Setting priorities: Testing a tool to assess and prioritize workplace chemical hazards.

BACKGROUND: Workplace Hazardous Materials Information System (WHMIS) training is obligatory for Ontario workplaces. The purpose of this training is to help workers understand the health and safety issues associated with using chemicals, including how to understand the information contained in the Safety Data Sheets (SDSs) that come with all chemicals. However, many workers still do not know how hazardous workplace chemicals can be and they find it difficult to objectively determine the level of hazard posed by the chemicals they use. OBJECTIVE: A team of researchers, unions, and health and safety associations created a tool for Joint Health and Safety Committees (JHSC) of small and medium-sized businesses to help them identify, assess and prioritize the health hazards posed by workplace chemicals using SDSs as the primary source of information. METHODS: The team recruited the JHSCs of six workplaces to pilot the usefulness of the Chemical Hazard Assessment and Prioritization (CHAP) tool. The CHAP tool helps workplaces rank their chemicals within one of five hazard levels using information contained in SDSs. RESULTS: Despite a difficult recruitment process, the participating JHSCs thought the CHAP process of assessing and prioritizing their workplace chemicals was useful. It raised their awareness of chemical hazards, increased their understanding of SDSs, and helped them prioritize their chemicals for improved control measures. CONCLUSIONS: Small and medium-sized businesses found the tool to be useful, but suggested that an electronic version would be easier to use.

With a little help from our friends: Collaborative research partnerships in three workplace-based occupational disease research projects.

BACKGROUND: Research conducted in collaboration between academic and non-academic partners (known as integrated knowledge translation [iKT]) in the field of occupational health and safety needs to be evaluated. OBJECTIVE: This study examined three collaborative workplace-based intervention projects that focused on reducing exposure to occupational carcinogens. Practice, policy and advocacy intermediary organizations partnered with multidisciplinary groups of researchers. This evaluation study sought to understand the characteristics of successful and unsuccessful iKT partnerships from the perspective of the intermediaries. METHODS: Researchers conducted face-to-face interviews with 21 intermediaries and used a thematic-driven "framework analysis" method to analyze the interviews, based upon an evolving conceptual framework. RESULTS: Seven enablers and barriers of collaboration were identified. Enablers included having: adequate capacity; defined project roles; the right partners; an inclusive project leader; mutual respect; good communication; and shared values and priorities. Lacking these was considered a barrier. Seven outcomes were identified as: improved relevance and quality of the research; learning about each others' "world"; building contacts; improved use of research in practice and policy; dissemination of the research; development of trust and goodwill; and continued collaborations. CONCLUSIONS: Recommendations for future collaborative studies include: spend time defining roles, responsibilities, and expectations; ensure practitioners have the time and resources, and the commitment to the project; and choose representatives from the organizations with the necessary skills or decision-making mandate.

Feasibility of clinicians asking patients about their exposure to occupational hazards: An intervention at five primary care health centres.

BACKGROUND: Ontario's occupational health and safety prevention system has identified a need for the systematic collection of occupational exposure data for ongoing surveillance and targeted prevention initiatives. OBJECTIVES: To examine the feasibility of collecting occupational exposure information within a primary care clinical setting. METHODS: Five healthcare centres were recruited. Working patients answered basic occupational exposure questions. Clinicians reviewed the answers with patients. Answers were entered into the patient's electronic medical records (EMRs). A knowledge broker supported the health centres throughout the trial with background information and linking to occupational expertise. Interviews with administrators and clinicians examined the usefulness of the survey to primary care, the barriers and facilitators, and sought suggestions for sustaining the practice. A cross-case analysis, framed by a conceptual model, was conducted from the feedback. RESULTS: Themes highlighted the importance of clinician and administrator buy-in, the perceived relevance of occupational exposures to primary care clinicians and the patient population, and the need for clinicians to feel confident about the health impact and relevance of occupational exposures to presenting clinical problems. CONCLUSION: Clinicians ask work exposure-related questions when patients have a health concern that the clinicians suspect may be related to a work exposure. No clear clinical purpose for routinely asking exposure questions emerged.

From awareness to action: Sudbury, mining and occupational disease in a time of change.

BACKGROUND: Miners work in highly hazardous environments, but surprisingly, there are more fatalities from occupational diseases, including cancers, than from fatalities from injuries. Over the last few decades, the mining environment has become safer with fewer injuries and less exposure to the toxins that lead to occupational disease. There have been improvements in working conditions, and a reduction in the number of workers exposed, together with an overall improvement in the health of miners. OBJECTIVES: This study attempted to gain a deeper understanding of the impetus for change to reduce occupational exposures or toxins at the industry level. It focuses on one mining community in Sudbury, Ontario, with a high cancer rate, and its reduction in occupational exposures. It explored the level of awareness of occupational exposures from the perspective of industry and worker representatives in some of the deepest mines in the world. Although awareness may be necessary, it is often not a sufficient impetus for change, and it is this gap between awareness and change that this study explored. It examined the awareness of occupational disease as an impetus to reducing toxic exposures in the mining sector, and explores other forces of change at the industrial and global levels that have led to an impact on occupational exposures in mining. METHODS: From 2014 and 2016, 60 interviews were conducted with individuals who were part of, or witness to the changes in mining in Sudbury. From these, 12 labour and 10 industry interviews and four focus groups were chosen for further analysis to gain a deeper understanding of industry and labour's views on the changes in mining and the impact on miners' health from occupational exposures. The results from this subsection of the data is the focus for this paper. RESULTS: The themes that emerged told a story about Sudbury. There is awareness of occupational exposures, but this awareness is dwarfed in comparison to the attention that is given to the tragic fatal injuries from injuries and accidents. The mines are now owned by foreign multinationals with a change from an engaged, albeit paternalistic sense of responsibility for the health of the miners, to a less responsive or sympathetic workplace culture. Modernization has led to the elimination, substitution, or reduction of some of the worst toxins, and hence present-day miners are less exposed to hazards that lead to occupational disease than they were in the past. However, modernization and the drop in the price of nickel has also led to a precipitous reduction in the number of unionized miners, a decline in union power, a decline in the monitoring of present-day exposures, and an increase in non-unionized contract workers. The impact has been that miners have lost their solidarity and power to investigate, monitor or object to present-day exposures. CONCLUSIONS: Although an increase in the awareness of occupational hazards has made a contribution to the reduction in occupational exposures, the improvement in health of miners may be considered more as a "collateral benefit" of the changes in the mining sector. Multiple forces at the industrial and global level have differentially led to an improvement in the working and living environment. However, with the loss of union power, the miners have lost their major advocate for miner health.

Sun Safety at Work Canada: a multiple case-study protocol to develop sun safety and heat protection programs and policies for outdoor workers.

BACKGROUND: CAREX Canada has identified solar ultraviolet radiation (UV) as the second most prominent carcinogenic exposure in Canada, and over 75 % of Canadian outdoor workers fall within the highest exposure category. Heat stress also presents an important public health issue, particularly for outdoor workers. The most serious form of heat stress is heat stroke, which can cause irreversible damage to the heart, lungs, kidneys, and liver. Although the need for sun and heat protection has been identified, there is no Canada-wide heat and sun safety program for outdoor workers. Further, no prevention programs have addressed both skin cancer prevention and heat stress in an integrated approach. The aim of this partnered study is to evaluate whether a multi-implementation, multi-evaluation approach can help develop sustainable workplace-specific programs, policies, and procedures to increase the use of UV safety and heat protection. METHODS/DESIGN: This 2-year study is a theory-driven, multi-site, non-randomized study design with a cross-case analysis of 13 workplaces across four provinces in Canada. The first phase of the study includes the development of workplace-specific programs with the support of the intensive engagement of knowledge brokers. There will be a three-points-in-time evaluation with process and impact components involving the occupational health and safety (OHS) director, management, and workers with the goal of measuring changes in workplace policies, procedures, and practices. It will use mixed methods involving semi-structured key informant interviews, focus groups, surveys, site observations, and UV dosimetry assessment. Using the findings from phase I, in phase 2, a web-based, interactive, intervention planning tool for workplaces will be developed, as will the intensive engagement of intermediaries such as industry decision-makers to link to policymakers about the importance of heat and sun safety for outdoor workers. DISCUSSION: Solar UV and heat are both health and safety hazards. Using an occupational health and safety risk assessment and control framework, Sun Safety at Work Canada will support workplaces to assess their exposure risks, implement control strategies that build on their existing programs, and embed the controls into their existing occupational health and safety system.

Did you have an impact? A theory-based method for planning and evaluating knowledge-transfer and exchange activities in occupational health and safety.

Few evaluation tools are available to assess knowledge-transfer and exchange interventions. The objective of this paper is to develop and demonstrate a theory-based knowledge-transfer and exchange method of evaluation (KEME) that synthesizes 3 theoretical frameworks: the promoting action on research implementation of health services (PARiHS) model, the transtheoretical model of change, and a model of knowledge use. It proposes a new term, keme, to mean a unit of evidence-based transferable knowledge. The usefulness of the evaluation method is demonstrated with 4 occupational health and safety knowledge transfer and exchange (KTE) implementation case studies that are based upon the analysis of over 50 pre-existing interviews. The usefulness of the evaluation model has enabled us to better understand stakeholder feedback, frame our interpretation, and perform a more comprehensive evaluation of the knowledge use outcomes of our KTE efforts.

Dancing the two-step: Collaborating with intermediary organizations as research partners to help implement workplace health and safety interventions.

OBJECTIVE: To evaluate the effect of the involvement of intermediaries who were research partners on three intervention studies. The projects crossed four sectors: manufacturing, transportation, service sector, and electrical-utilities sectors. The interventions were participative ergonomic programs. The study attempts to further our understanding of collaborative workplace-based research between researchers and intermediary organizations; to analyze this collaboration in terms of knowledge transfer; and to further our understanding of the successes and challenges with such a process. PARTICIPANTS: The intermediary organizations were provincial health and safety associations (HSAs). They have workplaces as their clients and acted as direct links between the researchers and workplaces. METHODS: Data was collected from observations, emails, research-meeting minutes, and 36 qualitative interviews. Interviewees were managers, and consultants from the collaborating associations, 17 company representatives and seven researchers. RESULTS: The article describes how the collaborations were created, the structure of the partnerships, the difficulties, the benefits, and challenges to both the researchers and intermediaries. The evidence of knowledge utilization between the researchers and HSAs was tracked as a proxy-measure of impact of this collaborative method, also called Mode 2 research. CONCLUSION: Despite the difficulties, both the researchers and the health and safety specialists agreed that the results of the research made the process worthwhile.

Searching for needles in a haystack: identifying innovations to prevent MSDs in the construction sector.

This study identified innovations that could potentially reduce the risk of MSDs in the construction sector. The action research approach was based on a collaborative model of researchers working with workplace representatives. We searched for innovations being used by construction companies. From a potential database of 125 innovations, the study focused on 20 innovations that varied in their penetration into worksites in the geographical area, represented a variety of trades, and were a cross-section of tools and work organizational processes. It examined the attributes of the innovations, and the barriers to their adoption. The analysis was based on observations of workers, surveys of workers and construction-safety consultants, and company interviews. The study found that innovations were adopted by companies for multiple advantages including productivity and quality, but not necessarily ability to reduce MSD risks, their non-complexity, and cost. The major barriers for adoption were the traditional culture of the construction sector rather than financial ones.