Health and safety is an essential part of our union’s work. Our members face a wide range of hazards. CUPE provides tools, resources and training to help members stay healthy and safe and to encourage activism. CUPE also conduct research on current and emerging health and safety hazards.

Accident and occupational disease investigations are done to determine the causes of physical injuries and occupational diseases. They are also undertaken to satisfy the legal requirements of health and safety legislation.

But for CUPE members, there is more to investigations than this. Investigations should also be used to uncover workplace problems, eliminate workplace hazards and strengthen workplace health and safety programs. Investigations can also provide information to back up workers’ compensation claims.

CUPE members shouldn’t wait for an accident or a disease to conduct an investigation. Near misses, health and safety incidents and complaints are signs that an accident or disease might be just around the corner. These should also be investigated to expose workplace hazards. Investigations must always focus on the root causes of the hazard.

The joint health and safety committee must play a leading role to uncover the hazards that led to the accident, disease or incident.

Usually, legislation requires that critical injuries and fatalities be investigated. Legislation in most jurisdictions stipulates that worker members of a joint health and safety committee investigate critical injuries and fatalities or be informed when they happen.

Health and safety legislation differentiates an accident from an incident. An accident is defined as an unplanned event that interrupts a work activity and that may or may not include injury. An incident is defined as an unplanned event that involves no physical injury. An incident and a near miss are basically the same thing.

What happens before an accident investigation?

A joint health and safety committee should form an investigation team as part of their normal activities. This will ensure that an investigation will be conducted properly

and efficiently if there is a need. Unions can have their own investigation team. Some CUPE locals have won the right to conduct union-only investigations. No matter who is in charge of investigations, CUPE members must be equal participants. Some jurisdictions require investigations be conducted jointly by the employer and workers.

CUPE investigators must be trained and ready ahead of time. A written investigation action plan or checklist must be in place.

The supervisor working where the accident took place should not be part of the investigation team. There could be an attempt to cover up the supervisor’s errors that led to the accident.

Investigations must always have a broad perspective on what led to the accident or incident. Investigations should never jump to quick conclusions, such as simply blaming the worker for what occurred.

What do you do if an accident happens?

The first people on the scene of an accident or incident must deal with the immediate problems. If the injured person needs medical attention, call an appropriate medical professional. The accident or incident must also be reported immediately to a supervisor or appropriate person at the workplace. Once the injured person is looked after, take a quick look at the site and see that nothing be moved or tampered with unless it is necessary to attend to injured persons or to prevent further injuries. Make sure all witnesses are identified.

Next, stop work, shut down equipment, seal the area off if necessary and follow established procedures. In some jurisdictions, nothing may be touched until a government inspector arrives. Inspectors and police have the right to collect and remove samples and equipment for analysis. If this happens, make note of it in the investigation report. Document what was removed and the location from where it was taken.

The investigation team must be ready to perform its duties. An investigation kit should be prepared ahead of time that contains:

  • A camera to photograph evidence.
  • Tape measure.
  • Pads of paper and pens.
  • Investigation checklist.
  • Flashlight with extra batteries.
  • Audiotape and/or video recorder.
  • Clear plastic bags to collect and protect physical evidence.
  • Protective gloves, HEPA masks and eye protection.

Before starting any investigation, first preserve physical evidence on the scene. Next, record the appearance of the scene with photographs, diagrams and written notes.

How do you collect information?

An investigation can begin once the scene has been recorded and the area secured. Try to start the investigation as soon as possible after the accident or near miss.

Investigators should ask and then discuss the following questions:

  • What happened?
  • Where did the accident happen?
  • When did the accident happen?
  • When was it noted and reported?
  • How did the accident happen?
  • Who is injured?
  • Who are the witnesses?
  • Who else was in the vicinity of the accident?
  • What equipment, machinery, chemicals, work processes and manual materials handling was involved?
  • What conditions changed as the work was being done and the accident happened?
  • What else was going on in the workplace as the accident happened?
  • What were the weather and/or traffic conditions?
  • What was the behaviour of the client or patient?
  • Why did things happen?
  • Why did things not happen?

The investigation team should record all of the information that comes from answering these questions. Investigators must uncover all sources of information. This means information should be gathered from:

  • Injured workers
  • Eyewitnesses
  • Physical evidence
  • Background information

Injured workers

An injured worker is a crucial information source. Interviewing an injured worker at the scene can sometimes be impossible, due to their physical and mental state. If a worker is too upset or too injured to be interviewed, you must hold off on interviewing until the worker has recovered.

Eyewitnesses

Eyewitness accounts are also vital. Witnesses are usually under varying amounts of stress due to the trauma experienced by seeing an accident or a near miss. Sometimes when a witness is upset, it is the investigator who must calm down the witness.

Investigators need to ask witnesses the following questions:

  • When did you notice the accident had taken place?
  • Where were you when you noticed the accident?
  • What activity were you doing when the accident happened?
  • What were the physical conditions (e.g., temperature, lighting, weather, etc.) at the time of the accident?
  • What did you see? What sounds did you hear?
  • Was there anything unusual in the workplace when the accident happened?
  • What do you think caused the accident?
  • Are there any other factors you think are important to the investigation?

Do not interrupt the witness or get emotional during the interview. Record all interviews with an audiotape or video recorder to avoid taking notes while listening to a witness. Make sure to first get the witness’ permission to record her/him.

Physical evidence

Investigators should take an inventory of physical evidence (i.e., materials and equipment) around the accident site. Look for:

    • Any broken or altered equipment and missing parts.
    • The condition of safety devices, guards and controls.
    • The location and condition of physical barriers that separate workers and the public.
    • The cleanliness of the accident site.
    • Poor lighting, any blind spots or poor sight lines.
    • Noise hazards around the accident site.
    • Chemical hazards around the accident site.
    • Where the injured workers are (or were) located.

Again, record this information with notes, diagrams and photographs.

Background information

Investigators also need to examine relevant background information. This includes information such as past accident reports, workplace inspections, training materials and maintenance records. This information might show unsafe conditions, accidents or near misses. These records can give investigators information to help identify causes and act to prevent further accidents. Investigators should be able to identify what caused the accident by combining all of the information from these different sources.

What happens after the information is collected?

A report on the accident must be written. The report describes what happened and what caused the accident.

Recommendations should also be presented in the report. Recommendations should be specific and have timelines for corrective measures. For example, if the accident happened because there wasn’t enough light to see the controls on a piece of machinery, the recommendations need to address the hazard directly. In this example, recommendations could start by suggesting:

      • Proper and adequate lighting to be installed to light all controls on all machinery within three days of the submission of this report.
      • Check lighting levels throughout the workplace. If poor lighting exists in other areas, it must be corrected within two weeks of the submission of this report.
      • Corrective measures to lighting levels must be done in consultation with CUPE members.

The written report needs to be thorough and state basic facts such as the “who, what, when, where, why and how” of the accident. Sections can be divided into Injured Worker Account, Physical Evidence, Eyewitnesses, Photographs and Drawings, Background Information and Recommendations. Often workplace health and safety committees have standard forms for accident investigations. If forms are too short, do not hesitate to attach information. The investigation report must be as detailed as possible to be effective in helping prevent future accidents or incidents.

The written report should be presented and discussed at a joint health and safety committee meeting and a union health and safety committee meeting. The recommendations should be tabled and the necessary changes made in the workplace. Follow-up work is also needed. The recommendations and changes that come out of an accident investigation must be monitored to see if they are working.

To summarize, the major steps for an accident investigation are:

      • Form an investigation team.
      • Report the accident to a designated person on the health and safety committee and to a supervisor.
      • Give first aid to the injured worker(s).
      • Start the investigation as soon as possible after the accident.
      • Identify the causes.
      • Report the findings and recommendations to the health and safety committee.
      • Develop a plan for improvement of the working conditions that led to the accident.
      • Evaluate the plan.
      • Apply the plan.
      • Monitor the plan’s effectiveness.

Occupational disease investigations

An accident is usually clear to everyone and an accident investigation is usually automatic. By comparison, occupational disease is harder to determine and to investigate.

Unhealthy workplaces are familiar to many CUPE members. Toxic substances, poorly designed equipment and inadequate ventilation are just a few of the ongoing hazards that contribute to occupational diseases. Because the symptoms of some occupational diseases – like occupational cancers – take decades to appear, the link between work and disease may not be clear.

When workers get sick from occupational disease, they often do not suspect a connection between their work and their illness. For this reason, occupational disease investigations should be carried out. They can be useful to investigate complaints, reports of illness or disease, or to support workers’ compensation claims.

There are important differences between accident investigations and occupational disease investigations. Occupational disease investigations are not as straightforward because:

      • Accidents and their causes are usually much more visible and the connections between the two are more apparent.
      • Some occupational diseases are also communicable diseases that can be transmitted. This can complicate how the illness should be treated, tracked and prevented.
      • Work-related symptoms can be confused with common illnesses and disease symptoms.
      • Chronic (long-term) effects usually do not appear until many years after the first exposure.
      • Many health care professionals know little about the causes of occupational diseases. They may miss the connection between the workplace and the disease entirely.
      • Very little is known about the health effects of many substances found in workplaces. For example, custodians, hospital workers and municipal workers use more new and potentially toxic cleaners, solvents and chemicals. Most have not been thoroughly tested for their safety.
      • Showing a link between occupational disease and the workplace requires intensive research, interviews and surveys.

Occupational disease investigations often require the help of worker-friendly organizations that have the knowledge and tools necessary to carry out the investigation. The Occupational Health Clinics for Ontario Workers (OHCOW) is an example of an organization that can help workers with an occupational disease investigation.

For support, contact your locals Joint Health & Safety representative and for more information, consult the Accident and Occupational Disease Investigations Guideline produced by the National Health and Safety Branch or contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

What is asbestos?

Asbestos is a mineral based fibre that has been widely used in building materials due to its resistance to heat and corrosive chemicals. Although there are six different varieties of asbestos minerals, there are three main types: chrysotile, amosite and crocidolite. Typically, asbestos appears as a whitish, fibrous material. The fibres can range in texture from coarse to silky. Although they may be too small to see with the naked eye, airborne asbestos fibres can cause cancer and lung disease.

Where is asbestos used?

Because of its resistance to heat and corrosion, asbestos has been woven, moulded and sprayed. It has been used on at least 3000 products ranging from brake linings to ironing board covers and children’s toys. Asbestos was widely used from World War II to the early seventies as fire-proofing on ceilings and beams, as insulation on boilers and pipes, sprayed inside ventilation systems and cavities, on automobile and truck clutches and brake linings and it was added to sprayed-on wall coatings. Asbestos has also been used in building materials, such as vinyl floor tiles and ceiling tiles. It has also been added to strengthen the cement used in pipes, asphalt and other formed objects.

Who is exposed?

The use of asbestos is so widespread that anyone who works in a building or area where asbestos was used and is now deteriorating or creating dust is in danger of contracting asbestos-related disease. This includes CUPE members working in schools, hospitals and libraries, many of which were built when the use of asbestos was extensive, that is during the period between 1945 and the early 1970s.

The aging process has caused many of the asbestos applications to flake and deteriorate, allowing the hazardous fibres to become airborne. In addition to aging, products containing asbestos which have been damaged by water, improper maintenance or removal can release fibres which can cause cancer and lung disease when they are breathed in or swallowed.

Although many CUPE members may be exposed in schools, hospitals and libraries, others may be exposed by working directly with asbestos:

•Maintenance and custodial workers may often unknowingly clean areas of the workplace where asbestos is present. They may be asked to remove or repair asbestos-containing materials such as pipe or boiler insulation, ceiling and floor tiles and walls.
•Sanitation workers may be exposed if asbestos, which is removed from buildings, is disposed of improperly.
•Mechanics who repair and replace brakes, clutches and transmissions may be exposed if asbestos dust is blown around.
•Carpenters may be exposed when they cut, sand, drill or remove asbestos-containing building materials that release fibres into the air.
•Plumbers, pipe-layers and electrical workers.
•Families and friends of workers may be exposed if asbestos dust and fibres collected on workers’ clothing is carried home.

Occupational hazards of exposure

When air contaminated with asbestos dust is breathed in, the small sharp, barbed-like asbestos fibres find their way deep into the lung tissues and other internal organs where they remain for life. Over time, they can cause fatal diseases. Breathing even small, invisible quantities of asbestos is known to cause cancer 20 to 30 years after exposure.

What are the effects of exposure?

Breathing in asbestos fibres can cause asbestosis and cancer. Asbestosis is an irreversible disease of the lung, which leads to scarring of the lung tissue. As the tissue scarring becomes more extensive, the lung loses its flexibility and breathing becomes more difficult. The loss of lung function often progresses to disability and to death.

Asbestos is also known to cause mesothelioma, which is a type of cancer almost exclusively associated with asbestos exposure. Mesothelioma develops in the thin membranes lining the lungs and abdomen.

This type of cancer is inoperable and always fatal.

Exposure to asbestos can cause other cancers as well. Asbestos workers have increased rates of lung cancer and cancers of the esophagus, stomach, large intestine and rectum.

Smoking also increases the risk of developing cancer. Exposure to asbestos and cigarette smoking is known to greatly increase the risk of developing lung cancer.

What is the cure?

There is no cure for asbestos-related diseases. If detected early, complications can be treated. Removal from exposure may prevent the condition from worsening. In any case, workers should ensure that their family doctor knows they have worked or been exposed to asbestos. Present legislation requires employers to ensure that designated exposed workers undergo ongoing medical assessment.

How is asbestos detected?

Wherever there is a fibrous material used in buildings, workers should automatically suspect that asbestos may be present. Demand that a sample be sent to a laboratory for testing and identification.

If asbestos is found to be present, a trained expert must be brought in to determine what should be done about it. Accumulations of dust should be checked for asbestos. An air-sampling program should be conducted to determine if airborne fibres are present. An important point to keep in mind is that if asbestos is able to be crushed with the bare hand (in this case the term often used is “friable”) any dust can become airborne and therefore a hazard exists, no matter what the results of the air sampling shows.

Does legal mean safe? What are the safe levels?

Even though there is no evidence of a “safe” level of exposure to asbestos, most jurisdictions have established occupational exposure limits for asbestos.

In British Columbia, the Workers’ Compensation Board’s Occupational Health Regulations set the exposure limit at 0.1 fibres per cubic centimetre (f/cm3) for all forms of asbestos. The regulations also designate asbestos as a carcinogen.

In Alberta, the government has established an occupational exposure limit or OEL at 0.1 (f/cm3) for all forms of asbestos.

In Ontario, the Occupational Health and Safety Regulations set the OEL at 0.1 (f/cm3) for all forms of asbestos.

Although these may sound like small numbers, an exposure of 0.1 fibre per cubic centimetre (or 100,000 fibres in each cubic metre of air) for an eight hour day means that a worker can easily breathe in up to a million fibres per day.

Management may make the claim that because a workplace is in compliance with government regulations, workers have nothing to worry about. This is false. Government standards for asbestos exposure are inadequate and will not protect workers from getting cancer. The standards were designed to protect asbestos factory workers against getting asbestosis, not to protect CUPE members from getting cancer.

Remember, legal does not mean safe.

What can be done?

Once asbestos is identified, steps must be taken to prevent exposure. The only permanent solution to eliminate the hazard is the removal of the asbestos. Sometimes the asbestos is covered up with other building materials. In other cases it is “encapsulated” or sealed with a coating. Encapsulation is not generally considered an adequate solution. The best method will depend on the condition of the asbestos, its location and what will likely disturb it in the future.

Whatever action is taken, the work must be done by properly trained workers following strict precautions to ensure that no one is exposed to asbestos. The work area must be enclosed and kept under negative pressure. Since there is no safe level of exposure, any asbestos that gets into the air will endanger the health of anyone in the area.

In repair shops where asbestos is present, local exhaust ventilation using special HEPA (High Efficiency Particular Air) dust collection vacuum cleaners that remove the asbestos fibres at their source, e.g., when brake linings are being changed, should be used. Air hoses should not be used, since they can blow dust around the workplace. Management should provide workers with special work clothes, showers and two lockers: one for clean clothes and one for dirty clothes. Management should also arrange to have the work clothes laundered under controlled conditions.

Who can help?

If you suspect that asbestos is present in your workplace, assistance can be obtained by contacting the CUPE National Health and Safety Representative in your region or CUPE National Health and Safety Branch.

You should also know that asbestosis, mesothelioma and asbestos induced lung, laryngeal and gastrointestinal cancer may be designated as notifiable diseases under your Occupational Health and Safety Act or the Workers’ Compensation Board.

How are asbestos diseases prevented?

Prevention of asbestosis and any associated cancers can only be achieved by preventing any exposure to asbestos.

Remember there are no safe levels of exposure to asbestos.

For support, contact your locals Joint Health & Safety representative or for more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

With global travel expanding, new limits on pesticides and insecticide resistance, bed bugs have spread to just about every city in the world. Even the cleanest houses, hotels or apartments are susceptible to bed bugs, though regular inspection and cleaning can help prevent an infestation.

What are bed bugs?

Bed bugs are small, wingless insects—about the size of an apple seed—with oval-shaped bodies. They feed on human blood, typically at night when people are asleep. They will bite all over, especially where there is exposed skin around the face, neck, upper torso, arms and hands. Workers that need to enter the homes, like home care workers, paramedics or public health inspectors are at especially high risk of exposure, along with those who travel frequently for work, and those who work in hospitals, nursing homes, shelters, municipal buildings and schools.

What are the effects of bed bugs?

Some people do not react at all to the bites, while others may have small skin reactions. In rare cases, some people can have severe allergic reactions. Current scientific evidence suggests that bed bugs do not transmit diseases. However there have been reports that show that while rare, bedbugs are capable of transmitting drug-resistant bacteria including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE). There can also be negative social consequences associated with bed bugs. Stigmatization, physiological distress, sleep disturbances, anxiety, depression and isolation can all occur due to a perception that people whose dwellings have been infested are unclean. This stigma may lead people to delay getting help when they discover an infestation in their own home, which can increase the likelihood of transmitting bed bugs to others. The treatment of bed bug infestation can become costly depending on the extent of the infestation.

How to check for bed bugs

Bed bugs prefer to be hidden. If you are concerned, you should check for live bed bugs or their shells, left over from the molting process, in the following areas:

•Behind headboards and around cracks and crevices of the bed and baseboards.
•In the seams and tufts of mattresses.
•Inside the box spring and along the bed frame.
•In and around nightstands or other bedside furniture such as window and door casings, pictures, mouldings, loose wallpaper, curtain folds and partitions and clutter.
•Wheelchairs and stretchers.

How to deal with bed bug infestations in the workplace

•Staff should be trained to identify signs of bed bugs, including bites, as well as where to look for them, how infestations spread, and how employees should respond to a possible infestation.
•Develop a written “bed bug action plan” and ensure all staff members are trained.
•Keep records of infestations to track trends in intensity, location, time of year, etc.
•If an area is suspected of being infested, use personal protective equipment such as coveralls, disposable shoe covers and gloves where appropriate and leave personal belongings in sealable plastic containers.
•If you think you may have been exposed to bed bugs in the workplace, inspect your clothing and equipment before leaving and change into fresh, unexposed clothing.
•Ensure procedures are in place and equipment is on hand to clean potentially infested clothing and other items.
•If your occupation puts you at a higher risk of exposure, you should incorporate bargaining language related to the prevention and treatment of infestations into your collective agreements that includes remediation cost recovery.

Sample language: In the event that an Employee contracts lice, scabies, pink eye, bed bugs or ringworm while performing his/her regular duties and such communicable condition requires treatment, eradication or medications for him/herself or his/her immediate family, the employer shall reimburse the Employee for all reasonable costs of such treatment upon production of receipts for expenses not covered under the Collective Agreement’s benefit plan.

How to avoid bed bugs while travelling

People who travel for work are at a heightened risk of exposure to bed bugs. The following information can help reduce the risk of exposure:

Check the hotel’s history of bed bug problems on travel websites.
•Keep your luggage on a rack rather than on upholstered furniture, the floor or the bed.
Hang personal items like purses, bags and coats from a hook or a door knob to keep them off the floor.
Check the bed for bugs, blood stains and droppings. Remove bed sheets and check the mattress, running your fingers along the upper and lower seams. Make sure to check the mattress tag, as bed bugs often hide there.
Check the bedside table. Look for signs of bed bugs in the drawers and along the wall on the side of the bed that is less likely to be disturbed by cleaning staff and guests.
•If signs of bed bugs are detected, request another room. Be sure to inform hotel management so they can close and treat the room. If you suspect that bed bugs have invaded your belongings, ask the hotel to process your clothing by putting them in a high heat dryer for 30 minutes. You should repeat the inspection of any new room you are offered.
Inspect your luggage carefully when you pack to leave.
•After your trip, unpack luggage outdoors, re-inspect clothing and then wash and dry your clothing on hot settings (or put delicates in the freezer for two weeks). Vacuum luggage thoroughly.

What can you do if you find bed bugs in your home?

If you find bed bugs in your home, your local Public Health Unit, landlord, building manager, healthcare provider or a pest control professional can help address the situation.

Sources:

bedbugsinfo.ca
hc-sc.gc.ca
ccohs.ca

For support, contact your locals Joint Health & Safety representative and for more information, consult the Accident and Occupational Disease Investigations Guideline produced by the National Health and Safety Branch or contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard OTTAWA, ON K1G OZ7
Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Cold is rightly regarded by many workers as a hazard. Lowering of temperatures either outdoors or indoors causes not only general physical discomfort, but a loss of dexterity, energy and alertness. It can also lead to severe physical damage and death.

The body comfort and safety of cold weather workers is dependent upon three major factors:

1.climatic conditions,
2.body heat and water vapor production,
3.the entire assembly of clothing.

Each of these factors is interrelated with the other.

Cold temperatures and the human body’s response

A cold climate has been defined in a number of ways, ranging from the temperature below 10°C1 to temperatures below room temperature (approximately 22°C2). For worker, safety it’s sensible to say that the sensation of cold is an accurate indication of coldness and the danger from cold.

Thermoregulation is the human body’s ability to regulate heat production by releasing body heat at the same rate it is produced. Blood circulation and conduction pass heat from within the body to the surface.

Blood vessels can dilate or constrict to vary the flow of blood to surface tissues. Heat is passed through the body and conducted out through clothing, can be affected by air currents. The evaporation of water vapour from the skin and respiratory tract also affects the regulation of heat production and loss. Temperature changes, physical activity and clothing all affect and alter this regulatory process in different ways.

Cold weather forces the loss of heat from the body. In order to increase the insulation and thus maintain the temperature of the inner body, the flow of blood to the skin is reduced. This causes loss of feeling and numbness in the extremities (fingers, toes, nose, ears).

A small temperature drop in the body core produces shivering. Shivering is the body’s protective mechanism of rapid muscle movement, which generates heat to help maintain inner body temperature. Shivering,numbness and discomfort are warnings that the body must be warmed by a warmer environment, by more vigorous physical activity or by increased insulation from the cold. As will be seen, these protective measures can themselves present their own hazards in cold weather.

Cold temperatures and wind chill

One of the most important, but often overlooked, considerations in cold weather work is the effect of wind combined with air temperature. The “wind-chill factor” can account for about 80 per cent of the total heat loss from the body.

Different combinations of air temperature and wind speed can present the same hazards. For example, when the air is calm and the temperature is 1°C, the body will feel cool. The same temperature with 40 km/h winds can produce bitter coldness. The wind blows away the thin layer of air that acts as an insulator between the skin and the outside air.

The importance of wind speed on cold weather work can be seen in the chart below.3 The “wind-chill factor” is derived from a mathematical equation and measures the rate of cooling of warm objects exposed to given wind and air temperature conditions. A temperature of 11°C and a wind speed of 16 km/h can produce a wind-chill factor of 1200 – the wind-chill factor where exposed flesh freezes. Yet the higher temperature of 2.8°C with a wind-speed of 48 km/h can produce the same.

The physical hazards of cold weather

The two main hazards of cold weather work are frostbite and hypothermia. The first can cause permanent damage. The second can be fatal.

a) Frostbite

Frostbite refers to the freezing of tissues. Theoretically, the freezing point of skin is 1°C, but frostbite may occur even if temperatures are not extremely low. It may occur at above 0°C if the worker is wearing wet, damp clothing or if the skin comes into contact with objects below the freezing point. Decreased blood circulation can also contribute to the occurrence of frostbite. Frostbite most commonly occurs in the cheeks, nose, fingers, toes and earlobes. These areas are poorly insulated by skin and most often left exposed. Fingers, for instance, are poorly insulated because of their long, thin, cylinder like shapes.

When frostbite occurs, crystals of ice form in the tissues, damaging them. Small blood vessels can be damaged when they become blocked with tissue debris. This causes further injury because the vessels are then unable to supply tissues with blood.

The classic signs of frostbite are loss of feeling and pallor. The first warning is a sharp, pricking sensation, but cold also produces numbness and anesthesia, which permits freezing without the warning of discomfort. Circulation and tissue can revert to their normal state if exposure is not acute.

If exposure is prolonged, tissue can actually die (tissue necrosis) in spite of the application of heat. Tissue necrosis can take place in four degrees of severity. In the first two degrees, tissue death does not extend beyond the outer layers of skin which reddens and blisters from the obstruction of blood flow. In the third and fourth degrees, there is complete necrosis of the skin and deep tissue death that can affect tendons, bones and joints. The farthest points from the affected areas become blue or blackish and gangrene can develop. The worker’s general condition may deteriorate with the severity of the frostbite and there may be chills and fever.

First aid: Areas affected by frostbite should not be rubbed with ice or snow. This only causes further freezing. Superficial frostbite can be treated by gentle heating of the affected areas, which should not be massaged or exposed to open fires. With deep frostbite, it is important to keep the affected worker warm and get him/her to the hospital as quickly as possible. During work, the fingers, nose tip, toes and ears, should be periodically exercised to keep them warm and to detect numb or hard areas indicating frostbite.

b) Hypothermia

Hypothermia is an acute problem, resulting from long exposure to cold. It occurs when body heat is lost faster than it is produced, resulting in body temperatures below 35°C. The lethal deep body temperature is 26°C.

The body can lose great amounts of heat in numerous ways: inadequate clothing, improper insulation, or fatigue from physical activity. As the body core temperature drops, shivering begins. If it continues to decrease, shivering actually decreases, respiration and the heart rate are slowed, and hypothermia sets in. The brain becomes less efficient, consciousness is dulled, muscular rigidity begins and breathing becomes shallow. These events could lead to eventual unconsciousness and possible death from exposure.

Some workers claim that constant exposure to cold makes them able to withstand these temperatures better. The reality is that workers learn to survive, rather than physically adapt to cold weather work. Getting used to cold weather work or habituation to cold may dull the awareness of being cold and carries with it an increased risk of hypothermia or cold injury. Hypothermia can affect a worker in temperatures well above freezing, especially when the worker is in cold water, is exposed to cool, high winds, is fatigued or has insufficient food.

First aid: When a worker suffers from hypothermia, immediate medical attention is necessary. The worker should be slowly warmed and hospitalization may be necessary for evaluating and treatment.

c) Immersion foot

The immersion of feet in cold water over an extended period or the wearing of damp footwear in cold weather can cause what is known as immersion foot or trench foot. Blood vessels spasm and cause extensive damage to foot muscles. The accumulation of fluid in tissues causes swelling, tingling, itching and severe pain followed by blistering, superficial skin necrosis and ulceration (skin lesions). Gangrene could also develop. When the foot heals, it is more sensitive to cold and the pain may last for years.

d) Other problems

Some research indicates that exposure to temperatures below freezing leads to chronic lung disease and sinus irritation. Other possible effects may be chronic headaches, arthritis and an increase in virus infections.6 There is also an association between acute pneumonia and unusual cooling. Blood system abnormalities may be caused or worsened.7

Falling temperatures can cause hands and fingers to become insensitive, so the probability of malfunction and accidents increases. Shivering can make it still more difficult to properly manipulate equipment. Hypothermia can cause confusion, leading to clumsiness that endangers the worker and those around him/her.

Under conditions of wind noise, severe cooling and the perceived threat of injury, workers may show lack of attention, hostility and a desire to withdraw from the workplace. This leads to work inefficiency, which could present a danger to the worker and others.

Preventative measures

In order to protect the body from the dangers of cold weather work, measures must include periodic warming of the body and the use of protective clothing. The provision of heated rest facilities for workers is essential and rest allowances should be increased.

a) Rest allowances

The following work/warm-up schedule can be used as a guide to the maximum work periods and number of rest periods that should be allowed at varying temperatures and wind speeds during moderate to heavy work activity. For example, at a temperature of 26°C with a 16 km/h wind, a worker should have a maximum work period of 75 minutes with two ten-minute breaks in a four-hour period.

If wind speed increases to 32 km/h at the same temperature, the maximum work period should be only 40 minutes with four ten-minute breaks in a four-hour period.8

During rest periods, certain precautions should be taken. Warmer clothes for resting in the cold weather should be provided since heat production from physical activity is decreased. Workers should also beware that carbon monoxide hazards can result from charcoal burning fires indoors, where there is inadequate ventilation.

In some cases, more physical activity could prove beneficial so that surveillance tasks without activity should be avoided in the cold. Increasing physical effort required for light tasks could increase needed body heat production.

Wind shields should be used when possible

b) Clothing

Clothing is the main barrier against cold weather and prevents body heat loss. An adequate clothing “system” which keeps workers comfortably warm is necessary. Clothing should provide high insulation, allow the escape of moisture from within, resist wetting from outside, shed snow, have a means of varying insulation and air flow, not restrict movement, have minimum weight and bulk, be easy to put on and take off and be durable.

Clothing must allow the escape of moisture from inside, yet not allow wetness in from outside. That is, workers should look for fabrics that breathe, allowing water from perspiration and sweat out, yet are waterproof. If the perspiration, resulting from increased physical activity, can’t escape, the body’s ability to regulate heat production and loss will be impaired.

Heat losses resulting from the accumulation of water in clothing can be large, particularly in windy conditions. The thermal conductivity of water is approximately 20 times that of dry fabric. So clothing meant to insulate the body from outside cold and maintain heat can be reduced to a fraction of its original value. Body heat is lost faster than it is produced. Depending on the degree of contact between clothing with the body, wearing wet clothing could be like immersing oneself in cold water.

The insulation value varies from fabric to fabric. Denim is loosely woven, it allows water to penetrate and cool winds to blow away body heat. Duck or goose down stops wind, but easily becomes waterlogged. Clear plastic or woven nylon, is a good protection against wind and water, but provides little insulation and can prevent moisture from escaping.

As already mentioned, fabrics used in cold weather clothing should be tightly woven and highly “air permeable”. Air entrapped within clothing fabrics and between clothing layers is a more effective insulator than the cloth itself. Clothing should also be worn loosely and in layers, thus adding to this warm air circulation. Even this insulation can be reduced by compression and disturbance of air layers caused by physical activity and winds. Insulated clothing could lose much of its thermal insulation just by the simple act of walking. Thus, two layers of tightly woven “breathable” fabric with a space between them are more effective wind breaks than one outer layer of fabric with low air permeability.

A good cold weather clothing system might consist of the following garments:

  • Underwear. Cotton shirt and shorts should be worn under thermal underwear. Long underwear in a two-piece style is better than one single garment. The fit should be loose so that blood vessels are not constricted.
  • Socks. High wool socks, are best and should encourage evaporation of sweat. Stretch socks restrict circulation.
  • Trousers. Wool and quilted trousers or lined thermal types, are the best. They should be roomy enough to prevent compressing. Belts are constricting; suspenders should be used. Conventional pants should be tucked into boots to prevent entry of snow and cold water.
  • Boots. The best are felt lined, rubber bottomed, leather-topped with removable insoles. Footwear should be waterproof and reach high up the leg.
  • Shirt. A wool shirt (cotton or synthetic shirt worn under for those allergic to wool) should be worn over underwear tops and suspenders with shirt tail worn outside pants to aid ventilation.
  • Head covers. At -4°C, a worker could lose up to 50 per cent of his/her heat production when resting and 75 per cent of it at -15 °C, from an uncovered head. Long hair and beards provide little insulation. They can, in fact, serve as a basis for ice build up and can mask the appearance of frostbite. Wool knit caps or hat liners that extend down the back of the neck, should be worn. A balaclava provides further face protection.
  • Face masks. These can be worn by workers who cannot afford reduced vision on the job. It is essential, when wearing facemasks, that they be removed periodically to check for frostbite.
  • Gloves and mittens. Mittens win for protection, but limit finger movement. It is best to carry both and they should never be worn when wet.

c) Other precautions

      • Food. Balanced meals and adequate liquid intake are essential for body heat production and the prevention of dehydration. Warm liquids should be provided.
      • Alcoholic drinks should not be given because they cause dilation of blood vessels. This allows the rapid loss of body heat and increases the risk of hypothermia.
      • Training. Workers should be trained in the use of proper clothing and the recognition of the early signs and symptoms of frostbite and hypothermia.
      • Machinery. Machinery and tools should be carefully designed to make them less hazardous and easier to use during cold weather. Metal parts should be insulated and sharp protrusions should be eliminated.
      • Fitness. Physical fitness can make work in cold weather easier. However, those suffering from vascular diseases should avoid working in cold weather.
      • Vehicles. Vehicle breakdowns in bad weather conditions can maroon workers (especially in rural areas). All vehicles should be provided with survival kits and a two way communications system.

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

What are critical incidents and critical incident stress?

Critical incident stress is a term used to describe the normal reactions of workers who experience or witness an abnormal, shocking critical incident or traumatic event. Being involved in or respond­ing to severe accidents, a direct injury to a worker or witnessing a catastrophic event such as the effects of a hurricane or terrorist attack can cause critical incident stress.

CUPE members’ work often involves the risk of witnessing or being part of critical incidents. Whether members work as first responders and dispatchers or work in hospitals, schools, airlines, libraries or municipal facilities, critical incident stress is a very real health and safety hazard for front line workers.

Examples that cause critical incident stress in the workplace are:

      • Death of a co-worker, either in the line-of-duty or other workplace incident
      • Serious or life-threatening injury to oneself or to co-workers
      • A near miss that threatens the health and safety of oneself or of co-workers
      • Suicide of a co-worker
      • Loss of a patient after rescue attempts
      • Death of or critical incident involving children
      • Violence inflicted on oneself or on a co-worker
      • Violent crime in or near the workplace
      • Events with excessive media interest
      • Natural disasters that affect work

Some workers are more prone to be exposed to a critical incident due to the nature of their occupation. CUPE members who work as para­medics, security guards, or in child safety related fields are far more likely to report experiencing a critical incident. It is incumbent upon employers of these workers to recognize that the higher risk an implement control measures that prevent the development of critical incident stress.

First Responders

Many CUPE members work as first responders, such as paramedics, police and security, fire­fighters and dispatchers. Their jobs put them at a much higher risk to experience critical injury stress, that when left untreated, can lead to PTSD and depression. It has been reported that between April 29 and December 31, 2014, 27 first responders died by suicide, and in the first six months of 2015, another 28 took their own lifei. Many workers are not afforded time off after a critical incident to take care of their own mental health which is negatively impacted by events they must face as part of their job. As a result, many first responders continue to work, being exposed to more critical incidents while they are trying to recover from previous incidents, thereby compounding the problem.

Also compounding the problem is the internal ‘macho’ culture of the workplace of many first responders. It is common for workers to be actively discouraged by their workplace culture to express their feelings, or ask for help, on and off the job. This culture reduces reporting, and prevents workers from seeking help.

http://www.tema.ca/

Reactions to critical incidents

Some CUPE members who experience critical incident stress could become overwhelmed and unable to cope with daily activities. After a critical incident, members’ attitudes about their work and workplace can change drastically.

Symptoms of critical incident stress can vary significantly between workers, even when they have witnessed or experienced the same traumatic event. Some people will experience symptoms immediately, while others will have symptoms develop gradually. They include such diverse symptomatology as shock, denial, anger, rage, sadness, confusion, terror, shame, humili­ation, grief, sorrow and even suicidal thoughts. Other responses include restlessness, fatigue, frustration, fear, guilt, blame, grief, moodiness, sleep disturbances, eating disturbances, depres­sion, nightmares, profuse sweating episodes, hyper-vigilance, paranoia, phobic reaction and problems with concentration or anxiety. Workers may experience flashbacks and mental images of the event(s). Some people will withdraw socially, and interpersonal relations can become strained. Absenteeism may increase and, in extreme situa­tions, workers may attempt suicide. If workers are still experiencing symptoms of critical incident stress 30 days after the initial traumatizing event, they can then be diagnosed by a professional with post-traumatic stress disorder.

Frequently, employers believe that workers should be able to deal with critical incidents without help. This shifts blame and responsibility on the worker for an event beyond their control. Instead, the real responsibility for assisting workers is the employer’s.

If there is no support from the employer or the worker’s concerns are dismissed, workers can feel let down by their workplace. Poor morale, increased workplace accidents, staff turnover, depression and even suicide can result.

What are additional systemic causes for critical incidents and critical incident stress?

While we usually think about critical incident stress occurring in occupations that deal with potential injury or death. However, an unsafe workplace can lead to critical injuries and related stress in other workplaces. For example, poor safety procedures may lead to critical incidents in any work place, like a fall from a roof or death while working alone. Understaffing and poor safety procedures can increase the likelihood of violent outbreaks by clients. Poor working conditions, excessive workloads and overtime can increase the safety hazards of lots of kinds of work. Proper health and safety policies and practices in all workplaces will reduce the likelihood of critical incidents.

What can be done about critical incidents and critical incident stress?

1. Identify the problem

The first step is to recognize that critical incidents are a serious health and safety hazards. If a critical incident has happened or can happen in your workplace, critical incident stress is likely to affect CUPE members. Surveys and mapping techniques are excellent tools to identify critical incident stress.

2. Preventive Actions

Where possible, the first goal should be to pre­vent the critical incident. For some occupations, critical incident stress is very hard to avoid or engineer away. Paramedics and other front line workers may experience very negative incidents that affect them as part of their job. Dealing with critical incidents will be discussed in the next section, it is important to recognize that in many workplaces, critical incident stress hazards can be prevented. The following actions can help reduce the likelihood of critical incidents in all workplaces.

  • Refuse unsafe working conditions and unnecessary overtime.
  • Conduct a full review of work organization and conditions that lead to critical incidents.
  • Conduct regular workplace inspections to prevent critical incidents and critical incident stress hazards.
  • Demand that employers take action on improving working conditions and hazards that can cause critical incidents and critical incident stress.
  • Insist employers manage work processes and organization so that critical incidents and critical incident stress are eliminated.

3. Dealing with a critical incident

Many CUPE members will face critical incidents during the course of their work and planning for them ahead of time is the most important step that can be taken. The following actions can help combat critical incident stress when an incident has occurred:

  • Implement a workplace critical incident stress program that puts the health and safety of workers first. Make sure a critical incident stress program includes the standard defusing and debriefing stages in addressing the critical incident stress needs of members (see below for more information).
  • Create a critical incident and critical incident stress policy for CUPE workplaces. A policy starts with the premise that critical incidents and critical incident stress are health and safety hazards and that all steps should be taken to prevent them.
  • Keep critical incidents and critical incident stress issues on the health and safety committee agenda until they are resolved.
  • Negotiate contract language where legislation does not provide for specific critical incident and critical incident stress controls, monitoring, or access to information about critical incidents and critical incident stress.
  • Sponsor CUPE education around the issue of critical incidents and critical incident stress and its effects.

Critical Incident Response Plans

Any critical incident response plan must involve qualified, well trained personnel. These should include specially-trained mental health profes­sionals and sufficient peer assistance from the workplace. Their focus is to lessen the impact of the critical incident through helping the members understand and obtain support to properly man­age their emotional responses to these workplace hazards.

Peer counselling or mental health professional counselling is often needed after a critical incident has occurred. This counselling is part of a critical incident stress program that should be coordinated by CUPE-trained health and safety representatives. It involves defusing, debriefing and follow-up.

The first step after a critical incident is defusing to relieve acute stress. Defusing usually happens three to eight hours after the incident. A coun­sellor or peer worker meets with one or more affected workers. Workers remain anonymous in any reports. The counsellor or peer worker provides information on normal reactions and how workers can take care of their emotional and physical health. The counsellor or peer worker also outlines resources available to workers who need more assistance.

Debriefing usually happens 24 to 72 hours after the incident. It is a process where workers talk about the emotional impact of the event. Debriefing is usually done by a mental health professional and involves letting workers talk about their reactions to reveal and release their emotions.

Defusing and debriefing are not substitutes for therapy. They are part of a larger process that attempts to let workers know that their reactions are normal and provide them with the necessary resources to seek professional help.

The follow-up process of a critical incident should be designed to provide contact and support for workers over the long term. As critical incident stress reactions can happen immediately after, a few hours after or a few months after a critical incident, follow-up procedures are vital to workers’ health, and the workers’ family members are usually included in the follow-up stage to make sure they can cope with the effects of critical incident stress at home.

Employee Assistance Programs (EAP) should have critical incident stress provisions. An EAP should also address violence, stress, overwork, depression, addictions, relationship and family problems, death, financial pressures and physical illness. A comprehensive EAP can identify and address problems before they lead to the critical incident stress getting out of hand and leading to worse mental health conditions. Along with a good EAP, workers need to be educated about the full range of resources available to them as well as how to use them.

It’s important to note that the best EAP will be of little assistance to members if working conditions are not fixed and workplace hazards not elimin­ated. The focus must be on preventing critical incidents from happening in order to prevent critical incident stress.

Attachments

Fact Sheet: Critical Incidents & Critical Incident Stress

Ebola virus disease (EVD) is a severe disease that causes haemorrhagic fever in humans and animals. Diseases that cause haemorrhagic fevers affect the body’s vascular system (how blood moves through the body). They can lead to significant internal bleeding, organ failure, and are often fatal.

Background

EVD was first identified in 1976 in two simultaneous outbreaks in Africa, including one near the Ebola river, where the disease got its name. There are five known species of Ebola: Zaire, Bundibugyo, Sudan, Taï Forest and Reston. The first three species, Zaire, Bundibugyo, and Sudan, have been associated with large outbreaks in Africa. The Reston species is not associated with disease in humans. The virus causing the 2014 West African outbreak belongs to the Zaire species.

Symptoms

Recent studies have shown that 95 per cent of patients that become infected by an exposure to EVD will show symptoms in two to 21 days. Humans are not infectious until they develop symptoms. The first symptoms are the sudden onset of fever, intense weakness and fatigue, muscle pain, headache and sore throat. The disease progresses to vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in stool). Laboratory findings include low white blood cell and platelet counts, and elevated liver enzymes. EVD infections can only be confirmed through laboratory testing.

Transmission

Person-to-person transmission from an infected individual is the most likely form of transmission in North America. EVD can be transmitted via direct contact (through broken skin or mucous membranes of the eyes, nose or mouth) with:

  • Blood or body fluids of a person who is sick with Ebola, including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen.
  • Objects (e.g. needles and syringes) that have been contaminated with the virus.
  • Surfaces and materials (e.g. bedding and clothing) contaminated with these fluids.

Transmission is most likely when EVD-infected people are symptomatic but not yet diagnosed. CUPE members who work as health care workers, first responders and in airline transportation are at the highest risk of exposure because they may come in contact with infected blood or body fluids of infected people before effective protocols are put into place.

The Centers for Disease Control and Prevention (CDC) report that Ebola is not spread through the air or by water. However, activities that put an unaffected person close enough (one metre) to come into contact with the airborne contaminates from aerosol-generating events are at high risk of contracting EVD. Aerosol-generating events include coughs, sneezes, profuse diarrhea or vomiting.

People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. According to the CDC men who have recovered from the disease can still transmit the virus through their semen for up to three months after recovery from illness.

There is no evidence that mosquitoes or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread the virus. Though transmission from animals is possible, this is not a significant concern in North America.

Treatment

Currently, the prognosis of a person infected by EVD is poor. Estimates of the fatality rate of people affected by EVD range from 50 to 90 per cent. Survival rates are greatly improved with the use of supportive treatments such as rehydration care with oral or intravenous fluids and the treatment of specific symptoms such as pain, nausea, fever, anxiety, and dialysis when there is kidney failure. In extreme cases, blood transfusion and clotting agents have been used to reduce the negative effects of internal and external bleeding. There are currently no 100 per cent-proven treatments available for EVD.

Prevention and control

It is CUPE’s position that any worker that is likely to be exposed to the Ebola virus should be protected. Appropriate personal protective equipment as well as training on its use and related procedures must be provided before an incident of potential exposure occurs. All workers also have the right to refuse work they feel is unsafe, or that they are not trained to perform safely.

General members of the public are at low risk, but because of the severity of the disease, everyone has a role to play to prevent it from spreading. The World Health Organization notes that “Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission.”

The first way to control an outbreak of Ebola is for the public to remain calm but vigilant. While most people are unlikely to be in a situation that exposes them to the Ebola virus, it is important to recognize symptoms, and contact or report to an appropriate medical facility for screening. Many of the early symptoms mimic the early stages of a common cold or flu. But anyone having symptoms, including a fever, who may have been in a place where they could have been infected, should first contact their local public health services. If they cannot be reached, all provinces have telehealth systems (numbers listed below) that can be contacted. They will advise whether it is appropriate to go to the emergency room, or what other steps you should take to receive treatment.

A person with a suspected or confirmed case of EVD will be placed in quarantine and a specialist team will work to identify people who may have been in contact with the infected person, particularly in the period after they developed symptoms. Those who were in contact are unlikely to spread the disease unless they start to show symptoms, so monitoring the health of identified groups for 21 days and separating the healthy from the sick can prevent further spread of the disease.

CUPE members who do not work in a medical setting but do routinely deal with the public and have concerns about being exposed may also take preventive measures. Employers should be encouraged to provide N95 masks for workers, as well as free disposable face masks and approved disinfecting hand rubs for clients. Workers dealing with the public should frequently sanitize their hands and disinfect surfaces around their work areas. Keep a safe distance from anyone exhibiting symptoms and avoid touching your face and neck.

Gloves can create a false sense of security. Unless you’re handling items that are likely to be contaminated, or you have an open wound on your hand, gloves provide little additional protection. Avoid touching your face or neck with or without gloves.

The care of infected individuals must be administered by health care workers carefully observing a high level of barrier separation from the infected person, along with certain cleaning and disinfecting techniques.

CUPE has prepared several position papers with recommendations for occupational protection from EVD for the following groups:

      • Health care providers
      • Health care support staff
      • Paramedics
      • Flight attendants

This information can be obtained by contacting the health and safety branch.

Residual transmission prevention

Though scientific studies have been conducted, it is not currently known exactly how long the Ebola virus can last outside the human body on contaminated surfaces. Estimates of several days are not unreasonable. As such, contaminated surfaces, clothing, materials etc. can still spread the disease for a significant amount of time. Until every surface or material has been effectively decontaminated, protective measures must remain in place.

The Ebola virus can be eliminated with heat, alcohol-based products, or bleach. According to the Public Health Agency of Canada, the virus is susceptible to 3 per cent acetic acid, 1 per cent glutaraldehyde, alcohol-based products, and a 10-minute exposure to dilutions of 1:10 of 5.25 per cent household bleach (sodium hypochlorite), or bleach powder (calcium hypochlorite). For surfaces that may corrode or discolour, they recommend careful cleaning to remove visible stains followed by contact with a 1:100 dilution of 5.25 per cent household bleach for more than 10 minutes. For other surfaces Ebola will be deactivated by heating to 60°C for at least 60 minutes, or boiling for at least five minutes. Gamma irradiation (1.2 x106 rads to 1.27 x106 rads) combined with 1 per cent glutaraldehyde is also effective at rendering the virus inert.

Provincial telehealth/telemedicine phone numbers

British Columbia
New Brunswick
Nova Scotia
Quebec
Prince Edward Island
Dial 811
Alberta 1-866-408-5465
Saskatchewan 1-877-800-0002
Manitoba 1-888-315-9257
Ontario 1-866-797-0000
Newfoundland 1-888-709-2929

Much of the information for this fact sheet was retrieved from sources at the following:

Public Health Agency of Canada accessed October 17, 2014
World Health Organization accessed October 15, 2014
Centers for Disease Control and Prevention accessed October 15, 2014

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachment
Fact Sheet: Ebola virus disease fact sheet

What is workplace violence?

Workplace violence is a serious health and safety concern. Workers do not expect to be victims of workplace violence. However, violence can hap­pen in any workplace and can have serious effects on workers, their families, their colleagues, and the way work is conducted.

While most people think of violence as physical assault, in reality it’s a much broader problem. Violence in the workplace is any incident in which an employee is abused, threatened or assaulted during the course of his or her employment, including the application of force, threats, verbal abuse, and sexual, racial or personal harassment.

Workplace violence is broadly defined, and not limited to incidents that occur within traditional workplaces. Violence can occur at functions and locations related to work, such as conferences, training sessions, social gatherings, work travel, a client’s home, or other work-related situations.

Anticipation or fear of violence is a stress factor that can cause physical and psychological prob­lems for workers.

What factors put workers at risk of violence?

Almost all workers are at risk of being exposed to violence in the workplace, however those who deal with the public are at a greater risk. Many workers are at a greater risk because they are exposed to discrimination-based violence, includ­ing women, racialized, Aboriginal, and LGBTTI workers, and workers with a disability.

Additional risk factors include:

  • Handling money, prescription medication or items of significant value.
  • Providing health care, educational, or per­sonal support services.
  • Conducting offsite inspections or performing enforcement duties.
  • Working with people who are unable to con­trol their behavior because of mental health conditions.
  • Working with people who may be under the influence of drugs or alcohol.
  • Working shorthanded or in high stress, low control work environments.
  • Working alone, in isolation, in low traffic areas, or near areas that are at risk of violent crime.

What legislative protections do workers have from violence in the workplace?

At the time of publication, all provinces with the exception of New Brunswick have specific vio­lence prevention language in their Occupational Health and Safety Act or related regulations. These laws require employers to provide a safe and healthy workplace by developing a violence prevention policy and making it accessible to all employees.

Employers must also perform a hazard assess­ment to determine if and where their workers may be exposed to violence. Information about factors contributing to workplace violence must be made available to all employees and assistance must be provided to those who have been exposed to workplace violence.

What can my local union do to help prevent violence in the workplace?

Unionized workers have additional options available to them to deal with violence in the workplace. Your joint health and safety com­mittee or your health and safety representative should:

  • Develop a workplace violence prevention policy that contains precise, concrete lan­guage. Training on this policy must be provided to management, workers, clients, contractors, and anyone who has a relationship with your workplace.
  • Outline a confidential process by which employ­ees can report violent incidents that ensures and communicates that no reprisals will be made against employees reporting violent incidents.
  • Identify all the factors that contribute to work­place violence, remove these factors where possible, and implement control measures to reduce the likelihood of violence occurring.
  • Regularly monitor and update the violence prevention policy. Also monitor the hazards analysis and corrective measures used to con­trol hazards that remain.
  • Bargain violence prevention language into your collective agreement.

What to do if you’re faced with violence in the workplace?

If it is safe, inform the person inflicting the behav­iour that it is unwanted and to cease immediately. If it is not safe, then take the steps needed to remove yourself from the violent situation.

  • Report the incident. If your life has been threatened or the situation warrants it, contact the police. Document the incident(s) and inform your supervisor, health and safety representative, and union representative of the incident(s). If the incidents continue, keep documenting and reporting them.
  • If you feel that your health and safety are at risk, you have the right to refuse work until the issue is rectified. It may also be possible to file a grievance or a complaint with the human rights commission.
  • If you’re unable to resolve the issue through the steps mentioned above, contact the govern­ment inspectors and request that they come to your workplace to investigate the incident(s).
  • Request additional support and information about any of these steps from your local health and safety committee members or representa­tive, local executive, national CUPE servicing representative, or your national health and safety representative.

Violence and harassment can often occur simul­taneously, and confronting these workplace hazards can be difficult. For additional resources, please consult CUPE’s Violence Prevention Kit and CUPE’s Harassment fact sheet.

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachment
Fact Sheet: Violence in the workplace

Work and the pressures of society often lead to overwhelming stress on workers. How that stress is or is not dealt with contributes greatly to our families’ well-being.

Poor working conditions, unsafe and unhealthy jobs, excessive noise, gases, chemicals, unrealistic work quotas, poor work organization, poor shift ‘scheduling, insufficient or overbearing supervision. All of these can and should be issues that the union can improve upon.

By eliminating these workplace stressors, we help reduce the number of factors that affect workers’ well-being.

Many employers have recognized the need to provide assistance for workers who are in distress. Employee assistance programs are present at many work-sites.

Too often these programs do not achieve the goal of assisting and counseling distressed workers. Instead, they are used to ensure that work performance does not deteriorate. Refusal or failure to use the EAP program can lead to discipline or dismissal.

Often the threat of EAP programs is used to improve work performance. Such programs do not help workers deal with the problems but only increase their anxiety and stress levels.

Elements of a good EAP

To be truly effective, an employee assistance program should include the following elements:

  • Be jointly administered by union and management;
  • Ensure complete confidentiality;
  • Be fully funded by employer;
  • Recognize the right to paid leave whenever treatment is required;
  • Ensure that professional services are independent of the employer (i.e., community-based services);
  • Use fellow employees as referral agents;
  • Provide training for referral agents;
  • Be completely voluntary;
  • Be governed by policy and procedures jointly developed by union and management;
  • Be available for whole family;
  • Not be used as a disciplinary tool;
  • Offer general information about health and well being.

Conclusion

Good EAPs can and do help employees cope with problems that are causing distress to them and their families. Many unions have negotiated or have participated in such programs. Without union participation, the effectiveness of such programs may be poor.

Jointly administered EAPs are more likely to provide assistance and to help CUPE members deal with the increasing pressures of modern life

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G 0Z7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachments
Fact Sheet: Healthier workplaces, healthier workers

heat-stressWhat is heat stress?

Heat stress is a build up of heat in the body to the point where a worker cannot maintain normal body temperature. When workers can’t cool themselves by sweating, serious heat illnesses can occur. Working in hot temperatures is a health and safety hazard and can lead to heat stroke, which can be fatal.

What causes heat stress?

Heat stress is caused by a number of factors that usually include:

  • High temperatures
  • High humidity
  • Intense physical work
  • Whether or not a worker is used to working in hot conditions
  • Lack of breaks
  • Lack of water
  • Poor working conditions
  • Lack of air movement and ventilation
  • Working in direct sunlight and lack of available shade
  • Working near machinery that gives off heat (dishwashers, boilers, etc.)

What happens when you get heat stress?

There are a number of conditions that result from heat stress, they include:

  • Heat rashesare one of the most common problems with heat stress. It appears as red bumps on the skin and can feel prickly. Heat rashes are caused by excessive sweat that doesn’t evaporate. The rash usually disappears when the worker gets to a cooler environment. Clothing that helps wick away sweat can sometimes prevent heat rashes.
  • Heat fatigueoften happens when a worker is not acclimatized to working in hot temperatures. It causes workers to react slowly and have impaired concentration. Workers must get out of the heat before more serious conditions develop.
  • Heat crampsusually happen from hard physical labour in a hot environment. Cramps are caused by the lack of water. Remember, water must be taken every 15 to 20 minutes in hot environments. Avoid alcohol, coffee, tea and carbonated drinks.
  • Heat exhaustioncauses headache, nausea, dizziness, blurred vision, weakness, and excessive thirst. Usually a worker’s skin is damp and looks muddy or flushed. Workers suffering from heat exhaustion should be removed from the hot environment, given fluids, loosen clothing, shower or sponge bath with cool water and rest in a cool place.
  • Heat collapseis very serious and causes fainting and workers may lose consciousness. Heat collapse results from the brain not having enough oxygen because blood goes to the body’s extremities. Heat collapse happens very quickly. Affected workers must be moved to a cooler area, and given fluids.
  • Heat strokeoccurs when the body’s internal system of temperature regulation fails and body temperatures rises to harmful levels. Heat stroke is a serious medical emergency. Symptoms of heat stroke are confusion, irrational behaviour, loss of consciousness, convulsions, hot dry skin, lack of sweating (usually), and an abnormally high body temperature. If body temperature is too high workers can die. Emergency responders must be called immediately.

What can be done to prevent heat stress?

To prevent heat stress employers must ensure:

  • There is adequate ventilation
  • Providing fans for cooling unless the temperature reaches 35 Celsius at which point fans can do more harm than good
  • There are shaded areas available when working outdoors
  • Water is made available to workers
  • There are increased breaks with short work cycles. Get to cool areas during breaks
  • More physically demanding work is done in the early morning or evening
  • Equipment that generates heat and is not being used is turned off
  • Workers who are pregnant do not perform physically demanding work
  • Training is provided on how to recognize and prevent heat stress
  • Medical help is called if a worker feels sick, dizzy, nauseated, has prickly skin, feels weak or has sudden vision problems
  • Hot surfaces in the workplace are shielded or insulated
  • Air conditioning and fans are provided
  • A proper acclimatizing process is in place for all workers who work in hot environments. Acclimatizing to hot conditions usually takes from one to three weeks and begins with a light workload that gradually builds to a normal workload.

Concerns of outdoor workers

Outdoor workers have to deal with the sun as an occupational hazard. Although it is a concern for everyone, CUPE members who must work outdoors are at particular risk from the effects of ultraviolet radiation (UVR), which can cause skin cancers.

Reducing UVR exposures include:

      • Avoid the mid-day sun
      • Work in the shade as much as possible. Portable shade devices should be made available
      • Wear protective clothing. Wide brim hats and light-coloured clothing made of tightly woven fabric are some of the best protection from the effects of the sun. The weave of the fabric should allow perspiration to evaporate easily.
      • Eyes should be protected by special purpose sunglasses that will filter out both UVA and UVB rays.
      • Use sunscreens. There are two types of lotions that can be applied – sunblocks and sunscreens. Sunblock creams such as zinc oxide or titanium dioxide create a barrier, which reflects UVR. Sunscreens absorb UVR and prevent penetration to the skin. Apply the sunscreen 15 to 30 minutes before going in the sun. Spread the sunscreen over all exposed parts of the body, paying particular attention to the nose, ears, neck, lips and any bald spots. Even though “waterproof” sunscreens allow up to 80 minutes between re-application, the Canadian Cancer Society recommends that you re-apply the sunscreen after perspiring heavily or if you get wet. The joint health and safety committee should be involved in the selection of protection and sunscreen that will be used.

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachments
Fact Sheet: Heat Stress

Hepatitis B is a potentially life-threatening disease. It causes a number of conditions, ranging from fever and jaundice to more serious illness, such as inflammation of the liver, cirrhosis and possibly liver cancer. Hepatitis B infection is transmitted by the hepatitis B virus (HBV) through exposure to blood and other body fluids. Any worker with occupational exposure to blood is at risk of contracting hepatitis B.

Is hepatitis B a serious problem?

Hepatitis B is probably the most frequently reported work related infectious disease in Canada. The hepatitis B virus is much more infectious than the HIV/AIDS virus. According to the U.S. Centre for Disease Control, one in four HBV-infected health care worker will develop jaundice or other acute (short-term) symptom.

Approximately ten per cent of infected persons infected with HBV become “chronic carriers”, which means that they can transmit the virus through their blood or body fluids. Many chronic carriers do not show symptoms of disease, so they are not aware that they can spread the HBV.

Spread of hepatitis B

Hepatitis B can be transmitted through blood and other body fluids such as saliva, semen and vaginal fluids. Workers can be infected through a splash of blood in the eyes, nose, or mouth or infectious body fluids coming into contact with a cut, sore or broken skin. The HBV can be transmitted by bites that penetrate the skin. Workers can also be infected if they are cut by a sharp or stuck with a needle contaminated with infected blood.

High risk worker groups include:

  • surgeons and operating room staff;
  • emergency room and ambulance staff;
  • blood bank staff;
  • dialysis unit workers;
  • clinical lab technologists (particularly those who do blood work);
  • haematology, nephrology, hepatology and cancer ward staff;
  • workers in institutions for the mentally handicapped;
  • workers in prisons;
  • dentists, dental assistants and hygienists;
  • pathologists and morgue attendants.

What are the symptoms?

Hepatitis may cause serious acute (short-term) and chronic (long-term) diseases of the liver for which there is no effective treatment. Infected persons show symptoms including tiredness, aches and pains, stomach upsets, and jaundice in some cases. When jaundice doesn’t occur the symptoms of a mild case are similar to the flu. Approximately 75 per cent of persons infected with HBV have no symptoms of acute hepatitis, while the remaining 25 per cent show clinical features, such as jaundice or liver swelling. One in several hundred people who are infected with HBV dies from overwhelming (fulminant) hepatitis.

While the acute infection can actually last up to six months, the chronic infections are of greater concern.

About 6–10 per cent of infected adults become chronic carriers of the disease (particularly those infected in early childhood or persons who have problems with their immune systems). While these persons may not develop liver disease, they can pass the virus on to others. A small number of the chronic carriers develop serious, chronic, incurable liver disease in the form of chronic active hepatitis, cirrhosis and liver cancer. Hepatitis infection is also associated with serious diseases outside the liver, including simultaneous swelling of arteries, joints and nerves throughout the body.

Preventing the spread of hepatitis B

The best way to prevent the spread of hepatitis is the establishment of a good basic infection control program, which limits exposure to all blood and body fluids. This should include:

  • treating all blood and body fluids as potentially infectious;
  • washing hands after physical contact with any body fluid, even if you were wearing gloves;
  • using gloves and any other protective clothing such as gowns and face protection whenever workers might come into contact with blood and body fluids;
  • strict control of potential contamination sources such as linen, dressings and paper goods such as tissues;
  • ensuring that employers provide sufficient numbers of puncture-resistant containers designed for needle and sharp disposal;
  • ensuring that staff who use needles and sharps dispose of them safely into puncture-resistant containers;
  • establishing the use of safer-designed needles to reduce needle-stick injuries;
  • proper sterilization of reusable equipment; and
  • training all workers in the hazards of hepatitis B (and other communicable diseases).

Immunization

A safe and effective vaccine is available to protect against hepatitis B. The hepatitis vaccination is a non-infectious vaccine prepared from recombinant yeast cultures, rather than human blood or plasma. Since the vaccine is genetically engineered, there is no risk of acquiring HIV/AIDS, HBV or other infectious disease from the vaccine.

The vaccine develops antibodies against the HBV to protect you from infection. The vaccine is good for at least five years, so a booster may be required.

While most vaccine recipients experience no side effects, approximately 20 per cent may have mild effects such as local reactions at the injection site including soreness, pain, warmth and swelling. Smaller numbers have reported flu-like symptoms including nausea, headache, dizziness, fever and chills. These normally last a few days or less.

What should I do if I’m stuck with a needle or splashed with blood?

If you get stuck with a needle or a sharp, gently squeeze blood from the wound, and then wash the area with soap and water. If blood or other body fluids get on or in your unprotected skin, eyes, nose, or mouth, wash the area immediately with soap and water. See your own doctor as soon as possible after the injury. If you have not had the hepatitis B vaccine, you should start the vaccination process. You should also get a hepatitis B immune globulin (HBIG) shot unless you know that the source of contact is not known to be infected with HBV.

Report the incident to your employer and to your joint health and safety committee. Make sure that all the necessary documents are completed: injury report, workers’ compensation report and any other related reports. Keep a copy of all reports and send a copy to your union.

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G 0Z7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachment
Fact Sheet: Hepatitis B

The Human Immunodeficiency Virus (HIV) attacks and kills the cells of the immune system. HIV infections progress through different stages, and affect people in different ways.

When HIV kills too many immune cells the infec­tion progresses into Acquired Immune Deficiency Syndrome (AIDS). With AIDS the body can no longer fight infections.

You can have HIV without knowing it. Some people may have flu-like symptoms when they first get infected (fever, sore throat, swollen glands), while others may have no symptoms at all, because the virus has not infected much of the immune system.

Although there are currently no cures for HIV, it can be treated and infection is preventable.

How is HIV transmitted?

To infect someone, HIV must get from the blood­stream of an infected person to another person’s bloodstream. HIV cannot penetrate unbroken skin.

There are only five bodily fluids that contain enough HIV to infect someone: blood, semen (including pre-ejaculatory fluid), rectal fluid, vaginal fluid and breast milk. These fluids can enter another person’s bloodstream by pass­ing through broken skin and mucous membranes (including the eyes, the opening of the penis or the wet linings of the body such as the vagina, rectum, or foreskin).

HIV is most commonly transmitted through unprotected sex; sharing unsterilized needles for drug use; during pregnancy to a fetus; or while breastfeeding. Though not common, it is also pos­sible to transmit HIV through tattoo application, acupuncture needles, or body piercing needles and jewelry.

How can HIV infections be detected?

The only way to detect HIV is through a blood test. If you think you may have been exposed to the virus, contact your health care practitioner immediately. Most large cities also have HIV clin­ics run by regional public health departments. These clinics offer HIV testing and support.

How is HIV prevented?

Outside of the workplace, simple practices can help prevent passing on HIV including safer sex and harm-reduction approaches with needles, which are scientifically proven to reduce risk of infection and reinfection.

Safer sex means protecting yourself and your partner(s) from HIV and other sexually trans­mitted infections (STIs) by using latex or polyurethane condoms correctly, water- or silicone-based lubricants, and getting tested regularly for STIs.

If you use needles for injections, protect your­self and others by using a clean, new needle and syringe at every use. Never share equipment with someone else. These practices are called harm-reduction approaches.

Are CUPE members at risk?

Most CUPE members are not at risk of becoming infected with HIV through exposure at work. HIV cannot be transmitted through cutlery or water fountains, public swimming pools or washrooms, coughing or sneezing. It cannot be transmit­ted through touching or caring for patients, unless direct contact with blood or bodily fluids is involved.

Workers most at risk of being exposed to HIV include health care workers; paramedics or other emergency medical workers; those involved with patient care and support (such as laundry, house­keeping and materials handling); and laboratory workers. Workers must recognize that all blood and bodily fluids they come into contact with are potentially infectious, and not just with HIV, but any number of diseases.

Examples of ways workers may be exposed to HIV in the workplace include but are not limited to needle stick injuries; an open wound that allows infected fluid to enter the body; or contact with infected fluids that touch mucous membranes such as the eyes, nose or mouth.

How can we protect workers at risk of exposure?

There are several measures employers can take to ensure that workers at risk of exposure to HIV are protected.

Establish an infection control program

Infection control programs are an important tool for controlling exposure to HIV and other blood pathogens. An infection control program may include, but is not limited to, the following:

  • Protective clothing and equipment for jobs with potential blood or bodily fluid exposure, includ­ing cleaning processes that may involve blood or other bodily fluids.
  • Facial protection for situations where there is a potential of blood or bodily fluid splattering or where procedures are being performed that can generate large droplets.
  • Waterproof gowns for situations where clothing may be contaminated with blood, bodily fluid, or excretions.
  • Waterproof gloves (i.e. nitrile) and one-way resuscitation devices for performing first aid and CPR. First aid training should include instruction in the use of disposable devices.
  • Proper disposal procedures at the point-of-use must be followed by all users of sharps. Sharps must be placed in puncture resistant containers that can be sealed and disposed according to procedures for biohazardous wastes.

Develop an HIV and AIDS workplace policy

The key elements of a workplace policy on HIV and AIDS should be:

  • Protection of persons with HIV and AIDS from harassment and discrimination.
  • Fair and compassionate treatment for persons with HIV and AIDS.
  • Reinforcement of the right for workers with HIV and AIDS to receive reasonable accommodations.
  • Continuation of health benefits or access to group coverage.
  • Protection of confidentiality about a person’s HIV status.
  • Prohibition of mandatory or workplace-imposed HIV testing for workers.
  • The right of all workers to a safe and healthy workplace.

What should be done about a potential exposure to HIV?

The most important step for dealing with a potential exposure to HIV needs to occur long before any potential exposures. Workers must be trained to know what steps should be taken in the event of an accidental exposure to bodily flu­ids. Organizations must have procedures in place that ensure workers can find out what bloodborne pathogens, including HIV, the patient has so that appropriate preventative measures can be taken. However, some people who are HIV-positive may not know they are infected, and may not show symptoms. If you have been exposed to bodily fluids as discussed above, follow your workplace reporting procedures and ensure that you con­tact a physician immediately to discuss treatment options to protect your own health.

For example, if a needlestick injury occurs, work­ers need to know who to contact for medical treatment, and what steps to take to inform their supervisor of the incident. There is drug treatment called post-exposure prophylaxis (PEP) available to reduce the risk of developing HIV for individ­uals who think they may have been exposed to the virus. This treatment must be prescribed by a doctor and taken within 72 hours of a potential exposure.

How are HIV and AIDS treated? Can they be cured?

There is currently no cure for HIV or AIDS but there are treatments for people living with HIV that slow or prevent AIDS from developing.

HIV destroys CD4 cells that are most critical to the immune system. Blood tests measure CD4 counts and the viral load. Many other routine tests can spot potential health issues even if there are no noticeable symptoms.

Anti-retroviral treatment (ART) has been suc­cessful in keeping the amount of HIV in the body at a low level. In many cases, ART stops the weak­ening of the immune system and allows it to recover from any damage that HIV might have caused.

A physician who specializes in HIV and AIDS treat­ment can prescribe an appropriate treatment plan and provide further information to support the person with HIV and their partner(s). AIDS service organizations and committees, as well as other health and social supports are available in many communities. Online support and informa­tion is available, though it’s important to use only reliable sources of information.

Developing an education and anti-discrimination program

All workers who run the risk of being exposed in the workplace should be informed about what HIV is, how it’s transmitted, how they could be exposed to the virus in the workplace, and what workplace control measures are available.

Some workers will have to deal with HIV and AIDS not only as an issue for patient/client care, but also as source of harassment, potential job dis­crimination and human rights issue if they, their family or their coworkers are HIV-positive or develop AIDS. The program must address how one works with a person infected with the virus (either a client/patient or a co-worker) in a supportive manner. The program must also address the fears coworkers and caregivers.

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachments
Fact Sheet: HIV and AIDS

In the city of Portage La Prairie in April of 1969, two CUPE members and a city official went to the sewage lagoons to check a valve on a feeder line. One member of the crew entered the valve chamber and collapsed. A second member went in to rescue him and also collapsed. The third member summoned help. By the time the fire department arrived both workers were dead. Air samples taken at the time showed hydrogen sulfide levels in excess of the measuring instrument’s upper limits.

There have been numerous workers killed through exposure to this gas in many different occupational settings. Hydrogen sulfide is a poisonous gas and the leading cause of death through gas inhalation in the workplace. One whiff of a sufficiently high concentration can cause death.

What is Hydrogen sulfide?

Hydrogen sulfide (H2S) is a colourless gas which at lower concentrations has a distinctive rotten-egg odour. Most exposure to it occurs by inhalation. Hydrogen sulfide is generated as a by-product in many industrial processes or by the decomposition of organic (previously living) matter. It is slightly heavier than air and is therefore especially dangerous in low-lying areas and confined or enclosed workspaces. At high temperatures (260 degrees Celsius, 500 degrees Fahrenheit) hydrogen sulfide reacts explosively.

Hydrogen sulfide goes by a number of names including: dihydrogen sulfide, sulphur hydribe, hydrosulphuric acid, sulfuretted hydrogen and hepatic gas. Its common names are stink damp, sour gas or sewer gas.

Deadly Poison

Hydrogen sulfide is a deadly poison. When inhaled it goes through the lungs and enters the bloodstream. To protect itself the body tries to break down the hydrogen sulfide as fast as possible into a harmless compound. Poisoning occurs when the amount absorbed in the blood exceeds the rate at which it is eliminated.

Exposure to high concentrations of hydrogen sulfide (acute exposure) can cause immediate coma and death from respiratory failure. Hydrogen sulfide builds up in the blood, paralyzes the nerve centres in the brain which stops the lungs from working. If not caught in time, acute poisoning is deadly.

Sub-acute exposure (exposure to lower levels) may result in headaches, dizziness, loss of balance, agitation, nausea, diarrhea. Chronic poisoning (repeated exposure to low levels) may result in slowed pulse rate, fatigue, insomnia, cold sweat, eye infections, loss of weight, skin eruptions. If a worker is suffering from any of these symptoms, hydrogen sulfide may be responsible. The presence of hydrogen sulfide may be responsible. The presence of hydrogen sulfide should be suspected and tested for.

Who is at risk?

  • sewage treatment plant workers
  • sewer workers
  • workers in manholes
  • tunnel workers
  • well diggers
  • workers in chemical laboratories

Enclosed and confined spaces are the danger areas prone to the rapid buildup of hydrogen sulfide gas. A confined space is any workplace (not necessarily small) which is wholly or partially enclosed and from which immediate escape is difficult (sewers, manholes, pits, tunnels, vats, tanks, ovens, grain elevators and open-topped spaces more than 4 feet in depth). Enclosed areas (wet wells, grit chambers, pump stations’ valve chambers) although easier to get in and out of, are still as dangerous in the accumulation of deadly gas. A room or a building can be considered an enclosed space.

Levels of Exposure

Hydrogen sulfide is measured in parts per million (ppm). The American Conference of Governmental Industrial Hygienists (ACGIH) has recommended a Threshold Limit Value (TLV)-Time Wrighted Average (TWA) of 1 ppm. 1 ppm is equal to 0.0001 per cent by volume, or only one-ten thousandth of one per cent of the total air volume. This is a time-weighted average exposure for a normal eight hour work day and a 40 hour work week to which nearly all workers may be repeatedly exposed without adverse effect.

A Short Term Exposure Level (STEL) of 5 ppm is also recommended. This STEL is a 15 minute time-weighted average exposure which should not be exceeded at any time during a work day even if the 8-hour time-weighted average is within the TLV. Exposure at STEL should not be repeated more than 4 times per day. There should be at least 60 minutes between successive exposures at the STEL.

In many Canadian jurisdictions exposure limits are similar to the Threshold Limit Values recommended by the ACGIH. Other countries (Czechoslovakia and USSR) have accepted lower limits of 7 ppm.

The recommended limit of 10 ppm does not guarantee worker safety. If should not be used as a guideline demarcating safe and dangerous concentrations of hydrogen sulfide. Because of wide variations in individual susceptibility some workers may experience problems at concentrations at or below the threshold limit.

The safest exposure to Hydrogen sulfide is no exposure at all.

Effects of exposure

Hydrogen sulfide at low levels has a distinctive rotten-egg odour and workers mistakenly assume that the absence of smell means that they are not exposed to it. Smell is a poor warning sign of hydrogen sulfide.

At higher concentrations a sweet smell may be noted, but at even greater concentrations, hydrogen sulfide can “paralyze” the sense of smell and the ability to smell is lost. Some workers are congenitally (by birth) unable to smell hydrogen sulfide. That is why the air should always be monitored by instruments designed to detect hydrogen sulfide.

Parts per million – Effects

0.13 – This is the odour threshold. Odour is unpleasant. Sore eyes.
4.6 – Strong intense odour, but tolerable. Prolonged exposure may deaden the sense of smell.
10-20 – Causes painful eye, nose and throat irritation, headaches, fatigue, irritability, insomnia, gastrointestinal disturbance, loss of appetite, dizziness. Prolonged exposure may cause bronchitis and pneumonia.
30-100 – Sickeningly sweet smell noted.
50 – May cause muscle fatigue, inflammation and dryness of nose, throat and tubes leading to the lungs. Exposure for one hour or more at levels above 50 ppm can cause severe eye tissue damage. Long-term exposure can cause lung disease.
100-150 – Loss of smell, stinging of eyes and throat. Fatal after 8 to 48 hours of continuous exposure.
200-250 – Nervous system depression (headache, dizziness and nausea are symptoms). Prolonged exposure may cause fluid accumulation in the lungs. Fatal in 4 to 8 hours of continuous exposure.
250-600 – Pulmonary edema (lungs fill with fluid, foaming in mouth, chemical damage to lungs).
300 – May cause muscle cramps, low blood pressure and unconsciousness after 20 minutes.
300 to 500 – ppm may be fatal in 1 to 4 hours of continuous exposure.
500 – Paralyzes the respiratory system and overcomes victim almost instantaneously. Death after exposure of 30 to 60 minutes.
700 – Paralysis of the nervous system.
1000 – Immediately fatal.

If caught in time, poisoning can be treated and its effects are reversible. Some workers may experience abnormal reflexes-dizziness, insomnia and loss of appetite that lasts for months or years. Acute poisoning which does not result in death may produce long-term symptoms such as loss of memory or depression, paralysis of facial muscles.

What can be done?

A program for worker protection

1. Monitoring and ventilation
First, workplace air should be monitored and hydrogen sulfide should be controlled so that no worker is exposed to levels above 10 ppm. All areas where toxic gases are detected should be ventilated with a fresh air-blower. The ventilation system should be non–sparking and inspected every six months. Any areas with sources of gas should be closed, blanked off, locked and tagged.

Modern continuous direct-reading electronic gas monitors with strip charts or circular chart recorders, sensitive to low levels of hydrogen sulfide, should be installed permanently in key locations near the ground. Such devices should have sound alarms that are set to warn workers when 10 ppm is reached.

Portable monitors should be clipped onto the worker’s belt and carried into confined spaces as a supplement or when fixed ones are not appropriate. These should warn workers with audible alarm and coloured lights and have the capacity to be used continuously for more than 8 hours without recharging batteries.

2. Preventing Work Practice
All entries to confined spaces should be posted with specific work procedures and safety checklist or permit system. The permit system would provide written authority for entering the area, list all potential hazards and the safety equipment necessary to ensure worker safety and identify that the workers involved have received proper current training in confined entry procedures. Safety equipment, first aid, rescue equipment and instructions should be in the immediate vicinity.

Before entering an unknown or confined area, sampling should be done with a remote monitor on a wand attached to a toxic gas meter. The monitor should reach the lowest point in the space and monitoring should continue throughout the course of work.

No one should enter a confined space without at least one standby person stationed outside who is in constant contact with the worker inside. A third person should survey the operation. Workers should be equipped with gas monitors.

A harness, safety belt and wrist lock attached to a lifeline should be worn in the event that an unconscious worker must be pulled out of a confined space. An aerosol type horn that can be blasted in case of emergency should also be worn. Rescuers should also be equipped with proper safety equipment.

3. Respirators and Respirator Problems
A suitable breathing apparatus (one approved by the U.S. National Institute for Occupational Safety and Health – NIOSH– or Canadian Standards Association – C.S.A.- standard Z94.4) must be worn when entering a confined space. NIOSH recommends any supplied-air respirator or self-contained breathing apparatus for levels of hydrogen sulfide of 10 to 100 ppm; up to 250 ppm – any supplied-air respirator with a full facepiece. Self contained respirators have air supplied from a cylinder worn on the back while supplied-air respirators have air supplied by a long line from a large stationary tank.

When the atmosphere is dangerous workers should wear a self-contained breathing apparatus. Air purifying filter or cartridge respirators easily leak, have a limited lifetime and should not be used when the atmosphere is dangerous. Air supplied respirators with masks hooked up to an air hose connected to a blower are not suitable for tight areas and may foul or break.

Appropriate respirators must always be used with proper fitting, be easily accessible, maintained and cleaned regularly. (See C.S.A. standard M1982 Selection, Care and Use of Respirators).

4. Record-keeping
Air monitoring should be conducted at each location where hydrogen sulfide may be released and a survey log kept. If concentrations are below the recommended ceiling the records must contain the basis for this conclusion.

5. Training
A comprehensive education/training program should be developed for workers which should include: knowledge of hazards from exposure; symptoms and how to deal with them; all emergency procedures (first aid, resuscitation, evacuation, meaning of alarms); training in the location of monitors, respirators. This training would be done quarterly and before a worker starts on the job. Workers should be certified as trained before being assigned to enter confined spaces.

6. Medical examinations
Workers should be given medical examinations annually and prior to starting a job. Particular attention should be paid to eyes, nervous and respiratory systems. Checkups should include the ability to use respirators and hear to and see warnings.

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Abbreviations:

ACGIH – American Conference of Governmental Industrial Hygienists
NIOSH – National Institute for Occupational Safety and Health
ppm – parts per million
TLV – Threshold Limit Value
TWA – Time Weighted Average
STEL – Short Term Exposure Level

Attachments
Fact sheet: Hydrogen Sulfide

What is Indoor Air Quality?

Poor indoor air quality (IAQ) is a hazard that affects CUPE members’ health. Indoor air quality is a term that describes the physical, chemical and biological state of indoor air. It usually refers to the air in non-industrial workplaces such as: universities, schools, day care centres, hospitals and office buildings.

What are the problems?

Cutbacks and employer inaction and ignorance about indoor air quality hamper the fight for clean indoor air. Energy conservation measures have led to reduced outdoor air intake due to the airtight construction of buildings. Less outdoor air intake contributes to the accumulation of contaminants. The combination of less outdoor air and inadequate maintenance of heating, ventilating and air conditioning (HVAC) systems, creates polluted indoor air. Poor indoor air quality often leads to CUPE members experiencing fatigue, headaches and irritation of the eyes, nose and throat.

Sometimes indoor air quality can cause Sick Building Syndrome (SBS) or Multiple Chemical Sensitivity (MCS). SBS is caused by tightly sealed and energy efficient buildings that lack proper ventilation. These buildings trap contaminants inside and stop the entry of fresh outdoor air.

SBS symptoms include dryness of the skin, eyes, nose and throat, headaches, fatigue, nausea and a susceptibility to colds and flu. The symptoms of SBS are less severe upon leaving the workplace. MCS can be caused by exposure to one chemical or a combination of chemicals. The best way to understand MCS is to think of it as a chemical immune-deficiency disease. Those who have MCS become hypersensitive to certain chemicals. MCS symptoms include skin rashes, irregular breathing, convulsions, central nervous system problems and eye, nose and throat irritation.

Some or all of the following health effects characterize poor indoor air quality:

  • Sick Building Syndrome (SBS) and Multiple Chemical Sensitivity (MCS).
  • Headaches, blurred vision and common irritations of the eyes, nose and throat.
  • Difficulty concentrating, fatigue and nausea.
  • Shortness of breath, wheezing, sinus congestion and occupational allergies.

What are the hazards?

Poor indoor air quality affects the physical and psychological health of CUPE members. Negative physical effects contribute to workplace stress. This stress can be compounded when members face undue pressure from employers who sometimes accuse them of complaining and dismiss reports about poor indoor air quality as minor. When members complain employers tell them they are “imagining things” or “don’t be hysterical”. But indoor air quality hazards are serious and need employers’ immediate attention.

Indoor air quality hazards fall into three basic categories: physical, chemical and biological.

Physical indoor air quality hazards include:

  • Improper temperature and humidity levels.
  • No HVAC maintenance workers or maintenance program in place due to cutbacks.
  • Lack of worker-controlled HVAC systems.
  • Workplace overcrowding due to cutbacks.
  • Placement of workspace partitions, furniture and equipment preventing proper ventilation.
  • Renovations that alter workplace layout without adjustments to HVAC system capacity.
  • HVAC systems that begin to operate after workers have arrived or shut down before the end of the workday.
  • Outdoor air intakes close to loading bays and busy streets.
  • Windows that don’t open.
  • Excessive noise and poor lighting.

Chemical indoor air quality hazards include:

  • Asbestos for example, in ceiling tiles, pipe and duct insulation, old wallboard and plaster.
  • Volatile organic compounds (VOCs) formaldehyde, organochlorines, phenols emitted from furniture, building materials, carpets and plastics.
  • Carbon dioxide exhaled from building occupants.
  • Carbon monoxide from gas burners and furnaces inside workplaces; vehicle exhaust and tobacco smoke outside workplaces.
  • Pesticides in plant sprays and insect and rodent control products.
  • Solvents such as benzene and toluene in cleaning products, copier toners and paints.
  • Hazardous dusts, fibres and odours from building materials and occupants.
  • Ozone from photocopiers, electric motors and electrostatic air cleaners.
  • Radon from naturally occurring radioactivity in minerals and soil around workplace foundations.

Biological indoor air quality hazards include:

  • Toxic moulds that grow on wood, drywall, upholstery, ceiling tiles, carpet and other building materials where enough moisture has accumulated.
  • Bacterial diseases like Legionnaire’s disease, Pontiac fever and Humidifier fever that originate in poorly maintained HVAC systems.
  • Dust mites that can cause allergic reactions.
  • Pollens and biological aerosols that don’t get filtered out of indoor air due to poor HVAC maintenance.

Identify the problem

A first step is recognizing that poor indoor air quality is a health and safety hazard in your workplace. Surveys and mapping techniques are excellent tools to identify indoor air quality hazards. An indoor air quality survey can be done in co-operation with the employer, in which case the union approves the survey and is involved in collecting and assessing the information generated by the survey. The union should conduct its own indoor air quality survey if the employer resists the idea or denies that poor indoor air quality is a problem. Surveys are an important tool in uncovering indoor air quality hazards.

When and where CUPE members get sick are key factors in identifying and resolving poor indoor air quality. Body mapping, hazard mapping and your world mapping techniques can be used, in addition to surveys, to identify indoor air quality hazards. Workplace inspections by CUPE members are an important tool in uncovering and identifying indoor air quality hazards, and should be carried out regularly.

Actions

Indoor air quality hazards largely centre on issues of control, cutbacks and employer neglect. Taking action on poor indoor air quality involves members exercising control at work.

The following actions can help combat poor indoor air quality: · Refuse unsafe working conditions caused by poor indoor air quality.

  • Report indoor air quality hazards.
  • Conduct regular workplace inspections to uncover indoor air quality hazards.
  • Put indoor air quality issues on the health and safety committee agenda.
  • Demand employers take action on testing for indoor air quality hazards.
  • Demand employers take action to fix indoor air quality hazards.
  • Insist employers increase the ventilation rate of outdoor air.

Strategies for change

The strategies outlined below complement the actions listed above. Poor indoor air quality can be eliminated by the following:

  • Keep indoor air quality issues on the health and safety committee agenda until they are resolved.
  • Monitor and test indoor air for contaminants.
  • Demand regularly scheduled maintenance and cleaning procedures on HVAC systems.
  • Give workers control by allowing them to adjust humidity, temperature and ventilation rates.
  • Demand employers obey health and safety laws and regulations pertaining to indoor air quality hazards.
  • Where legislation does not provide for specific indoor air quality controls, monitoring, or access to information about indoor air quality, the union can negotiate contract language that reflects the protection of members.
  • Put the issue of poor indoor air quality on the bargaining table.
  • Sponsor CUPE education around the issue of poor indoor air quality and its effects.
  • Create an indoor air quality policy for CUPE workplaces starting with a statement acknowledging that poor indoor air quality is a health and safety hazard, and that all steps should be taken to prevent the hazard.
  • Collective job action around the issue of poor indoor air quality.

Employers have the responsibility to provide a healthy and safe workplace. This responsibility is known as the general duty clause. Clean indoor air is an important part of a healthy workplace. Ending poor indoor air quality requires the participation of our membership. Through education and activism, poor indoor air quality can be eliminated from CUPE workplaces.

This fact sheet provides some information to address poor indoor air quality. Related information can be found in the CUPE Health and Safety Guidelines Breathing Easy: Ventilation in the Workplace and the CUPE Ventilation Fact Sheet.

For more information contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachments
Fact Sheet: Indoor Air Quality (IAQ)

What are Moulds?

Moulds are microorganisms that can grow on virtually any substance, indoor and outdoor, as long as moisture, oxygen, and an organic source are present. In nature, moulds play an important role in the breakdown of organic matter, like fallen leaves, plants and dead animals. In our workplaces, moulds can be a significant health hazard.

There are over 100,000 mould species in the world, and about 1,000 species commonly found in Canada.

How do moulds affect the health of workers?

Moulds produce thousands of tiny particles called spores as part of their reproductive cycle. When disturbed by air movement or contact, moulds release these spores into the air. The inhalation of spores, moulds or mould fragments can affect your health or make certain health conditions worse.

Lack of moisture causes moulds to become dormant. Dormant moulds still have the capacity to spread spores and fragments into the air, and can become active again when moisture returns.

Some moulds create and release mycotoxins, which slowly wear down the immune system and can lead to allergic or respiratory problems.

Workers exposed to mould can have different symptoms. Some may have no reaction at all. The most common effects of mould exposure are:

  • Irritation to the skin, eyes, nose, throat
  • Burning in the nose, nosebleeds
  • Difficulty breathing, asthmatic attacks
  • Watery eyes, runny nose
  • Fatigue, difficulty concentrating
  • Impairment of the immune system

In some cases lung and liver cancer can result from long-term exposure to aflatoxin, a toxic compound produced by certain moulds.

Individuals with weakened immune systems are particularly susceptible to mould-related illness and should avoid being exposed to it whenever possible.

How are mould hazards identified?

A combination of methods can be used in the detection and identification of mould hazards. A moulds hazard survey can be done in cooperation with the employer, in which case the union should approve the survey and be involved in collecting and assessing the information generated. If the employer resists the idea or denies the existence of mould, the union should conduct its own hazard survey.

Visual inspections are the most reliable method of identifying mould problems. When conducting a visual inspection, look for signs of water damage such as discolouration and staining. Be sure to look at carpeting and floor coverings, fabric on and underneath furniture, ceiling tiles and drywall, behind furniture, and areas where there is standing water like sinks, kitchens, air conditioners, etc.

Moulds can appear as dark spots or patches of any colour. They can have a variety of textures from woolly to slimy. They thrive in dark, moist environments, so they may be hidden from view. Dormant moulds often have a dry, powdery or crusty appearance.

Air sampling, surface sampling and bulk sampling (taking bits of drywall, flooring, etc.) are also methods used to identify the presence of moulds. The person taking the samples must be properly trained to do so and wear appropriate personal protective equipment.

How to prevent moulds from forming in your workplace

It is your employer’s responsibility to provide you with a healthy and safe workplace. Part of this duty is to ensure that all workers are protected from the health risks of mould. Mould hazards often arise as a result of cutbacks or employer neglect.

The following can help prevent mould growth in your workplace:

  • Keep relative humidity in the workplace between 30 and 60 per cent.
  • Conduct regular inspections and be diligent, particularly if you work in a sewage treatment plant or composting facility.
  • Make sure landscaping and eaves trough downspouts direct water away from buildings.
  • Ensure any high moisture areas are properly ventilated with local exhaust ventilation that captures the moisture and directs it out of the building.
  • Get employers to insulate cold surfaces to prevent condensation on pipes, windows, walls, roofs and floors.
  • Perform regular maintenance and cleaning of heating, ventilation and air conditioning systems.
  • Perform regular maintenance of buildings, especially roofs, basements and other locations where leaks occur.
  • Maintain proper staffing to conduct maintenance procedures, such as fixing and maintaining plumbing systems and fixing building leaks to prevent mould growth and other workplace hazards.

Most Canadian jurisdictions have a “general duty provision” in their occupational health and safety legislation requiring employers to take all reasonable precautions to protect the health and safety of employees, which includes protecting them from moulds hazards. CUPE recommends that members negotiate contract language for specific controls, monitoring, or access to information about moulds.

What should you do if there is mould in your workplace?

If mould is discovered in your workplace, it should be reported to management immediately. If the problem is not immediately rectified, report it to your health and safety committee, so that they can assist until the problem is fixed.

Fixing a mould problem includes identification and correction of the condition that allows the mould to grow, and safe removal of materials damaged by mould. Appropriate personal protective equipment should be used during remediation. The cleaning and removal process depends on the size and type of mould growth, the extent of the damage, and the location.

Trained professionals should carry out mould remediation. In workplaces where staff are expected to participate in mould removal, workers must be properly trained in mould remediation and the hazards associated with working around mould. Staff should be provided with appropriate personal protective equipment.

If your employer refuses to deal with mould, you may need to initiate a work refusal to protect your own health. Find out about your right to refuse at cupe.ca/health-and-safety/righttorefuse

For more information about other health and safety concerns related to air quality, including a sample workplace health survey, please refer to the CUPE Indoor Air Quality Guideline, or contact:

CUPE National Health and Safety Branch
1375 St-Laurent Boulevard
OTTAWA, ON K1G OZ7

Tel: (613) 237-1590
Fax: (613) 237-5508
Email: health_safety@cupe.ca

Attachments
Fact Sheet: Moulds

Health & Safety facts for new and young workers

Noise

Overwork

Pandemic influenza

Preventing Needlestick Injuries

Refusing unsafe work: It’s your right

Repetitive Strain Injuries

Stress

Sun alert

Ventilation

West Nile Virus

Working Alone