Ministry of Labour (MOL) inspectors initiate proactive inspections with an administrative compliance review and that may include, but is not limited to:

In 2017-18, MOL Inspectors will focus on employer compliance with the major hazards and health and safety priorities listed as follows.

Internal responsibility system

Inspection focus

The Occupational Health and Safety Act (OHSA) establishes legal requirements that provide a foundation for the internal responsibility system (IRS). The IRS is a system within an organization in which everyone has a responsibility for workplace health and safety that is appropriate to one’s role and function within the organization.

However, employers have the greatest responsibility with respect to health and safety in the workplace. The employer, typically represented by senior management, is responsible for ensuring that the IRS is established, promoted, and that it functions successfully. Strong leadership by senior executives, managers and supervisors is essential to setting the tone and establishing a corporate culture that nurtures the IRS and safety.

Joint Health and Safety Committees (JHSCs) assist in providing greater protection against workplace injury, illness and deaths. JHSCs include representatives from workers and employers and have specific roles and responsibilities under OHSA, section 9.

This co-operative involvement helps support a well-functioning IRS.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Ministry inspectors will continue to look for evidence of a strong IRS and a properly functioning JHSC when required.

Competent supervision is an important part of workplace safety culture and the IRS. The OHSA defines a supervisor as a person who has charge of a workplace or authority over a worker.

Under OHSA clause 25(2)(c), when appointing a supervisor, an employer must appoint a competent person. The OHSA defines a competent person as someone who:

  • is qualified because of his or her knowledge, training, and experience to organize the work and its performance
  • is familiar with the OHSA and its regulations as it applies to the work, and
  • has knowledge of any potential or actual danger to health and safety in the workplace.

For more information on a supervisor’s specific duties, see:

All parties in the IRS need to be trained adequately to carry out their duties under the OHSA.

Resources/compliance support

Ontario Ministry of Labour

Ontario Health Care Health and Safety Committee under Section 21 of the OHSA

Public Services Health and Safety Association

The Awareness Training Regulation

Inspection focus

In 2017-2018, inspectors will check on employer compliance with the Occupational Health and Safety Awareness and Training Regulation (O. Reg. 297/13) under OHSA.

As of July 1, 2014, employers in Ontario must ensure that all their workers and supervisors complete a basic occupational health and safety awareness training program. The content of the training must meet the new regulatory requirements.

Besides these requirements, employers continue to have ongoing duties under the OHSA to inform workers about workplace-specific hazards.

These include the general duty to “provide information, instruction and supervision to a worker to protect the health or safety of the worker” [clause 25(2)(a)].

Resources/compliance support

Ontario Ministry of Labour

Ontario Health Care Health and Safety Committee under Section 21 of the OHSA

Public Services Health and Safety Association

The Noise Regulation

In 2017-18, inspectors will check on employer compliance with O. Reg. 381/15 - Noise Regulation under OHSA.

The Noise Regulation came into effect on July 1, 2016, and extends noise protection requirements to all workplaces in Ontario under OHSA. It helps protect Ontario’s workers from noise-induced hearing loss, a leading cause of occupational disease for Ontario workers.

As of July 1, 2016, employers are required to put in place measures to reduce workers’ exposure based on a hierarchy of controls. Additionally, the noise regulation prescribes, for workers exposed to noise, a maximum time-weighted exposure limit of 85 dBA over an eight-hour work shift.

Besides these requirements, employers continue to have ongoing duties under the OHSA to inform workers about workplace-specific hazards.

These include the general duty to “provide information, instruction and supervision to a worker to protect the health or safety of the worker” [clause 25(2)(a)].

Resources/compliance support

Ontario Ministry of Labour

Public Services Health and Safety Association

Musculoskeletal disorders (MSDs) involving non-client-handling

Inspection focus

MSDs continued to account for the largest percentage of lost time injuries (LTIs) in the health care sector during 2015, according to Workplace Safety and Insurance Board (WSIB) data.footnote 4 Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Employers must:

  • know their workplaces’ MSD injury record
  • be aware of any MSD hazards
  • take appropriate action to protect workers from MSD hazards
  • ensure good maintenance of equipment
  • provide information, instruction and supervision to workers on MSD hazards and the protective measures in place and
  • establish written measures and procedures for the protection of workers in accordance with sections 8 and 9 of O. Reg. 67/93 – Health Care and Residential Facilities in consultation with the JHSC (or HSR), if the regulation applies to that workplace.

Other sections of O. Reg. 67/93 may also apply to the workplace. These may address issues such as manual material handling and equipment used for handling, lifting or moving materials.

Resources/compliance support

Ontario Ministry of Labour

Public Services Health and Safety Association

MSDs involving client handling (lifting, transferring and re-positioning patients/residents/clients)

Inspection focus

Client handling injuries account for almost half of all MSDs in the health care sector.footnote 5 Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Employers must ensure that workers:

  • have equipment available to assist them in moving clients, patients or residents and
  • are trained in its use.

Employers regulated under O. Reg. 67/93, in consultation with the JHSC or HSR, must establish written measures and procedures including but not limited to: assessing clients’ mobility status and communicating the acceptable client handling technique and how to perform the technique.

Employers are required to ensure that lifting equipment is properly inspected, serviced and maintained in accordance with the manufacturer’s instructions.

Employers not covered by O. Reg. 67/93 must take all precautions reasonable in the circumstance to protect workers. This is required by OHSA clause 25(2)(h). These duties apply for preventing MSDs.

Resources/compliance support

Ontario Ministry of Labour

Public Services Health and Safety Association

Slips, trips and falls

Inspection focus

Slip, trips and falls accounted for 17 per cent of all LTIs in the health care sector in 2015 (1,096 LTI claims).footnote 6 Inspectors will check on employer compliance with the Occupational Health and Safety Actt and its regulations.

Under the OHSA, all employers must:

  • take every reasonable precaution in the circumstances to protect workers
  • provide information and instruction and
  • ensure workers properly use or wear the required equipment.

In 2017-2018, ministry inspectors will focus on maintenance of work surfaces, general housekeeping, safe ladder use, etc. in accordance with sections 33 through 41 of O. Reg. 67/93. The goal is to decrease the risk of slip, trip and fall injuries.

Resources/compliance support

Ontario Ministry of Labour

Workplace Safety and Prevention Services

Public Service Health and Safety Association

Exposures to hazardous biological, chemical and physical agents

Inspection focus

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Hazardous biological and chemical agents at health care workplaces include:

  • viruses
  • bacteria
  • fungal spores/mould
  • nuisance dust
  • asbestos
  • chemicals used for laboratory work
  • sterilizing, disinfecting and cleaning
  • hazardous drugs such as anaesthetic gases and antineoplastic drugs
  • cryogenic gases.

Physical agents include:

  • noise
  • x-rays.

Exposure to these agents can occur during the provision of medical care and/or during routine activities such as housekeeping and construction activities.

Under the OHSA, all employers are required to:

  • provide information, supervision and instruction to workers to protect their health and safety [clause 25(2)(a)], and
  • take every precaution reasonable in the circumstances for the protection of workers [clause 25(2)(h)].

These duties apply to hazardous biological, chemical and physical agents in the workplace.

Employers covered by the O. Reg. 67/93 are required to:

  • develop, establish and put into effect written measures and procedures to protect workers who may be exposed to hazardous biological, chemical and physical agents, in consultation with the JHSC or HSR, if any
  • minimize health care workers’ exposure to hazardous agents (including hazardous drugs and sterilizing, disinfecting and cleaning chemicals) by complying with all applicable regulatory requirements, including:
    • making Material Safety Data Sheets (MSDS) / Safety Data Sheets (SDS) available (when applicable)
    • complying with prescribed procedures for safe use, handling and storage of hazardous chemical agents, specified gases and drugs
    • complying with prescribed worker education and training requirements
    • complying with prescribed and appropriate personal protective equipment (PPE), including training in its use, care, selection and limitations
    • developing a respiratory protection program
    • having emergency response procedures available in the event of a worker’s exposure to antineoplastic agents
    • ensuring proper maintenance of anaesthetic gas scavenging systems, including monthly inspection for leakage
    • making available control measures such as biosafety cabinets for the preparation of antineoplastic agents.

For more information, please refer to the section on antineoplastic and other hazardous drugs.

Resources/compliance support

Ontario Ministry of Labour

Inspections will focus on a workplace’s compliance with the OHSA and its regulations, including, but not limited to:

Public Services Health and Safety Association (see also WHMIS and infections section)

Contact with and struck-by-object injuries

Inspection focus

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Workers can be injured when they are struck by objects or when other types of contact occurs. These hazards can occur in material handling, or due to improper machine guarding, or lack of lock out and tag out of equipment and machinery.

These injuries accounted for 10 per cent of all LTIs in 2015 footnote 7 .

Employers are responsible for:

  • assessing the risk to workers and
  • developing and implementing measures and procedures for workers’ protection.

Compliance with clause 25(2)(a) of the OHSA requires workers to receive information, instruction and supervision regarding safe work practices and conditions.

Resources/compliance support

Workplace Safety & Prevention Services

Public Services Health and Safety Association

Workplace violence

Inspection focus

Health care workers are at increased risk of exposure to workplace violence due to factors such as:

  • working in the community
  • working alone
  • providing direct care to clients, patients or residents with cognitive impairments, and
  • working with the public.

Violence accounted for 12 per cent of all lost-time injuries (LTIs) in the health care sector in 2015 footnote 8 . Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Under the OHSA, employers must:

  • develop workplace violence policies
  • have a program to implement those policies that includes elements to summon immediate assistance when workplace violence occurs or is likely to occur; have measures and procedures to control the risks identified in the risk assessment; have measures and procedures on how to report incidents of workplace violence and explain how the employer will investigate and deal with incidents of violence
  • assess the risks of workplace violence
  • provide information and instruction to workers
  • provide information to workers who may be at risk of workplace violence from a person with a history of violent behavior.
  • take every precaution reasonable in the circumstances to protect workers from domestic violence that may enter the workplace.

The Workplace Violence Prevention in Health Care Leadership Table along with PSHSA have developed many tools for workplace parties to assist with workplace violence prevention and reduction. Please refer to the PSHSA Violence, Aggression & Responsive Behaviour (VARB) Project tools located here, and the Workplace Violence Prevention in Health Care Leadership Table products for phase 1.

Policies

All employers, who are subject to the OHSA must prepare policies with respect to workplace violence and workplace harassment and review them at least once a year [subsection 32.0.1(1)]. In a workplace where there are six or more regularly employed workers, the policies are required to be in writing and posted in the workplace where workers are likely to see them [subsections 32.0.1(2) and (3)].

Programs

Employers must set up programs to implement the policies [subsection 32.02(1)].

A workplace violence program must include the following:

  • measures and procedures to control risks identified in an assessment of risks
  • measures and procedures for workers to report incidents of workplace violence
  • measures and procedures for summoning immediate assistance and
  • how the employer will investigate and deal with incidents or complaints.

Specific duties regarding provision of information and instruction

Under the OHSA, an employer must provide appropriate information and instruction to workers on the contents of the workplace violence policy and program [subsection 32.0.5(2)]. All workers should be aware of the employer’s workplace violence policy and program. Workers should:

  • know how to summon immediate assistance
  • know how to report incidents of workplace violence to the employer or supervisor
  • know how the employer will investigate and deal with incidents, threats or complaints
  • know, understand and be able to carry out the measures and procedures that are in place to protect them from workplace violence and be able to carry out any other procedures that are part of the program.

Under the OHSA, an employer and supervisor must provide information, including personal information of a person with a history of violent behaviour if the worker can be expected to encounter that person in the course of his or her work and the risk of workplace violence is likely to expose the worker to physical injury.

Supervisors may need additional information or instruction, especially if they are going to follow up on reported incidents or complaints of workplace violence.

Assessment of risks for workplace violence

The employer must:

  • assess the risk of workplace violence that may arise from the nature of the workplace, type of work or conditions of work [subsection 32.0.3(1)]
  • take into account the circumstances of the workplace and circumstances common to similar workplaces, as well as any other elements prescribed in regulation [subsection 32.0.3(2)]
  • develop measures and procedures to control identified risks that are likely to expose a worker to physical injury. These measures and procedures must be part of the workplace violence program [clause 32.0.2(2)(a)].

The employer must advise the joint health and safety committee or health and safety representative of the assessment results. If the assessment is in writing, the employer must provide a copy to the committee or the representative [clause 32.0.3(3)(a)].

Employers must repeat the assessment as often as necessary to ensure the workplace violence policy and related program continue to protect workers from workplace violence [subsection 32.0.3(4)] and inform the joint health and safety committee, health and safety representative or workers of the results of the re-assessment [subsection 32.0.3(5)].

Please note that an assessment of the risks of workplace violence should be specific to the workplace.

Domestic violence

Employers who are aware of, or who ought reasonably to be aware of, domestic violence that would likely expose a worker to physical injury in the workplace must take every precaution reasonable in the circumstances to protect the worker [section 32.0.4].

General duties and application to workplace violence

The general duties under the OHSA for employers [section 25], supervisors [section 27] and workers [section 28] continue to apply with respect to workplace violence [section 32.0.5]. For example, workers would be required to report actual or potential hazards in the workplace relating to workplace violence to their employer or supervisor.

Other related information and instruction duties

Under the Occupational Health and Safety Act, an employer has a general duty to provide information, instruction and supervision to protect a worker [clause 25(2)(a)].

A supervisor has a duty to advise workers of any actual or potential occupational health and safety dangers of which the supervisor is aware [clause 27(2)(a)].

To protect workers, the employer must tailor the type and amount of information and instruction to the specific job and the associated risks of workplace violence.

Workers in jobs with a higher risk of violence may require more frequent or intensive instruction or specialized training.

For those workplaces that fall under the Health Care and Residential Facilities Regulation, O. Reg. 67/93, there are specific requirements for consulting with the joint health and safety committee or health and safety representative on certain matters, including worker training and educational programs in health and safety measures and procedures, and to reduce the measures and procedures for the health and safety of workers to writing (put them in writing).

For more information, see sections 8, 9 and 10 of the regulation.

For workplace violence reporting requirements, please see the Reporting occupational injuries and illnesses section in this sector plan.

Resources/compliance support

Ontario Ministry of Labour

Workplace Violence Prevention in Health Care Leadership Table

Ontario Health Care Health and Safety Committee under Section 21 of the OHSA

Public Services Health and Safety Association

Transportation hazards (including motor vehicle incidents)

Inspection focus

A large number of health care workers deliver services in the community and are required to drive in the course of their duties. Motor vehicle incidents are the primary cause of traumatic fatalities that have occurred in the health care sector.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. All employers are required to put in place precautions that are reasonable in the circumstances to protect the health and safety of workers.

Employers should assess potential motor vehicle hazards. Employers covered by O. Reg. 67/93 must:

  • put in place appropriate measures and procedures to prevent hazards
  • provide worker training to reduce risk of motor vehicle incidents and
  • establish written measures and procedures, in consultation with the JHSC or HSR, for the maintenance of employer motor vehicles, as per O. Reg. 67/93 sections 8 and 9.

Similarly, for those workplaces not covered by O. Reg. 67/93, employers are required to take all precautions reasonable in the circumstance to protect their workers under OHSA clause 25(2)(h).

These duties apply with respect to the prevention of motor vehicle incidents.

Resources/compliance support

Public Services Health and Safety Association

Safety in transition of care

Inspection focus

Transition of care refers to the progression of patients, residents and clients from one health care setting to another as their condition and care changes during the course of a chronic or acute illness.

Transition of care among health care providers has been identified by the ministry, its system partners and stakeholders as an occupational health and safety issue for health care workers.

Occupational health and safety related issues include, but are not limited to:

  • workplace violence and/or harassment
  • MSD risks related to client lifting and transferring and
  • infection prevention and control.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Effective communication and training of staff involved in the provision of care is essential not only to ensuring patient, resident or client safety, but also worker safety. Priority areas related to transfer of care include employee training and orientation and the development and implementation of standardized processes for communication and information transfer.

Resources/compliance support

Public Services Health and Safety Association

Competent supervision

Inspection focus

Competent supervision is an important part of workplace safety culture and the IRS.

The OHSA defines a supervisor as a person who has charge of a workplace or authority over a worker.

An employer should consider actual power and responsibilities when determining whether a person may be considered a supervisor under the OHSA. This includes considering the person’s authority rather than the job title. For example, a charge nurse may be a supervisor.

Under OHSA clause 25(2)(c), when appointing a supervisor, an employer must appoint a competent person.

The OHSA defines a competent person as someone who:

  • is qualified because of his or her knowledge, training, and experience to organize the work and its performance
  • is familiar with the OHSA and its regulations, as they apply to the work and
  • has knowledge of any potential or actual danger to the health or safety of employees in the workplace.

In 2017-2018, ministry inspectors will check that employers are complying with the Occupational Health and Safety Act and regulations, including requirements for competent supervision.

Resources/compliance support

Ontario Ministry of Labour

For more information on the specific duties of a supervisor:

Public Services Health and Safety Association

Needle and sharps safety

Inspection focus

In Ontario, Ontario Regulation 474/07 - Needle Safety, requires the use of safety-engineered needles in place of hollow-bore needles in:

  • hospitals
  • long-term care homes
  • laboratories and
  • specimen collection centres.

The regulation also requires the use of a safety-engineered needle any time a worker must use a hollow-bore needle on a person for therapeutic, preventative, palliative, diagnostic or cosmetic purposes.

Health care workers are also at risk of injury from other sharp medical devices such as:

  • scalpels
  • solid needles
  • medical instruments and
  • other materials.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Employers must ensure appropriate controls are in place for the use, handling and disposal of all needles and sharps at a workplace.

In workplaces covered by O. Reg. 67/93, employers in consultation with the JHSC (or HSR) must establish written measures and procedures for disposal of waste materials and sharp objects, such as needles, in accordance with sections 8 and 9 of O. Reg. 67/93.

Other sections of the regulation, such as sections 112 to 114 and section 116, may also apply to workplaces covered by O. Reg. 67/93. These sections refer to the safe disposal of needles and other wastes in health care workplaces.

Resources/compliance support

Ontario Health Care Health and Safety Committee under Section 21 of the OHSA

Public Service Health and Safety Association

Infections and infectious diseases

Inspection focus

Health care workers may develop disease through exposure to:

  • infectious materials
  • body substances
  • contaminated medical supplies/equipment
  • contaminated environments.

Transmission of infectious diseases occurs through injuries from sharps, direct or indirect contact as well as by droplet and airborne exposures.

In 2017-2018, the ministry will continue to focus on protecting workers from infectious diseases. Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Infections in workers that are acquired as a result of workplace exposures meet the definition of occupational illnesses under the OHSA. The nature of the illness must be reported to the MOL, JHSC (or HSR) and trade union (if any). In addition to isolated cases of worker infections, outbreaks of illnesses within health care workplaces occur every year and often workers are among those infected. Occupationally acquired infections represent a particular concern in the health care sector. They continue to occur frequently as part of common outbreaks of illnesses within workplaces in the sector.

In workplaces where O. Reg. 67/93 applies, measures and procedures for the control of infections must be established and put into effect in consultation with the joint health and safety committee or health and safety representative in accordance with sections 8 and 9.

Resources/compliance support

Ontario Ministry of Labour

Ontario Health Care Health and Safety Committee under Section 21 of the OHSA

Public Service Health and Safety Association

Ministry of Health and Long Term Care

Occupational illnesses and diseases

Inspection focus

In Ontario, occupational disease accounts for more occupational fatalities than traumatic occupational injuries across all sectors.

In 2015, 175 claims were allowed by the WSIB for deaths related to occupational disease. Two of these claims were in the health care sector. footnote 9

Exposure to chemical, biological and physical agents are among the five most serious hazards in health care, footnote 10 according to an analysis of WSIB injury data by the Public Services Health and Safety Association.

Of key concern are work-related:

  • noise
  • asthma
  • skin disease (dermatitis) and
  • occupational infections.

Work-related asthma (WRA) is caused or triggered by inhaling one or more substances in the workplace. There are two types of work-related asthma. The first type, occupational asthma (OA), occurs when a substance at work causes the worker’s asthma. It may occur after a long period of exposure to chemicals or result from a sudden chemical spill or leak. Health care workers are at risk of developing asthma from sensitizers in the workplace such as latex, certain drugs, sterilizing agents, disinfectants, glutaraldehyde and formaldehyde. The second type of asthma, work-exacerbated asthma (WEA), occurs when a worker already has asthma and it worsens because of irritants or other exposures/factors in the workplace like dust, smoke and cold temperatures.

Contact skin diseases are common in health care workers. Irritant contact dermatitis is more common and may result from exposure to wet work associated with frequent hand washing and glove use. Health care workers are also at risk of developing allergic contact dermatitis that may be caused by exposure to sensitizers found in rubber gloves.

Health care workers are also at risk of contracting occupational infections in the workplace. Influenza, tuberculosis, hepatitis and gastroenteritis are examples of occupational infections that may develop following contact with infectious diseases. Outcomes are better for occupational asthma and contact dermatitis if there is early recognition and avoidance of exposure. Preventing transmission of infections to workers with a good infection prevention and control program would eliminate occupational infections.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Reduction of exposure to hazardous chemical, biological and physical agents should focus on appropriate control measures, including the substitution of hazardous chemical substances with less hazardous substances. Employers should also be aware of their obligations to report occupational illnesses in accordance with clause 52(2) of the OHSA and applicable regulations.

Resources/compliance support

Ontario Ministry of Labour

Public Services Health and Safety Association

Ontario Health Clinics for Ontario Workers and Public Services Health and Safety Association

Reporting occupational injuries and illnesses

Inspection focus

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Under OHSA sections 51 and 52, an employer must notify the ministry, JHSC or HSR and trade union (if any) if workplace injuries or illnesses occur. This includes:

  • providing immediate notice of any critical injuries or fatalities
  • within 48 hours, providing a written report regarding critical injuries or fatalities
  • providing a written report of any occupational illness (including occupational infections) within four days of the employer learning of the illness.

If an accident, explosion, fire or incident of workplace violence occurs and a worker is disabled from performing his or her work or requires medical attention, but no one dies or is critically injured, the employer must notify the joint health and safety committee (or health and safety representative) and the union, if any, within four days of the incident. If required by the inspector, this notice must also be given to a Director of the ministry.

OHSA sections 51 and 52 specify that the notice must include certain details. The details that must be included in a report are specified in sector-specific regulations. For example, section 5 of O. Reg. 67/93 outlines illness reporting requirements for workplaces covered by that regulation.

Employers must:

  • be aware of their reporting obligations, and
  • take appropriate action to ensure that reporting requirements are met.

In 2017-2018, ministry inspectors will continue to review reporting obligations, including steps taken to prevent recurrence, with employers during workplace vists to determine if employers are in compliance.

Resources/compliance support

Workplace Hazardous Materials Information System

Inspection focus

The Workplace Hazardous Materials Information System (WHMIS) is a Canada-wide system designed to give employers and workers information about hazardous materials used in the workplace. WHMIS is changing to adopt new international standards for classifying hazardous chemicals and providing information on labels and safety data sheets. These new international standards are part of the Globally Harmonized System for the Classification and Labelling of Chemicals (GHS) and are being phased in across Canada between February 2015 and December 2018. During this transition period, the old requirements are referred to as “WHMIS 1988” and the new requirements are referred to as “WHMIS 2015”. Both the OHSA and the WHMIS Regulation (Regulation 860) have been amended to implement WHMIS 2015. For further details please see: Workplace Hazardous Materials Information System.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

The provincial WHMIS Regulation (Regulation 860) contains three core sections on:

  • product labels
  • Material Safety Data Sheets (MSDS) / Safety Data Sheets (SDSs)
  • worker education.

In addition, OHSA section 42 requires employers to provide:

  • instruction and training which is developed and implemented in consultation with the JHSC (or HSR)
  • periodic review of the training and instruction.

Resources/compliance support

Ministry of Labour

Public Services Health and Safety Association

Antineoplastic and other hazardous drugs

Inspection focus

Antineoplastic drugs are a group of specialized drugs used primarily to treat cancer as well as some non-cancerous conditions. Health care workers may be exposed to antineoplastic drugs during all steps of handling, such as transportation, preparation, handling, administration and disposal of waste and contaminated materials.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Employers covered by O. Reg. 67/93 must develop, establish and put into effect written measures and procedures to protect workers who may be exposed to antineoplastic agents or to material or equipment contaminated with antineoplastic agents, as required by OHSA section 97. This must be done in consultation with the JHSC (or HSR), if any.

Employers of workplaces not covered by O. Reg. 67/93 are required under the OHSA to provide information, supervision and instruction to workers to protect their health or safety [clause 25(2)(a)] and to take every precaution reasonable in the circumstances for the protection of a worker [clause 25(2)(h)]. These duties apply with respect to protecting workers from the hazards associated with antineoplastic drugs.

Resources/compliance support

Personal protective equipment

Inspection focus

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations:

  • Under OHSA, employers must ensure that personal protective equipment (PPE) that is provided is maintained in good condition and is used as required by the employer or by regulations.
  • Workers have a responsibility under OHSA to use the protective clothing, equipment or devices required by the employer.
  • For workplaces covered by O. Reg. 67/93 employers must also ensure that PPE is:
    • properly used and maintained
    • properly fitted
    • inspected for damage or deterioration and
    • stored in a convenient, clean and sanitary location when not in use.

Workers must:

  • be instructed and trained on its care, use and limitations before wearing or using it for the first time and at regular intervals thereafter
  • participate in the instruction and training provided by the employer.

Employers must develop, establish and put into effect written measures and procedures for the use, wearing and care of personal protective equipment and its limitations. This must be done in consultation with the JHSC or HSR, if any.

Personal projective equipment can include:

  • respirators
  • head protection
  • eye protection
  • foot protection
  • protective aprons
  • protective collars
  • gowns
  • gloves
  • fall arrest systems.

In 2017-2018, ministry inspectors will check that employers and supervisors have selected PPE that is appropriate for the hazard and that the equipment is providing an appropriate level of protection for the worker.

Resources/compliance support

Ventilation maintenance and monitoring

Inspection focus

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Employers covered by O. Reg. 67/93 must ensure that:

  • any mechanical ventilation system is inspected every six months by a person who is qualified by training and experience
  • the inspection report is filed with the employer and the JHSC (or HSR)
  • any mechanical ventilation system, such as a cooling tower, undergoes regular and preventative maintenance to prevent proliferation or colonization of Legionella bacteria in the system.

In 2017-2018, inspectors will check that health care workplaces are complying with the ventilation requirements in sections 19 and 20 of O. Reg. 67/93.

Employers not covered by O. Reg. 67/93 must take all precautions reasonable in the circumstances to protect their workers, as required by OHSA clause 25(2)(h). These duties apply with respect to ventilation systems.

Resources/compliance support

Asbestos

Inspection focus

Older health care facility buildings may have asbestos-containing materials (ACM). Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. In Ontario, the Asbestos on Construction Projects and in Buildings and Repair Operations Regulation (O. Reg. 278/05) requires:

  • the implementation of an asbestos management program in buildings where ACMs are present and in other specified circumstances
  • the building owner to establish a record containing the location and condition of actual or suspected ACMs
  • the record to be updated at least once annually and whenever the owner is aware of new information related to the ACMs
  • safe work measures and procedures that employers and workers must follow when performing work (e.g., Type 1, Type 2 and Type 3 operations) that involves ACMs.

Resources/compliance support

Common industrial hazards in health care workplaces

Inspection focus

Common industrial hazards found in health care workplaces can include:

  • entanglement, pinch and “struck-by object” hazards involving machines and equipment (e.g., conveyors, forklifts, lawnmowers)
  • confined spaces and restricted spaces
  • falls related to working at heights (e.g., ladders, scaffolds, loading docks)
  • electrical, pneumatic, hydraulic or kinetic stored energy hazards with insufficient lockout/tag out systems.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations. Some industrial type hazards in health care settings are not specifically addressed under the OHSA or O. Reg. 67/93.

For these workplaces, employers must:

  • take all precautions reasonable in the circumstances for the protection of workers, as required by OHSA clause 25(2)(h)
  • identify all workplace hazards
  • assess the risk to workers associated with the hazards
  • implement measures and procedures to control the hazards
  • provide workers with appropriate information and instruction and
  • provide workers with training and educational programs, when required by O. Reg. 67/93.

Resources/compliance support

Workplace Safety and Prevention Services

Public Services Health and Safety Association

Loading dock safety

Inspection focus

Workers can be exposed to a number of hazards when engaging in indoor and outdoor shipping activities at loading dock areas of health care workplaces. Issues can include the risk of slips, trips and falls, WHMIS, poor lighting, equipment safety and the development of musculoskeletal disorders. Workers can be seriously injured as a result of these hazards. Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Resources/compliance support

Construction hazards

Inspection focus

Construction projects (including renovations, structural maintenance, and new construction) in health care facilities are commonplace. Health care facilities need to protect the health and safety of health care workers by having a comprehensive plan to protect their staff during a construction project. Construction areas should be clearly marked and separated by fencing or other measures to prevent unrestricted access. Ministry of Labour construction health and safety inspectors enforce the OHSA and its regulations at construction projects across the province for the protection of construction workers, including at construction projects located in health care facilities. Details are given in the Construction Sector Plan. Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Health care workplaces covered by O. Reg. 67/93 must have written measures and procedures in place to protect health care workers’ health and safety. These could include:

  • a plan for a pre- and post-construction hazard risk assessment
  • hazard communication procedures
  • infection prevention and control measures
  • appropriate procedures to be taken during construction
  • controls limiting interaction between the construction work and health care staff
  • controlled access and egress in construction areas.

Consultation with the JHSC (or HSR) is required on developing those measures and procedures, and in providing worker training and educational programs regarding the measures and procedures developed. Employers are required to review these measures and procedures at least annually.

The employer in a health care facility has a duty to ensure that the measures and procedures prescribed (e.g., measures and procedures prescribed in O. Reg. 278/05) are carried out in the workplace [OHSA, clause 25(1)(c)].

Employers of workplaces not covered by O. Reg. 67/93, or any other specific regulation, are required under the OHSA to provide information, supervision and instruction to workers to protect their health or safety [clause 25(2)(a)] and take every precaution reasonable in the circumstances for the protection of a worker [clause 25(2)(h)]. These duties also apply with respect to protecting workers from construction hazards.

Resources/compliance support

Vulnerable workers (including new and young workers)

Inspection focus

Under the OHSA, employers are required to provide all workers with training, instruction and supervision to protect their health and safety.

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

The Ministry of Labour considers new workers to be those who, regardless of age, have been on the job for less than 6 months or who have been assigned to a new job, and considers anyone between the ages of 14 and 24 to be a young worker. For employers in workplaces covered by O. Reg. 67/93, the education and training programs must be developed in consultation with the joint health and safety committee or health and safety representative.

Resources/compliance support

Ontario Ministry of Labour

Public Services Health and Safety Association

Emergency management (preparedness, response and recovery)

Inspection focus

Inspectors will check on employer compliance with the Occupational Health and Safety Act and its regulations.

Under OHSA, employers not covered by O. Reg. 67/93 must:

  • take every precaution reasonable in the circumstances to protect workers from hazards at all times, including during an emergency and
  • provide information, instruction and supervision about emergencies.

For workplaces covered by O. Reg. 67/93, emergency management must include:

  • development and implementation of written measures and procedures for worker health and safety, including training and educational programs
  • a risk assessment to develop:
    • emergency measures and procedures and
    • training and educational programs.

Resources/compliance support

Footnotes

  • footnote[4] Back to paragraph WSIB Enterprise Information Warehouse (EIW) Claim Cost Analysis Schema, June 2016 data snapshot, courtesy of Public Services Health and Safety Association.
  • footnote[5] Back to paragraph WSIB Enterprise Information Warehouse (EIW) Claim Cost Analysis Schema, June 2016 data snapshot, courtesy of Public Services Health and Safety Association.
  • footnote[6] Back to paragraph WSIB Enterprise Information Warehouse (EIW) Claim Cost Analysis Schema, June 2016 data snapshot, courtesy of Public Services Health and Safety Association.
  • footnote[7] Back to paragraph WSIB Enterprise Information Warehouse (EIW) Claim Cost Analysis Schema, June 2016 data snapshot, courtesy of Public Services Health and Safety Association
  • footnote[8] Back to paragraph WSIB Enterprise Information Warehouse (EIW) Claim Cost Analysis Schema, June 2016 data snapshot, courtesy of Public Services Health and Safety Association
  • footnote[9] Back to paragraph According to By the Numbers 2015: Workplace Safety and Insurance Board (WSIB) Statistical Report.
  • footnote[10] Back to paragraph WSIB Enterprise Information Warehouse (EIW) Claim Cost Analysis Schema, June 2016 data snapshot, courtesy of Public Services Health and Safety Association