Topic 2: Workplace training
The scope of this chapter is workplace training related to occupational disease (OD) prevention. Consideration is given to training program development, ongoing education and knowledge reinforcement, and delivery methods/modes.
Ontario legislative and regulatory requirements
Please note: this is not an exhaustive listing of all legislation and regulations related to workplace training but provides a brief overview.
The Ontario Occupational Health and Safety Act and its regulations and codes provide direction for broad health and safety training requirements. These include awareness training, WHMIS training and mandated/accredited training for JHSC members. Employers are required to provide information, instruction and supervision to a worker to protect their health and safety and acquaint them (or their supervisor) with any workplace hazards. Supervisors must complete basic two-day OHS awareness training.
There are also more specific training requirements in a number of the regulations:
- For requirements focused on exposures that may cause OD, in addition to the broad training requirements, the Designated Substance (DS) Regulations require employers to have control programs that include training workers and supervisors on the health effects of designated substances and measures and procedures required to protect them from exposure.
- Training is necessary for respirator usage in the control requirements for exposure to biological or chemical agents.
- The noise regulation requires workers with a hearing protection device to have instructions on its use and care.
- Physicians conducting medical surveillance under the Designated Substance Regulations are required to provide education to the worker.
In Ontario, many diverse organizations provide training, including OHS professionals in larger companies, the four sector Health and Safety Associations (HSAs), the Workers Health and Safety Centre (WHSC), and many private organizations. Typically training related to OD hazards is embedded within more general OHS training.
The MLITSD Chief Prevention Officer (CPO) may establish standards for training programs and persons who provide training. However, none currently exist specific to OD. Inspectors may review training practices, sometimes as part of a complaint or incident.
The HSAs and WHSC have substantial education product development expertise. This expertise is primarily internal, but content knowledge originates from literature reviews and external experts such as provincial research centres, including the Centre for Research Expertise in Occupational Disease (CREOD), Occupational Cancer Research Centre (OCRC), Institute for Work and Health (IWH), Centre for Research in Occupational Safety and Health (CROSH), and others.Sector-specific training tends to focus on hazards versus health and disease. Exceptions include a mining health module added to supervisor training and a diesel exhaust and health module added to JHSC part 2 training.
Consultation and review summary
Note a comprehensive summary of CREOD research is provided on the CREOD website.
There has been considerable research on OD-specific training studies in Ontario, particularly focused on occupational skin disease. Key findings include the following:
- For selected occupational diseases where training has been studied, a significant proportion of workers report not receiving hazard-specific training.
- Even those that report hazards specific training say that there are significant gaps in the content.
- Workers report examples of good effective training, such as CPR and first aid, while WHMIS was identified as an example of ineffective training (such as, forgettable due to the content, delivery method and lack of follow-up).
- Generally, training is focused on safety and injury prevention rather than OD.
- Workers expressed a desire to learn about prevention strategies, workplace hazards and occupational disease in addition to hands-on training specific to their job tasks.
- Effective training characteristics were described as multi-modal with multiple teaching methods to address different learning styles, such as in-person, hands-on training with a demonstration component, use of visuals, use of personal narratives and negative framing or use of potential worst-case scenarios to highlight the importance of prevention.
- Other issues identified were a lack of follow-up and a lack of supervisor support.
Other research from IWH found:
- Less than 20% of workers report training in the first year on the job.
- Active awareness training was associated with stronger impacts than passive training.
- A review of the mandated fall-from-height training found a modest effect in reducing injuries targeted by the training.
Reports and reviews
Review of Recommendations from the Expert Advisory Panel On Occupational Health & Safety (December 2010)
This report and its recommendations focused on several topics, including workplace training.
The implementation of the recommendations varies. Several key recommendations include:
- Implement and audit training standards: The new prevention organization should create, implement and audit training standards that apply to the training required by the Occupational Health and Safety Act. It should also have the authority to develop standards for overarching development, design and evaluation of training quality and develop mandatory training standards for instructors and trainers.
- Establish Ontario as a jurisdictional leader in OHS continual learning and training: The new prevention organization should work with other ministries and training organizations to develop a graduated Occupational Health and Safety Awareness and Training Strategy to establish Ontario as a jurisdictional leader in OHS continual learning and training.
- While the recommendations noted apply to training broadly, there are other important directions to note regarding overall training strategy related to a) developing mandatory H&S training for all workers; health and safety reps, and supervisors; b) addressing the specific training needs of vulnerable workers and smaller workplaces; and c) improving health and safety education and training in schools. Many of these points were reiterated during this review, including in the focus groups.
Mining health, safety and prevention review (2015)
The mining review addressed processes that would be helpful to better understand and address OD. Highlights include:
- a mining sector risk assessment was completed, and five hazards were prioritized
- one of the five priorities was exposure to airborne hazards
- the need to raise awareness among workers and employers of controlling risks to health was highlighted
- there was strong support for mandatory training standards and a Common Core Curriculum
- the need for continuing improvement related to training delivery, supervisor training and access to refresher training was noted
The following points were raised during meetings with stakeholders/key informants during the review.
There is a broad mix of training/education modes that need to be considered in designing education programs, including:
- online, classroom and hands-on teaching
- posters, binders and reminder cards
- audit tools, apps, checklists and health assessment tools
- There are a large number of publicly funded and private organizations delivering training and little is known about what training is delivered, how and by whom. However, the Ontario.ca website does provide information on available training/trainers for mandated training programs.
- Sector risk assessment studies (root cause analysis) have proven successful in engaging and building useful educational responses.
- The use of an innovative “extended services” method developed by Workplace Safety North (WSN) shows good promise in addressing issues of training capacity and geographic reach. WSN develops the training and provides support to local trainers in workplaces to deliver.
- The four sector-based Health and Safety Associations (HSAs) prioritize curriculum development based on both ministry priorities and demand (revenue-generating opportunities).
Stakeholder focus groups
Overall, there was concern expressed about the lack of standards for OD training (content, learning methods, trainers), the health and safety system’s capacity to deliver, and ultimately a question of whether training makes a difference to prevention and the health of workers.
- There is some level of confusion among employers about the need for training beyond WHMIS (such as, what is mandatory) and acknowledgement that there is very little training specific to disease risks.
- The decentralized approach to training in Ontario with 100s of service providers presents a quality risk.
- Training programs may lack adult learning principles and provide little consideration of the benefits of virtual vs in-person training and/or the unique needs of small and medium workplaces.
- Little attention is given (for example in WHMIS) to how learning is applied in specific workplaces.
- The current audit approach (how many attended and completed the course) is insufficient and needs to move to a demonstration of knowledge acquisition specific to the workplace (for example handling products as per the safety data sheet).
- There is a role for HSAs to back up Ministry requirements for designated substances training.
- Connecting training with medical screening would be helpful.
The overarching theme in the discussion of solutions was the need to move from a training mindset to an education mindset. Education refers to a process of learning that includes a mix of interactive delivery modes, application and learning in practice (in the workplace), and continuing education and improvement of skills and knowledge over time.
Solution themes related to training delivery:
- Focus more on worksite/job specific knowledge acquisition and follow-up using the mining sector training as a good example.
- Provide more training support for non-union and/or smaller worksites.
- Move from monitoring whether training has occurred to whether training is effective.
- Improve delivery of education by providing:
- a way to test for transfer of learning
- a quality assessment of instructors
- a mix of in-person training and online self-study courses
Solution themes related specifically to OD:
- Embed an OD training module in all existing health and safety training (for example, general awareness training for workers and supervisors, WHMIS, certification training)
- Improve training curriculum/content by:
- centralizing curriculum development for OD
- starting with designated substances (DS) but not stopping there
- developing education programs including training modules, mini education guides, point of work reminders (for example posters, QR codes, etc.)
- having HSAs customize core curriculum as needed
- Work with and leverage WHMIS by:
- revisiting existing standards and introducing new where they are not working
- updating WHMIS data sheets to better describe the hazards
- linking MSDS data sheets to training in real time
- developing sector specific WHMIS training based on risk and feasibility assessments
Summary review findings
- Employers tend to focus on ministry requirements to prioritize use of time and resources to train supervisors and workers.
- Given few OD-related regulations and guidelines, occupational disease risk-specific information is often embedded in more general health and safety training programs, such as JHSC certification training.
- There is no practical way of knowing what OD training is happening in workplaces.
- OD training program development in Ontario is highly decentralized, resulting in:
- duplication of effort
- limited standards for training programs and trainers
- no ability to monitor, evaluate and track OD training at a system level
- Delivery concerns include:
- too much information to retain or the information is forgettable/not relevant
- poor reinforcement of learning in practice
- feasibility of training requirements for small businesses
- awareness resources and training need to be better integrated to reinforce learning
Note: the following recommendations related to OD training may apply to workplace training generally. The recommendations of previous reports (Dean, Mining) have resulted in some changes in training practices, but there is a need for continuing implementation of their recommendations and their application to OD specifically.
- Employers and workers receive relevant, timely, and useful information OD about hazards in their workplace, the associated health effects, and methods of prevention.
- Prevention information is provided in a manner that supports its successful acquisition and subsequent effective use in practice.
2.1 Reinforcing the direction of the Dean Report, it is recommended that Ontario become a jurisdictional leader in OHS continual learning and training
- use an adult education model of learning
- align best practices across government supported organizations (HSAs)
- review required training to assess whether it should be accredited
- improve the audit process to move from confirming a course/training has been delivered to probing/assessing worker knowledge, skills and behaviours
Short term recommendations
While in the end, we would like all training to meet the highest standards, there are steps to take as we travel there. Given there is very little OD-specific content, the following recommendations are meant as stepping stones to robust OD training:
2.2 Develop e-learning modules for key occupational disease-causing exposures starting with the designated substances. The modules should be freely available to all. These could be used as building blocks for of a more extensive training program but also would provide small businesses and workers with at least basic information. Also, standardize this messaging with any awareness initiatives.
- Focus on designated substances where there is a regulatory requirement for training. There are a few training programs in existence through HSAs primarily focused on asbestos.
- MLITSD assign an expert core team (drawn from HSAs and add clinical expertise) to develop core content for e-learning modules.
- Sector HSAs customize modules as required.
- Create a suite of products to complement the e-learning modules with consistent information, such as awareness materials/resources and reinforcement tools considering:
- messaging posters
- worker hazard information card (with exposure, key prevention strategies and adverse effects)
- reminders in the workplace at the site of the hazard
- possible refresher module for supervisors to support and reinforce ongoing learning with their workers related to OD
2.3 Trial innovative ways to reach marginalized workers and workplaces with understanding it must be evaluated to assess effectiveness and scalability
- Work with community health centres with experience in workplace health issues and patients/workers experiencing marginalization) that has done this work.
2.4 Change the audit focus from compliance (training delivered) to demonstrated knowledge/learning
- Develop a checklist for inspectors to use when in organizations with DSs.