Part I: Medical surveillance programs – General requirements

Application

This Code applies:

Worker health information

1. At pre-placement and periodic medical examinations in respect of a designated substance, a worker shall be advised by their physician of:
   1. Adverse health effects and symptoms associated with exposure to the designated substance, in the context of the individual worker’s health;
   2. The importance of notifying their employer if they are experiencing symptoms possibly resulting from exposure to the designated substance so that appropriate follow-up can be arranged (e.g. review of control measures and referral for medical assessment);
   3. The results of any clinical tests and if not available at the time of the medical examination, the process for ensuring that the worker is notified of the results when they become available;
   4. The importance of good personal hygiene practices in preventing exposures to the designated substance (e.g. hand washing after working with the designated substance);
   5. The hazards associated with eating or drinking in areas where there is the risk of exposure through ingestion of designated substances such as lead and mercury;
   6. The reproductive risks associated with exposure to certain designated substances such as lead and mercury;
   7. With respect to asbestos, coke oven emissions, and silica, the harmful effects of smoking and exposure to the designated substance; and
   8. Non-occupational sources of exposure to the designated substance (e.g. lead and the use of munitions) which may contribute to exposures.
2. At an exit examination, a worker shall be advised:
   1. Where appropriate, of the possible risks of future health effects associated with past exposures to the designated substance including, but not limited to:
      • For asbestos, the risk of asbestosis, lung cancer and mesothelioma.
      • For benzene, the risk of aplastic anemia and leukemia.
      • For coke oven emissions, the risk of lung and skin cancer and chronic bronchitis.
      • For silica, the risk of silicosis, lung cancer and connective tissue disease.
   2. To inform their personal physician^{footnote 1[1]} of their history of exposure to a designated substance and provide copies of their health records, as may be appropriate, to their personal physician.
   3. That further medical follow-up should be determined by their personal physician based on the worker’s individual risk profile, exposure history and current best practices.

Notification of results of medical examinations and clinical tests

After advising a worker and the worker’s employer that the worker is fit with limitations or unfit to continue working in exposure to a designated substance in accordance with subsections 29 (2) and (3) of O. Reg. 490/09 - Designated Substances, physicians are reminded of the provisions of subsections 29 (6) and (7) concerning the notification of the workplace joint health and safety committee and the Ministry of Labour, Immigration, Training and Skills Development’s Provincial Physician of that advice.

Contact the Provincial Physician:

• Phone: toll-free at 1-877-202-0008
• Email: MLITSD.Provincial.Physician@ontario.ca
• Mail:
  Ontario Ministry of Labour, Immigration, Training and Skills Development
  C/O Provincial Physician
  Occupational Health and Safety Branch
  505 University Avenue, 19th Floor
  Toronto, ON
  M7A 1T7

Record keeping

The items listed in (a) through (g) form part of a worker’s exposure record. Subsection 27(1)(a) of O. Reg. 490/09 requires employers to provide a copy of the worker’s personal exposure record to a physician who conducts the medical examinations or supervises the clinical tests.

1. In accordance with sections 30 and 31 of O. Reg. 490/09 – Designated Substances, a physician who conducts medical examinations or supervises the clinical tests of a worker must keep a copy of a worker’s exposure record, where provided by the employer in accordance with subsection 27(1)(a) of O. Reg. 490/09 (See Footnote 1), and the records of any medical examinations and clinical tests (health records).

   These records must be kept in a secure place until the later of the following dates:

   If the physician is no longer able to keep the exposure records or health records, the records must be forwarded to the Provincial Physician, Ministry of Labour, Immigration, Training and Skills Development, or to a physician designated by the Provincial Physician.

   1. The 40^th anniversary of the date the first record was made;
   2. The 20^th anniversary of the date the last record was made.
2. The records required by sections 30 and 31 should include the following information:
   1. Worker’s name (in full).
   2. Date of birth.
   3. Gender.
   4. The worker’s occupations or jobs at the workplace, including start dates and end dates.
   5. The kinds of operations and/or processes in which the worker was involved.
   6. Concentrations of airborne designated substance(s) to which the worker was exposed.
   7. Use of personal protective equipment, including respiratory equipment and type.
   8. Medical examination reports.
   9. Results of clinical tests (e.g. blood and urine tests, chest radiographs and pulmonary function tests).
   10. Copies of all relevant correspondence concerning health (e.g. referral letters), and any information concerning the actions taken in response to abnormal clinical tests, and
   11. Copies of the Health Professional’s Report (Form 8) to the Workplace Safety and Insurance Board, if completed.