Occupational disease landscape review
Read recommendations to improve worker health by linking disease prevention and health care. This independent report was submitted by Dr. Linn Holness and Janet Brown to the Ministry of Labour, Immigration, Training and Skills Development.
For 40 years, I have worked in the healthcare and occupational health and safety systems.
My interest in occupational medicine was sparked when I was a medical resident. During a Friday ward round, a chest physician presented chest X-rays of miners with silicosis — a preventable but incurable lung condition that can lead to serious disability. That piqued my interest and led me back to university for studies in occupational and environmental health.
After an energizing practicum experience at the Ministry of Labour, occupational medicine was firmly embedded in my being.
I started my clinical work at St Michael’s Hospital in 1983, whose founders believed that care for workers with injury and disease fell within their mission. While initially focused on occupational lung disease, my practice shifted to occupational contact dermatitis. I started my work week in the clinic, seeing workers with skin disease that might be related to their work.
Those workers taught me so much. Not only did they tell me about their disease, but also how it affected them and their families. I learned that even when it is “just a rash,” it can have a major impact on many lives. Those stories were foundational elements of my teaching, both for medical trainees and also for occupational health students training to be hygienists. The workers’ issues and problems planted the seeds for much of my research: focused on their disease and its diagnosis, but also their journey through the healthcare system and the impacts of their disease on their lives. It sparked broader questions about how healthcare providers deal with occupational disease and how prevention has or hasn’t worked in their workplaces. It prompted the creation of tools to assist with their journey.
I have seen the good and the challenges in both systems.
Over the years, a cadre of us from different organizations, but with a passion for OD, advocated in the occupational health and safety system for a place at the table for OD. Finally, there was a table for us — we had made progress.
My interest in all of this started with reviewing chest X-rays of older workers with silicosis. It is heartbreaking to think that 40 years later, we have younger workers in this province dying of acute silicosis.
There is still much work to do.