Accident Prevention e-News January 2008	Volume 3/Issue 1/January 2008
In this Issue: IAPA/QMI webinar: Making the Business Case for Health & Safety Adding value to RSI Day Nurse’s workplace murder not just a health care issue 2008 H&S promotions calendar In the News

IAPA/QMI webinar: Making the Business Case for Health & Safety

Learn how to “sell” OHS to senior management across your company by registering for a free IAPA/QMI* webinar on February 28, from 1:00 p.m. to 2:00 p.m. EST.

Through a collaborative relationship between IAPA and the Quality Management Institute (QMI), a 60-minute, interactive, web-based seminar is being offered where session leaders will

• describe new measures and metrics that make OHS a business imperative
• showcase firms whose OHS programming has helped them notably improve organizational performance, and
• identify success factors that can help participants to move forward.

The webinar will give participants an opportunity to

• view graphics illustrating key concepts and definitions
• examine where a managed OHS system fits into an OHS continuum
• assess their firm’s location on the OHS continuum, and
• access electronic supporting resources.

“Integrated OHS management systems are a topic that a lot of people have been talking about for some time,” says Pj Murray, IAPA’s Manager, Research and Development. “But in terms of implementation, many are looking to learn from others who have formally embraced the concepts, or are at the stage of deciding whether to register through a formal structured standard such as OHSAS 18001 or CAN/CSA Z1000. This webinar format allows IAPA and QMI to provide participants with concentrated information, expertise and tools in a tremendously accessible format.”

The webinar is aimed at people “who are interested in more than compliance, and are looking toward performance excellence,” says Murray. “These are people who understand the value of these systems and are looking for ways to sell the concept to their senior managers. It’s also aimed at corporate leaders looking for ways to galvanize support across their organization.”

All you need
The IAPA/QMI webinar is offered at no cost to participants. All you need to take part are

• a computer
• Internet access, and
• a phone line so that you can listen to the teleconference portion.

How you benefit
In general, webinars enable you to

• save time
• avoid travel expenses
• ask questions and speak with colleagues in the comfort and privacy of your own workplace
• share data
• help your firm make decisions faster
• improve management communication, and
• increase productivity.

Registration for Making the Business Case for Health & Safety is limited.

• Visit the QMI website for additional information and registration.

* QMI is a division of CSA Group and is North America’s leading management system registrar.

Adding value to RSI Day

February 29, the least repetitive day on our calendar, marks International RSI Awareness Day. It’s an ideal opportunity to celebrate achievements and commitments to reduce repetitive strain injuries (RSIs).

RSIs and overexertion injuries, which share root causes, are both classified as musculoskeletal disorders (MSDs). Every year, Ontario’s Workplace Safety and Insurance Board accepts roughly 42,500 lost-time MSD claims, which represent an average of three million lost-time days and cost workplaces $380 million in direct costs alone. The real cost to Ontario is estimated to be $1.2 billion per year.

To help workplaces concerned about the debilitating effects of MSD injuries and costs, the Occupational Health and Safety Council of Ontario released in 2007 its Musculoskeletal Disorder (MSD) Prevention Guideline for Ontario (available on IAPA’s website). The guideline and an accompanying resource manual offer workplaces a prevention framework.

Expected early this year, possibly in time for RSI Day, is a final version of the council’s MSD Prevention Toolbox, containing such “tools” as worksheets, surveys, hazard identification tools, and guidance on risk assessment methods.

Leading up to February 29, you’ll hear many useful tips on how to reduce the risk of RSIs. But for lasting results, look for ways to integrate injury prevention into your existing organizational processes. Appearing below are suggestions on how to eliminate MSD hazards at the planning, design, purchasing and installation stages. These suggestions are adapted from the Resource Manual for the MSD Prevention Guideline for Ontario.

To put the suggestions into a broader context, Accident Prevention e-News spoke with Ivan Szlapetis, an IAPA ergonomics specialist.

Given the increasing attention paid to RSIs, are the numbers dropping?

“Yes and no. RSIs result from exposure over time to such risk factors as repetition, static and dynamic force, awkward postures, insufficient rest, contact stresses, extreme temperatures, and vibration. What this means is that, in the long term, reducing or eliminating exposure to these risk factors now will certainly lead to a significant decrease in the frequency, severity and cost of new injuries. However, in the short term the numbers may actually rise due to past exposure and growing awareness. As people grasp the links between working conditions and injury symptoms, they may be more likely to report their symptoms.”

Do you see government interest in RSIs increasing or decreasing?

“Definitely not decreasing. The Workplace Safety and Insurance Board has set a goal to reduce lost-time injuries by another 35% in the next five years. MSDs are the most common cause of lost-time claims, and so will remain a key issue for years to come. Furthermore , MSD prevention was a significant component of the training received by the 200 new inspectors recently hired by the Ministry of Labour. It’s on their radar screen. ”

BC, Alberta, and now the federal government all have ergonomic regulations. Do you see this happening in Ontario?

“It’s possible. Certainly organized labour is very interested in regulation."

What’s holding employers back from making changes to the workplace?

“Many employers have already taken significant steps. However, I think others are afraid they may be opening up a can of worms. They may believe there’s not much that can be done, at least without significant disruption and expense.

“However, that’s not necessarily the case. For even the simplest job, there may be 10 different ways of performing it. A couple of ways may be very good, and a couple very bad. Identifying which are best practices, and building them into the training process, can prevent injuries and improve productivity at little cost.

“As for workplaces with that 60-year-old ergonomically incorrect punch press that never breaks down, risk reduction may be achieved with minor adjustments to the design of the die, or with administrative controls. Further ergonomic improvements should be integrated with other quality and process improvement activities that help to make the company more competitive.”

Planning to prevent MSDs
Designing MSD hazards out at the start often costs less than adding controls to manage them afterwards. Appearing below are suggestions adapted from Resource Manual for the MSD Prevention Guideline for Ontario.

When planning
You can help to eliminate MSD hazards while planning any new project, expansion, process, or product line. Discussing how a new product, machine or tool is likely to affect workers helps to ensure that MSD hazards are considered and addressed during the design stage.

When designing
Involve architects, engineers, industrial designers and others by considering how

• the worker(s) will use and interact with the design
• materials will be used or produced, and
• the design will operate and be maintained.

Steps to consider in the design stage include:

• ensuring that in-house engineers, maintenance personnel and designers are trained to address MSD hazards
• developing in-house design processes and standards that address MSD hazards at the design stage where practical, using mock-ups of new designs or testing different design options
• considering how the design will be used by all workers, whether they will work at or around it, or be responsible for maintaining it, and
• liaising with other designers, manufacturers and suppliers to stay aware of new technology and alternative materials that will eliminate or reduce MSD hazards.

When purchasing
Many workplaces purchase their equipment or workstations from a supplier and do little or no in-house design. The resource manual suggests that these workplaces establish a review process that looks for MSD hazards when purchasing workstations, equipment, tools, materials, etc.

This review process will be more effective if purchasing department workers are trained to consider MSD hazards or have access to someone with the training. Ensure engineering or design specifications provided to the purchasing department highlight factors that are important for MSD prevention. Finally, consider developing in-house purchasing standards for frequently purchased items (e.g., tools, gloves, chairs, furniture).

When installing
A good design is one where the exposure to MSD hazards is minimized. However, improper installation can compromise any design benefits. For example:

• if the installers put a component in a slightly different location (e.g., to cut costs on wiring), the new location may lead to awkward work postures for workers
• if the pieces of equipment in the new work area are placed closer together to save space, this can lead to problems for both workers and maintenance staff.
• if company workers are installing equipment, ensure that they have been trained to prevent MSD hazards and are instructed to note any key issues to be considered during installation.
• if an outside contractor is doing the installation, advise the contractor of key issues.

Regular inspections and checks by workplace parties during the installation phase will help to ensure that equipment is installed in a way that eliminates or reduces exposure to any MSD hazards.

How IAPA can help

1. Free downloads, including the Musculoskeletal Disorder (MSD) Prevention Guideline for Ontario , resource manual and draft toolkit.
   
   
2. Consulting and assessments —IAPA ergonomic specialists can assist you with
   • ergonomics assessments: office and industrial
   • physical demands analyses (PDAs)
   • job task analyses.
     
     
3. Training and products on everything from back care safety to the psychosocial side of MSDs.

Nurse’s workplace murder not just a health care issue

“Don’t let the setting of Lori Dupont’s murder distract you from potential issues in your own workplaces,” advises Joan Burton, IAPA’s Senior Strategy Advisor, Healthy Workplaces.

Burton ’s comments were prompted by the release of recommendations by an inquest jury examining Dupont’s death. A nurse at Hotel-Dieu Grace Hospital in Windsor, ON, Dupont was stabbed to death in a hospital recovery room by ex-boyfriend Marc Daniel, an anesthesiologist who later committed suicide.

The jury’s wide-ranging findings and recommendations, 26 in total, are addressed to the hospital, Ministry of Health and Long Term Care, Ministry of Labour, Ontario’s safe workplace associations, and others (see “What the jury found”).

“I’m very pleased that the jury looked at the incident, and the contributing factors, from a very broad perspective,” says Burton.

Many findings from the inquest investigation were troubling. For instance, the coroner’s jury observed that there “seemed to be much confusion and indecision” in how to deal with Marc Daniel. The doctor, whose medical skills were highly regarded, had a history of behavioural problems. According to inquest testimony and media reports, two nurses had previously filed formal complaints over verbal abuse. Other complaints had also accumulated. One involved breaking a nurse's finger while snatching a pillow out of her hands.

Daniel’s abusive treatment of Lori Dupont was often witnessed by co-workers. Testimony indicated that several had approached their supervisors or talked among themselves about her situation. However, they were uncertain how to address the situation within the workplace’s code of conduct.

“Whether the source of a conflict is work or home related,” says Joan Burton, “if it plays out in the workplace we have to know how to respond. It’s no different from substance abuse. We can’t tell someone to stop the substance abuse, but we can put measures in place to prevent it from compromising worker health and safety.”

“If a worker expresses discomfort in reporting concerns or filing a complaint,” continues Burton, “this suggests there’s been little communication from management that violence is a workplace hazard that needs to be addressed. Many workers who observe a physical workplace hazard would probably feel perfectly comfortable raising it as an issue. But not all workplace hazards are physical. They can be psychosocial. We have an equal responsibility with the hazards we can’t see as we do with the ones we can see.”

Janis Seaman, a development specialist in IAPA’s research and development department, points out that incidents of workplace violence and harassment in any industry sector often involve people with authority over others. “And when it also involves people with skill sets considered very valuable by the workplace,” says Seaman, “this can lead to two sets of rules. In one set, incidents may be attributed to ‘having a bad day.’ The best way to avoid this is to formulate and communicate policies and procedures that apply to everybody.”

Seaman and IAPA consultant Andrew Harkness have been working with the Ministry of Labour and other health and safety system partners on a workplace violence prevention guideline and tools for employers. The guideline will serve as a risk/priority assessment tool to help employers focus their prevention efforts. A companion “action plan builder” will help employers build a prevention program suited to their workplace environment and issues. These materials will likely be available this spring. For a look at existing materials, see “Addressing violence in your workplace.”

What the jury found
Several findings and key recommendations appear below.

1. Despite significant and documented complaints of serious disruptive behaviour problems and infractions of the policies and by-laws, there appeared to be much confusion and indecision as to how to deal with Daniel. Recommendation: develop a process or mechanism for the early identification of and response to disruptive… behaviour, including timely and effective disciplinary actions.
   
   
2. An assessment process conducted after Daniel was suspended for his behaviour relied on interviews with only Daniel and no one else. There was no documented consultation with hospital administration or employees affected by his behaviour, including Lori Dupont. Among the recommendations: a “robust assessment program and clear guidelines for monitoring, reporting and follow-up,” and a staged approach to evaluation/assessment, management/treatment, and follow-up/outcomes.
   
   
3. People were uncertain about how to file a complaint about Daniel’s abuse and harassment. Recommendation: employers should design and implement a policy to address domestic violence as it relates to the workplace. Components would include
   • providing education and training on how to identify and respond to signs of abuse
   • imposing an obligation to report witnessed abuse or harassment
   • formulating an organized response to direct threats of domestic violence that occur at work
   • developing a safety plan for the victim.
     
     
4. Evidence indicated that psychological and emotional abuse can be more easily overlooked than physical abuse. Recommendation: the Ministry of Labour review the Occupational Health and Safety Act to consider including protection of workers from emotional or psychological harm rather than just physical harm.

Outstanding issues: grievance and litigation
Following Dupont's death, the Ontario Nurses' Association filed a grievance against the hospital. As well, her family filed a civil suit claiming more than $12 million in damages. Among the defendants: Hotel-Dieu Grace Hospital, 10 of its most senior administrators, Daniel's treating psychiatrist in 2005, and Daniel's estate.

Addressing violence in your workplace
IAPA offers the following resources:

• to assess risk of violence from external sources, use the Workplace Violence Hazards Inspection Form
• to assess risk of violence from internal sources, use the Employee Risk Assessment Questionnaire
• learn to recognize, assess and control common situations that lead to workplace violence with Controlling Violence in the Workplace Video-Based Training. Includes a video, administrator’s guide, and five participant guides, certificates, and hazard control forms.
• download Creating Healthy Workplaces, a comprehensive rationale for creating a physically and psychologically healthy work environment.
• visit IAPA’s “New Focus on Workplace Violence” resource page
• attend IAPA’s national conference and trade show Health & Safety Canada 2008, which will feature sessions and exhibits on workplace violence, psychosocial risk management, and other mental health issues.
• arrange for on-site delivery of these IAPA courses: Creating Healthy Workplaces and Psychosocial Risk Management. Both courses can help firms create a healthy workplace with less risk of conflict and violence.

2008 H&S promotions calendar

Building interest in or sustaining the momentum of your health, safety and wellness programs and activities depends on a number of factors, including targeted promotions and campaigns. To help you leverage opportunities, IAPA offers the following calendar of health, safety and wellness promotions. Where known, related organizations are indicated.

In the News

WSIB announces voluntary registration program

Haven’t registered your business? The Workplace Safety and Insurance Board is offering full amnesty for those who register by March 31. From April 1 onwards, unregistered employers will receive a partial amnesty.

Employers are required to register with the board within 10 days of hiring their first worker. Employers who are not registered with the WSIB, and should be, can face significant financial and legal penalties.

Full amnesty means employers will not be prosecuted under the Provincial Offences Act, and will pay no retroactive premiums during the full amnesty phase, no penalties for not reporting, and no reconciliation interest on retroactive premiums.

Partial amnesty means no penalties for not reporting, no reconciliation interest on retroactive premiums, and no prosecution at the time of registration. However, during this period, the effective date for registration is the date of first hire or January 1 of the year preceding the date of voluntary registration, whichever is later. This means the maximum retroactive premium that employers will be required to pay will be for the current year plus one prior year.

For questions about the implementation of this policy or to register through the VR policy, contact your nearest WSIB office.

CAW to receive asbestos awareness award

On March 29, the US-based Asbestos Disease Awareness Organization will bestow its Tribute to Unity award to the Canadian Auto Workers, for its efforts to unite, educate and empower asbestos victims and mental health workers.

The organization was founded by asbestos victims and their families in 2004. It seeks to raise public awareness about the dangers of asbestos exposure and asbestos-related diseases, and give asbestos victims a united voice to help ensure their rights are fairly represented and protected. Four other recipients will receive awards:

• Aubrey K. Miller, MD, MPH, senior medical officer and toxicologist, Environmental Protection Agency (EPA), will be presented with the Tribute to Hope Award for his efforts to ban asbestos
• Barry Castleman, ScD, Environmental Consultant will be recognized with the Dr. Irving Selikoff Lifetime Achievement Award in honour of his dedicated research into the social and medical impact asbestos has had on humankind
• John Thayer, former US Capitol tunnel worker supervisor and asbestos victim will be presented with the Tribute to Inspiration Award for being a bridge to hope and strength for victims of asbestos exposure
• John McNamara, mesothelioma victim, will be honoured posthumously with the Alan Reinstein Memorial Award for his commitment to advocacy to eradicate mesothelioma and offer support to patients and their families.

On October 4, 2007, the US Senate unanimously passed a bill to ban asbestos. Before becoming law, the bill must be approved by the US Congress and signed by the President.

The bill would prohibit the sale of asbestos products two years after it becomes law, provide federal funding for the development of medical treatments, and initiate a public education campaign. US asbestos use has declined from 800,000 tons annually in the 1970s to 2,300 tons in 2006.

Every year, about 10,000 Americans die from asbestos exposure-related illnesses such as mesothelioma. These illnesses usually appear decades after exposure to asbestos fibre, but then progress rapidly. Most patients with mesothelioma die within two years of diagnosis.

According to a 2006 study by the Rand Institute for Civil Justice, 730,000 Americans had filed compensation claims for asbestos-related injuries from the early 1970s to the end of 2002, costing businesses and insurance companies more than $70 billion.