radon.

Silicone wristbands are being increasingly used to assess human exposure to semi-volatile organic compounds (SVOCs). However, it is unclear what exposure pathways wristbands integrate. To test the hypothesis that wristbands integrate inhalation and dermal exposures, we measured 38 chemicals from four compound groups (PAHs, PBDEs, nBFRs, and OPEs) in silicone wristbands and brooches, active air samples (Occupational Safety and Health Administration Versatile Sampler or OVS cartridge), and hand wipes from 10 adults during a 72-hour period. Phenanthrene, BDE-47, 2‑ethylhexyl 2,3,4,5‑tetrabromobenzoate (EHTBB), tris[(2R)‑1‑chloro‑2‑propyl] phosphate (TCIPP), and tris(1,3‑dichloro‑2‑propyl) phosphate (TDCIPP) were the predominant compounds in all four matrices. In a linear regression analysis, the compound levels in OVS were positively associated with those in wristbands and brooches for nBFRs and OPEs, but not for PAHs and PBDEs. The compound levels in wristbands were positively associated with those in hand wipes and brooches for all chemicals. The regressions between the levels in wristbands and OVS or brooches combined with the levels in hand wipes showed stronger, supporting the hypothesis that wristbands captured inhalation and dermal exposure pathways.

Background Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts. Methods To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants. Results We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity. Conclusions This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.

From 1943 to 1980, some underground gold and uranium workers in Ontario, Canada were required to inhale aluminum dust for silicosis prevention. Workers were exposed to the dust for up to 30 min daily. This study explored the perceived organizational impact on workers exposed to the aluminum dust treatment in Northeastern Ontario. This qualitative descriptive study included 16 respondents who participated in individual semi-structured interviews. All respondents were Northeastern Ontario workers who were exposed to aluminum dust treatment for at least 1 year. Interviews were transcribed verbatim and analyzed thematically. Themes that emerged were: 1) confidence and trust in companies, 2) lack of participants' and heath care providers' knowledge, and 3) need for compensation and formal apology. Workers' perceived that their long term health was impacted by exposure. The results will be used to help workers, companies, and unions address workplace exposures. The latest information about McIntyre powder will enhance the knowledge about the impact of the exposure.

Exposure to occupational carcinogens is often overlooked as a contributor to the burden of cancer. To estimate the proportion of cancer cases attributable to occupational exposure in Canada in 2011, exposure prevalence and levels of 44 carcinogens were informed by data from the Canadian carcinogen exposure surveillance project (CAREX Canada). These were used with Canadian Census (between 1961 and 2011) and Labour Force Survey (annual surveys between 1976 and 2013) data to estimate the number of workers ever exposed to occupational carcinogens. Risk estimates of the association between each carcinogen and cancer site were selected mainly from published literature reviews. Population attributable risks were estimated using Levin's equation and applied to the 2011 cancer statistics from the Canadian Cancer Registry. It is estimated that 15.5 million Canadians alive in 2011 were exposed, during at least one year between 1961 and 2001, to at least one carcinogen in the workplace. Overall, we estimated that in 2011, between 3.9% (95% CI: 3.1%-8.1%) and 4.2% (95% CI: 3.3%-8.7%) of all incident cases of cancer were due to occupational exposure, corresponding to lower and upper numbers of 7700-21,800 cases. Five of the cancer sites - mesothelioma, non-melanoma skin cancer, lung, female breast, and urinary bladder - account for a total of 7600 to 21,200 cancers attributable to occupational exposures such as solar radiation, asbestos, diesel engine exhaust, crystalline silica, and night shift work. Our study highlights cancer sites and occupational exposures that need recognition and efforts by all stakeholders to avoid preventable cancers in the future.

ObjectivesExperimental studies suggested that bisphenol A (BPA) exposure increased the risk of metabolic syndrome (MetS) through the mechanism of insulin resistance. All previous epidemiological studies of BPA and MetS were cross-sectional studies, and their findings were mixed. This study aims to provide further evidence on the association between urinary BPA and risk of MetS using a prospective cohort study in China.MethodsThe study population was from the Shenzhen Night shift workers’ cohort. A total of 1227 male workers were recruited from the baseline survey in 2013 and then followed until 2017. Modified Adult Treatment Panel III criteria were used to identify the cases of MetS. Urinary BPA concentration was assessed using high-performance liquid chromatography–tandem mass spectrometry, and it was categorised into three subgroups by tertiles to obtain the adjusted HR (aHR) and 95% CI using Cox proportional hazard model.ResultsDuring 4 years of follow-up, 200 subjects developed MetS. Compared with the lowest urinary BPA subgroup, a weakly increased risk of MetS was suggested among those with the middle (aHR=1.19, 95% CI 0.87 to 1.63) and high level of urinary BPA (aHR=1.16, 95% CI 0.84 to 1.59); however, the significant association with MetS was restricted primarily to the smokers, showing a positive gradient with urinary BPA (middle level: aHR=2.40, 95% CI 1.13 to 5.08; high level: aHR=2.87, 95% CI 1.38 to 5.98; p trend=0.010).ConclusionThis prospective cohort study provided further evidence that exposure to BPA may increase the risk of MetS, and this association was further positively modified by cigarette smoking.

OBJECTIVES: Secondhand smoke (SHS) is a known lung carcinogen that is also associated with cardiovascular disease and premature death. An important source of exposure to SHS is the workplace. In the past, efforts have been made to reduce workplace SHS exposure across Canada, with corresponding benefits to public health. This study estimated the number of workers exposed to SHS in Canada in 2006 and 2016 and their level of exposure. METHODS: The proportion of workers exposed to SHS and the proportion of workers reporting specific workplace smoking restrictions by occupation and province, acquired from the 2007–2009 and 2010–2012 Canadian Tobacco Use Monitoring Surveys, were applied to 2006 and 2016 Canadian census data to estimate population-level exposure. Workers were assigned to exposure levels (possible, moderate, high) using workplace smoking restrictions. Only moderately and highly exposed workers were considered exposed. RESULTS: The number of exposed workers decreased by 20% from 520,000 in 2006 to 418,000 in 2016. Workers were equally split between moderate and high exposure groups. Trades, transport and equipment operators, and workers in primary industry had the highest rates of overall exposure. The proportion of workers exposed varied by province, with the lowest rates in Ontario (approximately 2% in both years), and the highest in Saskatchewan in 2006 (6%) and Newfoundland in 2016 (4%). CONCLUSION: Workplace SHS exposure persists. The findings can help prioritize high-risk groups for interventions and inform studies of the burden of occupational disease. Further characterization of exposure is needed to better inform enforcement and prevention.