Broadly speaking, a workplace injury is any form of ill health—such as a physical or mental injury or illness—that arises because of a worker’s employment. Instances of work-related ill health can encompass a vast array of injuries and illnesses. Most work-related injuries will be minor and temporary (such as a slight burn), while others will be permanent (such as an amputation) or life-threatening (such as cancer). Some injuries will be acute (such as a laceration) and some will take years to manifest themselves (such as silicosis). Let’s review a workplace incident that resulted in several workplace injuries and two fatalities.

The Lakeland mill explosion—one of two in BC that year—was a major workplace incident. Yet, sadly, these deaths and injuries were but a drop in the bucket. In 2012, the Association of Workers’ Compensation Boards of Canada (AWCBC) reported 245,365 accepted workers’ compensation claims for time-loss injuries. Time-loss injuries are injuries so serious that workers cannot go to work for a period of time. The AWCBC also reported 977 accepted workplace fatality claims. AWCBC. (2014). National work injury, disease and fatality statistics 2010–2012. Ottawa: Association of Workers’ Compensation Boards of Canada. As we’ll see below, these (alarming) statistics significantly under-report the true level of workplace injury in Canada.

Before turning our attention to the practicalities of how to reduce the risks of work-related injuries, it is important to spend some time thinking about what we mean by a workplace injury. While there is little dispute that the injuries that occurred at the Lakeland mill were workplace injuries, the work-relatedness of other injuries can be contested. It is also important to give some thought to what causes workplace injuries. Most explanations tend to focus on the immediate cause of the injury (e.g., the mill blew up). While the explosion did indeed cause the workers’ injuries, that is a superficial analysis of injury causation. Other, less obvious factors created the conditions that led to the explosion.

Despite the vast range of potential injuries, when most people think of a workplace injury, what comes to mind is an acute injury caused by an obvious physical cause. For example, a fall from a height may break a worker’s wrist. There are three main reasons why we tend to focus on acute physical injuries:

• Acute injuries are commonplace. In 2012, 92.5% of Canada’s 245,365 accepted time-loss injuries were acute physical injuries while only 7.5% were illnesses. Ibid
• Acute injuries are easy to see and understand. It is obvious when a worker falls from a height, and we intuitively understand how the fall hurt the worker. Contrast this with a diagnosis of mesothelioma (a form of cancer caused by asbestos). Such a diagnosis is often known only to the worker, his family, and his doctor. And the 20-year lag between exposure and diagnosis obscures the work-relatedness of the injury. Indeed, the worker may not know that he was exposed to asbestos in the workplace.
• Acute injuries receive a disproportionate share of public attention. Most of us have limited personal experience with workplace injuries. Instead, what we know about them comes from media reports.

Occupational health and safety (OHS) laws often specify clear rules to protect workers from falls and other physical hazards. The rules around exposing workers to hazardous substances are much more ambiguous.

Similarly, workers’ compensation boards (WCBs)—which provide injured workers with wage replacement and other benefits—use the “arises-and-occurs” test to determine whether an injury was work-related (and thus whether the worker will receive compensation). The arises-and-occurs test requires workers to demonstrate that their injury arose from and occurred during the course of their employment. It is easier for workers with acute physical injuries to show that this is the case than it is for workers who have developed an occupational disease. This is because occupational diseases often take years to manifest themselves and the cause of the disease may be unclear. Not surprisingly, then, the majority of accepted workers’ compensation claims are for acute physical injuries.

What causes workplace injuries? The obvious answer is workplace hazards. A workplace hazard is any source of potential injury or illness in a workplace. For example, a puddle of water on a floor creates a slipping hazard that could result in a worker sustaining injuries from a fall. Similarly, the presence of lead in the workplace could result in lead poisoning. Yet work-related hazards are not always so obvious. Sometimes the way in which work is organized causes health effects. For example, precarious employment—“paid work characterized by limited social benefits and statutory entitlements, job insecurity, low wages”—is associated with high risks of ill health.Vosko, L. (2006). Precarious employment: Towards an improved understanding of labour market insecurity. In L. Vosko (Ed.), Precarious employment: Understanding labour market insecurity in Canada. Montréal: McGill-Queen’s University Press, p. 4. Some studies suggest that jobs that demand a lot of effort but provide workers with little control over their work and little support can damage workers’ health via stress.Lewchuk, W., Clarke, M., & de Wolfe, A. (2011). Working without commitments: The health effects of precarious employment. Montréal: McGill-Queen’s University Press.

In order to cause a workplace injury, the hazard acts upon the worker in some way. Physical hazards often entail a transfer of energy that results in an injury, such as a box falling off a shelf and striking a worker. Ergonomic hazards occur as a result of the interaction of work design and the human body. Chemical hazards are more complex. They may cause harm to human tissue in a variety of ways (e.g., some chemicals cause burns) or interfere with normal physiological functioning (e.g., some substances cause hallucinations). Biological hazards are organisms—such as bacteria, molds, funguses—or the products of organisms that harm human health. Psycho-social hazards are social environment and psychological factors that can affect human health and safety.

When considering the cause of an injury, it is useful to distinguish between proximate cause and root cause. Proximate cause is the event that is immediately responsible for the injury. Root cause refers to the ultimate or “real” cause of an injury. For example, if a worker falls down, the proximate cause may be that the worker lost her footing on a wet surface. Yet why was the surface wet? The root cause of the injury may have been an inadequately maintained hose that leaked. Considering both the proximate cause and root cause of an injury results in a better understanding of what caused the injury and, consequently, what can be done to prevent it.

The real world, of course, is messier than the proximate-and-root-cause model suggests. There is often a chain of causality that leads to an injury. In the example above, why was the hose not properly maintained? The root cause of that may well have been inadequate staffing levels. And what caused the inadequate staffing levels? Perhaps the employer was trying to minimize the cost of production. Why would the employer be trying to minimize costs? Perhaps because the employer feels pressure to maximize profitability.

When thinking about what causes injuries, it is also important to realize that there are both technical explanations and political-economy explanations. The technical approach to injury emphasizes the mechanism(s) of injury. 

The political-economy approach to explaining workplace injury examines issues of power and financial gain to reveal why some hazards are remediated and others are not. This approach recognizes that employers and workers have differing interests in the workplace and therefore view workplace injuries differently.

Since perfect safety is unattainable, employers often adopt a cost-benefit approach to safety: safety should only be improved when it costs less to prevent the injury than the injury itself costs.Tucker, E. (1983–84). The determination of occupational health and safety standards in Ontario, 1860–1982. McGill Law Journal, 29, 260–311. This isn’t to suggest that employers actively wish to see their workers injured or don’t take safety seriously. Rather, it highlights that employers and managers face structural pressures and that these pressures shape how they behave and, indeed, how they view issues like workplace safety.

These pressures are also felt in the public and non-profit sectors, where profit affects decisions in a more indirect fashion. While neither sector worries about profit per se, both have finite resources and face pressure to keep costs down. Non-governmental (non-profit) organizations rely heavily on funding from private donors and government grants, and these funders demand efficient use of their dollars.

The introduction to this chapter noted that there were 245,365 accepted workers’ compensation claims for time-loss injuries in 2012.AWCBC. (2014). As astounding as these annual time-loss injury numbers are, they profoundly understate the true level of workplace injury in Canada. The understatement of injury numbers occurs in a number of ways. First, time-loss injuries are accepted workers’ compensation claims where a worker could not report to work due to the injury.

Not all workers must (or can) report their injuries to a workers’ compensation board (WCB). In fact, only about 85% of workers are covered by workers’ compensation in Canada. So, right out of the gate, we know time-loss claims represent only 85% of all time-loss injuries. Second, WCBs don’t accept every time-loss claim filed by workers. Exact data on acceptance rates is unavailable, but approximately 5% of all workers who submit a claim have that claim rejected and thus those injuries are excluded from the total above. So far, then, the 245,365 claims represents only about 80% of all time-loss injuries. Third, not all workers report their injuries. The best data available suggests that 40% of injuries go unreported.Shannon, H., & Lowe, G. (2002). How many injured workers do not file claims for workers’ compensation benefits? American Journal of Industrial Medicine, 42(6), 467–473. All in all, this suggests the true number of time-loss injuries likely is closer to 430,000 per year.

Moreover, time-loss claims comprise only a fraction of all injuries. Missing from these numbers are all other injuries where the worker could go to work (albeit with an injury). This includes injuries requiring medical aid only or injuries where the employer was able to modify the worker’s duties to prevent time loss. It also includes injuries where the worker just decides to soldier on, such as burns, cuts, sprains, and strains, as well as injuries where the worker receives benefits from private medical insurance. The true number of workplace injuries is possibly as great as 10 times the reported number of time-loss injuries.Barnetson, B. (2012). The validity of Alberta safety statistics. Just Labour, 19, 1–21. The idea that there might be 2.4 million workplace injuries in Canada each year suggests that state injury-prevention efforts are not very effective.

So why are so many workplace injuries not reported? There are several explanations. Employers may discourage workers from reporting injuries because injury claims can affect employers’ workers’ compensation premiums as well as their ability to successfully bid on some contracts. Employers may offer workers paid time off and private insurance benefits in order to avoid workers’ compensation claims. The risk of this arrangement for workers is that, if the worker is re-injured at a later date and requires workers’ compensation benefits, there will be no record of the original injury and thus the “new” injury may not be fully compensable.

At the end of the investigation into the Lakeland mill explosion, the company was fined $724,000—a fine the owners are appealing at the time of writing. The decision of a coroner’s jury that the explosion was an “accident”—the outcome of unintended or unexpected events—outraged families of the dead workers. The BC government had earlier decided not to proceed with criminal charges. Throughout this text, we will explore workplace hazards, assessments and controls that may help employers eliminate or reduce the likelihood of occupational injuries.

All 14 of Canada’s jurisdictions, have occupational health and safety legislation—laws that grant rights to and impose duties upon workers and employers in order to reduce the level of workplace injury. In this chapter, we will review the responsibilities and the rights of workers, the legal implication of the legislation, and the relationship between safety laws and other pieces of legislation.

Beginning in the 1970s, the federal, provincial, and territorial governments all enacted legislation—laws—that regulate occupational health and safety (OHS). The distribution of powers under the Canadian constitution means Canada has 14 jurisdictions (federal, 10 provincial, and 3 territorial) when it comes to health and safety laws. Most employers and workers are covered by the occupational health and safety law of the province or territory in which they work. About 10% of the workforce is, however, covered by the occupational health and safety provisions in the federal government’s Canada Labour Code. The Canada Labour Code covers employees of the federal government. It also covers workers in industries that are, by their nature, interprovincial, such as banking, telecommunications, interprovincial transport, and uranium mining. Each jurisdiction has its own amalgam of acts, regulations, policies, and guidelines.

An act is a federal, provincial, or territorial law that sets out the broad legal framework around occupational health and safety in each jurisdiction. 

A regulation typically sets out how the general principles of the Act will be applied in specific circumstances and is enforceable. Guidelines and policies are more specific rules about occupational health and safety. Other supporting guidance can be found in standards and codes. These documents provide employers with direction on health and safety implementation in the workplace. An example would be CSA  Z795-03 which refers to the Coding of Work Injury or Disease Information and is published by the Canadian Standard Association (CSA).Employment and Social Development Canada (ESDC). (2017, February 16). Psychological Health in the Workplace. Retrieved May 30, 2022, from https://www.canada.ca/en/employment-social-development/services/health-safety/reports/psychological-health.html

Occupational health and safety legislation consists of rights and responsibilities. Let us look at the foundation of health and safety, the internal responsibility system, and explore the topic of due diligence. In addition, we will take a closer look at the rights and responsibilities of employers, employees, supervisors and joint health and safety committees.

The Internal Responsibility System (IRS)

Canadian OHS is based upon the internal responsibility system (IRS). The IRS assumes that workers and employers have a shared responsibility for workplace health and safety. Employers are obligated to take steps to ensure that workplaces are as safe as reasonably practicable.For example, Section 3-8(a) of the Saskatchewan Employment Act (2013) states: “3‐8 Every employer shall: (a) ensure, insofar as is reasonably practicable, the health, safety and welfare at work of all of the employer’s workers;” Employers are also required to advise workers of hazards and to require workers to use mandated safety equipment. The decision by governments to give employers the power to determine how to address workplace hazards bolsters employers’ broader management rights to control and direct work.

It can be difficult for employers to know when they have met their duty to make work as safe as reasonably practicable. Meeting the reasonably practicable standard means taking precautions “that are not only possible but that are also suitable or rational, given the particular situation.”Government of Canada, Labour Program. (1993). Labour Standards Interpretations, Policies and Guidelines 808/819-IPG 057, p. 4. The generally accepted test is that of due diligence.

Employers who have taken the steps to address the hazards within their control to prevent foreseeable injuries have exercised their due diligence. This matters for two reasons. First, due diligence prevents injuries by controlling hazards. Second, if an injury occurs, employers who have completed the steps can use this due diligence as a defence to avoid penalties under OHS legislation.

Employer Responsibilities

 Employers have specific responsibilities when it comes to health and safety legislation. In Ontario, for example, some of the employer responsibilities include:

• Establish and maintain a health and safety committee , or cause workers to select at least one health and safety representative.
• Take every reasonable precaution to ensure the workplace is safe.
• Train employees about any potential hazards and in how to safely use, handle, store and dispose of hazardous substances and how to handle emergencies.
• Make sure workers know how to use and handle the equipment safely and properly.
• Make sure workers use any necessary personal protective equipment.
• Immediately report all critical injuries to the government department responsible for OH&S.
• Appoint a competent supervisor who sets the standards for performance, and who ensures safe working conditions are always observed.

Employee Responsibilities

 There exists a misperception that only the employer has responsibilities under occupational health and safety legislation. Employees, however, have specific responsibilities under the law. Some of the employee responsibilities under the Occupational Health and Safety Act include:

• Work in compliance with OH&S acts and regulations.
• Use personal protective equipment and clothing as directed by the employer.
• Report workplace hazards and dangers to the supervisor or employer.
• Work in a safe manner as required by the employer and use the prescribed safety equipment.
• Tell the supervisor or employer about any missing or defective equipment or protective device that may be dangerous

Supervisor/Manager Responsibilities

 Individuals with titles such as supervisor or manager have specific responsibilities under occupational health and safety legislation. In Ontario, for example, supervisors and managers are to:

• Make sure workers work in compliance with OH&S acts and regulations.
• Make sure that workers use prescribed protective equipment and/or devices.
• Advise workers of potential and actual hazards.
• Provide workers with written instructions as to the measures and procedures to be taken for protection of the worker.
• Take every reasonable precaution in the circumstances for the protection of workers.

This section on responsibilities was taken from:

OH&S Legislation in Canada – Basic Responsibilities, https://www.ccohs.ca/oshanswers/legisl/responsi.html, OSH Answers, Canadian Centre for Occupational Health and Safety (CCOHS),  April 8, 2019. Reproduced with the permission of CCOHS, 2022.

Joint Health and Safety Committee

Joint health and safety committees are an important mechanism by which workers exercise their right to participate in occupational health and safety matters. Joint health and safety committees comprise employer and worker representatives who regularly meet to discuss health and safety issues. The “logic” of these committees is that they marry the job-specific knowledge of workers with the broader perspective of managers to identify and resolve OHS issues. The legislative requirements for JHSCs vary by jurisdiction and organization size. Unions may also negotiate mandatory JHSCs into their collective agreements.

Among the tasks joint health and safety committees perform are conducting hazard assessments, providing education and training, and investigating incidents. While a joint health and safety committees can propose hazard mitigation strategies, occupational health and safety legislation empowers the employer to determine how to control such hazards. In this way, joint health and safety committees are advisory committees rather than decision-making committees. Research suggests that worker participation in occupational health and safety tends to be more effective in larger workplaces and in the presence of trade unions.Nichols, T., & Walters, D. (2009). Worker representation on health and safety in the UK – Problems with the preferred model and beyond. In D. Walters & T. Nichols (Eds.), International perspectives on representing workers’ interests in health and safety (pp. 19–30). Basingstoke: Palgrave Macmillan. Workers in smaller firms and in workplaces reliant upon various subcontracting and outsourcing arrangements are less likely to have access to joint health and safety committees.Johnstone, R. (2006). Regulating occupational health and safety in a changing labour market. In C. Arup, P. Gahan, J. Howe, R. Johnstone, R. Mitchell, & A. O’Donnell (Eds.), Labour law and labour market regulations (pp. 617–634). Sydney: Federation Press. 

How workers behave on joint health and safety committees can influence the effectiveness of worker participation. Worker representatives who collect their own information about occupational health and safety assert their knowledge about hazardous conditions, mobilize their co-workers to support demands for improvements, and propose alternative solutions appear to be more effective than more passive representatives.Hall, A., Forrest, A., Sears, A., & Carlan, N. (2006). Making a difference: Knowledge activism and worker representation in joint OHS committees. Relations Industrielles/Industrial Relations, 61(3), 408–436. The effectiveness of this more activist orientation suggests employer occupational health and safety behaviours can be shaped by workers’ behaviour in the workplace, as well as by external enforcement by the state.

The role of the state in the Internal Responsibility System is primarily one of education and enforcement. Governments often run safety awareness campaigns aimed at workers. Governments also employ OHS officers who perform worksite inspections in order to identify health and safety violations and ensure their remediation. Inspections may be random or targeted (e.g., focusing on high-injury industries, such as residential construction). Inspections may also be triggered by worker complaints.

Inspectors will also investigate serious workplace injuries and fatalities. Where inspectors find violations of OHS rules, they may order employers to remedy the situation. This is the most common response of OHS inspectors and can sometimes include issuing a stop-work order, which halts operations at the worksite until an unsafe situation is resolved. Some jurisdictions also give OHS inspectors the power to issue tickets or other financial penalties to workers and employers who are in contravention of OHS rules. The government can also seek to prosecute those who violate the law. This most often occurs when there has been a serious injury or fatality or a pattern of non-compliance with the law. Conviction can result in fines, jail time, or other penalties. Prosecutions are relatively rare in Canada.

Canada’s Criminal Code was amended in 2004 to allow for the criminal prosecution of individuals and organizations that direct the work of others when a worker is injured and the employer failed to meet its due diligence requirements. Criminal prosecution is designed to address cases of profound moral failings, such as the wanton disregard for safety that cost 26 workers their lives in 1992 at the Westray Mine in Nova Scotia. Only a handful of prosecutions under the Criminal Code have occurred, with few resulting in convictions.Bittle, S. (2012). Still dying for a living: Corporate criminal liability after the Westray mine disaster. Vancouver: University of British Columbia Press. 

Occupational health and safety laws are part of a broader web of rules that regulate employment. Other laws passed by legislatures that impact OHS include fire and building codes, occupational-specific regulations, laws regulating hazardous materials (both in the workplace and the broader environment), employment (or labour) standards, human rights, and workers’ compensation schemes.

Hazardous Products

The federal Hazardous Products Act established the Workplace Hazardous Materials Information System (WHMIS). WHMIS protects workers by requiring employers to label hazardous materials and provide safety data sheets (SDS) which outline the hazards of the substance. This information assists workers in exercising their right to know about workplace hazards. Each of Canada’s 14 jurisdictions have included aspects of WHMIS in their own OHS systems.You can learn more about WHMIS at http://whmis.org/

Governments also regulate aspects of certain occupations. For example, workers whose job requires them to handle or use explosives may be required to undertake specific training and hold a permit. Governments have also enacted environmental laws that regulate air, water, and soil pollution, waste management, and climate change. While environmental regulations are not normally considered a part of occupational health and safety, there is no clear boundary between environmental hazards and workplace hazards.

Employment Standards

All Canadian jurisdictions have enacted laws setting out the minimum terms and conditions of work. These employment standards (or labour standards) acts often outline maximum hours of work and required rest breaks. These requirements prevent workers from becoming overly tired, which increases the risk of injury. Employment standards legislation also usually contains limits on the employment of minors, reflecting their greater vulnerability to occupational injury due to their physical and intellectual immaturity. Such laws preclude employers from recovering the cost of customer theft from workers’ wages. As the vignette at the beginning of this chapter suggests, though, employment standards laws are unevenly enforced, thereby reducing their contribution to injury prevention.

Human Rights

It is important to consider the impact of human rights legislation on OHS. Human rights acts preclude discrimination on various grounds, such as gender, family status, age, sexual orientation, and disability. The duty to accommodate injured workers that flows from human rights legislation. In short, employers are expected to modify work and workplaces, up to the point of undue hardship for the employer, so as not to discriminate against workers with temporary or permanent disabilities.

Workers’ Compensation

Being injured on the job affects workers in many ways. Historically, injury has often meant poverty, because injured workers frequently can’t work. At the beginning of the 20th century, provincial governments enacted workers’ compensation systems to provide injured workers with wage-loss benefits, medical treatment, and vocational rehabilitation. Prior to the creation of workers’ compensation, workers injured on the job were forced to sue their employers for compensation. Workers often could not afford to sue, and if they did sue they rarely won, which meant injured workers often ended up financially dependent upon their families or charity. The unfairness of this system was a source of significant social instability, and governments enacted workers’ compensation laws to partly address workers’ needs and thereby stave off industrial and social conflict.Risk, R. (1983). This nuisance of litigation: The origins of workers’ compensation in Ontario. In D. Flaherty (Ed.), Essays in the history of Canadian law (Vol. 2, pp. 418–491). Toronto: University of Toronto Press. In exchange for immediate, predictable, and stable compensation, injured workers gave up their right to sue their employer for workplace injury. This exchange is often called the historic compromise.

Every province and territory has established a WCB that operates under these principles. When workers experience a serious work-related injury (e.g., the worker requires medical aid or can’t go to work the next day), the worker, employer, and doctor are all required to report the injury to the WCB. In assessing whether an injured worker is eligible for benefits, the WCB uses the two-part “arises-and-occurs” test. To be compensable, an injury must be caused by an event arising out of, and occurring during the course of, employment.

Where it is not possible to determine if an injury arose or occurred, workers’ compensation legislation generally gives the benefit of the doubt to the injured worker. Some workers’ compensation systems also grant presumptive status to certain types of injury. Certain diseases, for example, are so closely linked with certain kinds of work (e.g., farming and farmer’s lung) that claims are presumed to have arisen and occurred unless there is evidence otherwise.

Once an injury has been found to be compensable, workers are eligible to receive wage-loss, medical, and vocational rehabilitation benefits. Wage-loss benefits provide financial compensation to workers whose income is reduced by an injury. The level of wage-loss benefit and when wage-loss benefits commence varies by jurisdiction, although rates are set so that workers ordinarily receive less than their regular wage. Injured workers can also receive medical and vocational rehabilitation benefits. Medical benefits cover the costs of treating an injury, thereby relieving workers and the taxpayer-funded health care system of these costs. Vocational rehabilitation benefits include programs designed to increase the probability of a worker returning to employment. When a worker dies as the result of a workplace injury, the worker’s dependents are eligible to receive fatality benefits, including funeral costs and wage-loss benefits.

While workers’ compensation entails significant benefits to injured workers, the administration of these benefits has come under heavy criticism. Injured workers often report that their interactions with the WCB—wherein workers’ claims are often met with skepticism and workers are sometimes surveilled—can be psychologically damaging.Lippel, K. (2007). Workers describe the effect of the workers’ compensation process on their health: A Québec study. International Journal of Law and Psychiatry, 30, 427–443. Injured workers are also more likely to live in poverty.Ballantyne, P., Casey, R., O’Hagan, F., & Vienneau, P. (2016). Poverty status of worker compensation claimants with permanent impairments. Critical Public Health, 26(2), 173–190. doi: 10.1080/09581596.2015.1010485 In some jurisdictions, workers face having their wage-loss benefits reduced because the WCB deems them to be employable, even though they have been unable to find a job.Barnetson, B. (2010). The political economy of workplace injury in Canada. Edmonton: Athabasca University Press. These concerns are often related to the way workers’ compensation is funded and, in particular, to the operation of experience-rating systems.

Employers fund workers’ compensation by paying premiums. Premiums are based upon an employer’s payroll multiplied by the assessment rate the WCB has set for the industry in which the employer operates. Typically premiums are expressed in the form of X dollars per $100 of payroll. Some provinces further modify individual employer’s premiums based upon the employer’s claims record. These experience-rating systems reward employers that have low claim costs and penalize employers that have high claim costs. As we saw in Chapter 1, experience rating is a controversial system. Linking claim costs to premium rebates does reduce the number and duration of claims, but it is unclear if this means an actual reduction in the number or severity of injuries or reflects employer gaming of the experience-rating system.Tompa, E., Hogg-Johnson, S., Amick, B., Wang, Y., Shen, E., Mustard, C., Robson, L., & Saunders, R. (2013). Financial incentives for experience rating in workers’ compensation: New evidence from a program change in Ontario, Canada. Journal of Occupational and Environmental Medicine, 55(3), 292–304. Gaming may include suppressing claims as well as disputing worker claims, thereby undermining the no-fault basis of workers’ compensation.

Many injured workers are able to perform productive work while they are recovering from injuries. Providing workers with an opportunity to return to work (RTW) by, for example, modifying their duties may help workers recover. The idea that return-to-work is rehabilitative is hotly contested. Less controversial is that RTW programs help employers minimize their claims costs.Tompa et al. (2013). Such programs also ensure that employers meet the duty to accommodate workers found in human rights legislation.

This chapter outlined the legal framework the state has enacted to prevent and compensate work-related injuries.  To fully appreciate how injury prevention and compensation laws operate we have to be prepared to understand both the technical requirements of the laws and the political economy of their enforcement.

Canadian governments have made employers and workers jointly responsible for OHS via the IRS. In addition to OHS laws, governments have passed other legislation that makes workplaces safer, including fire and building codes and hazardous materials and environment protection regulations. It is essential that every employer understand the occupational health and safety legislation that applies to their workplace(s) and implements the essential components of a safety program including training, hazard identification, incident investigation and controls. 

The key to preventing workplace injuries and fatalities is to identify hazards and control them, otherwise known as Hazard Recognition, Assessment and Control (HRAC). This chapter examines how workers and employers identify, prioritize, and control workplace hazards. A workplace hazard is anything that might harm, damage, or adversely affect any person or thing under certain conditions at work. It can be an object, process, context, person, or set of circumstances which has the potential to create injury or ill health. While this definition may seem vague, it is intentionally vague in order to ensure that anything that could potentially harm a worker is included.

 Hazard recognition (which is sometimes called hazard identification) is the systematic task of identifying all hazards present, or potentially present, in a workplace. It is the first step of any HRAC process. The second step is hazard assessment (which is sometimes called hazard analysis). In a hazard assessment, workers and employers determine which of the hazards needs to be addressed most urgently. Finally, the hazard control process sees preventive and corrective measures implemented to eliminate or mitigate the effect of the hazard(s). Let’s review a mobile workplace incident to see how hazard recognition, assessment and control measures may have prevented such a tragedy.

The core purpose of HRAC is to methodically identify and control workplace hazards. Some hazards are easier to identify than others. For example, it is easy to see that an extension cord lying across a busy hallway may cause someone to trip. It is more difficult to determine if a cleaning agent is toxic or if a machine is producing too much noise. Even more challenging is identifying factors that are increasing stress among workers or are the precursors of harassment. Similarly, some hazards are also easier to control than others. Eliminating the hazard posed by the extension cord is a quick and easy fix. Other hazards may be much more expensive to control or may reflect a core aspect of the production process. Some controls may be complex, requiring multi-faceted solutions. Further complicating the HRAC process are the conflicting interests between workers and employers around hazards. Employers and workers might disagree over what constitutes a hazard, how serious the hazard is, and what the most appropriate control should be.

A near miss is an unwanted, unplanned event that did not cause an injury or property damage but may have done so if conditions had been slightly different.Infrastructure Health & Safety Association. (n.d.). Never miss reporting a near miss. IHSA.ca Magazine, 18(1).

Hazard recognition or identification is perhaps that most important function of an employer, a safety program, a health and safety representative/committee. Let’s review the business case for making hazard recognition a key activity at work.

Reduce Risk. The best way to reduce the number of workplace incidents is to avoid the incidents completely. Get ahead of the hazards, be proactive, identify hazards, assess risk and implement the controls necessary to minimize or eliminate the risk. An example, if the employer identifies low-lighting in the parking lot, have the lighting fixed, updated, replaced to reduce the chance of a workplace incident in the parking lot such as a slip and fall or a theft. The goal of the hazard recognition activity is to eliminate or reduce the risk of future incidents.

Financial. The investment in hazard recognition is low compared to the cost of a workplace incident. Employees that will assist with hazard recognition are already on the payroll. The employer needs to task employees to complete a thorough review of the workplace. Don’t forget meeting rooms, washrooms, eating areas, storage cabinets and parking lots. The employer may choose to hire a third-party company to assist or lead the hazard recognition activity. Either way, the cost of these pro-active activities is less than the cost of a workplace incident.

Participation.  In some jurisdictions, the legal system talks about the “rights of the worker” which includes the right to know and the right to participate. There is no easier way to provide workers with the right to participate than to involve them in the identification of workplace hazards. An example, strike a small committee consisting of members of the health and safety committee and employees that work in the maintenance area to perform a walk through of the maintenance area to identify hazards that others may not see.

Training. Once an employer identifies workplace hazards, it is easy to establish a safety training program. An example, a wheelchair manufacturer recognizes they cannot eliminate the use of sharp objects and metal in their work process. They implement a “sharps” training program that emphasizes the use of proper PPE (Personal Protective Equipment) such as gloves, to every employee and re-trains employees on the sharps safety program annually.

Due Diligence. At the center of each safety program is due diligence, or the act of doing everything possible to ensure the safety of individuals in the workplace. An example, employers should the appropriate safety signage is located throughout their workplace in languages that represent the diversity of their employees.

Internal Responsibility System. The IRS or Internal Responsibility System suggests everyone is responsible for safety. An example, at the monthly staff meeting, the leadership team encourages employees to report hazards in the workplace and reviews safety concerns identified in the past 30 days, as well as the actions taken to eliminate or minimize each hazard.

Compliance and Record Keeping. Should an employer need to provide evidence of their safety program and compliance with safety legilation, keeping hazard identification forms on file is a required practice. For example, should an organization receive unplanned visit from their government safety agency or ministry, the organization must be able to retrieve hazard identification records that demonstrate a pro-active approach to safety.

The HRAC process starts with comprehensively identifying all the hazards in a workplace. The five  categories of hazards include physical, ergonomic, chemical, biological and psycho-social. Let’s review each one in detail.

1. Physical hazards typically entail a transfer of energy from an object, such as a box falling off a shelf, which results in an injury. These are the most widely recognized hazards and include contact with equipment or other objects, working at heights, and slipping. This category also includes noise, vibration, temperature, electricity, atmospheric conditions, and radiation. All of these hazards can create harm in certain contexts.
2. Ergonomic hazards occur as a result of the interaction of work design and the human body, such as work-station design, tool shape, repetitive work, requirements to sit/stand for long periods, and manual handling of materials. Ergonomic hazards are often viewed as a subset of physical hazards. For the purposes of hazard assessment, it is useful to consider them separately because they are often overshadowed by more obvious physical hazards. 
3. Chemical hazards cause harm to human tissue or interfere with normal physiological functioning. The short-term effects of chemical hazards can include burns and disorientation. Longer-term effects of chemical hazards include cancer and lead poisoning. While some chemical substances are inherently harmful, ordinarily safe substances can be rendered hazardous by specific conditions. For example, oxygen is essential to human life, but in high doses can be harmful.
4. Biological hazards are organisms—such as bacteria, molds, funguses—or the products of organisms (e.g., tissue, blood, feces) that harm human health. 
5. Psycho-social hazards are social, environmental, and psychological factors that can affect human health and safety. These hazards include harassment and violence but also incorporate issues of stress, mental fatigue, and mental illness.

Recognizing each type of hazard requires different methods and approaches. Analyzing each category of hazard separately allows us to consider the specific issues associated with the category. There are many ways to identify hazards in a workplace. There are many companies and consultants offering commercial hazard assessment packages to employers for a fee. The pre-prepared packages can help establish a framework upon which to build. There are also free resources available from reliable organizations, such as the Canadian Centre for Occupational Health and Safety which allow the hazard assessment process to be tailored to specific workplaces. A common feature of robust hazard recognition systems is that they examine the workplace from multiple perspectives to ensure that all hazards are identified.

It is useful to start the hazard assessment process by considering the nature of the work and workplace. The context of work affects the type of hazards in the workplace. For example, recognizing that work takes place at a remote workplace—such as a tree-planting operation or oil-field drilling site—raises issues of emergency response times, travel hazards, and working alone. Similarly, if workers are hired on a part-time or temporary basis, this may affect communication and training. Vulnerable workers—such as newcomers to Canada or youths—may be reluctant to identify hazards for fear of losing their jobs. These examples demonstrate that hazards do not merely reside in the task of working but also in the wider context of the employment relationship. One of the common omissions in hazard recognition is ignoring the underlying factors that lead to the creation of hazards. A narrower scope of recognition fits the employer’s interests in limiting safety to proximate causes but it can undermine the effectiveness of the HRAC process.

Hazard Identification Techniques

There are a variety of hazard-identification techniques, and these are often used in combination to create a fuller picture of a workplace’s hazards:

• Inspecting the workplace: Physically observing the workplace and how work is performed within it is a powerful step in identifying hazards. The inspection should not be limited to considering physical objects, such as machines, tools, equipment, and structures, but should also include observing processes, systems, and work procedures.
• Talking with workers: Passive observation can miss many important aspects of how work is performed. Getting the perspective of the people conducting the work will reveal other insights. This can be done informally through discussions or through more formal means such as surveys or interviews.
• Job inventory: Acquiring job descriptions and specifications can also reveal hazards. Mapping out the flow of work to create a task analysis allows for a systematic examination of how a job is supposed to be conducted. It is important to compare this data with worker interviews to identify instances where work practices differ from formal procedures.
• Records and data: Reviewing records of previous workplace incidents, safety reports, and other documentation can yield useful information about the hazards in a workplace.
• Measuring and testing: Sometimes, to discover if something is a hazard, you will need to measure or test it. This is particularly true for noise, chemical hazards, and biological hazards.
• Research: Knowing something is present in the workplace may be insufficient to determine if it is a hazard. You may need to conduct research on a substance, material, design, or environment to assess its potential for harm.

The hazard identification process must be carefully documented. Hazard identification forms should break the identified hazards into their main types as well as by work area, job, or process performed. There are many generic forms available online. It will be necessary to adapt these to reflect the nature of the work and the workforce.

Once hazards have been identified, it is necessary to prioritize which hazards will be controlled first. Much like hazard recognition, hazard assessment is not just a technical practice. Through prioritizing, certain hazards will be brought to the forefront, and will therefore be more likely to be controlled, while others will be downgraded and likely receive little or no attention. It is important to be mindful of who benefits and who is harmed by the prioritization decisions.

Risk assessment is a common tool used by those determining the priorities in hazard assessment. Risk is the likelihood that a hazard will result in injury or ill health. A risk assessment quantifies the likelihood of injury or ill health by assessing the probability, consequences, and exposure posed by the hazards:

• Probability is the likelihood that the hazard will result in an incident.
• Consequences refers to the severity of injury or ill health that will result from an incident.
• Exposure refers to how often or regularly workers come in contact with the hazard.

Once the probability, consequences, and exposure of a hazard have been quantified, they can be inputted into a mathematical formula to quantify the risk:

The greater the final number, the greater the risk posed by the hazard. Quantifying risk allows us to compare the relative risk of several hazards. For example, workers in a gas station face all manner of hazards, including slippery surfaces, gasoline fumes, and the potential for robbery. Without looking at the assessment below, which of these three hazards should the employer control first? Most people tend to say robbery. Yet quantifying the risks suggests that robbery poses the least risk of the three hazards:

1. Slippery surfaces: Possible (2) × Significant (3) × Frequent (3) = 18
2. Exposure to gasoline fumes: Possible (2) × Significant (3) × Continuous (4) = 24
3. Robbery of cash on premises: Rare (1) × Catastrophic (4) × Continuous (4) = 16

Risk assessment tools allow the assessor to compare hazards, either overall or on a factor-by-factor basis, in order to identify which hazards should have the highest priority for control. It may be important, for example, to note that robbery poses the least risk of the three hazards but has the highest level of consequence and is a hazard to which workers are continuously exposed. These features may influence the type of control that is appropriate.

The final step in the HRAC process is to determine and implement the most appropriate control for each hazard. Hazard control is a regulatory requirement in every Canadian jurisdiction and entails implementing measures to eliminate or reduce the potential of a hazard causing an incident. Employers must exercise due diligence in the HRAC process in order to avoid prosecution for any workplace injuries under OHS law. Some forms of hazard control are more effective than others, and, consequently, a hierarchy of controls (with five levels) has been established:

• Elimination removes the hazard from the worksite. For example, relocating work performed at a height to ground level eliminates the risk of falling. This control is most easily implemented at the design stage, thereby preventing the hazard from entering the workplace.
• Substitution entails replacing something that produces a hazard with something that does not. For example, we might replace chemical-based cleaning solvents with plant oil–based solvents. Substitution is similar to elimination but is less effective because the new object or process may introduce different hazards or fail to completely remove the original hazard.
• Engineering controls are modifications to the workplace, equipment, materials, or work processes that reduce workers’ exposure to hazards. For example, installing guards on machinery, building guard rails, installing ventilation systems, or purchasing ergonomically designed workstations all isolate workers from hazards, but they do not eliminate the hazard. These controls can be incomplete, become inoperative due to lack of maintenance, or be overridden and therefore are less effective than elimination or substitution.
• Administrative controls are changes to work process, policies, training, or rules designed to reduce exposure to hazards. For example, policies restricting the time workers spend in contact with a chemical hazard, “no-go” zones that restrict workers’ movements in certain locations, mandatory training sessions, permit systems to control access to equipment or spaces, changes to schedules to prevent excessive shift work, or working-alone procedures that require regular check-in are all administrative controls. Administrative controls do not actually control a hazard. Rather, they attempt (via rules and processes) to limit workers’ exposure to the hazard.
• Personal protective equipment (PPE) is equipment worn by workers that is designed to protect them should they come into contact with a hazard. For example, helmets, goggles, gloves, and fall protection systems are forms of PPE. PPE is considered the least effective control because it does not control the hazard or restrict workers’ contact with the hazard and is heavily reliant upon human action for its effectiveness. PPE places the burden of implementation on the worker. Workers may choose not to wear or be pressured into not wearing the PPE. 

Multiple controls can be combined to provide a higher degree of control. Different levels of control may be appropriate at different times. For example, when first addressing a hazard it may be necessary to use PPE until a more permanent engineering control can be implemented. It is important to not unduly delay the implementation of the (likely more effective) engineering control. Employers have flexibility in how they control hazards, but that flexibility should not be interpreted as permission to disregard their due-diligence obligation to implement the most effective hazard control.

A more worker-centered approach is to consider the location of the control. In this approach, the focus is on where and when the hazard is controlled in the context of where the worker is in the production process. In this approach, hazards can be controlled at three locations:

• Control at the source addresses the hazard where it first occurs. This type of control prevents the hazard from entering the workplace via elimination, substitution, or some types of engineering controls.
• Control along the path addresses the hazard at some point between its source and when workers encounter the hazard (i.e., it prevents the hazard from reaching the worker). Some types of engineering controls (e.g., machine guards, local ventilation) control the hazard along the path.
• Control at the worker implements controls over the hazard only after it reaches the worker. These controls are designed to prevent or reduce the consequences of the hazard, rather than control the hazard itself. PPE and administrative controls are both examples of control at the worker because they both require that the burden of the control be placed almost exclusively upon the worker.

Examining controls by considering their location relative to the worker changes how we assess whether a control is effective by emphasizing the burden placed on workers with each control option. Note how the effectiveness of the control increases as the control moves closer to the source of the hazard.

The location approach allows for a more nuanced understanding of how different groups of workers can be differentially affected by a hazard. When attention is turned to the worker, rather than the hazard, differences between workers become more evident. For example, administrative controls are less effective for new workers, because they are less familiar with the rules and have not yet developed the skills required to work safely. Looking at how those administrative controls are located relative to the worker makes it more likely that their shortcomings for new workers will be identified. Similarly, the location approach draws more attention to the consequence of control failure and emphasizes the harm that can occur to workers when the system fails.

Fifteen-year-old Andrew James died under a pile of hot asphalt because his employer failed to identify, recognize, and control workplace hazards. While the HRAC process doesn’t guarantee that workers will never be injured on the job, it can dramatically reduce the incidence of workplace injuries and fatalities. Following the HRAC process should have changed the work processes James’s employer used and, in turn, would likely have saved James’s life despite the challenges posed by the mobile nature of the worksite.

HRAC is not immune from the conflicts inherent in the employment relationship. Employers and workers each have vested interests in the outcomes of an HRAC process. Collaboration is key to the hazard recognition, assessment and control process. Stackholders from various areas of the business need to be included in the hazard identification, assessment and control process in order to eliminate or reduce workplace incidents.

A hazard (which is sometimes called an agent) is anything that might harm, damage, or adversely affect any person or thing under certain conditions at work. It can be an object, process, context, person, or set of circumstances that has the potential to create negative health and safety outcomes. In this chapter, we will focus our attention on physical hazards. A physical hazard typically (but not always) entails a transfer of energy that results in an injury, such as box falling off a shelf and hitting a worker or a worker falling from a scaffold and hitting the ground.

Physical hazards are the most widely recognized hazards and include contact with equipment or other objects, working at heights, and slipping. This category also includes noise, vibration, temperature, electricity, atmospheric conditions, and radiation. More recently, OHS practitioners have also included the design of work and the workplace as physical hazards, suggesting it is important to attend to the ergonomic effects of work. This chapter discusses how to identify physical hazards and to determine ways to control some of the more common physical hazards. In discussing physical hazards, it is important to keep in mind that non-traditional work relations, such as the one highlighted in the opening vignette, can compound the risk associated with a physical hazard. We discuss the health and safety implications of non-traditional work relations more fully in the book.

Identifying Physical Hazards

In 2012, 50% of all WCB time-loss injuries in Canada were caused by physical hazards. Injuries caused by contact with an object/machine or falls was the most common type of injury.AWCBC. (2014). National work injury, disease and fatality statistics 2010–2012. Ottawa: Association of Workers’ Compensation Boards of Canada. Injuries caused by physical hazards are both overrepresented and underestimated in mainstream OHS. As we saw in Chapter 1, physical hazards are overrepresented in media portrayals of workplace incidents because they conform to commonly held views of safety hazards.Barnetson, B., & Foster, J. (2015). If it bleeds it leads. Hazards such as a slippery floor or an unguarded saw blade are easy to imagine and their effects on workers’ health are clear and direct.

At the same time, employers often underestimate the prevalence of (and thus fail to control) physical hazards. For example, an extension cord lying across a hallway floor is often seen as no big deal because it is a readily apparent and easily understood tripping hazard that we expect workers to avoid as a matter of course (“pick up your feet!”). When such hazards result in an injury, we often blame the worker for her inattention to the hazard rather than examine why the hazard was present and why the hazard was not controlled. The loose extension cord, for example, could have been eliminated as a hazard by re-running the wiring through the ceiling or moving the powered device closer to the plug in.

This example is a reminder that the definition of cause affects decisions about injury control. If worker carelessness or inattention is deemed to be the cause of an incident, then the controls will focus on correcting the worker rather than removing the hazard. Indeed, often the nature of physical hazards lends itself to devising “simple” solutions designed to alter worker behaviour rather than controlling the hazard itself. For example, the contact hazard posed by a doorway with unusually low clearance may be addressed by posting a sign saying “caution: low doorway” and expecting workers to duck as they pass through it. A more effective (but costlier) solution is to increase the doorway’s height.

Physical hazards also sometimes hide in plain sight. Often a hazard is so pervasive or workers’ behaviours to avoid the hazard are so routinized that the hazard is rendered almost invisible. For example, workers in a kitchen may use a dishtowel when opening an oven door to prevent the hot handle from burning them. Habitually turning a dishtowel into PPE prevents the injury and renders the hazard invisible. When identifying physical hazards, it is important to adopt the outlook of someone new to the workplace to bring back into view any hazards that have become invisible over time.

Noise and vibration are related physical hazards that are treated very differently in OHS regulation and management. Noise has been well studied and there is a long (albeit incomplete) list of rules for controlling noise hazards. By contrast, less than half of Canadian jurisdictions have any regulations governing vibration exposure. This section examines the nature of each hazard, their health effects, and briefly considers effective control options.

Noise is simply defined as sound energy that moves through the medium of the air. More scientifically, sound consists of small air-pressure changes caused by the vibration of molecules. The energy from the molecules exerts influence on neighbouring molecules, causing the sound to disperse throughout an area. Human eardrums are designed to detect the small pressure changes and then transfer them through a network of three bones to the inner ear where tiny hair-like cells turn the vibrations into electrical impulses interpreted by the brain. Noise is always present around us.

Noise can damage the structures of our ears and lead to hearing loss. Noise can also cause other health effects (see below). Three characteristics of noise affect whether it becomes a hazard: frequency, duration, and loudness.

• Frequency  is vibration of the medium (e.g., air molecules) through which sound energy moves. We measure frequency in Hertz (Hz) (i.e., the number of vibrations per second). We experience sound frequency as the pitch of noise. Fast vibration yields a higher-pitched noise than slow vibration. We can normally hear sounds with frequencies between 20 Hz and 20,000 Hz. Sounds extending beyond the low and high end of our hearing range are not registered by our brains (i.e., we cannot hear them), but they can still harm our ears.
• Duration is the length of time a worker is exposed to noise. How long a worker is exposed to noise is important. Yet, as discussed below, even short-term exposure can cause damage, especially if the noise is sudden and at a high frequency.
• Loudness (or intensity) is the amount of energy that is being carried through the medium. Loudness is measured in decibels (dB). The key feature of decibels is that they are a logarithmic scale. Unlike linear scales (where each step on the scale represents the same increase, such as a car’s speedometer), each increase on a logarithmic scale is an order of magnitude greater than the previous increase. For example, a sound measured at 10dB is 10 times more intense than a sound measured at 0dB (the lowest audible sound). But a sound measured at 20dB is 100 times more intense than the sound measured at 0dB. Noise over 85dB is generally considered hazardous for human hearing.

The mostly widely accepted health effect of noise exposure is hearing loss. If the loss is temporary, such as after a music concert, it is called a temporary threshold shift (TTS), meaning the normal range of human hearing has been reduced. This effect usually reverses itself over a short period of time. Nevertheless, TTS is a signal that the noise exposure was harmful and that continual or repeated exposure can accumulate and lead to Permanent threshold shift(PTS). Men typically have higher rates of PTS. Some of this gender effect is due to job segregation (i.e., men typically work in louder workplaces than women). It is also possible that some of this effect reflects physicians failing to link female hearing loss to occupational exposures. Women are often exposed to noise in food, bottling, and textile factories as well as service industry jobs.European Agency for Safety and Health at Work. (2003). Gender issues in safety and health at work: A review. Luxembourg: Author.

Extended exposure to noise hazards can lead to non-hearing health effects as well. It can induce a sensitive startled response to sound and cause changes in endocrine and biochemical systems, nausea, headaches, and constricted blood vessels.Key, M. M., Henschel, A., Butler, J., Ligo, R. N., Tabershaw, I., & Ede, L. (1977). Occupational Diseases: A guide to their recognition (Rev. ed.). Cincinnati: U.S. Department of Health, Education and Welfare. Sound can also create health effects without prolonged exposure. Acoustic trauma is caused by a short, intense exposure to noise, usually of high frequency (see Box 4.2). Exposure to this hazard can lead to a series of short- and long-term health effects. Short-term effects include a full sensation in the ears, sharp pain around the ear, nausea, or dizziness. Longer-term effects can include headaches, fatigue, anxiety, and hypersensitivity to sound.Safe Work Australia. (2011). Managing Noise and Preventing Hearing Loss at Work. Canberra: Author.

The regulations generally seek to limit worker’s noise exposure to no more than 85dB(A) during an eight-hour shift. The duration of acceptable exposure declines by half for every 3dB(A) increase. So acceptable worker exposure drops to 4 hours at 88dB(A), 2 hours at 91dB(A), and so forth. The logic of TWA leads to a ceiling of noise exposure at approximately 115dB(A). Box 4.3 provides some real life examples of these noise levels.

There are significant shortcomings in this approach to regulating noise exposure. First, while the use of dB(A) does partially address the issue of frequency, regulations do not adequately address the health effects of short, intense, and high frequency sounds, such as those that cause acoustic trauma. Second, there is insufficient evidence to determine if an exposure at 85dB every day over a period of many years is safe. Third, the rules do not account for individual variation. Research has established that people possess different degrees of sensitivity to noise. Some have greater physiological and psychological reactions to lower levels of noise, while others appear to be more tolerant.Passchier-Vermeer, W., & Passchier, W. F. (2000). Noise exposure and public health. Environmental Health Perspectives, 108 (Suppl. 1), 123–131. As with other types of hazards (e.g., carcinogenic substances), some individuals appear to be more susceptible to harm than others. The reasons are complex, but a universal standard designed to address the so-called “average” person will leave some workers inadequately protected from noise hazards.

Segmental vibration occurs when only parts of the body are affected by the vibration. This is usually caused by higher-frequency vibration. The most common and concerning form of segmental vibration is hand-arm vibration. Hand-arm vibration results from gripping power tools such as jackhammers, saws, and hammer drills. An important aspect of hand-arm vibration is that a tight grip is required to control the vibrating tool, but the tighter the worker grips, the worse the effects of the vibration. Hand-arm vibration syndrome (sometimes called Raynaud’s phenomenon or “white finger”) is caused by restriction of blood and oxygen supply to fingers and hands, which causes damage to blood vessels and nervous systems. The first symptoms are tingling in the fingers, loss of sensation, loss of grip strength, and whitening of the fingers when exposed to cold. Initially, these effects are reversible, but over time they become permanent.Groothoff, B. (2012). Physical Hazards: Noise and Vibration. In Health and Safety Professionals Alliance, The Core Body of Knowledge for Generalist OHS Professionals. Tullamarine, VIC: Safety Institute of Australia, p. 12. Because vibration is the movement of particles, it is related to noise and is often associated with noise exposure. As with noise, individual susceptibility to vibration exposure effects varies. How hard the worker grips the tool, their posture, their sensitivity to motion sickness, and other factors can shape how the exposure manifests itself, which can make it difficult to ascertain the seriousness of the health risk. Men most often manifest vibration-related injuries, reflecting occupational segregation. That said, women in some female-dominated occupations (e.g., dental hygiene) frequently report vibration-related injuries.European Agency for Safety and Health at Work. (2003). Exposure to vibration, while widely recognized as a safety hazard, is largely unregulated. Only British Columbia has standards restricting exposure to types of vibration. Those rules adopt a time-weighted average approach similar to that used for noise regulations.

Noise and vibration are measured in similar ways. Both require a specialized meter to detect the intensity of the molecular movement. These meters can provide accurate measurements of real-time levels. Nevertheless, the meters cannot assess the susceptibility of a worker to noise/vibration exposure, nor the degree of damage sustained by the exposure. This means that, even if vibration standards are established, workers may still be harmed by these hazards. OHS regulations also require that workers exposed to noise undergo regular audiometric testing to detect any threshold shift (there are no equivalent requirements for vibration exposure).

Controlling noise and vibration hazards is a complex undertaking. In both cases, the most effective way to control the hazard is elimination, substitution, or engineering controls. Such controls can be expensive, as they require replacing machinery, altering processes, or eliminating tasks from the workplace. Controls along the path can also be implemented by erecting sound barriers to muffle noise or installing vibration resistant material on tool handles. The most common, yet least effective, controls for noise and vibration are time restrictions and PPE. Restricting workers’ exposure to noise or vibration can reduce the effect of these hazards but does not address the full range of risk to the worker.

Humans are a temperature-sensitive species and have evolved a finely tuned system that regulates our internal temperature. Under normal circumstances, the body interacts with its environment to maintain a core body temperature at about 37 degrees Celsius. When the environment becomes too cold or hot, our bodies have difficulty generating or shedding sufficient heat to maintain temperature homeostasis.

When temperature extremes prevent our bodies from properly self-regulating, we experience thermal stress. Temperatures that are too high can lead to heat stroke. Early signs of heat stroke include fatigue, dizziness, confusion, lightheadedness, nausea, and sudden, unexplained mood swings. Prolonged exposure leads to fainting and death. Heat stroke can cause damage to muscles, the heart, kidneys, and the brain. Humidity interferes with the body’s ability to shed heat (through sweating) and, therefore, can lower the temperature at which thermal stress occurs. Conversely, when temperatures are too low, we can experience hypothermia. Initial symptoms of hypothermia include dizziness, fatigue, nausea, sudden euphoria, or irritability. Pain in extremities and severe shivering may also occur. Advanced hypothermia can lead to frostbite and frozen extremities, and unconsciousness leading to death. Wind can intensify the effects of cold, as it strips heat away from the body.

Exposures to extreme temperature are most common among workers working outdoors, although thermal stress can occur in some indoor locations (e.g., a meat cooler or a non-air-conditioned office on a hot summer day). Employers should also pay attention to thermal comfort. Thermal comfort is the condition in which a person wearing normal clothing feels neither too cold nor too warm. It is a function of temperature, humidity, and air movement within an indoor workplace. A lack of thermal comfort may not pose a direct health risk, but it can exacerbate existing hazards or be a factor that increases risk of an incident occurring. For example, thermal discomfort may lead to rushing, heat-induced fatigue, or mental distraction.Health and Safety Executive, Government of Great Britain. (2011). Thermal Comfort. http://www.hse.gov.uk/temperature/thermal/

Extreme temperature is unevenly regulated in Canada. Some jurisdictions, such as Alberta and Ontario, have no OHS provisions addressing extreme heat or cold. Other provinces offer general duties to prevent thermal stress, while a minority of jurisdictions have adopted temperature limits established by external agencies. Gender-based job segregation can affect heat and cold exposures on worksites. For example, Karen Messing’s study of meat processing found that, while women did not work in the extreme cold of meat freezers, their work required them to stay relatively immobile at their work stations, where temperatures hovered around 4 degrees Celsius. Men in the study experienced significant lower temperatures working in the meat freezers, but their work was more active and the additional body heat generated by this activity attenuated the effects of the cold.Messing, K. (1998). One-eyed science: Occupational health and women workers. Philadelphia: Temple University Press.

Temperature poses a unique OHS challenge in that it is often not possible for an employer to control the hazard at the source (since the weather is out of our control). The most effective control for preventing thermal stress is to limit workers’ exposure to hazardous temperatures. It can, however, be difficult to determine what temperature is too hot or cold for work to occur. There are many factors, including wind chill and humidity, individual temperature sensitivity, and the nature of the work being performed (light or heavy effort) that shape when a worker is at risk of thermal stress. Compounding these issues is that of variability. Weather conditions and work tasks change over time. This instability in working conditions requires closer monitoring of changes in the hazard than is the case with most other physical hazards.

The American Conference of Governmental Industrial Hygienists (ACGIH), an industry group of OHS professionals working in government, has established a matrix for determining when work should be reduced and, ultimately, ceased.ACGIH. (2013). Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices. Cincinnati: ACGIH. For example, the ACGIH recommends that work cease completely at temperatures between −32 and −43 Celsius, depending on wind chill. On the warm end, the limits are more complicated due to humidity effects, but temperatures above 30 Celsius require work reduction or cessation. Within the recommended maximum and minimum, the degree of exposure is dependent upon clothing and other factors, such as access to fluids and rest breaks to warm/cool. Thus the need to establish controls extends beyond the extremes to ensure workers are shielded from the effect of hot or cold temperatures. Other controls include relocating work, installing heating/cooling devices, work-rest cycles, preventing working alone, and minimizing manual effort.

Radiation is any energy emitted from a source, including heat, light, X-rays, microwaves and other waves, and particles. Radiation is categorized into two forms: ionizing and non-ionizing. Ionizing radiation is radiation with enough strength to remove electrons from a molecule as it passes through. The electron loss causes the molecule to become positively charged (called an ion). Examples of ionizing radiation include X-rays, gamma rays, alpha particles, and neutrons. Non-ionizing radiation is unable to ionize molecules but may have other effects, and includes microwaves and radio waves as well as ultraviolet, visible, and infrared light.

Ionizing radiation can occur naturally at low levels from a variety of sources but is uncommon in workplaces. It is most often found in medical, nuclear, and research facilities. When ionizing radiation is present in a workplace, it poses a significant safety hazard. Both short exposures to high levels of radiation and long-term exposure to lower levels have serious health consequences. It is estimated that people are exposed to approximately 0.0125 rem (a standard measure of radiation) of naturally occurring radiation per year. Short-term exposure of 1000 rem will lead to death within a few days. An exposure as low as 10 rem will lead to significant increase in the risk of cancer later in life.

Long-term, lower-level exposure is also a concern as it, too, can lead to increased risk of cancer. The recommended annual exposure for the general public is 0.1 rem. Nevertheless, the ACGIH recommends an annual limit for workers exposed to ionizing radiation to be 2 rem, a figure much higher than public health limits. Controls for ionizing radiation are quite expensive and technical, requiring significant engineering controls. Specialized training is also required, and exposure to ionizing radiation should never be taken lightly.

The most common non-ionizing radiation exposure is ultraviolet light (UV). UV radiation damages our skin, leading to burns and permanent skin darkening as well as heightened risk of skin cancer. It also damages our eyes and can cause pain and swelling in the eye and blurred vision, a condition variously called snowblindness, welder’s flash, or flash burn. The sun is the most common source of UV radiation, but UV radiation can also be produced by welding equipment, black light lamps, mercury lamps, counterfeit currency detectors, fluorescent tubes, and nail-curing lamps.

Controls for non-ionizing radiation should include replacing radiating equipment, proper maintenance to prevent fugitive radiation (such as with microwave ovens), separating workers from the radiation source, reducing exposure time to low levels, and using UV-blocking PPE (e.g., hats, clothing, sunscreen).

Returning to our opening vignette, the owner of Metron Construction, scaffold supplier Swing N Scaff, and project manager Vadim Kazenelson were all convicted of offences after the Toronto scaffolding collapse. Metron was fined $750,000 for offences under the Ontario OHS Act. Swing N Scaff was ordered to pay $400,000, also under the OHS Act. In June 2015, Kazenelson was convicted under the Criminal Code for criminal negligence causing death and criminal negligence causing bodily harm. He was sentenced to 3½ years in prison. At the time of writing, both his conviction and his sentence are under appeal. Criminal prosecution is rare in Canada (there have been fewer than 10 since the Westray amendments were enacted in 2004) and so Kazenelson’s conviction is noteworthy.

These convictions may have brought some solace to the families of the four killed workers. Yet, given the number of annual injuries in Canadian workplaces, clearly many hazards—including obvious physical hazards—remain uncontrolled in Canadian workplaces. While this situation may, in part, reflect the fact that some hazards are difficult to identify and control, we also need to be cognizant that employers often have a financial incentive to cut corners on safety.

Fracking is but one example of the growing threat that chemical hazards pose to the health of workers. It also demonstrates that there is no clear division between a workplace hazard and an environmental hazard. There is no comprehensive list of chemical substances that workers may be exposed to in the workplace, but the number is suspected to be at least 80,000. As we will see below, there is toxicological data available for about 1% of these chemicals, and the data that is available is highly suspect. The essentially unregulated nature of chemical exposures in the workplace is an important argument for adopting the precautionary principle in occupational health and safety.

Chemical Hazards

Chemicals are everywhere in the modern workplace, from printer toner to engine exhaust to sink cleaners. While most chemical exposures do not cause ill effects, some certainly do. As we saw in Chapter 3, chemical hazards cause harm to human tissue or interfere with normal physiological functioning when they enter our bodies. Some chemicals irritate our tissue while others poison our systems or organs. Chemicals can asphyxiate us or negatively affect the functioning of our central nervous systems. Chemicals can also cause our immune systems to overreact, change our DNA, cause cancer, or damage a fetus.

There are four routes of entry by which chemicals can get into a worker’s body, the most common being through respiration (i.e., breathing in contaminated air) and absorption through the skin. Chemicals can also enter our bodies through ingestion (i.e., we can eat them—usually accidentally) and through cuts in our skin. Our bodies excrete some chemicals in our sweat, exhaled breath, urine, or feces, while retaining other substances. Our bodies metabolize some chemicals into other substances, which may be more or less toxic than the original substance.

Chemical hazards have varying levels of toxicity (i.e., ability to cause injury). Toxicity can be local or systemic. Local toxicity is a reaction at the point of contact. For example, you might experience a burn on the skin of your fingers after handling spicy peppers in a restaurant kitchen. Systemic toxicity occurs at a point in the body other than the point of contact. Allergic reactions after prolonged exposure to latex would be an example of systemic toxicity (see Box 5.1). Another example might be organ damage following skin absorption of a pesticide while picking fruit.

Acute toxicity represents the immediate harm caused by exposure to a chemical substance. Chronic toxicity represents a substance’s ability to cause harm over a longer period of time. The time between exposure to a chemical hazard and the development of symptoms from that exposure is called the latency period. Many of the consequences of exposures to chemical hazards (e.g., occupational diseases) have a latency period that is measured in years. As we saw in Chapter 2, this delay can confound the relating of diseases to occupational exposures.

Although only a fraction of all chemical exposures result in a worker’s death, toxicity is often measured in terms of a substance’s lethal dose  (LD) as determined from animal experiments. For example, the toxicity of a chemical tested on rats via ingestion might be expressed as Oral LD50 (rat): 56mg/kg. What this means is that when rats were fed the substance, half (the ‘50’ after the LD) died shortly after ingestion when given 56 milligrams of the substance per kilogram of animal weight. These LD50 values are measures of substances’ acute toxicity and allow us to compare the toxicity of substances. Substances with a lower LD50 are more acutely toxic than substances with a higher LD50 because lower LD50 substances cause half of the animals to die at lower doses. The toxicity of substances may also be measured based upon their lethal concentration (LC) in the air or water.

These toxicity measures show us that the dose (or amount) of a chemical that enters the body affects whether the chemical exposure causes harm and the degree of harm. For example, some chemicals are relatively harmless in low concentrations, such as the methane gas found in Jessica Ernst’s well water. But, in high concentrations, methane can displace oxygen and cause rapid heart rate, fatigue, nausea, and, eventually, death by asphyxiation. (It is also flammable and potentially explosive.) That said, it is important to note that doses that are too low to cause acute toxicity can still cause chronic toxicity, especially if the dose is repeated over time. Prolonged exposure to silica dust, for example, can give rise to silicosis—a lung disease that impedes respiration—but silicosis may not manifest itself for 10 to 30 years after the exposure.

While toxicity data is helpful in identifying chemical hazards, it is important to be cautious when using it. Lethal dose measures focus on the acute toxicity of a substance and are less useful in assessing a substance’s chronic toxicity or the effect of repeated exposures to low doses. Toxicity experiments also tend to be based upon ingestion of the substance because ingestion-based experiments are less expensive than experiments based upon respiration or contact. This bias may reduce the accuracy of the resulting data because most chemicals enter our bodies through respiration or skin absorption. Toxicity data is also based upon animal experiments, and these results may not be perfectly applicable to humans. Perhaps most concerning is that toxicity experiments typically assess the toxicity of a single substance in isolation. This ignores the reality that most workplaces expose workers to multiple chemicals and these exposures may interact synergistically. That is to say, exposures to multiple chemicals may increase the toxicity of each chemical out of proportion to its toxicity in isolation.

As discussed in Chapter 3, controlling chemical hazards begins by identifying worker tasks and environmental factors associated with the location. Subsequently, we must identify and list each chemical a worker is exposed to and the route(s) of entry for that chemical. The potential hazard posed by each exposure and the risk of exposure should be determined along with control strategies. Control strategies used should follow the hierarchy of controls, beginning with elimination (e.g., using non-chemical processes) and substitution (e.g., using a less hazardous chemical), then progressing to engineering controls (e.g., physically isolating workers from the chemical). Government of Alberta. (2011). Best Practices Guidelines for Occupational Health and Safety in the Healthcare Industry. Edmonton: Author.

Less effective control approaches include administrative controls that minimize or standardize exposures and the provision of personal protective equipment (PPE). In addition, some workplaces provide special facilities (e.g., showers, lunch rooms) to minimize workers’ exposure to chemicals. Some organizations will also undertake extensive medical and environmental monitoring and record keeping. This can include monitoring the level of a hazard in a specific area area, the dose experienced by a worker (personal monitoring), or the presence of a chemical or its metabolic residue in a worker’s blood, body fluids, or tissues (medical monitoring). While not hazard controls per se, monitoring and record keeping can provide data that can help to adjust administrative controls, assess the effectiveness of PPE, and identify early signs of health effects.

In practice, controlling exposure to chemical substances can be difficult. Workplaces often use multiple chemicals, which may have poorly documented synergistic effects. Further, the ways in which products are used may change over time, thereby reducing the effectiveness of administrative controls such as exposure and handling protocols. For example, a reduction in the number of cleaning staff in a hotel may mean workers must now work faster because their workloads have increased. Prior to the staffing change, workers may have used one chemical product to clean toilets and, subsequently, another product to clean the bathroom floors. To cope with the reduced time the workers are given to clean the entire bathroom, the workers may begin applying both products at the same time, creating the possibility of hazardous chemical interactions. Such a change in practice may be unknown to the employer. This example demonstrates that health and safety can be profoundly affected by other human resource practices, such as job design, staffing, and scheduling.

Toxicity data is used to generate occupational exposure limits (OELs). OELs for chemical hazards represent the maximum acceptable concentration of a hazardous substance in workplace air. In theory, workers exposed to a chemical substance at the OEL for their entire working life will experience no adverse health effects. Each jurisdiction in Canada sets its own OELs. As we saw in Chapter 4, there are also OELs for physical hazards such as noise, radiation, and (more rarely) vibration. There are approximately 800 OELs in Canada.

Provincial and territorial regulations can set three types of OELs, depending on the nature of the substance’s toxicity:

• A time-weighted average exposure value (TWAEV) is the maximum average concentration of a chemical in the air for a normal 8-hour working day or 40-hour working week.
• The short-term exposure value (STEV) is the maximum average concentration to which workers can be exposed for a short period (e.g., 15 minutes). The STEV is often higher than the TWAEV.
• The ceiling exposure value (CEV) is the concentration that should never be exceeded in a workplace.

OELs for a vapour or gas are often set as parts per million (ppm). Aerosols (e.g., dust, fumes, mist) are normally set as milligrams per cubic meter of air (mg/m³). Fibrous substances (e.g., asbestos) are typically set as fibres per cubic centimeter of air (f/cc or f/cm³). Compliance with OELs is often assessed via air sampling. Periodic air samples do not necessarily capture normal working conditions because the act of testing may temporarily change workplace behaviour. This dynamic is called the observer effect.

When establishing OELs, governments often follow threshold limit values (TLVs) published by the ACGIH. The TLVs are the ACGIH’s recommendations for allowable chemical exposure. While it is an arms-length body, concerns about its recommendations have been raised. Nearly one sixth of all the ACGIH’s TLVs have been set based upon unpublished corporate data, which raises concerns about the validity and reliability of the results. Further, the committees that set these standards have included a significant number of industry representatives and consultants—many of whose relationships to industry were hidden while they were members—thereby raising concerns about conflict of interest in the establishment of TLVs.Castleman, B., & Ziem, G. (1988). Corporate influence on threshold limit values. American Journal of Industrial Medicine, 13(188), 531–559.

Indeed, many scientists dispute the notion that there is any safe level of exposure for carcinogens and reproductive hazards. In this view, so-called safe levels of exposure reflect simply the point below which scientists are (at present) unable to detect ill effects. Box 5.2 takes on the thorny issue of why the ongoing reduction in OELs—while doubtlessly beneficial to workers—is evidence that OELs have not been very effective at protecting them.

This critique of OELs raises important questions about the validity of information contained in material safety data sheets (MSDS). An MSDS is supposed to contain information about potential hazards, safe use, storage, and handling practices, and emergency procedures. Manufacturers and suppliers must provide and employers must make available an up-to-date MSDS for any chemicals that are considered controlled products by WHMIS. Often the information in MSDSs is based upon OELs. Inaccurate OELs can undermine the utility of MSDSs, which are the key method by which information about chemical hazards is communicated. Further, analysis of the content of MSDSs has also found them to be incomplete, inaccurate, sometimes out of date, and often incomprehensible to workers.Nicol, A-M, Hurrell, C., Wahyuni, D., McDowall, W., & Chu, W. (2008). Accuracy, comprehensibility, and use of material safety data sheets. American Journal of Industrial Medicine, 51(11), 861–876. These findings raise profound questions about the effectiveness of chemical hazard assessment, recognition, and control efforts. More detailed and accurate information is available in databases provided by organizations such as the Canadian Centre for Occupational Health and Safety (e.g., ChemInfo database), but these resources can be expensive to access and difficult for workers to find.

As we saw in Chapter 3, biological hazards are organisms or the products of organisms (e.g., tissue, blood, feces) that harm human health. There are three types of organisms that give rise to biological hazards:

• Bacteria are microscopic organisms that live in soil, water, organic matter, or the bodies of plants and animals. For example, the E. coli bacterium lives in human and animal digestive tracts and some strains can cause food poisoning, infections, or kidney failure when ingested.
• Viruses are a group of pathogens that cause diseases such as influenza (the “flu”) when they enter our bodies.
• Fungi are plants that lack chlorophyll, including mushrooms, yeast, and mould. Many fungi contain toxin or produce toxic substances. For example, stachybotrys chartarum (black mould) produces toxins called mycotoxins that cause nausea, fatigue, respiratory and skin problems, and organ damage when the toxic spores are inhaled.

Insect stings and bites, poisonous plants and animals, and allergens are also biological hazards. Like chemical hazards, biological hazards can enter our bodies via respiration, skin absorption, ingestion, and skin penetration and can cause both acute and chronic health effects. Our bodies do have mechanisms by which to cope with some biological hazards. For example, our respiratory system has five layers of defence to prevent harmful particles from entering our body, beginning with the hair-like projections (cilia) on the cells that line our airways (which filter out particles) and ending with cells (macrophages) in the air sacs (alveoli) of our lungs that trap and route impurities into the lymphatic system for disposal. Organisms that enter our body are also subject to attack by our immune system. Yet these mechanisms are not effective against every biological hazard or every exposure.

Like all workplace hazards, control strategies for biological hazards should follow the hierarchy of controls. Historically, the provision of adequate washing and toilet facilities was an engineering control that significantly reduced worker exposure to many biological hazards. Recent technological improvements, such as automatically flushing toilets and automatic taps, soap dispensers, and towel dispensers, have further limited workers’ contact with bacteria in washrooms.

As noted in Box 5.3, providing workers with vaccinations  is an administrative control that can reduce worker susceptibility to viruses. Mandatory vaccinations are, however, controversial. Public health officials in Alberta have been attempting to increase the rate of annual vaccination for influenza among health-care workers (which sits at about 55%) and are considering mandatory vaccinations. In British Columbia, workers who do not receive a flu shot must wear a mask when interacting with patients.CTV. (2014, December 1). Doctors split on mandatory flu vaccines for health-care workers. http://www.californiahealthline.org/capitol-desk/2015/8/committee-oks-vaccine-requirement-for-day-care-workers-floor-vote-next

While mandatory vaccination for health-care staff is advocated as an important step to protect patients (who may be particularly vulnerable to influenza), opponents note that mandatory vaccination significantly interferes with the rights of health-care workers to control their own health and that the annual “flu shot” is only about 60% effective at preventing influenza.Simons, P. (2014, January 4). Time for Alberta’s health care workers to roll up their sleeves and get the flu shot. Edmonton Journal. http://www.edmontonjournal.com/health/ns+Time+Alberta+health+care+workers+roll+their+sleeves+shot/9348177/story.html Some critics privately assert that employers may be more interested in reducing worker sick-time totals than protecting patient health. This charge should again draw our attention to the potential for financial considerations to affect employer OHS practices.

Science plays an important role in both injury prevention and compensation. It has identified hazardous chemical and biological agents, determined the mechanism(s) by which these substances cause harm, and suggested ways to control hazards and treat injuries. It is important for OHS practitioners to understand how scientific conclusions are reached and the limitations of these conclusions.

The scientific method is a process of formulating, testing, and modifying hypotheses. A scientific hypothesis is a proposed explanation of a phenomenon that can be empirically tested to confirm, refine, or refute this explanation. We conduct measurement, observation, and experimentation to gather data that is compared against the hypothesis. If the data agrees with our hypothesis, we may conclude the hypothesis to be true. However, we cannot be certain the results are not the result of chance or a flaw in the method design. In other words we need to ensure the results are both valid and reliable. Validity means the results of the experiment or observation accurately reflect the real world. For example, a scale measuring weight is valid if it correctly reports your actual weight. Reliability is the degree to which the results would be consistent if the measurement or observation were performed again. The scale in our example would be reliable if it produced the same result every time you step on it (assuming your weight has not changed).

The questions of validity and reliability plague scientific researchers, and achieving them is a key element of the scientific method. They are particularly challenging for the kinds of research usually associated with OHS-related matters because most of those issues involve human behaviour and physiology. When dealing with humans acting in the real world, there are limits to the control we can achieve over the measurement. It is unethical, for example, to intentionally expose someone to a toxic substance to measure its effects. Also, we cannot identify and control all the possible variables that may affect our results.

As a result, we can never be absolutely certain our results are accurate. As a result, scientists are concerned with false positives and false negatives. A false positive result occurs when we conclude a difference or relationship exists when it does not. False negatives occur when we conclude no difference or relationship exists when it does. Scientists tend to be particularly concerned with false positives because of their potential consequences. For example, saying a drug is effective at treating a disease when it actually is not can harm patients by subjecting them to an ineffective course of treatment. False negatives can also have real-life consequences as they may lead to inaction on health threats. The potentially harmful consequences of false positives means scientists are prone to being very conservative in their conclusions.

Further complicating matters is that most research conducted on OHS matters can only identify a correlation between two variables (e.g., exposure to asbestos and lung cancer). Demonstrating that asbestos (rather than some other, unmeasured, substance) causes lung cancer requires more complex research. The lack of clarity around cause also contributes to scientists’ conservatism around findings. Unclear causation also is used by employers and government agencies, such as WCBs, to deny the harmfulness of a substance and the injury claims associated with exposure to it. For example, smoking also causes lung cancer and so, if an asbestos-exposed worker also smokes, it can be much more difficult for her to demonstrate that her cancer was the result of the asbestos exposure. This is a common issue for workers who develop long-latency diseases.

The reason that scientific practices matter to OHS practitioners is that health and safety is contested terrain. As we saw in Chapter 1, the interests of employers and workers don’t always align. While scientific analysis has been immensely helpful to workers seeking to identify chemical and biological hazards or receive compensation for injuries caused by such hazards, employers can use the conservative culture of scientific research to slow or block worker efforts in these regards. As Box 5.4 shows, employers will often exploit such doubt in an effort to block regulation of hazardous substances.

As noted at the beginning of the chapter, the health risks from fracking affect both workers at the well sites and nearby residents. This example demonstrates that when it comes to chemical and biological hazards there is no clear boundary between occupational health and safety and public health or between workplace hazards and environmental hazards. In this way, biological and chemical hazards can be pervasive and difficult to recognize because exposure occurs in multiple settings.

Chemical and biological hazards are also challenging because of the level of complexity involved in their interactions with the human body. It is much harder to ascertain the risk associated with using a cleaning agent than the risk posed by working on a roof or operating an espresso maker. Health effects may only develop from prolonged exposure, or the disease may have a long latency period. Often, pinpointing the cause of a disease can also be difficult due to exposure to multiple hazards, a lack of knowledge about what we are exposed to in the workplace, and the lack of a clear boundary between work-related and environmental exposures.

As a result, this area of OHS relies heavily on science to understand the effects of chemical and biological hazards. Nevertheless, the nature of scientific practices often result in overly conservative conclusions when assessing the risk these hazards pose to workers. Issues with such scientific conventions can be compounded by employers’ long-standing efforts to deny the existence of chemical and biological hazards and avoid taking action to control them. As a result, there is strong evidence suggesting that current protections are inadequate and systematically under-protective of workers. Even if the precautionary principle is not a legal requirement in Canadian workplaces, this dynamic makes a strong argument for adopting the principle for moral reasons when it comes to chemical and biological hazards.

Workplace harassment—often perpetrated by supervisors on subordinates—is a pervasive issue in workplaces. Wal-Mart’s unwillingness to protect Boucher when she complained is also not uncommon. Interestingly, the hazard posed by harassment and the injury it caused to Boucher were only recognized when she sued her employer, a process entirely separate from Ontario’s OHS and workers’ compensation systems. The case demonstrates both that workplace harassment has real health consequences and that employers are often reluctant to recognize psycho-social hazards as legitimate health and safety concerns.

Psycho-social hazards are the social and psychological factors that negatively affect worker health and safety. Psycho-social hazards can be hard to isolate in the workplace because they reside in the dynamics of human interactions and within the internal world of an individual’s psyche. Yet it is increasingly recognized that social and psychological aspects of work have real and measurable effects on workers’ health. Harassment, bullying, and violence are examples of psycho-social hazards. Other forms include stress, fatigue, and overwork. Even the absence of social interaction, in the form of working alone, produces its own hazards. Much of the challenge is recognizing that these hazards pose real threats to workers’ health. This chapter examines the types of psycho-social hazards and discusses their impact on health and safety.

We all experience stress at some point in our lives. Stress is a change in our physical and mental state in response to situations we perceive as challenging or threatening. Situations causing stress are known as stressors. Stress can have a positive effect, making us more alert or more prepared to take on an important challenge. Stress can also have a negative effect, causing a range of physical and mental ailments. There are four types of stressors:

• Acute stressors are time-specific events of high intensity and short duration that occur infrequently, such as a performance review, a car accident, or unexpected encounter.
• Episodic (or daily) stressors may be similar to acute stressors but occur more frequently, have a longer duration, and may be of lower intensity. Making repeated requests of a worker to work overtime is an example of an episodic stressor.
• Chronic stressors are stressors that persist over a sustained period of time, and include job insecurity, work overload, or lack of control.
• Catastrophic stressors are a subset of acute stressors but differ in their intensity, threatening life, safety, or property. Robbery and physical assault are examples of catastrophic stressors.

Stress can arise from all aspects of our lives, including our work. Workplace stress is stress that is brought on by work-related stressors. Canadians report work to be the biggest source of life stress. Almost three quarters of Canadian workers report that their work entails some stress, with 27% reporting that work is “quite a bit” or “extremely” stressful.Crompton, S. (2011, October). What’s stressing the stressed? Main sources of stress among workers. Canadian Social Trends, 44–51. The most frequently identified workplace stressors are heavy workloads, low salaries, lack of opportunity, unrealistic or uncertain job expectations, and lack of control over work.American Psychological Association (2015). 2015 Work and Well-Being Survey. Washington: APA.

These five factors demonstrate that workplace stress arises out of situations and events within the employer’s control. This, in turn, makes the occurrence of workplace stress an occupational health and safety issue.

Workplace stress produces a range of physical and mental health effects. Early physical signs of negative stress include increased heart rate, sweating, and nausea, reddening of the skin, muscle tension, and headaches. Early emotional and mental effects of negative stress include anxiety, depression, apathy, sleep disturbance, and irritability. Long-lasting or intensifying stress results in a worsening of these symptoms as well as the appearance of new symptoms, such as lasting depression, heart disease, chronic digestive issues, reduced sex drive, uneven metabolism, and increased susceptibility to infectious diseases.

Research led by Robert Karasek has revealed that job control is a key factor in determining how work-related stress affects us. His job demands-control model is explained in Box 6.1. It is also possible for negative effects of stress to manifest themselves in groups of workers and not just individuals, due to workplace dynamics and environment. Group manifestation can arise from so-called toxic workplaces. Toxic workplaces  are characterized by “relentless demands, extreme pressure, and brutal ruthlessness,” and represent the extreme of stressful workplace environments.Macklem, K. (2005). The toxic workplace. Maclean’s, 118(5), 34.

Second, isolating workplace stressors can be difficult, especially chronic stressors. Non-work stressors do affect workers and can also be used by employers as an excuse to deny that stress-related health effects have workplace causes. Also, as with other types of ill health, individuals have different tolerances for stress, meaning the same stressors may affect one worker more than another. As a result, it can be difficult to have chronic stress recognized as a workplace hazard or the cause of a workplace injury or ill health. A workers’ compensation board, for example, is more likely to accept claims resulting in catastrophic or acute stress (e.g., post-traumatic stress disorder) than chronic stress.

Related to stress is the experience of fatigue. Fatigue is the state of feeling tired, weary, or sleepy caused by insufficient sleep, prolonged mental or physical work, or extended periods of stress or anxiety. Acute, or short-term, fatigue can be caused by failure to get adequate sleep in the period before a work shift and is resolved quickly through appropriate sleep. Chronic fatigue can be the result of a prolonged period of sleep deficit and may require more involved treatment. Chronic fatigue syndrome is an ongoing, severe feeling of tiredness not relieved by sleep. The causes of chronic fatigue syndrome are unknown.

While lack of sleep is the primary cause of fatigue, it can be enhanced by other factors, including drug or alcohol use, high temperatures, boring or monotonous work, loud noise, dim lighting, extended shifts, or rotating shifts. As with other conditions, workers have differing sensitivity to fatigue. Fatigue can also make workers more susceptible to stress and illness.

Fatigue is a legitimate health and safety concern because workers who are experiencing fatigue are more likely to be involved in workplace incidents. Lack of alertness and reduced decision-making capacity can have negative effects on safety. Research has shown that fatigue can impair judgment in a manner similar to alcohol. WorkSafeBC reports the following effects:

• 17 hours awake is equivalent to a blood alcohol content of 0.05 (the legal limit in B.C. and Alberta)
• 21 hours awake is equivalent to a blood alcohol content of 0.08 (the legal limit in Canada)
• 24–25 hours awake is equivalent to a blood alcohol content of 0.10.WorkSafeBC. (2014). Fatigue can also make workers more susceptible to stress and illness. WorkSafe Bulletin WS2014-14: 1.

Most cases of fatigue are resolved through adequate sleep. The average person requires 7.5 to 8.5 hours of sleep a night (remember, this is an average—some require more, some less). While an employer cannot control how well a worker sleeps, they can adjust the workplace to mitigate fatigue. Shift scheduling is one of the most important administrative controls of fatigue: employers can ensure shifts are not too long or too close together as well as avoiding dramatic shift rotations (we discuss shift work in more detail in Chapter 7). Employers can also ensure that workplace temperatures are not too high, work is interesting and engaging without being too strenuous, and adequate opportunities for resting, eating, and sleeping (if necessary) are provided.

Workplace violence is any act in which a person is abused, threatened, intimidated, or assaulted in his or her employment. It can include physical attack, threats of physical attack, threatening language or behaviour (e.g., shaking a fist), or physically aggressive behaviour. The data around the prevalence of workplace violence is mixed. If judged by workers’ compensation claims, workplace violence is quite rare: only 2.5% of all Canadian lost-time injury claims in 2012 were related to incidents of violence (about 6000 incidents).AWCBC. (2014). National Work Injury, Disease and Fatality Statistics 2010–2012. Toronto: Association of Workers’ Compensation Boards of Canada. That said, Statistics Canada reports that 17% of all acts of criminal violence (violence illegal under the Criminal Code) occurred at a workplace. They calculate that this amounts to more than 350,000 acts of workplace violence in Canada.Statistics Canada. (2008). National Yearbook 2008. Ottawa: Government of Canada. The discrepancy is partially explained by the fact that many of those criminal acts did not result in the acute injury of a worker and, therefore, no workers’ compensation claim was filed. This discrepancy reinforces the limited value of workers’ compensation claim data as an indicator of hazardousness in the workplace.

Whether more or less prevalent, workplace violence can extract a significant toll on workers, leading to injury and psychological ill health (e.g., post-traumatic stress disorder). Health-care workers are most likely to experience workplace violence, followed by social workers and workers in retail or food service. It is notable that these occupations tend to be female-dominated. Customers, clients, and patients are the most common perpetrators of workplace violence, although violence from co-workers or supervisors remains prevalent.

While acts of violence are unpredictable, an employer can take steps to develop a violence-prevention plan to minimize both the risk of a violent act and the harm caused by the act. Violence prevention should be a part of the overall HRAC process. Particular actions to consider include workplace design to restrict access, increasing visibility and communication, and creating escape routes for workers. Administrative policies and work practices can reduce some of the common risks: these might include reducing the use of cash, eliminating the use of working alone, and implementing a buddy system. A prevention program should also incorporate training for managers to spot warning signs of violence, and steps to reduce stress levels in the workplace. Governments can also take action by expanding the definition of violence as a workplace hazard.

A growing concern in workplaces is the issue of workplace harassment and bullying. Workplace harassment  is behaviour aimed at an individual (or group) that is belittling or threatening in nature. This can include actions (e.g., unwanted touching) or words (e.g., insults, jokes) that have the effect of causing psychological harm to victim(s). Harassment can take a variety of forms, including racial/ethnic harassment, sexual harassment, and general workplace harassment. Bullying  is similar to harassment and comprises repeated actions or verbal comments that lead to mental harm, isolation, or humiliation of a worker (or group), often with the intent to wield power over them. Often harassment and bullying are used interchangeably and, indeed, the definitions are highly similar. In this book, we differentiate the terms for two reasons. First, harassment is often associated with specific grounds protected under human rights legislation, such as gender, race, age, and religion. Bullying applies more broadly to any set of behaviours that create harm. Second, it is accepted that harassment can occur unintentionally, while bullying is a more intentional process. Both are ways for the harasser/bully to exercise control and power over the harassed/bullied through fear, humiliation, embarrassment, and denigration.

Harassment and bullying can involve physical contact but are distinguished from violence in that the purpose is not physical harm but emotional and psychological harm. Harassment and bullying can also include acts that indirectly affect the targeted worker(s), such as undesirable shift scheduling, unreasonable workloads, spreading rumours, or denying leave requests. Harassment, bullying, and violence can occur concurrently.

There is debate about how to best conceptualize harassment and bullying. Many argue that it is a human rights issue and should be treated through human rights processes, usually meaning independent tribunals or the courts. Others suggest that harassment and bullying are instances of individual misconduct best resolved through human resources processes such as better selection, training, and disciplinary practices. The authors of this text argue, without intending to reduce the significance of the human rights dimensions of harassment, that harassment and bullying are also health and safety issues. The reason harassment and bullying are OHS issues is that they can be controlled by the employer and have clear health effects for the targeted worker(s).

The psychological effects of harassment and bullying can be extensive and include anxiety, panic attacks, depression, shame, and anger. The physical effects mirror those of stress and can include inability to sleep, stomach pain or headaches, high blood pressure, heart palpitations, and loss of concentration/memory, as well as eating and digestive disorders. Further, workers exposed to harassment are found to be more at risk of illness, injury, and assault.Rospenda, K., Richman, J., Ehmke, J., & Zlatoper, K. (2005). Is workplace harassment hazardous to your health? Journal of Business and Psychology, 20(1), 95–110. The negative health outcomes and increased risk of illness and injury can persist well after the harassment has ceased. In extreme cases, bullying and harassment can cause post-traumatic stress disorder (PTSD). PTSD is typically brought on by a terrifying event, and symptoms include flashbacks, severe anxiety, and uncontrollable thoughts about the event.

While all workers can be victims of harassment and bullying, certain groups of workers are more likely to be the targets, because of their respective statuses in society at large. Two such groups include women and racialized workers (see Box 6.5), who make easier targets because the bullying and harassment are consistent with widely held prejudices (e.g., consider how common race and gender jokes are). Recent research has shown that experiencing multiple forms of harassment—gender and ethnic harassment along with general workplace harassment—compounds the negative health effects compared to experiencing one form, putting racialized women at particular risk of negative health effects from harassment.Raver, J., & Nishii, L. (2010). Once, twice, or three times as harmful? Ethnic harassment, gender harassment, and generalized workplace harassment. Journal of Applied Psychology, 95(2), 236–254.

• The screaming Mimi: A bully who displays mood swings and unpredictable anger and commonly uses public humiliation as a tool.
• The constant critic: A hypercritical nitpicker who regularly points out others’ inadequacies and errors, and uses negative evaluation of performance as a tool to belittle.
• The two-headed snake: Aimed at rising in the organization, they aim their bullying at those below them, using rumours and divide-and-conquer schemes to turn co-workers against the target.
• The gatekeeper: Obsessed with control, they allocate resources and information in ways to ensure the target’s failure and to create reasons to question their performance.Namie, G. (2003). Workplace bullying: Escalated incivility. London, ON: Ivey School of Business.

These types of bullies may sound very familiar, but it is important to not forget that the issue of bullying is workplace-wide and not solely the result of an ill-mannered or calculating personality. The categories should be interpreted as strategies employed by bullies, rather than personality sketches.

Often, managers bully or harass subordinates (although bullying from co-workers and clients/customers is also common). This is not surprising, given that bullying and harassment are ways to wield power over another person. Managers, because of their role in an organization, already possess power over workers. Attempts to exercise this power can lead to management approaches that rely upon bullying. Some researchers suggest that employers may overtly or covertly encourage bullying by managers as a way to maximize the work the employer can extract from its workers.Beale, D. (2011). Workplace bullying and the employment relationship. Work, Employment & Society, 25(1), 5–18.

The line between “tough” management and “bullying” management can be difficult to ascertain, especially if the bullying takes the form of misuse of managerial prerogatives such as scheduling, work assignments, and the like. Usually bullying as a management technique is reflective of the organizational culture that has developed in a workplace. For their part, workers respond to OHS threats such as bullying with a range of behaviours that include exit, voice, patience, and neglect. 

Workplace policies are important, but they are only as effective as the degree of their implementation and enforcement. Effective policy implementation requires the employer to train all workers, including managers, on how to prevent and address harassment. Training for managers is particularly important. It can help managers spot possible harassment and teach them the difference between legitimate management discretion and bullying management techniques. Training workers around respectful interactions and cultural sensitivity can help distinguish between legitimate interpersonal conflict and bullying and harassment.

Finally, research shows that the leading indicator of workplace bullying and harassment is the organization’s climate. In workplaces where workers feel unsafe, incidents of bullying and harassment are more frequent. Conversely, creating a safe and respectful climate increases workers’ sense of safety and lowers the negative consequences of bullying and harassment.Law, R., Dollard, M., Tuckey, M., & Dormann, C. (2011). Psychosocial safety climate as a lead indicator of workplace bullying and harassment, job resources, psychological health and employee engagement. Accident Analysis & Prevention, 43(5), 1782–1793. Creating a safe workplace climate is a multi-levelled process, requiring a high degree of commitment to respectful interactions, clear communication, transparent management, and individual and collective accountability.

It may seem strange to include working alone as a psycho-social hazard, given that it is a working condition that removes psycho-social interactions from the workplace. Yet it is precisely the absence of other people that makes working alone a significant psycho-social hazard. Working alone is a unique type of hazard in that, in and of itself, it may not be hazardous. Nevertheless, working alone exacerbates other hazards present in the workplace.

Working alone occurs when a worker is performing tasks out of contact with persons capable of offering assistance in case of emergency. If an incident were to occur (e.g., if the worker became unconscious) there would be no one available to respond, increasing the risks of harm to the worker. The key to working alone is that the worker is isolated in some fashion from co-workers or responsible individuals. A worker can be working alone even if there are other people present in the workplace. For example, a receptionist in the front room is working alone if others in the office cannot hear or see him.

A second key aspect of the concept is that the contact needs to be with someone capable of and responsible for responding. A worker can be working alone even if there are members of the public present (e.g., a crowded street). The public are not responsible for the worker and so may not respond (or even be aware of the need to respond) should something happen. Certain types of working alone situations come quickly to mind (e.g., the gas station attendants discussed in (Chapter 2), but there are many types of working alone that may not be as obvious.

Who works alone and why?

Many different kinds of workers can find themselves working alone. Consider these common examples:

• A barista opening up a coffee shop early in the morning
• A farm worker cleaning out a grain bin
• A homecare nurse visiting patients in their homes
• A custodian cleaning a school overnight
• A postal worker delivering mail
• A front receptionist greeting customers
• A truck driver transporting goods between cities
• A maintenance worker repairing a machine in a shut-down portion of a factory

How many of these jobs could be performed more safely if there were two workers present? Most of these jobs would have a lowered risk of incident or reduced consequences from an incident if a second worker were present. This raises the question as to why these jobs are routinely performed alone.

Usually employers cite economic efficiency as the reason for having workers work alone. It makes no sense (financially) to have two receptionists greeting customers or having a passenger with the truck driver. Nevertheless, in many cases, assigning two workers to perform a job has little effect on efficiency. For example, sending homecare workers in pairs adds safety, increases the quality of patient care, improves working conditions, and does not negatively affect the number of patients seen in a day.

Employers utilize working alone when it makes economic sense for them. Those considerations are valid, but for OHS practitioners, safety considerations must also be included in the calculation. How many jobs regularly performed alone really need to be structured in that fashion? And how much working alone is simply the result of habit and convention?

The risks associated with working alone are diverse. Common concerns include the possibility of theft, assault, or attack by an outside party or a worker’s client or patient. This risk is increased by the presence of money, drugs, or other valuables. Women are also more at risk of assault when working alone in these situations. Other risks include uncontrolled hazards causing harm to a worker without others noticing and taking action. For example, a worker working alone may pass out from gas exposure or fall on a slippery surface and have no one to come to their aid. Even injuries like heart attacks or other health issues can be made worse by the lack of immediate response.

There are two basic ways to control the hazard posed by working alone. The first approach is to eliminate it by ensuring workers are never in a situation where they are out of contact with other workers. Policies that require a minimum of two workers to be on shift at a time, or prohibiting late night overtime, can administratively control working alone. Prohibiting working alone is a central practice of emergency first responders (i.e., police, fire, ambulance). Keep in mind that eliminating working alone does not eliminate other hazards, which may require other controls. For example, two workers in a remote location will still require some communication strategy in case something happens to either or both of them.

The second approach to controlling working alone is to establish a two-step communication process with workers working alone. First, the worker needs a way to communicate to another person if they are in need. Radios, telephones, or panic buttons can all work as outgoing communication devices. Second, there needs to be incoming communication on a regular basis in case the worker is unable to communicate (e.g., they are unconscious). This incoming communication can take the form of a regular check-in to the worker or an automatic response if the worker fails to complete a periodic check-in. The frequency of check-ins is determined by the nature of the hazards to which the worker is exposed.

The choice between hazard elimination and communication controls is controversial. Employers argue that prohibiting working alone is too costly and inefficient. Some also argue that employing two workers is not necessarily safer than one worker (e.g., two workers can just as easily be rendered unconscious by hydrogen sulfide gas on a remote worksite as one). This latter argument confuses hazards associated with working alone (e.g., lack of assistance) with other hazards of the work (e.g., chemical hazards). Worker advocates, on the other hand, argue that communication devices, while useful, are not fail-safe and do not address all the risks associated with working alone. For example, there can be significant time delays between when an incident occurs and when the automatic response is triggered. Further, the automatic response may not result in immediate assistance being rendered.

There are times when prohibiting working alone is not practicable. Yet the bulk of the debate about working alone rests around issues of cost, efficiency, and employer control over the work process. Working alone is another example of how employer and worker interests may conflict around issues of health and safety.

Somewhat ironically, Meredith Boucher’s experience of harassment at Wal-Mart occurred because she refused to create a safety hazard by falsifying food inspection data. Her supervisor’s subsequent decision to expose her to a psycho-social hazard (which her employer failed to control despite repeated requests) was only resolved when she sued her employer and manager. A faster and less costly way to resolve this issue would have been to treat the harassment she experienced as a health and safety issue. This would have allowed Boucher to refuse the unsafe work and force an investigation when Wal-Mart failed to remediate the hazard. It also would have made her eligible for workers’ compensation benefits if the harassment caused her to experience ill health.

Psycho-social hazards—such as stress, fatigue, violence, harassment, and bullying—are the result of inadequately controlled workplace hazards. Working alone is a product of choices about how to prioritize safety and efficiency. While not all aspects of psycho-social hazards are within the control of employers (e.g., how much an employee sleeps at night), employer decisions about job design, workplace culture, and acceptable behaviour from co-workers, supervisors, and members of the public are among the root causes of the injuries caused by psycho-social hazards.

Maleka is a precarious worker. Precarious employment is non-standard work that lacks stability, security, and control. It can be part-time or temporary, and is under-protected by regulation. Precarious workers lack control over how or when the work is performed. Benefits are rare and usually the wages are insufficient to support a family. Vosko, L. (2006). Precarious employment: Understanding labour market insecurity in Canada. Montréal: McGill-Queen’s University Press.Women and racialized workers are more likely to be found in precarious employment. Vosko, L. (2000). Temporary work: The gendered rise of a precarious employment relationship. Toronto: University of Toronto Press. Precarious work is also linked to increased risk of work-related injury and poorer health outcomes, including increased stress and poorer physical well-being. The precariousness of the employment relationship leads to worse OHS conditions. Further, gender and race have OHS implications because certain groups of workers are more likely to hold precarious jobs.

Precarious work is one example of how the structure of work and the employment relationship itself can be linked to ill health. This chapter will discuss how work itself can be an OHS issue. In addition to explaining the reasons precarious work leads to worse health, it will also examine work structure issues such as shift work, working for a small employer, and the health effects of different forms of work.

OHS practitioners rarely identify work itself as an occupational hazard. Traditional approaches look at aspects of work—such as work location, tools, and processes—to identify hazards that could harm workers. Yet studying the entirety of work, and even broader effects of work that spill over into workers’ home lives, provides a fuller picture of the health effects of work. Indeed, there is a growing body of research that shows that the structure of work, the nature of the employment relationship, and the type of the employer all have measurable physical and psychological effects on workers. For that reason, it is an area demanding greater attention by OHS practitioners.

Karasek’s Job Demands-Control Model, which was introduced in Chapter 6, links high demand and low control over work to high levels of worker stress. Karasek’s model was the first to connect the nature of the employment relationship to health and safety outcomes. Yet the degree of control over one’s work is only one aspect of employment that can affect workers’ health. This section examines three other dimensions to work that have health consequences: shift work, extended work hours, and emotional labour.

Shift work requires workers to work outside of regular weekday hours. It may include regular evening or night work, rotating schedules, split shifts, irregular shifts, or on-call work. Shift work is a growing trend in Canada. In 2005, nearly 30% of employed Canadians did not work 9 to 5, Monday to Friday hours.Williams, C. (2008). Work-life balance of shift workers. Perspectives on Labour and Income, 9(8), 5–16. The most common form of shift work is rotating schedules, where a worker cycles through a series of day, evening, and night shifts. Not surprisingly, shift work is particularly common in health care and emergency services. It is almost as prevalent, however, in sales and service (e.g., consider the growth in 24-hour stores and restaurants).

The primary concern about shift work is its potential to disrupt a worker’s circadian rhythms. Circadian rhythms(commonly known as the biological clock) are the daily (24-hour) cycles our body follows to ensure (in humans) high activity during the day and low activity at night. Sleeping and waking, eating, adrenalin, body temperature, blood pressure, pulse, and many other bodily functions are regulated by circadian rhythms. When work occurs outside of that daily rhythm, it places strain on the body as it is forced to alter the cycle. A second concern is that shift work is associated with behaviour contributing to poorer health, including smoking, poor diet, and increased alcohol consumption.Saunders, R. (2010). Shift work and health. Toronto: Institute for Work and Health. Shift work also disrupts family and social activities. This disruption adds stress and reduces the support that workers can draw upon to manage stress.

Some forms of shift work disrupt the rhythms more than others. The worst forms of shifts are those that are constantly changing (irregular shifts, rotating schedules, on-call), as well as those that invert the natural rhythm (for example, permanent night shifts). Workers whose rhythms have been disrupted can experience insomnia and non-restorative sleep, as well as changes in hormone levels, which can affect cell growth. Workers rarely become habituated to shift work, even after long periods on disruptive shifts.Haus, E., & Smolensky, M. (2006). Biological clocks and shift work: Circadian dysregulation and potential long term effects. Cancer Causes and Control, 17, 489–500.

Research into shift work has been extensive and shows a wide range of health effects. In the short term, shift work leads to shortened and less restorative sleep and chronic tiredness and lack of alertness, as well as stomach aches, indigestion, and heartburn. Shift work is associated with increased risk of workplace incidents and injury. The risk increases as the number of days on the disruptive shift grows. It also jumps if the disrupted shift lasts longer than eight hours.Institute for Work and Health. (2010).

Longer-term exposure to shift work is associated with a series of illnesses and conditions. Shift workers report significantly higher rates of burnout, emotional exhaustion, stress, anxiety, depression, and other psychological distress. Shift work increases a worker’s risk of developing diabetes, and some studies have also found a greater risk of heart disease. Some studies have also suggested a link between shift work and pregnancy complications. Likely the most significant long-term risk of shift work is increased risk of cancer, in particular breast cancer. The International Agency for Research on Cancer (IARC) has concluded that disruptive shift work is “probably carcinogenic to humans” (Group 2A)—the second most conclusive category in the IARC.Ibid.

Much less research has been conducted at mitigating the negative effects of shift work. Some recommendations have included:

• Restricting consecutive evening/night shifts to no more than three
• Avoiding permanent night shifts
• Using forward rotation for rotating shifts (moving from morning to evening to night) rather than the opposite
• Providing more than 11 hours’ rest time between shifts
• Limiting weekend workKnauth, P., & Hornberger, S. (2003). Preventive and compensatory measures for shift workers. Occupational Medicine, 53(2), 109–116.

The effectiveness of these measures has been sparsely studied and therefore their mitigating power is uncertain. At this time, the only reliable method for addressing shift work’s health effects is preventive: eliminating or minimizing shift work in the workplace. This may be particularly challenging for essential services such as health care and emergency response, given the 24-hour nature of that work. Nevertheless, considering the health risks, there is room to question the value in 24-hour restaurants, late-night convenience stores, and other all-night service industries.

Extended work hours is defined as working for long hours over a period of time. Most commonly it entails working extra hours in a day or over the course of a week. There is some disagreement whether an extended work day is defined as over 8 hours or over 12 hours. In general, extended work weeks are defined as anything over 40 hours. The most obvious consequence of extended work hours is fatigue and the increased risk of error associated with it.

One of the reasons there is disagreement over how to define extended work days is that the research is contradictory regarding the effect of working between 8 and 12 hours. Some (but not all) studies have shown that working beyond 8 hours in a day leads to increased risk of incidents and sleep disruption. When workers work more than 12 hours, the research becomes clearer that this schedule is linked to increased injury rates, more illnesses, and an overall lower level of perceived general health. Some studies have found a link between long hours and pre-term birth. Over the longer term, extended workdays are associated with weight gain, increased use of alcohol, and smoking.Caruso, C., Hitchcock, E., Dick, R., Russo, J., & Schmit, J. (2004). Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries, and Health Behaviors. Cincinnati: NIOSH.

Working extended hours over the course of a week is also associated with negative health effects. Workers who work longer than 40 hours in a week are more likely to become injured. One study found that workers who worked 64 or more hours a week were almost twice as likely to be injured than those who worked less than 40.Lerman, S., et al. (2012). Fatigue risk management in the workplace. Journal of Occupational and Environmental Medicine, 54(2), 231–258. Prolonged exposure to long workweeks leads to worsening mental health and an increase in unhealthy behaviour, including poor diet and increased alcohol consumption. Women’s mental health appears to be more negatively affected by long hours than men’s mental health.Milner, A., Smith, P., & LaMontagne, A. (2015). Working hours and mental health in Australia: Evidence from an Australian population-based cohort, 2001–2012. Occupational and Environmental Medicine, 72(8), 573–579. doi: 10.1136/oemed-2014-102791

When the two types of extended work are combined—working both long shifts and long workweeks—the effects are magnified. Other work factors, such as work pace, temperature, and mental exertion required also intensify the health and safety risks of longer working hours. Particularly concerning is the combination of long hours and shift work (common in health care and other emergency services).Lerman et al. (2012). Extended working hours also create stress in family and social spheres as work encroaches upon those aspects of workers’ lives.

At the core of all these findings is the physical strain put on the human body by long hours of work. The worker is unable to achieve sufficient rest between periods of work to recover from the exertion of work. Complicating the picture, however, is that many workers prefer extended hours. Extended shifts often result in a compressed workweek, meaning more days with no work. Others appreciate feeling important, busy, or challenged by long hours. As with many aspects of occupational health, workers vary in their susceptibility to the negative effects of long hours.

This hazard is easily controlled by reducing the number of hours worked. The reason employers don’t control this hazard is that longer shifts simplify scheduling and reduce pressure to hire more staff. These economic benefits for employers (paid for by workers in the form of ill health) ensure that long working hours and weeks remain commonplace practices.

Emotional labour is a term describing any aspect of a job that requires workers to regulate their emotions to meet organizationally defined rules and to display the required emotions to customers. In other words, workers engage in emotional labour when they are asked to display an emotion—empathy, happiness, friendliness— that they may not actually feel. Emotional labour is a key part of work in many occupations involving clients, patients, or customers and is required of a wide variety of workers, including nurses and doctors, store clerks, restaurant/bar servers, airline attendants, and teachers. Box 7.1 provides a more detailed discussion of emotional labour and its significance.

Emotional labour is a well-established concept in the study of work but is rarely discussed in OHS. The studies that have been performed find extensive performance of emotional labour leads to higher levels of anxiety, stress, and emotional exhaustion in workers.Deery, S., Iverson, R., & Walsh, J. (2002). Work relationships in telephone call centres: Understanding emotional exhaustion and employee withdrawal. Journal of Management Studies, 39(4), 471–496. These psychological states lead to a variety of physical and mental ailments over time, including depression.

Emotional labour can also be linked to workplace violence and harassment, in that moments of intense emotional labour are often associated with managing threatening behaviour from customers or clients. Essentially, the worker is forced (by lack of alternatives) to manage a dangerous situation by regulating her own emotions, including fear. One result is that the trauma of the event may then be compounded by the mental costs of regulating emotions under a stressful situation, leading to intensified psychological stress.Smith, P. (2012). The emotional labour of nursing revisited: Can nurses still care? New York: Palgrave-MacMillan.

Little work has been done to examine how to mitigate the negative health effects of emotional labour, in large part because it is not widely recognized as a significant health hazard. Reducing the need for emotional labour by allowing for a greater degree of honest expression of feelings is a key aspect of reducing the consequences of emotional labour. Allowing safe spaces for “venting,” establishing zero-tolerance policies for customer misbehaviour, and revoking policies requiring workers to engage in emotional labour (e.g., smile policies) are all ways to control the health hazard of emotional labour.

Shift work, long hours, and emotional labour are linked because they all introduce a health risk into the workplace by altering how, when, or what kind of work is performed. In this way, they are distinct from other hazards discussed in previous chapters because they are associated with the nature of work itself rather than a specific task or location. Also, because they are inextricably linked with the employment relationship, employers have been resistant to recognizing and controlling the hazards they pose.

Work in the 21st century is becoming increasingly insecure. While the standard employment relationship (SER), the term for permanent, full-time, secure employment with a single employer, is still the most common form of job, its proport the term for permanent, full-time, secure employment with a single employer, is still the most common form of job, its proportions are dropping. Fewer than two thirds of jobs in Canada fit the definition of SER. The fastest-growing segment of non-SER jobs is precarious employment, which now comprises 20% of jobs in the country.Lewchuk, W., et al. (2015). The precarity penalty: The impact of employment precarity on individuals, households and communities—and what to do about it. Toronto: McMaster University & United Way Toronto. Precarious workers earn less and are less likely to have benefits (or may have fewer benefits) than other workers. Women, immigrants, and young workers are more likely to hold precarious jobs than other Canadians.Vosko (2006). For employers, precarious work lowers labour costs and increases flexibility, both of which lead to higher profits. While not as prevalent as in the private sector, precarious work is also present in the public and non-profit sector as these employers feel the pressure to reduce costs and emulate private sector practices.

The rise of precarious employment is concerning for a number of economic and political reasons. It reflects growing inequality in Canada and contributes to racial and gender divisions in society. Most worker advocates talk about the economic unfairness of precarious employment and the problems it creates in the labour market and in communities. Precarious employment is also a health and safety issue. The status of being a precarious worker leads to worsened health and safety outcomes.

Repeated studies with different types of precarious workers have shown that they are more likely to get injured at work and their injuries tend to be more severe.Underhill, E., & Quinlan, M. (2011). How precarious employment affects health and safety at work: The case of temporary agency workers. Relations Industrielle/Industrial Relations, 66(3), 397–421. Precarious work is associated with deteriorating health and safety conditions in the workplace,Quinlan, M., Mayhew, C., & Bohle, P. (2001). The global expansion of precarious employment, work disorganization and consequences for occupational health: A review of recent literature. International Journal of Health Services, 31(2), 335–414. and precarious workers are found to be less aware of their safety rights and have more difficulty exercising those rights.Lewchuk, W., Clarke, M., & de Wolff, A. (2008). Working without commitments: Precarious employment and health. Work, Employment & Society, 22, 387–406. Precarious employment has direct effects on workers’ health. Precarious workers report worse mental health, including increased stress-related illness, depression, and anxiety. Evidence for decreased physical health is more mixed, but precarious work is associated with higher levels of mortality among workers.Lewchuk, W., Clarke, M., & de Wolff, A. (2011). Working without commitments: The health effects of precarious employment. Montréal: McGill-Queen’s University Press.

There are two explanations for precarious work being associated with decreased health and safety outcomes. Michael Quinlan and Philip Bohle developed the Pressures, Disorganization and Regulatory Failure (PDR) model to explain how precarious work leads to poor health and safety outcomes. Their model looks at three groups of factors that shape practices at precarious workplaces. First, precarious workers experience economic pressures because of income insecurity and competition for work which lead them to accept work intensification and dangerous work while making them reluctant to report injury and ill health. Second, the contingent nature of the work relationship breaks down structures that facilitate workplace safety, such as safety procedures, training, and communication. Third, the effectiveness of government safety regulations is reduced because enforcement is more difficult, some forms of work are not protected by regulation, and some workers lack knowledge of their health and safety rights. The result of these factors is workplaces that are less safe.Quinlan, M., & Bohle, P. (2004). Contingent work and occupational safety. In J. Barling & M. Frone (Eds.), The psychology of workplace safety (pp. 81–106). Washington: American Psychological Association.

The PDR model attempts to explain the increased health and safety risks through precarity’s effects on the workplace structure and practice. While this model does help us understand the workplace dynamics of precarious work, it provides an incomplete understanding of the broader effect of precarity on health. The consequences of precarious work do not restrict themselves to the workplace but spill over into the workers’ private lives, as they take stress, anxiety, and insecurity home with them.

In an attempt to build a more holistic analysis of precariousness and work, Wayne Lewchuk and his colleagues have developed the Employment Strain Model (ESM)  . ESM looks at the employment relationship in its entirety to understand how workers’ health is affected by engaging in precarious work. The model suggests that the strain of being uncertain about employment combined with the stress of having to make extra effort to maintain and attain work are the cause of the worsened health outcomes. Box 7.2 provides a more complete explanation of the model.

No work has been done to determine how to reduce the ill effects of precarious work, in large part because precarity is not yet widely recognized as a health and safety hazard. Since the origins of its effect begin before work begins, it is a challenge to identify work-related solutions. The only effective method for reducing the health effects of precarity is to create jobs that are more secure and support workers more fully. This solution requires broad-scale social, political, and economic change.

Despite its seeming intractability, it is important to understand the health and safety implications of precarious work. The discussion demonstrates that workplace health extends beyond the workplace. The significance of precarious work is that it is not only the work itself that affects safety; the employment status also plays a large role in determining worker health. 

In Canada, 98% of all employers are small enterprises (<100 employees). Small enterprises employ two thirds of private-sector workers.Industry Canada. (2013). Key Small Business Statistics, August 2013. Ottawa: Author. Small enterprises are also common in the non-profit sector. Most of the research focusing on small and medium enterprises (SMEs) (<500 workers) has been conducted in the past 15 years and has found that workers employed by SMEs are more likely to experience work-related injury and illness. Incidents are more common in SMEs, especially those resulting in fatal or serious injuries, and SME workers are more likely to be exposed to physical and chemical hazards.Hasle, P., & Limborg, H. (2006). A review of the literature on preventative occupational health and safety activities in small enterprises. Industrial Health, 44, 6–12. That said, some studies have found that their psycho-social working conditions are better due to the close social relationships associated with SMEs. Psycho-social conditions are, however, highly dependent upon the behaviour of the employer.Sørensen, O., Hasle, P., & Bach, E. (2007). Working in small enterprises—Is there a special risk? Safety Science, 45, 1044–1059.

Researchers attribute these poor outcomes to particular attributes of SMEs. The tendency of SMEs to have informal management structures, unstructured approaches to OHS, and a lack of OHS resources and knowledge are all factors that contribute to the heightened risk of injury. SME owners also tend to downplay safety risks, see safety as a relatively minor matter compared to the other challenges of running a business, and view government regulations as bureaucratic interference. They also overestimate their knowledge of OHS and, importantly, tend to push responsibility for safety down to their employees.Legg, S., Laird, I., Olsen, K., & Hasle, P. (2014). Creating healthy work in small enterprises—from understanding to action: Summary of current knowledge. Small Enterprise Research, 21, 139–147.

These attributes of SMEs interact with other factors. For example, SMEs are more likely to provide precarious work and employ vulnerable workers such as women, immigrants, and youth. Combining inadequate OHS structures in SMEs with the vulnerable and precarious attributes of SME workers intensifies the health and safety risks to those workers.

When examining how to improve the safety climate in SMEs, attention has tended to focus on tailoring training and education approaches for an SME environment or simplifying safety management systems. Recommendations include building trust and communication, creating action-oriented education, checklists, and integrating safety goals with management goals.Hasle & Limborg. (2006). Few of these proposed methods have been rigorously evaluated to determine their level of effectiveness, and their application has been sporadic.

A broader view of the issue reveals that the current system of injury prevention, regulation, and enforcement was designed for (and by) large enterprises. Rules are detailed and written in technical and legalistic language. Hazard control efforts often require extensive knowledge, training, and investment. OHS inspectors lack the resources required to cover the large number of SME workplaces, while the close social relations in SMEs make it less likely that workers will complain for fear of being identified and ostracized. Watering down regulations for small workplaces, often the preferred solution of SME employers, would only make matters worse, as it would further relax safety requirements. Improving the safety conditions in SMEs requires reforms to the OHS system that address the dynamics specific to SMEs that place workers at risk.

In particular, the reforms need to recognize that the conflicting interests found in all workplaces are more acute in SMEs. The employer, who is likely on the worksite daily, sees the effects of safety measures on productivity and cash flow, making them more likely to resist safety improvements. Employers’ close contact with the workers makes it harder for workers to recognize and give voice to the idea that worker interests (safety) may be in conflict with employer interests (profit or cost containment). More effective training approaches do not erase that conflict.

Who you are affects your safety at work. Different groups of workers have varying safety experiences in the workplace. For example, 63% of WCB-reported injuries in Canada happen to men, even though they make up 52% of the workforce.AWCBC. (2014). National Work Injury, Disease and Fatality Statistics 2010–2012. Ottawa: Association of Workers’ Compensation Boards of Canada. While it may seem on the surface that race and gender have no impact on health and safety—hazardous workplaces affect every worker—in fact, both have a profound impact on how safe a worker is at work. Race and gender can affect health and safety in two ways. First, they can shape how much risk a worker is exposed to. Second, race and gender affect the kinds of hazard workers face.

As suggested above, men are more likely to be injured and to be more seriously injured than women. Racialized workers are also more likely to be injured among both men and women. This means that racialized men have the highest injury rates overall.Leeth, J., & Ruser, J. (2003). Compensating wage differentials for fatal and nonfatal injury risk by gender and race. Journal of Risk and Uncertainty, 27(3), 257–277. Further, immigrants, in particular racialized immigrants, also possess disproportionately high injury rates.Mousaid, S., De Moortel, D., Malmusi, D., & Vanroelen, C. (2016). New perspectives on occupational health and safety in immigrant populations: Studying the intersection between immigrant background and gender. Ethnicity & Health, 21(3), 251–267. http://dx.doi.org/10.1080/13557858.2015.1061103 Even citizenship status can affect safety, as the lack of status of undocumented workers (i.e., workers who do not have a valid visa to work in a jurisdiction) undermines their safety at work and their ability to stand up for their rights.Flynn, M., Eggerth, D., & Jacobson, J. (2015). Undocumented status as a social determinant of occupational safety and health: The workers’ perspective. American Journal of Industrial Medicine, 58(11), 1127–1137. doi: 10.1002/ajim.22531

A variety of explanations have been offered for these differential safety outcomes. One explanation centres on ascribed characteristics of the workers themselves. Women are claimed to be more risk-averse than men, and thus they seek out less dangerous occupations. Racialized workers are said to be less risk-averse due to lower education levels and lower income levels. They may also be assigned more dangerous tasks because of the belief that they have poorer language skills. A second explanation critiques the assertion that workers “choose” their paths free of social and economic constraints. While some individual choice is always present, workers’ choices are often limited by their circumstances. Economic and social vulnerability, fear of losing employment, and lack of options can lead workers to accept degrees of risk they would not otherwise choose.Leeth, J., & Ruser, J., (2006). Safety segregation: The importance of gender, race, and ethnicity on workplace risk. Journal of Economic Inequality, 4, 123–152.

It is very important to remember that the racial and gender relations present in society do not stop at the workplace door. Attitudes, stereotypes, and behaviours about race and gender that pervade societal structures shape what happens at work. They govern what job opportunities are available to different groups of workers and they shape how work is conducted in the workplace. For example, due to stereotypes about masculinity and femininity, men are more likely to work in more physically demanding jobs (e.g., construction), which are linked to higher rates of injury. Women, in contrast, are discouraged from those occupations—both through overt discrimination and through job designs that do not accommodate the greater social reproductive responsibilities of women. While individuals do choose their career paths, we cannot understand those choices in isolation from the social forces that shape them.

In North America, there are clear power imbalances between men and women and between so-called “white” (or sometimes Anglo) workers and racialized workers. These imbalances do not work in isolation but cut across both race and gender. They are also reproduced in the workplace and thus will shape the health and safety experience of each worker. Those effects are complex but need to be integrated into our understanding of health and work. At the core, workers from groups that have less power in society will also have less power in the workplace to protect their safety. They will have less control over their choice of job. And they will have fewer options in navigating hazards in the workplace.

A second effect of gender and race is that groups of workers experience different kinds of hazards and risks. In part, this is due to occupational differences (e.g., construction entails different hazards than office work). But even workers doing the same job will experience the workplace from a different perspective, altering their health and safety. This can manifest itself in physical and psycho-social ways. As we saw in Chapter 5, women face additional chemical hazard risks (i.e., embryotoxicity and teratogenicity) due to their child-bearing abilities. Racialized workers are more vulnerable to workplace harassment (or violence) motivated by racism. Importantly, these different exposures can have significant health and safety impacts, as outlined below.

The health and safety experience of a worker does not change because they happen to be male or female, Hispanic or Scottish. Rather, their OHS experience differs because the social meaning attributed to a specific gender or ethnicity alters a worker’s relationship to work, employers, co-workers, and customers. That relationship then shapes the worker’s health and safety at work (and in society). That a worker’s health and safety experience is rooted in these social relationships means the experience can be changed. If we alter our notions of masculinity and femininity and break down racial divides, gendered and racialized health and safety outcomes will be diminished. Such large-scale social change goes beyond the role of an OHS practitioner. Yet the differential health and safety experiences of women and racialized workers can be reduced if OHS practitioners become aware of the gender and race in the workplace and take action to reduce the power imbalances that arise from those dynamics.

Karen Maleka is more vulnerable to occupational injury and illness, not because of the job she performs but because of the nature of her employment relationship and, possibly, her gender and race. This chapter examined various hazards that arise out of the dynamics of work itself, rather than the tasks and locations of that work. Shift work, extended work hours, and emotional labour—all aspects of the job fully within the control of the employer—have negative health effects, regardless of what other hazards may be present in the workplace. We also saw that the size of the employer can lead to worse safety outcomes, which may interact with the mounting evidence that being a precarious worker has significant health and safety consequences. Finally, we considered how gender and race also shape workers’ experience of safety at work.

That the nature of work and the employment relationship can affect workers’ health is a new concept for OHS. It requires us to rethink what constitutes a hazard and how hazards cause health consequences, including how they interact with non-work aspects of workers’ lives. It also causes us to contemplate new ways of controlling these new types of hazard. The existing recognition, assessment, and control system is inadequate for the task of determining how to reduce hazards of this kind. What is required is a more explicit recognition that employment is a power relationship, and that power permeates all aspects of workers’ lives. Addressing the kinds of hazards discussed in this chapter requires a broader, more holistic understanding of how workplace health is shaped.

This incident identifies the importance of training and emergency preparedness in minimizing the risks posed and harm caused by workplace hazards. While it would have been better to eliminate (or otherwise control) the conditions that killed and injured the mushroom-farm workers, informing workers about the hazards and what to do in case of emergency could have prevented these injuries. This chapter begins by examining health and safety training in the workplace. It then looks at what learning theory can tell us about designing effective training programs. Finally, we tackle the issue of emergency preparedness in the workplace.

Health and Safety Training

One way to control workplace hazards is to provide workers with health and safety training. Training entails providing workers with the knowledge, skills, or behaviours to reduce the risk of a workplace injury. Training is most effective at preventing injuries when the risk of injury is caused (or exacerbated) by a lack of knowledge or skill. Conversely, training will be less effective if the risk of injury is caused by some other factor or if workers are prevented or discouraged from applying the training by some aspect of the job.

There are many forms of OHS training. If you think back to jobs you or family and friends have held, you might well have been given an orientation during your first few days. This might have covered such basic information as the location of the washrooms, fire exits, and some hazards specific to the job. This was a rudimentary (and somewhat inadequate) form of safety training. Some workplaces may offer more thorough safety orientations to new workers that address workplace hazards, emergency procedures, PPE training, policies (e.g., how to report injuries and near misses), and job-specific OHS skills (e.g., robbery prevention, fire suppression). Training on how to use equipment and other job-related orientation can also enhance workplace safety. Governments can also provide various kinds of broad safety education, such as Alberta’s “Bloody Lucky” campaign discussed in Box 8.1.

Legislation may also compel employers to provide certain kinds of training. For example, if a workplace exposes workers to hazardous materials, workers must be educated about the nature of the hazard(s) and trained in how to work with the product(s) in a safe manner (including responding to spills and emergencies) through WHMIS (described in Chapter 2). This means that WHMIS training may be mandatory for some workers and that the specifics of the training will vary between worksites (or even within one worksite over time) as the hazardous materials change.

Legislation may also require mandatory first-aid training. For example, Ontario requires all employers subject to the Workplace Safety and Insurance Act to provide mandatory first-aid equipment, facilities, and trained workers in each workplace. The degree of training required depends upon the number of workers in the workplace. Nova Scotia’s Occupational Health and Safety First Aid Regulations place additional obligations on employers when workers are employed in remote locations (i.e., locations farther than 30 minutes of surface travel away from an emergency-care facility that is open during the hours of work).

The goal of most safety training is ensuring that work is performed safely in the workplace. For this reason, training tends to focus on developing worker skills and behaviours that prevent incidents. Training can, however, focus on educating workers about their rights at work, including their right to information and their right to refuse unsafe work. That form of training is usually not in the interest of employers, who prefer to focus on modifying worker behaviour via skills and knowledge training. Unions and other worker organizations often incorporate rights education into their safety training courses. This difference is one of the characteristics that distinguish union safety education from employer safety training. Combining safety knowledge with worker rights can be an effective way increase safety in the workplace as workers gain both safety knowledge and insights into how to advocate for themselves. Box 8.2 examines how union safety training can affect workers’ health.

Broadly speaking, there is good research evidence that OHS training can change workers’ safety behaviour. There is also encouraging evidence that OHS training positively affects workers’ knowledge and attitudes. That said, there is no conclusive evidence that OHS training has a meaningful effect on workplace injury rates.Institute for Work & Health. (2010). Effectiveness of OHS education and training. Toronto: Author. http://www.iwh.on.ca/sbe/effectiveness-of-ohs-education-and-training More striking is that the rate of OHS training in Canada appears to be low, with only 1 in 5 workers reporting health and safety training during their first year of work with a new employer.Smith, P., & Mustard, C. (2007). How many employees receive safety training during their first year of a new job? Injury Prevention, 13(1), 37–41.

This evidence suggests that assertions that training is an effective way to make workplaces safer may not be true. When faced with such an assertion, it is useful to consider who is making that claim and how it may be in their interest. For example, Alberta farm workers were long excluded from the ambit of OHS legislation because of concerns about the cost of implementing OHS programming on farms. When faced with criticism about the number of workplace injuries on farms, farm industry organizations repeatedly argued for safety training, despite compelling evidence from Saskatchewan that safety training had no effect on farm injury rates.Hagel, L., Pickett, W., Pahwa, P., Day, L., Brison, R., Marlenga, B., Crowe, T., Snodgrass, P., Ulmer, K., & Dosman, J. (2008), Prevention of agricultural injuries: An evaluation of an education-based intervention. Injury Prevention, 14(5), 290–295. In this case, farmers were using training-as-a-panacea as a way to evade what they feared would be costly regulation. Farm workers—often precariously employed and racialized workers—bore the cost of the lack of regulation in the form of heightened risk of workplace injuries.

Learning the process wherein we acquire knowledge and skills that can lead to behavioural change—is an important outcome of training. As we saw in the discussion of social construction in Chapter 1, our behaviours are often shaped by our assumptions about the world. OHS training is no different: we each have a theory (albeit perhaps incomplete and poorly articulated) about how “best” to teach others. Over time, educational theorists have identified several different approaches to training.  These learning theories are conceptual frameworks that describe how learners absorb, process, and retain information. These descriptions of learning often contain prescriptions about how to teach. Two learning theories that are broadly used to structure OHS training are behaviourism and social cognition.

Behaviourism asserts that attaching rewards and punishments to specific worker actions can shape how workers behave. In effect, workers can be conditioned to act in desired ways via positive and negative reinforcement. Positive reinforcement is essentially rewarding a worker when the worker demonstrates a desired behaviour in order to elicit further instances of the desired behaviour. Negative reinforcement  is removing some sort of undesirable stimulus (such as no longer yelling at the worker) when a worker demonstrates a desired behaviour. (Negative reinforcement is different from punishment, wherein undesired behaviour results in sanctions.) Over time, behaviourism asserts, workers begin to exhibit the desired behaviour even when there is no more positive or negative reinforcement.Saks, A., & Haccoun, R. (2013). Managing performance through training and development (6th ed.). Toronto: Nelson.

The value of behaviourism is that it draws our attention to the fact that rewards and punishment affect learning and that this effect occurs both during and after the training process. For example, we might train workers to always walk around a vehicle to look for hazards or dangerous conditions prior to entering the vehicle and starting it up. This training may require positive reinforcement (e.g., praise) or punishment (e.g., discipline if the worker is observed not doing a walk-around). More importantly, behaviorism tells us that, if workers who act in accordance with their training are mocked by co-workers or hassled by their supervisor for holding up the delivery process, it is unlikely that the workers will continue to do vehicular walk-arounds. This suggests that training may need to also address workplace cultural practices if we want the training to be effective.

Social Cognition theory asserts that learning occurs through observation and imitation and thus through formal and informal interactions with others. The social learning process typically begins by workers observing how others act and the consequences of those actions. Workers may then emulate safety behaviours that appear successful for others, assuming the worker has the confidence and skill necessary to perform these actions. Box 8.3 highlights the time and support that are sometimes necessary for workers to successfully emulate safety behaviours and the need for workers to adapt such behaviours to the continually changing demands of work.

Social cognition theory also suggests workers are often able to manage their own safety behaviours through self-monitoring, self-evaluation, and self-rewarding.Ibid. This belief in worker self-regulation stands in contrast to the external regulation emphasized in behaviourism. Behaviourism’s emphasis on external regulation of workers’ behaviours (i.e., workers cannot be trusted to act safely) sometimes harkens back to the negative views of workers embodied in the careless worker myth that we read about in Chapter 1.

More generally, learning theories draw our attention to the fact that training is not done to employees, but rather requires their participation. Consequently, the effectiveness of training is enhanced when it is developed with workers’ interests and preferences in mind. For example, an organization may provide WHMIS training primarily to comply with legislative requirements. Workers may be more engaged by the training if it is presented as a way to reduce their risk of injury from hazardous materials and is delivered using training methods that are both practical and interesting.

Skilled trainers also recognize that workers may have both vocational (i.e., job-related) and non-vocational goals when participating in training. Some workers may see training as a way to advance their careers or interact socially with co-workers, or simply as a novel experience. Creating room for workers to meet their non-vocational goals may increase their engagement with the job-related material. One way to better address the needs of workers is to involve workers in the development of the OHS training they must take.

As in other aspects of OHS, competing workplace interests shape training. Employers are conscious of productivity and the cost of training, and so they will prefer training that delivers the information quickly, inexpensively, and with minimal impact on production or service delivery. As noted above, workers’ interests in training are more varied. Union-sponsored safety education is normally the only alternative source of OHS training available to workers.

Instructional Design  is a process of systematically developing training to meet particular goals and objectives. Figure 8.1 provides an overview of the process. The process begins by conducting a needs assessment to determine what kind of training is required to meet organizational goals. Organizational goals for health and safety training often include meeting legislative requirements or seeking to reduce injury rates, enhancing (or remediating!) the organization’s reputation for safety, or qualifying for workers’ compensation premium rebates. Employers seek to meet these goals by changing workers’ knowledge, skills, or behaviours via training.

Identifying specific organizational goals often clarifies who needs to be trained and the nature of the training that is required. Continuing with the example started in the last section, an organization seeking to meet its obligation to provide WHMIS training would train those workers who will work with hazardous materials. The content of the training will be shaped by which hazardous materials were used in the workplace and the selected control strategies. Whether a workplace would retrain workers who had previously received training might depend upon the nature of the hazard (which may have changed over time), the control strategies adopted (e.g., some PPE may require workers to undergo periodic retraining), and the additional cost (if any) of the retraining.

The question of cost reminds us that a needs assessment is not an entirely technical undertaking. What training is needed is not always perfectly clear, and those responsible for designing training can legitimately choose among different training options. For example, do workers with no responsibility for containing chemical spills require this training? This discretion over how to train is exercised in a particular economic and political context. Employers in capitalist economies are influenced by the profit imperative either directly or indirectly (in the case of public and non-profit sectors), which often causes them to seek to minimize labour costs (which include the cost of training). This often means that a needs assessment entails a cost-benefit analysis of the training, which may shape the kind of training employers choose to provide.

Figure 8.1 The instructional design process

Once the broad organizational goals of training have been identified, our attention then shifts to planning the training program, including developing the specific training objectives and methods and selecting trainers. Training objectives typically identify what the worker is expected to know or be able to do at the end of the training and establish some level of acceptable post-training performance. Training objectives may also help employers identify materials (e.g., MSDSs, PPE, administrative procedures) required for workers to apply the training in the workplace. Carrying on with the earlier WHMIS training example, workers might be expected to identify the ways in which each type of hazardous material can cause harm and be able to perform any physical skills associated with the control strategy adopted for each hazard (e.g., monitoring ambient levels of a gas). They might also be expected to always comply with the control strategies when working with the materials after the training and face periodic evaluation of their compliance and potential sanction for non-compliance.

After the training objectives have been established, it becomes necessary to determine what training methods will be used to accomplish the objectives. Most of us have sat through classroom-based training at some point, and online training is becoming increasingly common because its cost is relatively low and it can be offered when it is convenient to the learner. Lecture- or demonstration-style training may not be the most effective way to teach OHS skills and procedures. Experiential training (e.g., hands-on training or real-world simulations) may be more effective. It may also take more than a single demonstration or opportunity to practice for workers to become proficient at OHS skills and then integrate them into their work practices.

The final step in planning the training program is to select the trainer. Training may be provided by staff members or contracted to an outside provider. This decision is often based upon the required expertise (e.g., being licensed to provide training for particular kinds of equipment) and the cost. A common pitfall in OHS training is selecting a provider (who often has a pre-packaged program) before determining the training objectives and methods. This approach may reduce the effectiveness of the training, as usually training is not a one-size-fits-all proposition.

Techniques of delivering training are beyond the scope of this book, although the discussion above provides some examples of different delivery strategies. After the training has been delivered, it is important to evaluate the effectiveness of the training. There are four types of training outcomes that can be assessed and listed in ascending order of measurement difficulty:

• Reaction: Trainees’ satisfaction with the training venue, content, and activities is easy to assess (e.g., using a questionnaire). This information may be used to improve participants’ subjective experience of future training events but does little to assess the degree to which the training has met the training objectives.
• Learning: It is possible to measure the knowledge and skills trainees gained from the training through testing (e.g., multiple-choice quizzes, demonstrations). These measures are useful at measuring short-term outcomes of training. Learning outcomes can also be assessed partway through a longer training program in order to identify which aspects of the training require reinforcement or additional practice.
• Behaviour: OHS training often seeks to alter trainees’ behaviour, so measuring behavioural change in the workplace over time may be a useful assessment. This can be done through observation or by reference to indicators of desired behaviours (e.g., monitoring workers’ level of exposure to radiation). 
• Results: The purpose of training may be to affect overall organizational performance (e.g., lower injury rates). When assessing such outcomes, it is important to be mindful of non-training factors that may affect organizational results and that a positive outcome may not be due to the training itself.

Assessment activities are often determined during the design phase. This approach tends to most closely align assessment with the training objectives and ensure assessment is appropriate for the chosen training method. Concluding the WHMIS example, if the organizational goal is meeting (and being seen to meet) legislative requirements around hazardous materials, this goal can be met by demonstrating that workers received the training. Assessing workers’ learning and behaviour might tell both the employer and the workers important things about the effectiveness of the training at imparting knowledge and skills and altering behaviour. That said, cost considerations might affect the degree to which the achievement of training objectives get measured.

Emergencies are sudden events that pose a hazard to workers’ health and safety and require immediate action. Obvious examples include weather or transportation events such as the 2013 flood in Calgary, Alberta, or the tanker-car explosion in Lac-Mégantic, Quebec. Fortunately, most emergencies are of a much smaller scale. The release of hazardous gases at the Burnaby mushroom farm is an example. The workers had no warning that they would be exposed to a powerful chemical hazard in a confined space, and the exposure rapidly incapacitated, injured, and killed them. While preventing such events is ideal, emergency plans can significantly mitigate the harm caused by emergencies.A good introduction to emergency planning in Canada is available here: http://www.ccohs.ca/pandemic/pdf/Business_continuity.pdf

Like all HRAC activities, emergency planning begins by evaluating what hazards might trigger an emergency in the workplace. Emergencies can be caused by hazards specific to the workplace (e.g., a leak of dangerous chemicals in a hardware store) or by events outside the workplace (e.g., the risk of retail workers becoming ill during an outbreak of the flu). Once the most likely causes of an emergency at a workplace have been identified, it is necessary to consider how each cause would affect the workplace and how the underlying hazards can be controlled.

This process can lead to the development of one or more emergency plans that outline the steps necessary to respond effectively to the emergency. The details of these plans will differ based upon the nature of the hazard: a chemical spill obviously requires a different set of responses than a pandemic.

Emergency planning can be much more complicated when the worksite changes frequently (e.g., in construction) or is mobile (e.g., in oil-and-gas exploration). Knowing there is an emergency and developing evacuation protocols is much more difficult when facing constantly shifting circumstances.

Emergency planning is linked to safety training because all workers need to know what to do and where to go in the event of an emergency. Emergency responders (people assigned to respond to the emergency) require additional levels of training to spot hazards and engage an effective response (e.g., evacuate injured workers, stop a gas leak). Part of emergency preparedness is a comprehensive training plan for each worker at the level they require it.

Health and safety training can play an important role in reducing the number and severity of workplace injuries. The five workers who were injured or killed at the Langley mushroom farm in 2008 were harmed because they were exposed to uncontrolled hazards. While controlling these hazards through elimination, substitution, or engineering controls would have been the best way to prevent this incident, informing the workers about the well-known risks associated with manure composting and enclosed spaces and providing them with the training and equipment necessary to do the work safely might have also prevented it. Even if a hazard is controlled through engineering controls, there is still a need to ensure workers understand the nature of the hazards that could exist if the engineering control failed. Indeed, even providing the workers with basic training about their workplace rights and the hazard recognition process might have prevented the incident or reduced its consequences.

In this case, the employer appeared ignorant of the hazards in the workplace and therefore did not see any reason to provide training. Circumstances like these—where the employer may be unqualified to run their business in a safe manner—is one of the reasons that all Canadian jurisdictions have OHS inspection programs. Had the employer been made aware of the hazard and its obligations to control the hazard, it is possible that these workers would still be alive. Similarly, if the employer had an emergency response plan, it is possible that some of these workers would have avoided injury when attempting to rescue their colleagues.

Employers are responsible for investigating workplace incidents. Before the formal incident investigation begins, the employer needs to take the necessary steps to meet both internal and external reporting requirements.

Pre-Investigation

• Has the employer provided the injured parties with the necessary level of first aid and called 9-1-1 if required? Don’t forget that witnesses may need support as well.
• Has the employer notified internal stakeholders of the recent incident? These stakeholders may include human resources, health and safety representatives or committee members, union representatives, and the leadership team.
• Has the employer notified the external stakeholders of the recent incident? These stakeholders may include family members of the injured parties, third party contractors/employers, temporary agencies, legal counsel, head-office personnel, law enforcement, workers compensation and necessary government agencies.

Workers Compensation

Regardless of an employer’s location, there are reporting requirements following a known workplace injury or illness. In Ontario, for example, the Workplace Safety and Insurance Board (WSIB) requires an employer to submit a Form 7 within three days of being notified of an individuals work related illness or injury. Revithe “Injured at Work” brochure to become familiar with the injured worker reporting expectations of WSIB.

Additional Resources
Injured at Work? A Guide to Reporting Injured Workers and Employers 

Government Agencies

When preparing the emergency contact sheet at work, employers need to ensure they include information relating to government agencies that need to be contacted in the event of a workplace incident or death. In Ontario, for example, employers must submit a written report to the Ministry of Labour  (MOL) within 48 hours of a critical injury. Refer to the Ministry of Labour’s website to become familiar with their definition of a critical injury.

Incident investigations are intended to uncover all of the key facts about how and why an incident occurred so that action can be taken to prevent it happening again. Not conducting the investigation in a careful and thorough manner can undermine the results and create the risk of a repeat incident. Any incident where significant injury occurs should be thoroughly investigated, but there is value in investigating minor injury and near miss events as well, as they can reveal important insights that might prevent a future injury. Let’s look at the incident at a Canadian sawmill to learn more about the impact of workplace incidents. 

Some employers may not realize the benefits of conducting a thorough incident investigation. The Canadian  Center for Occupational Health and Safety suggests the top reasons for conducting incident investigations include:

• most importantly, to find out the cause of incidents and to prevent similar incidents in the future
• to fulfill any legal requirements
• to determine the cost of an incident
• to determine compliance with applicable regulations (e.g., occupational health and safety, criminal, etc.)
• to process workers’ compensation claims
• Root cause discovery and the discovery of contributing factors is a significant reason for conducing an incident investigation. Once an employer identifies the root cause and contributing factors, it may result in training or re-training individuals, policy change, signage, PPE just to name a few. An employee cannot work towards avoiding or minimizing the risk of a similar incident without the identification of the root cause and contributing factors.
• Meeting legal expectations and compliance is essential for every employer. A workplace incident may involve government workplace inspectors and, in some instances, law enforcement.
• Understanding both the direct and indirect costs of a workplace incident allow an organization to justify additional safety measures that will eliminate or reduce these financial costs going forward.
• Employers must ensure they have gathered the correct information needed to accurately report workplace incidents to Workers Compensation in a timely manner.Incident Investigation, OSH Answers Fact Sheets, Canadian Centre for Occupational Health and Safety (CCOHS). 

Who investigates an incident is a particularly important question. The lead investigator should be someone with investigative experience, knowledge of the work and work processes, and an understanding of how incidents are caused. Many workplaces will task a senior health and safety official or senior manager with managing incident investigations. No one should investigate an incident alone, and other people should be selected to assist, to provide different perspectives, and to divide the workload. Other possible participants should include joint health and safety committee members or some other worker representative, people linked to the work that had been performed, and, in most cases, the direct supervisor of the work (although there are cases when inclusion of the supervisor may not be appropriate). Union agreements often stipulate that a union steward or representative participate in incident investigations. Anyone who is identified as an investigator should be properly trained beforehand.

Creation of an investigation kit is also an important pre-incident task. An incident investigation kit is a pre-assembled box or tote containing the tools, forms, and material needed in an investigation. It is recommended the employer place a piece of sealing or tamper proof tape around the investigation kit. This sealing tape can easily be cut open and it allows the employer to quickly identify when the kit has been used in order to re-stock any missing items. Investigators can then act quickly by grabbing the kit and beginning their work. The following graphic illustrates some of the materials that should be included in an employer’s investigation kit.

A successful incident investigation begins with a consistent process designed to uncover what happened so future incidents can be avoided. Investigations need to be performed as soon after the incident as possible and be completed as quickly as possible. Witnesses’ recall may deteriorate over time and important evidence may disappear if there is a delay. The sooner an investigation is completed, the sooner changes can be made to make the worksite safer. Employers may also be required to report incidents and investigation results within a specified time period.

Step 1. Scene Security  

Securing the scene entails two actions. First, any uncontrolled hazard (e.g., leaking gas) needs to be eliminated to ensure the safety of the investigators and others. Second, the scene needs to be protected so that no evidence can be destroyed or altered (intentionally or unintentionally) until the completion of the investigation. Protection normally includes restricting access to the scene. In some circumstances, it may also require protecting the scene from inclement weather.

Step 2. Identify and Interview Witnesses

Investigators normally prioritize interviewing witnesses, including the injured worker(s). Witnesses should be interviewed as soon as possible after the incident while their memories are fresh and uncontaminated by discussing the event with others. A few principles should be followed in interviewing to ensure accurate information and the well-being of the witness:

• Ensure the witness is physically and emotionally well. Witnessing an incident can traumatize people and assistance, such as counselling, may be necessary before an interview takes place.
• Be clear about the purpose of the interview and the investigation, highlighting that it is not about laying blame.
• Interview witnesses separately and in a neutral location. A worker representative should be provided if the witness requests it or if the union agreement requires it.
• Allow witnesses to describe what happened in their own words. Do not lead or put words in their mouths.
• Ask only questions that elicit more information or clarify answers. Do not ask the witness “why” they think something happened.
• Be an active listener. Ensure the investigator has correctly heard them by repeating or summarizing what they said.
• Record the interview in some fashion—either with detailed notes or (if appropriate) audio recording.
• Be aware of power relations. Interviews can be distorted by unrecognized power imbalances, such as the interviewer being the supervisor of the worker, or the worker who was injured being under the witness’s supervision. These dynamics can be a barrier to accurate reporting of the incident.

Step 3. Complete the Investigation

The next step in an investigation is to gather evidence. There are a number of techniques for collecting the relevant information. They will be used in various combinations depending on the nature of the incident and the workplace. Gathering might begin with a walk-through, which is an inspection of the incident scene to get an overall picture of the environment. A walk-through may also clarify which additional evidence-gathering techniques are appropriate. These further techniques should include recording the scene through photos or video or drawings (if photos or video are not practical) to create a visual record of the scene.

Another investigative technique is a re-enactment of the incident, which is a simulation designed to recreate the circumstances that led to the incident. A re-enactment might entail asking witnesses to act out the events that took place before the incident, or re-establishing a set of conditions relevant to what occurred. The value of the re-enactment is that it can identify how circumstances, events, or behaviours interacted to cause the incident. These interactions can be difficult to identify solely through witness testimony because of the limited perspective any one witness will have on an incident. Other investigative techniques might include inspecting machinery and tools, checking logs and records, collecting debris, materials and other relevant items, or conducting air sampling or noise testing. Investigators should also gather any relevant company policies, government regulations, or operator’s manuals and guides.

Step 4. Root Cause Analysis

Once all the information has been gathered, the next step is to analyze the data to determine the causes. This is a crucial step, and is often where investigations go wrong. The immediate reasons for the incident will be the first to appear. These causes will usually be worker error or some factor that may appear to be uncontrollable. Stopping the investigation at this point will lead to an incomplete analysis and the investigation will likely fail at one of its key goals—preventing future incidents. Additional analysis of the data will reveal underlying reasons for (the “root cause” of) the incident. A simple way to think about probing data for root causes is to keep asking “why?” Asking why something happened allows the investigators to get past their initial understanding of the incident. 

In an attempt to help investigators get to root cause, a variety of analysis models have been developed. The domino theory dates back to 1936 and remains popular due to its ease of illustration. It envisions cause as a series of five dominos lined up together.Heinrich, H. (1936). Industrial accident prevention. New York: McGraw-Hill. Each domino represents factors reaching back from an incident. The first (closest) domino is labelled Injury, followed by Incident, Unsafe Acts and Conditions, Personal Defects (e.g., equipment failure, personal factors), and finally Background (e.g., lack of management control). The theory contends that injury results from failure at all five levels. If any of the failures does not happen (i.e., one of the dominoes is removed from the chain), an injury will not occur. For example, if a worker is taught to work safely, an injury might be prevented even though failures in background decisions still occurred.

A more recent revision to domino theory is the Swiss cheese model.Reason, J. (1990). Human error. Cambridge: Cambridge University Press. This model retains the five factors giving rise to injuries that are outlined in domino theory. Each of these dominoes is then given “holes” that represent various subfactors that influence whether an incident occurs or not, such as organizational influences, local working conditions, unsafe acts, and defences, barriers, and safeguards. In the Swiss cheese model, an incident requires that the holes in the dominoes line up—in other words, a failure must occur in each domino. This model emphasizes that injuries are the result of multiple failures. If one of the subfactors is functioning properly, then weakness in the other four may still not lead to an incident. For example, bad organizational culture (an organizational influence) around safety may not lead to injury if there are appropriate guards (a defence, barrier, or safeguard) to prevent injury. The domino theory and Swiss cheese models are popular because of their simplicity in articulating a core principle that an investigator must look beyond immediate actions and explore underlying factors that contributed to the incident. 

Step 5. Reporting and Recommendations  

The next step in the investigation process is to write a formal report outlining the findings and making recommendations. In some respects this can be considered the most crucial phase, as a careful investigation is without value if the recommendations fail to improve the situation. The incident report will be the permanent record of the incident and its causes and thus should clearly outline what happened and why it happened. It may even have future legal ramifications, as its recommendations may be used by government inspectors to determine if an employer met the standard of due diligence in controlling hazards after the incident.

Incident reports can take different forms depending on context, organization, and situation. All incident reports should include the following elements:

• Who performed the investigation
• Details of the incident, including date, time, persons involved, outcomes
• Details of the investigation and how it was conducted, timelines, etc.
• An outline of the factors that led up to the incident
• Clear identification of the root causes of the incident
• Specific recommendations designed to prevent future incidents

In designing a report template, a report that requires investigators to answer open-ended questions is preferable to a report that provides a checklist of options. To elicit action, recommendations need to be specific and directed to the identified causes. Nevertheless, if they are too specific, they risk not addressing systemic issues adequately. The recommended action also needs to be within the control of the employer. This can be difficult when environmental conditions played an important role in the incident. For example, bad weather may have been a factor in an incident. While the employer cannot control weather, the employer can implement controls that neutralize the effect of weather on workers. There is also the issue of how to report on the role of human error in the incident. Should human error be identified during the incident investigation, it should be identified without assigning blame.

The investigator(s) should ensure all affected parties receive a copy of the investigation report, including involved workers, the joint committee (if applicable), and responsible managers. It is the responsibility of the employer to implement recommendations. Often employers will delay implementation, seek out other solutions, or respond that the recommendation is too expensive or not practicable. Lack of follow-through on recommendations is a reality of in practice and it can undermine both workplace safety and how carefully investigators examine future incidents. An action plan should accompany the report in order to assign timelines and resources to implement the recommendations.

Step 6. Follow up

The final step in the incident investigation process is follow up. During the reporting stage, specific recommendations were put forward which most often include corrective and preventative measures. The goal is to eliminate or minimize the risk of a similar incident happening in the future. One question to ask is “have the recommendations been implemented?” If the employer discovers the recommendations have not been fully implemented as yet, review the action plan to determine if the appropriate timelines and resources have been assigned to this phase, and revise if necessary.

Finally, the employer needs to determine if the recommendations are effective? As everyone in the workplace is part of the IRS (Internal Responsibility System), it is important to include stakeholders such as the health and safety representative or committee, the area supervisor and union representation (if applicable) to determine the effectiveness of the corrective and preventative measures.

All investigations have the task of preventing injury and ill health, meaning they should be conducted with care and precision. This chapter examined the key steps involved in an incident investigation. Every employer must ensure they have trained incident investigators and an incident investigation toolkit on site. There are action items that need to take place following a workplace incident, some to meet internal expectations and some to meet external expectations, such as government and legal requirements. An employer needs to know who to contact under which circumstances, when to contact them and which forms to complete. Every employer needs to be prepared to conduct a thorough and timely incident investigation in order to meet expectations and protect its people. 

Disability management is a set of employer practices designed to prevent or reduce workplace disability and assist workers in recovering normal functioning as quickly as and to the maximum degree possible. In sections that follow, we’ll examine each of the three interrelated aspects of disability management:

Before discussing disability management, it is useful to consider what the term disability means. Disability is often discussed as a characteristic of a worker (i.e., the worker is disabled). While a worker may indeed have an impairment, it is important to remember that it is the workplace context that turns the impairment into a disability. See more information in the box below. 

Disability management is often said to minimize the cost of disability to employers.Tompa, E., de Oliveira, C., Dolinschi, R., & Irvin, E. (2008). A systematic review of disability management interventions with economic evaluations. Journal of Occupational Rehabilitation, 18(1), 16–26. These practices also ensure that employers meet their duty to accommodate. Human rights legislation requires employers to avoid discriminatory workplace practices. This chapter focuses specifically on employers’ obligation to accommodate workers with temporary or permanent physical or mental injuries, regardless of whether the impairment was caused by a workplace injury.

Employers’ duty to accommodate requires employers to alter work, work practices, or the workplace in order to allow workers with disabilities to perform meaningful work. The duty to accommodate requires employers to make any necessary efforts to accommodate the worker’s disability-related needs up to the point of undue hardship. The threshold of undue hardship varies from workplace to workplace. To claim undue hardship, typically, an employer is required to demonstrate that an accommodation is economically unsustainable, interferes with a legitimate operational requirement, or poses a health-and-safety threat.Manitoba Human Rights Commission. (2010). Reasonable accommodation. http://www.manitobahumanrights.ca/publications/guidelines/reasonable_accommodation.html In these circumstances, an employer is still required to provide whatever accommodation is possible short of undue hardship.

Risk assessment is an important part of operations management. One risk to an organization includes the failure to develop and implement a disability management program. Three areas of risk associated with disability management include legal, corporate image and financial.

Legal Compliance

It is important that an employer recognize and follow legislation surrounding disability management. For example, in Ontario, an employer is expected to comply with AODA (Accessibility for Ontarians with Disabilities Act) legislation and the Ontario Human Rights Commission legislation. Both pieces of legislation provide helpful definitions of disability, clearly outline the ways in which individuals with disabilities are to be accommodated in the workplace and provide the employer with useful resources to assist with implementation.

Organizational Reputation

Every organization wants to be known as a responsible corporate citizen. Should an employer develop a reputation for failing to support individuals that have suffered a workplace injury, illness or disability, the impact on the organization may be costly.  With the ease of use and popularity of social media, it is easy for employees and former employees to share information about their employer, including disability management and return to work practices. From a morale standpoint, most would agree that a good employer takes care of their employees by introducing disability prevention strategies and return to work programs. Job candidates research potential employers online prior to applying for a job or attending a job interview. What will this potential employee find out about the employer’s safety record and culture? Lastly, every organization needs to be concerned about their reputation within their industry as the competition for sales is fierce in a global economy.

Financial Consideration

What is the cost to an organization if they fail to follow good disability management practices? There are direct costs such as the premium costs associated with Workers Compensation. In Ontario, an organization’s WSIB (Workplace Safety and Insurance Board) premiums are partially based on the number of lost time accident days an employer incurs. If an injury is deemed to be a  lost time accident it typically means the employee is absent from work on the day(s) following their injury. Employers need to use their implement their disability management program to minimize their lost time incident rating. When an injured employee is off work, there are also indirect costs associated with these absences such as productivity issues and the cost of hiring and/or training an employee to cover for an injured employee. Other indirect costs to an employer may include the negative impact on morale and engagement when an employee is off work due to a workplace injury, illness or disease.

While all employers have legislative obligations to prevent injury (as outlined in Chapter 2), some employees also provide an employee assistance program (EAP) as part of their disability management program. These programs normally provide access to short-term psychological counselling to help employees to cope with personal problems. The underlying logic of EAPs is that personal issues can affect work performance and, if untreated, can sometimes become more profound.

EAPs are often one aspect of workplace wellness programs. Such programs are health promotion activities designed to help workers to improve their health and well-being. These programs often focus on specific issues (e.g., smoking cessation, weight loss, stress management). Again, the underlying logic of these programs is that healthier workers will be more productive workers. It is worth noting that many of these programs help workers to adapt to workplace hazards rather than seeking to remove the hazard by modifying the work. Stress management, for example, rarely seeks to eliminate the workplace causes of stress. Instead, it seeks to help the worker cope with that stress to maintain the worker’s productivity.

Some wellness initiatives that do actually modify the workplace are things like flexible work arrangements, such as compressed workweeks. In a compressed workweek, a worker puts in slightly longer hours but fewer days per week. Some workplaces will also allow job sharing, wherein two workers share a single position with each worker working some portion of the full-time job. Another option is telecommuting, wherein workers perform work away from the office (e.g., at home). This option can allow workers to better balance otherwise conflicting work and home responsibilities.

Other wellness initiatives include job design and job rotation. In job design, department leaders work with the Human Resources department to review the makeup and expectations of a job to ensure the workload and physical requirements of the role are realistic and support good overall health. In job rotation, employers cross-train employees to rotate job coverage so no one person experiences an entire shift of heavy lifting, awkward positioning, or risk of repetitive strain injury. A different strategy for reducing the possibility of injury through interventions in workers’ personal lives is the use of alcohol and drug testing in the workplace. Some employers feel this private behaviour outside of work can affect safety at work, and therefore take steps to identify workers whose alcohol or drug use may affect their work.

A bona fide occupational requirement (BFOR) is a rule necessary for the proper performance of a job, and such a rule can prevail even if it causes otherwise prohibited discrimination. For example, it is unlawful for an employer to refuse to hire a worker because the worker is blind. Yet, if an employer were hiring a delivery driver, requiring the worker to hold a valid driver’s licence (which a blind worker cannot acquire) would be a bona fide occupational requirement. This requirement is permissible because holding a driver’s licence is rationally connected to the job and reasonably necessary for the accomplishment of a legitimate work-related purpose.
Ontario suggests a three-part test to determine if drug and alcohol testing is a BFOR:

• the standard or test has been adopted for a purpose that is rationally connected to the performance of the job
• the particular standard or test has been adopted in an honest and good faith belief that it was necessary to the fulfillment of that legitimate work-related purpose
• the standard or test is reasonably necessary to accomplish that legitimate work-related purpose (i.e., it is impossible to accommodate individual employees sharing the characteristics of the claimant without imposing undue hardship upon the employer) Ontario Human Rights Commission. (2015). Drug and alcohol testing: Basic principles. Toronto: Author. http://www.ohrc.on.ca/en/policy-drug-and-alcohol-testing/drug-and-alcohol-testing-basic-principles

This approach places significant restrictions on employer drug testing. For example, drug testing typically shows the presence of drug-related residue in a worker’s system, rather than measuring the actual degree of worker impairment. Since a test that does not measure impairment cannot be rationally connected to job performance, such testing is not a BFOR. Alcohol testing after an incident, when an employer has cause to suspect impairment, or at random for workers in safety-sensitive positions, may be permissible because alcohol testing does measure impairment. It is important to be mindful that different rules may apply in different circumstances and jurisdictions.

There are many causes of disabilities, including workplace injuries. As noted above, all Canadian jurisdictions require employers to accommodate workers with disabilities to the point of undue hardship. Both workers and employers have roles to play in ensuring that a disability is accommodated. Employers do not have to implement the accommodation suggested by a worker. Rather, they are obligated to reasonably accommodate the worker. Once an accommodation is established, the worker is obligated to inform the employer if the need for or nature of the required accommodation changes and provide documentation to support such accommodation.

There are a number of ways that employers commonly accommodate disabilities. The duties of worker may be modified so that the worker is able to perform them despite the disability. For example, a warehouse worker with a torn rotator cuff in her shoulder may still perform those parts of their normal duties that do not require lifting, pushing, pulling, or overhead work. A machine operator who develops contact dermatitis on their hands from exposure to chemicals may be assigned to an entirely different job, such as quality checks.  Such modified work may be permanent or temporary, depending upon changes in the worker’s abilities. Accommodating permanent disabilities may also entail retraining workers to perform jobs they are presently unqualified to perform.

Employers may also make workplace modifications in order to accommodate disabilities. A common and obvious change is adjusting buildings, equipment (e.g., work stations), and tools to accommodate workers with mobility impairments. Less obvious changes to the workplace including providing nitrile gloves to staff members who are allergic to latex products or adopting scent-free workplace policies to accommodate workers with chemical sensitivities.

“Our research shows that if you don’t get a worker back within 90 days of their injury, the chances that they ever go back to work drop by 50 per cent,” said David Marshall, president and CEO of Ontario’s Workplace Safety and Insurance Board, in 2015. Brennan, R. (2015, January 31). Meet the man injured Ontario workers ‘love to hate.’ Toronto Star. http://www.thestar.com/news/canada/2015/01/31/meet-the-man-injured-ontario-workers-love-to-hate.html Marshall’s views are shared by many employers and OHS practitioners who see a return-to-work (RTW) program as a way to reintegrate injured workers into the workplace via practices such as modified work. As an added bonus, RTW programs save employers money on their workers’ compensation premiums.

Organized labour and injured worker advocates have a different view of RTW, with Ontario Federation of Labour president Sid Ryan calling Marshall “the equivalent of the modern day bounty hunter. His job is to disqualify injured workers from receiving their rightful benefits . . . [His] $400,000 [salary] is his bounty for his work over the last year.” Catherine Fenech, of the Ontario Network of Injured Workers Groups, notes “an increase in workers being told the board thinks they can go back to work no matter how badly injured they are.” Ibid.

The final component of disability management consists of programs designed to assist workers in recovering from temporary impairment (such as injuries and illnesses) that cause disabilities. The most common disability recovery program is sick leave, which is paid leave designed to help workers recover from short-term illness or injury. Sick leave is so widely available because it is sometimes specifically required by employment standards legislation and generally seen as a reasonable accommodation required by human rights legislation.

Most employers are required to enroll their workers in their provincial or territorial workers’ compensation system, which provides wage-loss and other benefits in the event of a work-related injury of illness. Some employers also provide workers with disability insurance purchased from a private insurer. Disability insurance benefits provide wage-loss replacement for workers who require a longer period of time away from work for reasons other than a work-related injury. The specifics of disability insurance vary among workplaces and frequently reimburse only a portion of the wages lost.

Modified work may also be used to help workers to recover from a temporary impairment that causes disability. Work hardening entails providing a worker with the opportunity to gradually return to work (via increasing hours and work demands) in order to build stamina. Employers may also provide coaching or other forms of support to workers who are returning to work. As noted below, the beliefs underlying these return-to-work strategies and their manner of implementation are the subject of some controversy. Box 10.4 discusses the National Institute of Disability Management and Research, which provides research-based evidence for practitioners.

As noted above, return-to-work (RTW) programs are designed to reintegrate injured workers into the workplace via practices such as modified work. This approach stands in contrast to the historical practice of having workers stay off work (most often collecting workers’ compensation wage-loss benefits) until they are fully recovered. By providing injured workers with modified work, employers are able to reduce the cost of injury borne by workers’ compensation claims. In jurisdictions that operate experience-rating programs, reducing workers’ compensation claim costs can result in a reduction in an employer’s workers compensation premiums. In short, RTW programs can save employers money.

When considering the relationship between injury duration and the likelihood of workers returning to work, it is important to be mindful that more seriously injured workers are likely to both require a longer period of recovery and have a lower chance of ever returning to work. MacEachen, E., Ferrier, S., Kosny, A., & Chambers, L. (2007). A deliberation on ‘hurt versus harm’ in early-return-to-work policy. Policy and Practice in Health and Safety, 5(2), 41–62. This is a very plausible explanation for why workers who are off work longer may also be less likely to return to work.

There is some evidence that workers with back pain recover more quickly when they remain active. On the surface, this correlation might seem to suggest that RTW can, in fact, be rehabilitative. It is not clear, however, to what degree work is analogous to the more generalized term activity. Work differs from other activities (e.g., going for a walk) because it occurs in the context of a power relationship designed to maximize productivity. Consequently, some employers will promise, but not truly provide, suitable modified work. When this occurs, workers face pressure to work in a manner that can be contrary to their medical restrictions, thereby creating the risk of re-injury. Ibid. More troubling is that there is no evidence to support the notion that activity aids recovery from injuries other than lower back injuries. That is to say, proponents of RTW are not only misstating the benefits of RTW but are also overstating the medical benefits of activity in general.

There are numerous Stakeholders—primarily employers and workers, but also governments, unions, and medical practitioners—involved in disability management and return to work strategies. Each stakeholder brings a unique perspective to the table. It is the job of the employer to ensure the concerns of each stakeholder is taken into account as they seek to manage workplace disabilities and return to work programs, and stakeholders are included in the process.  

The field of disability management encompasses disability prevention, accommodation, and recovery. A complete disability management program serves to meet employers’ statutory obligations to prevent and accommodate disabilities created by occupational health and safety, human rights, and workers’ compensation legislation. Such programs can also minimize the cost of injuries and disabilities borne by employers, primarily by returning workers to productive work as quickly as possible.

While the facts are complex, this case illustrates how health and safety issues develop differently in practice than they do in textbook examples. In theory, MacPhee-Lay acted appropriately. She expressed concerns about a hazard and conducted research to support them. Yet her employer seems to have fired her for trying to ensure her workplace was safe. In considering this case, we need to recognize that the circumstances of her complaint cannot be disentangled from the dynamics of her employment relationship, which had begun to deteriorate prior to the complaint. We should also be cognizant that she was challenging her employer’s ability to implement a new work process, behaviour that employers often suppress by disciplining one worker as an example to the rest.

The case also points out weaknesses in OHS laws and government enforcement activity. MacPhee-Lay’s case was not decided on the merits of her safety concern. Neither the OHS officer nor the panel disputed her claims about the grill’s safety hazards. Instead, her complaint was dismissed based upon a narrow reading of the Act that produced a procedural loophole the appeal panel used to excuse the employer’s conduct. Research suggests that arbitration and labour boards often defer to employers in matters of disciplining workers who refuse unsafe work. Harcourt, M., & Harcourt, S. (2000). When can an employee refuse unsafe work and expect to be protected from discipline? Evidence from Canada. ILR Review, 53(4), 684–703.

This chapter examines OHS in practice to reveal the ways in which working toward safety in real workplaces is more complex than we might anticipate. It extends our analysis of how power shapes workplace health and safety. It looks at how the internal responsibility system does not work exactly as intended. And it also considers the nature of government OHS enforcement in the 21st century and how it can impede workplace safety. The chapter concludes by offering some practical tips for workers, OHS activists, and safety practitioners about how to improve safety in Canadian workplaces.

Throughout this book, we have considered how the power imbalance in Canadian workplaces—an imbalance that favours employers and allows them to advance their interests at the expense of workers’ interests—affects OHS policy and practice. We have already discussed many of the mechanisms that benefit employers, from the careless-worker myth to behaviour-based safety. This section extends this analysis to consider how contemporary OHS arrangements developed and how they have slowly eroded the role of workers in workplace safety.

Today, OHS is a highly technical and highly professionalized field. Safety professionals are often extensively trained, and research has improved the effectiveness of hazard recognition, assessment, and control tools. OHS is also a multi-million dollar industry. Employers hire consultants and safety specialists to provide a wide range of services, from training to technical monitoring and control to designing safety systems. Most industries have developed industry safety associations (more on this below), both to offer many of these services and to lobby governments on employers’ behalf.

Safety was not always a sophisticated industry. The modern OHS movement arose out of worker activism and (sometimes illegal) workplace action that forced employers and governments to address safety concerns. During the 1960s, a series of wildcat strikes in industrial plants across Canada raised the profile of OHS issues.Richardson, B., & Newman, D. (1993). Our health is not for sale. Ottawa: National Film Board of Canada. In the 1970s and 1980s, worker safety activists formed a network that pushed for better hazard control, trained workers to protect their health, and forced legislative change that created the contemporary health and safety regime.Storey, R. (2005). Activism and the making of occupational health and safety law in Ontario, 1960s–1980. Policy and Practice in Occupational Health and Safety, 1, 41–68. Most often the activism was conducted in the face of opposition from both employers and government.Storey, R., & Lewchuk, W. (2000). From Dust to DUST to dust: Asbestos and the struggle for worker health and safety at Bendix Automotive. Labour/Le Travail, 45, 103–140.

Despite government reluctance to take action on OHS, early government regulators recognized and enacted legislation and enforcement practices designed to mitigate the power imbalance in the workplace. For example, OHS pioneer Robert Sass, who wrote Canada’s first OHS legislation (in Saskatchewan) and was the architect of the three worker rights (i.e., the rights to know, participate, and refuse), argued that employer and state resistance to improving workplace safety was driven by the profit imperative of capitalism.Sass, R. (1986). The workers’ right to know, participate and refuse hazardous work: A manifesto right. Journal of Business Ethics, 5(2), 129–136; Sass, R. (1989). The implications of work organization for occupational health policy: The case of Canada. International Journal of Health Services, 19(1), 157–173. This view was consistent with historians’ understanding of government and employer safety efforts in the late 19th and early 20th century, which were designed to ensure that unsafe workplaces did not compromise employers’ ability to make a profit.Tucker, E. (1990). Administering danger in the workplace: The law and politics of occupational health and safety regulation in Ontario, 1850–1914. Toronto: University of Toronto Press. It is useful to remind ourselves that the profit imperative is also present, somewhat indirectly, in public and non-profit sector workplaces as well.

Over the last 30 years, the link between OHS and the broader struggle between worker and employer interests in the workplace has been obscured by employer efforts to professionalize safety. Professionalized OHS entails segregating safety issues from the rest of work by transforming OHS into a “neutral” practice of objectively measuring and correcting hazards. Employers benefit from narrowing OHS to a merely technical undertaking because, for example, it allows them to address safety issues with inexpensive (and often inadequate) controls (such as issuing workers PPE) rather than altering the work process to eliminate or at least control workers’ exposure to the hazard. This narrow approach has also legitimized employer’s cost-benefit analysis in OHS, as discussed in Box 11.1. Overall, this professionalization has rendered invisible the conflicting safety interests of employers and workers.

In professionalized OHS, safety becomes another tool with which the employer can control how the worker will perform their work. Safety becomes a monologue by the employer, rather than the dialogue between workers and employers that was envisioned by Sass and others. The implications of this change are evident in most workplaces across all sectors. There is little discussion between workers and their supervisors about how to control hazards. There is little debate about whether PPE is sufficient or whether something more is required. And the experiences of workers like Andrea MacPhee-Lay tell us what can happen when a worker speaks up about safety.

Another consequence of professionalized OHS is that the safety role of unions is diminished. When safety is seen as part of the employment relationship, the union has a legitimate role to play in safety (e.g., training workers, inspecting workplaces, raising issues on JHSCs) and safety is a condition of work that can be negotiated. Indeed, many unions appoint or elect a safety representative who engages with the employer to negotiate appropriate safety provisions. When employers outsource OHS to consultants and broadly treat it as a function separate from the work process, the union loses some of its ability to shape workplace safety.

The sidelining of unions is more than just a theoretical labour relations problem. Unions make workplaces safer. Unionized workplaces have lower incident and injury rates than non-union workplaces.Yi, K. H., Cho, H. H. & Kim, J. (2011). An empirical analysis on labor unions and occupational safety and health committees’ activity, and their relation to the changes in occupational injury and illness rate. Safety and Health at Work, 2(4), 321–327. Unionized workers are also more likely to hold beliefs—for example, that taking risks is not part of their job—that contribute to safer work practices.Gillena, M., Baltz, D., Gassel, M., Kirsch, L., & Vaccaro, D. (2002). Perceived safety climate, job demands, and coworker support among union and nonunion injured construction workers. Journal of Safety Research, 33(1), 33–51. Unionized workplaces are safer due to a combination of better training (that teaches workers how to use their safety rights to make the workplace saferHilyer, B., Leviton, L., Overman, L., & Mukherjee, S. (2000). A union-initiated safety training program leads to improved workplace safety. Labour Studies Journal, 24(4), 53–66.), a more formalized process for worker participation (such as safety meetings and JHSCsYi, K. H., Cho, H. H., & Kim, J. (2011). An empirical analysis on labor unions and occupational safety and health committees’ activity, and their relation to the changes in occupational injury and illness rate. Safety and Health at Work, 2(4), 321–327.), and less fear among unionized workers of repercussions for exercising their rights.

The safety effect of unions demonstrates that OHS is most effective when workers are actively engaged in dialogue about safety and empowered to make change. This more democratic approach to safety runs counter to employers’ interests in maintaining control over the work process. Thus employers use their greater power in the workplace to shape OHS in ways that diminish workers’ roles. The reality of workplace safety under capitalism is that employers and workers want different (and often mutually exclusive) types of OHS, and over the past 30 years employers have slowly been winning this struggle.

The IRS is built upon the premise that employers and workers are jointly responsible for safety and that, by working together, they can make workplaces safer. After almost 40 years of operation, the IRS has not lived up to its potential. While workplaces are safer than they were 40 years ago, particularly when it comes to the dangers posed by physical hazards, workers continue to have little success in exercising their three safety rights and work-related ill health remains largely ignored.

Right to Know 

The right of workers to know what hazards they are exposed to in the workplace is a foundational one. Without knowing about workplace hazards, workers cannot meaningfully participate in safety activities or know which work they ought to refuse as unsafe. In practice, most workers rely upon their employer for safety information.Walter, V., & Haines, T. (1988). Workers’ perceptions, knowledge and responses regarding occupational health and safety: A report on a Canadian study. Social Science & Medicine, 27(11), 1189–1196. This reality has two consequences. First, whether the worker is informed about a hazard depends on the employer’s ability and willingness to provide information. Training has been found to be one of the most effective methods for creating safety awareness and behaviour.Vinodkumar, M., & Bhasib, M. (2010). Safety management practices and safety behaviour: Assessing the mediating role of safety knowledge and motivation. Accident Analysis & Prevention, 42(6), 2082–2093. Yet, as we saw in Chapter 8, a recent study found that only 1 in 5 Canadian workers received safety training in their first year on a job.Smith, P., & Mustard, C. (2007). How many employees receive safety training in their first year of a new job? Injury Prevention, 13, 37–41. In practice, then, employers often don’t provide safety information to workers and this employer decision (or, less charitably, this employer strategy) cannot help but hamstring workers’ ability to participate and refuse.

Second, the employer controls what information it gives workers and can use this power to highlight (or downplay) certain hazards and control measures. For example, an employer has an interest in focusing attention on hazards that are within the workers’ control or that can be controlled by worker vigilance (such as physical hazards) because these hazards are relatively cheap to control. Using this same logic, an employer also has an interest in downplaying hazards that require the employer to take action to control (e.g., workload and shift work, chemical hazards) because these controls are relatively expensive or difficult or challenge their authority to manage. While it is often said that knowledge is power, in OHS, the distribution of knowledge appears to mean that knowledge most often increases employers’ power.Sass, R. (1992). The limits of workplace health and safety reforms in liberal economics. New Solutions, 3(1), 31–40. While unions can counter the employer monopoly on information, union membership is in a slow decline. Further, unions are virtually absent in growing industries, which also happen to employ large numbers of precarious workers.

Right to Participate

The right to participate gives workers a process for addressing safety issues, usually via a JHSC. While JHSCs can be effective at improving safety outcomes, not every worker has access to a JHSC.Lewchuk, W., Robb, L., & Walters, V. (1996). The effectiveness of Bill 70 and Joint Health and Safety Committees in reducing injuries in the workplace: The case of Ontario. Canadian Public Policy, 22(3), 225–243. In most jurisdictions, only employers with more than 10 or 20 employees are required to have JHSCs— meaning about a third of workers have no access to JHSCs—and Alberta and the Territories do not require any employer to have JHSCs. Even if an employer voluntarily creates a JHSC, there are no requirements for equal participation by workers, appropriate investigative powers, or even regular meetings. What this means is that workers at smaller employers, which tend to both employ more vulnerable workers and have higher rates of incidents and injuries, have basically no right to participate.

In workplaces with JHSCs, the committees often struggle with employers ignoring recommendations, agendas dominated by minutiae and pro forma processes, lack of safety knowledge among committee members, inadequate resources (both time and money), and, not surprisingly, worker disengagement. Non-functioning JHSCs fundamentally limit the right to participate. As we saw in Chapter 2, there are ways workers can improve the effectiveness of JHSCs. These efforts are most likely to be successful in unionized workplaces where the union can train and empower workers. Yet even with the support of a union, workers’ efforts to increase the effectiveness of JHSCs can face profound limits if the employer resists and the state refuses to regulate.Milgate, M., Innes, E., & O’Loughlin, K. (2002). Examining the effectiveness of health and safety committees and representatives: A review. Work: A Journal of Prevention, Assessment and Rehabilitation, 19(3), 281–290; Walters, D. (1996). Trade unions and the effectiveness of worker representation in health and safety in Britain. International Journal of Health Services, 26(4), 625–641. Even the most effective JHSCs have no ability to compel employers to address unsafe workplaces. Leaving it up to the employer to decide whether and how to address hazards reinforces the greater power of employers in the workplace. Rather than provide workers with a platform from which to assert their rights, JHSCs become a means to channel worker discontent around safety issues into a process that employers can manage and control. Further, some critics of the IRS argue that the creation of a formal structure and location for airing safety grievances delegitimizes other informal forms of worker expression (e.g., on the shop floor, at union meetings) and thus undermines the ability of workers to act outside of the internal responsibility system.Barnetson, B. (2010). The political economy of workplace injury in Canada. Edmonton: Athabasca University Press.

Many recent employer safety initiatives are designed to bypass the traditional IRS processes—particularly in large workplaces. Safety management systems are programs that construct goals and performance measures related to safety, often with the assistance of an outside consultant. These systems may engage workers at a rhetorical level (e.g., by involving them in the creation of “value” statements), but mostly they further concentrate control over safety in the hands of employers who set and measure safety targets. Some employers also create workplace wellness systems that promote forms of wellness that financially benefit employers (see Box 11.2). In this way, the growing professionalization of safety also undermines workers’ right to participate.

Right to Refuse

The right to refuse at first seems to be the strongest worker safety right. Indeed, the right to refuse represents one of the few times when a worker can legally disobey his or her employer (by refusing to perform dangerous work). In practice, though, refusing unsafe work has turned out to be a weak right. Three factors have undermined the power of the right to refuse. First, most legislation and its interpretation have narrowed the instances when workers can legally refuse. They cannot refuse simply because a hazard exists. There must be some degree of immediacy to the risk of injury, which effectively precludes refusing work on the basis that the work puts the worker at risk of occupational disease. Also, the danger must not be “normal” for the worker’s occupation. These restrictions make refusing unsafe work difficult for many workers.

Second, the rules around the right to refuse only require the employer to investigate the refusal and preclude the employer from punishing the worker for their refusal. No other action is required. Employers are allowed to assign a different worker to perform the same task. Or the employer can make minor changes to reduce the risk just enough that the worker will agree to do the task. Or they can do nothing at all and say everything is fine. If the worker continues to refuse, the resolution process is lengthy and legalistic. Further, pursuing the matter requires the worker to confront their employer, possibly over a period of weeks, in a direct manner that can be intimidating for many and, as Andrea MacPhee-Lay found out, can end in termination.

As a result, workers rarely invoke the right to refuse. One of the few studies examining the frequency of refusals found that only 1% of Ontario workers used their legislative right to refuse.Walters, V., & Haines, T. (1988). Workers’ use and knowledge of the internal responsibility system: Limits to participation in occupational health and safety. Canadian Public Policy, 14(4), 411–423. Workers are more likely to refuse in a unionized setting, where additional protections from employer retaliation are present. In most workplaces, instead of formally refusing unsafe work, workers are more likely to adopt informal methods to avoid dangerous situations, including quietly altering the work process or pace of work, refusing overtime, calling in sick, or requesting a transfer.Gray, G. (2002). A socio-legal ethnography of the right to refuse dangerous work. Studies in Law, Politics and Society, 24, 133–169. Workers’ reluctance to engage in a direct confrontation with their employer over safety matters reflects the third factor undermining the right to refuse: employment is a relationship of power, and workers’ three safety rights do not adequately mitigate employers’ greater power in the workplace such that workers can protect themselves. A recent study found that one third of Ontario workers expected that raising a health and safety concern would have a negative affect their future employment. The percentage was even higher among racialized workers and among workers facing a high degree of precarity.Lewchuk, W. (2013). The limits of voice: Are workers afraid to express their health and safety rights? Osgoode Hall Law Journal, 50, 789–812.

This discussion suggests the IRS is not very effective at protecting workers’ safety. This conclusion is consistent with the large number of workplace injuries in Canada each year. Some workers are able to increase the effectiveness of the IRS via unionization, but the most vulnerable workers (such as women, racialized workers, youth and precarious workers—groups whose memberships often overlap) are less unionized and thus receive little (or no) protection from the IRS.

The other cornerstone of the modern OHS regime is government regulation and enforcement. Government legislation is intended to complement the IRS by establishing safety standards and practices and intervening in cases when employers fail to meet them. Essentially, state enforcement is designed to address instances where the IRS system fails to result in safe workplaces. In practice, OHS enforcement has evolved to reinforce the employer-dominated IRS rather than regulate its operation.

Governments mostly rely upon complaint-driven enforcement wherein workplace inspections are triggered by individual complaints or in response to incidents (i.e., a serious injury or fatality). Complaint-based investigations may at times be supplemented by targeted inspections of specific industries (e.g., residential construction) or working situations (e.g., employers of migrant workers). Complaint-based enforcement has been adopted due to the limited resources allocated to OHS inspections relative to the number of employers in the jurisdiction. For example, in 2008, Alberta had 84 OHS inspectors to cover 144,000 employers.Government of Alberta. (2008). Report to the Minister of Justice and Attorney General: Public Fatality Inquiry. Okotoks: Justice and Attorney General.

The primary goal of workplace inspections is to achieve compliance with the OHS legislation. When a violation is found, a compliance order is normally issued that requires the employer to remedy the violation within a set timeline. (One exception to this norm is that stop-work orders are sometimes issued if the violation poses imminent danger of harm.) Given the limited budgets allocated to OHS inspection, a follow-up inspection may occur weeks later or not at all.

Research finds that inspections are up to 10 times more likely to occur in industrial and other so-called traditionally dangerous worksites (e.g., manufacturing, construction, mining) than other industries (e.g., education, health care, office environments). Forestry workers are 20 times more likely to be the subject of an inspection than nurses, despite the significant hazards faced by nurses (e.g., physical hazards associated with lifting, violence, exposure to biological hazards).Barnetson, B. (2010). Further, the vast majority of inspections are conducted during regular business hours (Monday to Friday, 9 to 5).Ibid.

While OHS enforcement has changed over time, most of these changes have eroded the effectiveness of the system. In comparison to today, OHS enforcement in the 1970s and 1980s was more active: governments conducted more inspections, laid more charges, and achieved more convictions than they do today.Tucker, E. (2003). Diverging trends in worker health and safety protection and participation in Canada, 1985–2000. Relations Industrielles/Industrial Relations, 58(3), 395–426. The move away from active enforcement was caused by pushback from employers, who were unhappy with practices such as unannounced inspections, prosecutions, increased workers’ compensation premiums, and a growing list of prescriptive regulations, which stipulated specific requirements an employer must meet (e.g., standards for fall protection equipment).

In response, governments changed the roles that government, employers, and workers play in enforcement. While the details of this shift differ between jurisdictions, there is a clear pattern across Canada away from enforcement and toward education and collaboration. Governments conduct fewer unannounced inspections, implement intermediary steps before issuing compliance orders, and conduct fewer inspections and prosecutions overall. Employer groups have been given a larger role in drafting of regulations, which has shifted OHS from prescriptive regulations toward performance-based regulation, which identifies desired outcomes and leaves the specifics of how to achieve them to the employer.

Industry safety associations (ISAs), bodies formed by employers in an industry to deliver safety services and advocate on behalf of the employers on safety issues, have also achieved greater influence. ISAs have become more involved in establishing regulatory standards and delivering training and education to workers. In some jurisdictions, ISAs have been authorized to conduct workplace safety audits to determine eligibility for safety incentives, such as workers’ compensation premium reductions. Audits differ from inspections in that they do not identify hazards or non-compliance with regulations. Instead, audits assess whether a workplace has an appropriate safety system in place to deal with safety matters. They evaluate the quality of paper flows and communications systems, the presence of training and safety manuals, and whether appropriate paperwork is completed. Employers prefer audits to inspections, as audits are educative in nature rather than punitive.

Proponents of this shift (including employers, industry associations, safety professionals, and right-wing governments) assert that cooperation is a more effective way to achieve employer compliance. This assertion sits uncomfortably with the actual result of the partnership approach: employers have increased their control over safety in their workplaces and increased their influence over government policy. Research has shown that so-called tripartite consultations, which involve government, employers, and labour as equal partners at a table to discuss OHS issues, reproduce power imbalances and provide a structural advantage to employers in determining the shape of new safety regulations.Foster, J. (2011). Talking ourselves to death? The prospects for social dialogue in North America—Lessons from Alberta. Labor Studies Journal, 36(2), 288–306. The partnerships model of OHS works in concert with the professionalization of OHS to remove safety issues from the work floor, where workers are active agents, and place them in boardrooms, where workers become passive recipients of negotiated agreements between employers and governments.

The two sawmill explosions in British Columbia in 2012 (detailed in Chapters 1 and 9) help us understand the perils (for workers) of overly close relations between employers and the state. Shortly after the Babine sawmill blew up, an internal WorkSafeBC memo identified expected employer pushback as a reason to delay additional enforcement focused on reducing the risk of wood dust explosions:

• Industry sensitivity to the issue given the recent event and limited clarity around what constitutes an explosion could lead to push back if an enforcement strategy is pursued at this time.Neilsen, M. (2015, October 15). WorkSafeBC memo a reason for inquiry into sawmill blasts, union says. Prince George Citizen. http://www.princegeorgecitizen.com/news/local-news/worksafebc- memo-a-reason-for-inquiry-into-sawmill-blasts-union-says-1.2082588

Roughly 20 days later, the Lakeland mill exploded—due to wood dust accumulation. In effect, government concern about employer interests delayed enforcement action that might have saved workers’ lives. Box 11.3 examines how Alberta’s shift toward a partnership model set the stage for the regulatory capture of provincial OHS enforcement by employers. Overall, government decisions to shift away from active OHS enforcement in favour of collaborating with employers have profoundly undermined an important bulwark for workers against the power of the employers in the workplaces and further weakened the IRS.

How to get things done

Given the above discussion, one might be forgiven for being pessimistic about the prospects for safer and healthier workplaces. The shortcomings of the current OHS system are significant. Nevertheless, we should not lose sight of the fact that workplaces today are, in some ways, safer than they were 40 years ago and there is a higher degree of awareness of safety issues in the workplace. This suggests that it is possible for committed individuals (and groups of individuals) to make positive change in workplaces and in policy—even if the extent and speed of those changes is constrained by unfavourable circumstances.

Historically, workers made advances in health and safety when, armed with information, they mobilized collectively and politically.Storey, R., & Tucker, E. (2005). All that is solid melts into air: Worker participation in health and safety regulation in Ontario, 1970–2000. In V. Mogensen (Ed.), Worker safety under siege: Labor capital, and the politics of workplace safety in a deregulated world (pp. 157–186). Armonk, NY: M. E. Sharpe. While this mobilization was not sustained when OHS energies were channelled into the structures and processes of the IRS regime, this history is informative. Specifically, it identifies the components of effective OHS advocacy, for workers, OHS activists, and safety professionals:

1. Education and information: Research has shown that, when workers are armed with information about the hazards they face and options for controlling them, they act upon this knowledge to the degree to which they are able.
2. Increasing power: Power in the workplace is essential to ensuring accurate and complete information is available and that workers can meaningfully act upon it. By recognizing the importance of power in OHS, we acknowledge that OHS advocacy must extend beyond technical arguments about safety and requires political action to create power.
3. Using the IRS: While the IRS has many shortcomings, effective advocates learn how to work within the IRS system as it exists and then supplement those actions with pressure from outside the system (e.g., via government enforcement, outside expertise, mobilization of workers)

Alan Hall and his colleagues have studied what makes worker representatives effective in OHS matters.Hall, A., Forrest A., Sears, A., & Carlan, N. (2006). Making a difference: Knowledge activism and worker representation in joint OHS committees. Relations Industrielle/Industrial Relations, 61(3), 408–436. Their research has identified three types of OHS activists:

1. Technical-legal representatives are well-informed workers who immerse themselves in the technical and legal aspects of OHS and perform those functions well. These workers typically act as if OHS is divorced from other labour-management issues and see their job as working with the employer to achieve solutions cooperatively.
2. Politically-active representatives, by contrast, understand well the power relations at work and see OHS as just another field of conflict with the employer. These workers tend to dismiss the importance of research and accurate information. As a result, while they are willing to engage the employer on OHS issues, they do not bring an independent source of information to their argument.

3. Knowledge-active representatives are thought to be the most effective activists because they recognize the political nature of OHS but also actively pursue independent and autonomous information to bolster both their legitimacy and their capacity to challenge the employer. They are also likely to equally divide their time between IRS-related activities (i.e., attending JHSC meetings, conducting inspections) and political activities (i.e., educating and mobilizing workers, engaging government enforcement).Hall, A., Oudyk, J., King, A., Naqvi, S. & Lewchuk, W. (2015). Identifying knowledge activism in worker health and safety representation: A cluster analysis. American Journal of Industrial Medicine (Online First, July 23). doi: 10.1002/ajim.22520 Box 11.4 provides a more detailed description of knowledge-active representatives.

This analysis suggests some practical ways in which a person (or group) can increase the effectiveness of OHS efforts. Workers who have access to a JHSC (or other OHS venue in their workplace) can improve safety by ensuring the worker representatives are informed and engaged. Safety practitioners and managers can improve JHSCs effectiveness by ensuring employer representatives are senior enough to have influence over how the organization responds to safety concerns. In addition, all actors can ensure there are clear meeting agendas, minutes, and timelines that are communicated to all workers, ongoing training of JHSC members, and that the members of the JHSC get out of the meeting room and regularly inspect the workplace and interact with workers.Workers’ Health and Safety Centre. (1998). Occupational Health and Safety: A Training Manual (3rd ed.). Toronto: Author.

Increasing workers’ input into (or autonomy over) training enhances workers’ knowledge of workplace hazards and control strategies. This undermines the employer’s ability to shape hazard identification and control through limiting what workers know. Allowing worker involvement may also result in training that is more engaging to participants and recognizes the varied motives workers have for participating in it. Worker-oriented training might also draw attention to psycho-social hazards in the workplace or the health effects of employment practices.

While OHS legislation and regulation have value, workers’ experience with the IRS is that it is not adequate to protect them or guarantee safe and healthy workplaces. One strategy for building upon the IRS is to entrench stronger levels of OHS protections in collective agreements and company policies. These protections might include enhanced participation rights, greater protection for refusals, and protection from reprisals. Similarly, OHS rights and obligations—such as conducting and publishing hazard assessments every time work processes change—can be incorporated into work routines. As part of this process, workers might encourage (or pressure) their employer to adopt the precautionary principle. For example, they might create an expectation that no new chemicals or processes will be introduced until the employer can demonstrate that the chemicals or processes do not create a hazard.

Finally, workers and OHS activists can draw upon political and economic power derived from collective action. We usually think of unions as the vehicle by which workers act collectively. For some workers, joining a union may well be a pathway to healthier and safer workplaces. Yet workers should be mindful of the history of OHS wherein change has come from groups of workers acting outside of established organizations—engaging in political lobbying, public demonstrations, and wildcat strikes. While trade unions can be a source of valuable resources, access to those resources often comes with an expectation that workers will act within the IRS. Given the limitations of the IRS, gaining union support may reduce the capacity of some workers to effect health and safety change.

Workers who cannot or do not want to join a union may rely on legal challenges to seek legislation that better protects their right to health. This right is found both within the Canadian Charter of Rights and Freedoms and the International Covenant on Economic, Social and Cultural Rights (which itself builds upon a more general right articulated in the Universal Declaration of Human Rights: “Everyone has the right to work, to just and favourable conditions of work and to protection against unemployment”).United Nations. (1948). Universal Declaration of Human Rights. Geneva: United Nations; United Nations. (1966). International Covenant on Economic, Social and Cultural Rights. Geneva: United Nations. Such legal strategies, while appealing, move conflict into the courts—yet another venue dominated by the employers and governments.

In the end, workers and OHS activists may well end up back where they began—cooperating with one another by sharing information, pooling resources, and politically agitating for safer workplaces. This is a lonely and dangerous path because, in capitalist economies, there is no necessary link between the interests of workers and employers around occupational health and safety. Defying the will of the employer and the state is risky. Yet perhaps better this risk (with its prospect of safer and healthier workplaces) than the certain risk of allowing employers to organize work as it suits their interests.

The irony of Alison MacPhee-Lay’s case discussed at the beginning of the chapter is that she might have won her complaint had she waited until the grill proposal was implemented. If customers were in the room and she was required to use it, she may have been able to invoke her right to refuse— although no one can be sure whether that hazard would have been deemed an “imminent danger.” This case highlights one of the shortcomings of Canada’s health and safety system: it prioritizes procedural issues (i.e., did the worker refuse correctly) over substantive ones (i.e., was there a legitimate OHS hazard).

The current OHS regime was intended to empower workers to advocate for their own health and safety. Instead, it has entrenched employer power to control the work process. Workers do advocate for their own interests, but they often do it in spite of the system rather than because of it. The system has become highly technical and specialized, separating the issues from the people who are most affected by them—workers. The evolution of the system is best understood within a context of capitalism and the ways in which employers under capitalism act to further their interests.

Nevertheless, change is always possible in any system. Existing processes and structures in the safety regime can be utilized to make change. Advocates must also step outside the formal structures to force change from the outside. It is the combination of strategic engagement with the structures and mobilization of workers that will ultimately make workers safer.

As part of the workplace safety program, employers are responsible for ensuring their workers are protected from hazardous products, previously referred to as controlled products. WHMIS, or the Workplace Hazardous Materials Information System, is designed to protect workers from the health effects of exposure to hazardous products.

Globally, there has been a move to align all hazardous product legislation to create uniformity. As such, the GHS, or the Globally Harmonized System of Classification and Labelling of Chemicals, was created to support such uniformity. In 2015, Canada updated its WHMIS legislation to what is known as WHMIS 2015 to align with GHS. Throughout this chapter, we will review the three elements of WHMIS 2015, look at hazard classification and the transportation of dangerous goods. Take the time to complete this activity that highlights the transition to WHMIS 2015.

Within WHMIS 2015, there are two types of hazard groups; physical and health hazards. Additionally, these two hazard groups are further broken down into hazard classes and hazard categories.

Let’s explore each of these elements individually to fully understand their importance for your workplace safety program. 

Labels

The first element of WHMIS 2015 focuses on the label attached to a hazardous product. There are two types of labels in WHMIS 2015. The supplier label is affixed to the hazardous product by the supplier prior to the product arriving at the workplace. The workplace label is affixed to the hazardous product if the original supplier label falls off, or if a worker decants the product into a new container.

See the poster by the Canadian Centre for Occupational Health and Safety to review the required content of a supplier label and a workplace label. In addition, below you will find a WHMIS label activity you can complete to assist with your understanding of hazardous product labels.

Pictograms are graphics that help the worker to instantly recognize the type of hazardous product they are working with and the immediate hazard, such as a corrosive material. Pictograms can be found on the safety data sheet, or on the supplier label attached to the hazardous product.

WHMIS 2015 consists of 10 pictograms. Review the pictogram poster from the Canadian Centre for Occupational Health and Safety as it highlights all 10 pictograms every worker needs to be familiar with.

Safety Data Sheets (SDS)

The second element of WHMIS 2015 focuses on Safety Data Sheets. Before a supplier ships a hazardous product to a workplace, they are responsible for attaching a Safety Data Sheet. Once received by the workplace, the employer must make the new data sheet available to all workers 24 hours a day, 7 days a week, in an accessible area. This might include a hard copy of the data sheet in a binder and/or an electronic copy of the data sheet on an accessible computer.

Each safety data sheet consists of 16 sections, and in Canada, the safety data sheet must be available to workers in both English and French. Review the handout from the Canadian Centre for Occupational Health and Safety which details the 16 sections of the safety data sheet.

Education and Training

The third element of WHMIS 2015 is education and training. Whether it is an existing employee or a new hire, everyone must have WHMIS 2015 training. Equally important is the training record. Every employer must ensure they can quickly and easily access training records for all safety training programs, including WHMIS 2015. These records may be required by a court, a government agency, workers compensation, an inspector, or the joint health and safety committee to name a few.

During the WHMIS 2015 training session, it is important to instruct workers on the location of the Safety Data Sheets (SDS), and how to read the data sheet as it contains important first aid, usage and storage instructions. In addition, workers need to know how to read a workplace and a supplier label. Should an employee decant a hazardous product from a labelled container into a new container, the individual must immediately advise their supervisor so a workplace label can be created and attached to the new container. Lastly, every worker must understand the WHMIS 2015 pictograms so they can recognize the type of risk they are handling.

Workers may not think about the ways in which a hazardous product could enter their body. There are four routes of entry: inhalation, ingestion, absorption and injection. Review the information provided by the Canadian Centre for Occupational Health and Safety (CCOHS) on the 4 routes of entry.

In WHMIS 2015, the supplier, the employer and the employee each have specific roles and responsibilities that support keeping workers safe while handling a hazardous product. Let’s review each role individually as it is meant to support the Internal Responsibility System.

The Supplier

The supplier is responsible for correctly categorizing the product they supply to the customer, and if it is found to be a hazardous material, the supplier must attach a supplier label to the product and provide the customer with a Safety Data Sheet (SDS).

The Employer

As with most safety legislation, the employer has specific requirements under WHMIS 2015. If a hazardous product is used in the workplace, the employer is required to:

• Educate  and train workers on the hazards and safe use of products.
• Ensure that hazardous products are properly labelled.
• Prepare workplace labels, as needed.
• Prepare SDSs, as necessary (e.g., if an employer manufactures a hazardous product that is used on-site).
• Provide access to up-to-date SDSs to workers.
• Ensure appropriate control measures are in place to protect the health and safety of workers.WHMIS 2015 - General, OSH Answers Fact Sheets,  Canadian Centre for Occupational Health and Safety (CCOHS).

The Employee

As workers are part of the Internal Responsibility System (IRS), they have responsibilities under WHMIS 2015. Some of the workers responsibilities include participating in training sessions, wearing the provided personal protective equipment when working with hazardous products and reporting any containers that are missing labels to their supervisor.

While WHMIS 2015 addresses the handling of hazardous products in the workplace, it does not cover the transportation of dangerous goods. Specific legislation, know as the Transportation of Dangerous Goods Act is designed to address the movement of dangerous goods from one location to another.  As stated by the Canadian Centre for Occupational Health and Safety (CCOHS), “The purpose  of the Transportation of Dangerous Goods (TDG) Act and Regulations is to promote public safety when dangerous goods are being handled, offered for transport or transported by road, rail, air, or water (marine).” Transportation of Dangerous Goods (TDG) - Overview, OSH Answers Fact Sheets , Canadian Centre for Occupational Health and Safety (CCOHS).

If an employer is to ensure an employee’s “right to know” as describe in occupational health and safety legislation, WHMIS 2015 knowledge is an important part of that responsibility. An employee must be informed of the hazardous products they are working with, how to handle them, the PPE to be worn around them, how to store them, and the first aid to be administered in case of a workplace incident. WHMIS 2015 must be a part of every new employee onboarding session and part of every employee’s ongoing safety training.