Overview

The Ministry of Labour, Immigration, Training and Skills Development’s Code for Medical Surveillance for Designated Substances (Code) sets out the Medical Surveillance Program requirements for the following designated substances: asbestos, benzene, coke oven emissions, isocyanates, lead (inorganic and organic), mercury (alkyl and non-alkyl compounds) and silica.

It applies to employers that are required to provide for medical examinations required under subsection 20(4) of Ontario Regulation 490/09 – Designated Substances.

Worker participation in medical surveillance programs is not mandatory. In accordance with subsection 28(3) of the Occupational Health and Safety Act (the Act), a worker must consent to participate. It is recommended that the benefits and limitations, if any, of medical surveillance programs be communicated to workers to assist in this determination.

Medical surveillance programs established in accordance with this Code may assist in the detection of exposure-related adverse health effects for appropriate medical follow-up, including removal from exposure, and may direct the need for immediate evaluation of primary exposure control measures. They help protect the health of workers by:

  • Providing direction to examining physicians concerning the medical examinations and clinical tests used in the determination of a worker’s fitness for working in exposure to the designated substance;
  • Identifying workers with conditions which may be aggravated by exposure to the designated substance and establishing a baseline measure for determining changes in health;
  • Evaluating the effects of exposure to the designated substance on workers;
  • Enabling remedial action to be taken in the workplace when necessary; and
  • Providing health information targeted to the individual worker.

In accordance with section 29 of Ontario Regulation 490/09, physicians conducting medical examinations or supervising clinical tests of a worker are governed by this Code in making a determination of whether a worker is fit, fit with limitations or unfit to continue working in exposure to the designated substance.

Physicians conducting medical examinations and/or supervising clinical tests of a worker must be competent to do so because of knowledge, training and experience in occupational medicine.