Top 25 Exposures
[based on the International Classification of Diseases (ICD)]

April 1, 2017 to March 31, 2022

International Classification of Diseases (ICD)

April 1, 2017 to March 31, 2022

Background

At the request of airport screeners, OHCOW assessed the face masks provided by their employer to protect them from exposure to SARS-CoV-2 at their workplace. This assessment was to determine, first of all, if the masks met the standards of the ESDC directive that stipulates they must meet the specifications of Class 1 medical masks, according to ASTM F2100-9 – Performance of Materials used in Medical Face Masks. Additionally, it was to address other concerns about the masks. Some workers were experiencing facial skin irritation and rashes, and workers wanted OHCOW to recommend an alternative. Also at their request, OHCOW presented an overall COVID preventative measures strategy to airport screeners at a national conference. 

Intervention/Approach

Although the masks provided by the employer met the requirements of the ESDC directive, OHCOW suggested that the directive was not adequate for potential SARS-CoV-2 exposures that may be encountered during airport screening activities. Airport screeners work in close proximity to infected passengers from around the globe in areas of crowding and inadequate ventilation, and are at a heightened risk of exposure. While the directive addressed the material filtration efficiency of the masks, it did not specifically require masks to be tight-fitting respiratory protective devices. 

OHCOW recommended tight-fitting filtering-facepiece respirators, such as the N95 variety, and a program that included fit testing, maintenance and training as well as the other requirements of CSA Standard Z94.4 (Selection, Use and Care of Respirators). Using respirators instead of the masks provided may also minimize the potential for skin irritation encountered by the medical masks. 

At a national conference, OHCOW delivered a session on strategies and measures to prevent the transmission of SARS-CoV-2 virus to an audience of airport screeners, addressing concerns specific to their work environment.  In addition to respiratory protection, the content addressed workspace ventilation assessment and control, testing, vaccination and other administrative controls to mitigate the spread of the virus/disease. 

OHCOW Impact

OHCOW’s recommendations contributed to heightened awareness of recommended respiratory protection practices (including device selection) that will mitigate the potential for viral transmission from infected passengers and co-workers. The provision of proper respiratory protection devices could also minimize the occurrence of skin irritation that was reported.  Furthermore, the knowledge transfer for all types of measures to mitigate the spread of COVID among airport screeners provides the workers with tools to make recommendations to the employer to reduce potentially hazardous situations. 

Background

A 58-year-old firefighter who had been employed within Fire Services for 29 years was working at a structure fire when he began experiencing tightness in his chest, and a discomfort that he described as a feeling of severe indigestion. He reported his symptoms to his safety representative but did not seek medical attention. Two weeks later he was called to tend to a campfire that required him to walk approximately 1 kilometer into the bush. Following this call, his symptoms returned, and he reported to his safety officer that he would be seeking medical attention, which he did four days later at the local hospital. Evidence of ischemia was detected on his electrocardiogram, with a normal troponin level indicating an absence of myocardial damage. Coronary angiography revealed extensive coronary artery disease with subtotal occlusion involving multiple vessels. He subsequently underwent urgent coronary artery surgery with 6 bypass grafts. It is reported in the clinical notes he had no identified coronary artery disease (CAD) risk factors. The firefighter filed a WSIB claim; however, his claim was denied on the basis that his symptoms did not appear following an unusual physical exertion. It was also concluded that the firefighter did not suffer a myocardial infarction (MI) but rather had suffered from unstable angina. 

Intervention/Approach

OHCOW’s approach was to complete an occupational hygiene review of past exposures and an occupational medicine review of the worker’s CAD in the context of these exposures. The focus was not on a possible MI following exertion during the campfire incident (which is what the original claim was based on) but rather on the long-term lifetime development of CAD. The OHCOW physician did not find clinical evidence in the medical records provided to support the diagnosis of MI. As such, both the occupational hygiene and medical reviews were focused on chronic firefighter exposures and the development of CAD. There is considerable evidence in the literature to support this association. 

Firefighters are exposed to a variety of chemicals and these differ from fire to fire. The products of combustion may derive from natural substances, polyvinyl chloride (PVC), flame retardants, fillers, plasticizers, and dozens of other synthetic materials. Plus,  incomplete combustion can produce an abundance of CO. Carbon monoxide may exert its toxic effects on the heart and blood vessels in a couple of ways, either by causing acute, short-term effects on oxygen delivery or by contributing to the development of cardiovascular diseases such as atherosclerosis. 

Firefighters have significant exposure to smoke particulate matter during fire suppression. Particulate matter has cardiovascular effects. For example, long-term repeated exposure to elevated concentrations of particulate matter has been associated with cardiovascular mortality and the initiation/progression of atherosclerosis. Atherosclerosis (build-up of material inside coronary arteries) can accumulate over decades with no immediately obvious physiological indications, further demonstrating the dangers of repeated exposures to structural fire smoke. 

These materials may be inhaled, absorbed through the skin, and ingested during the activities required by firefighter response to incidents. Although there is typically personal protective equipment (PPE) for respiratory (SCBA and/or air-purifying respirators) and skin contact (turnout gear) used during responses to fires and other incidents (e.g. chemical spill/release), exposures are still possible due to the limitations of the PPE. Furthermore, there are times during incident response when PPE is removed (e.g. overhaul/post-fire inspection procedures) and the presence of contaminants (e.g. respirable and ultrafine particulates) remains. 

Studies have shown an increasing risk of circulatory disease with increasing duration of employment. Career length, not age, moderately correlates with ischemic heart disease (IHD) severity among firefighters. Career length is a proxy measure of occupational exposures which contributes to IHD. When assessing IHD risk in firefighters, health practitioners should consider incorporating the occupational exposure history (i.e., career length) in addition to age when providing risk reduction services. Although they may be more fit than the general population, firefighters are exposed to carbon monoxide, cyanide and other toxic gasses, as well as strenuous physical demands during the course of employment, that increase cardiovascular disease risks. 

An occupational hygiene review and occupational medicine report were prepared by OHCOW and forwarded to the Firefighters Association advocate who subsequently submitted the documents to the WSIB as part of the claim file. 

OHCOW Impact

Two WSIB operational policies are applicable to the case: 

1. Workplace Safety and Insurance Board Operational Policy 15-03-12, Heart Injuries in Firefighters and Fire Investigators states: If a full-time, part-time or volunteer firefighter or fire investigator sustains an injury to the heart in the circumstances prescribed in the applicable Regulation, the injury is presumed to be a personal injury arising out of and in the course of the worker’s employment, unless the contrary is shown. 
2. Workplace Safety and Insurance Board Operational Policy 15-03-10, Heart Conditions states: The WSIB accepts claims as work related when…the cardiac condition is established as a disablement “arising out of and in the course of employment.” The WSIB accepts entitlement for cardiac conditions under the following (among other) circumstances: inhalation of smoke and various noxious gasses and fumes, e.g., fire fighters. 

 OHCOW medical and hygiene reports concluded the following: 

A wide variety of exposures encountered by firefighters have been linked to the development of cardiac disease. The firefighter has been exposed to these throughout his 29 years of service. It is therefore reasonable to conclude that his exposures as a firefighter contributed to the development of heart disease and subsequent injury. 

 At this point in time we await the WSIB decision on the appeal of the initial denial of benefits. If the WSIB accepts the appeal for this case, there may be other firefighters with CAD that could benefit from future WSIB claims. 

 A firefighter with no breathing apparatus during overhaul inspection post fire

Background

A labour union at a manufacturing facility had contacted the OHCOW ergonomists for assistance with a situation involving the operators of Class IV forklifts.  The employer wanted to implement a reverse driving policy to replace a long-standing practice of having the forklift operators drive in a forward-facing direction whenever possible.  This long-standing practice meant that forklift operators were driving in reverse for only brief moments such as backing out of a tractor-trailer or reversing the front forks out from under a load.  The forklift operators were resistant to the proposed policy based on a concern that a significant increase in their reverse driving time would have a negative impact on the longer-term health of their backs and necks.

The union estimated that the forklift operators were working at a 95% utilization time with the current practice of driving in a forward direction whenever possible.  The employer saw an opportunity to decrease the utilization time by having the forklift operators carry twice the load.  This would require reverse driving because an operator’s view is severely obstructed in a forward direction by a double load.  The union felt the reverse driving policy would trade off longer-term health concerns for immediate productivity gains.

Intervention / Approach

The employer acknowledged that they had little information on the risks associated with reverse driving, but in a seemingly contradictory statement to the union, the employer suggested that having forklift operators reverse drive for up to 50% of a shift was a best practice that seemed to be working out well in other facilities.  When the union requested to see any data that would support the employer’s claim that the best practice was working out well, they received an assortment of documents.  The union forwarded the documents to the OHCOW ergonomists for review and comment.

One such document provided by the employer as justification for a significant increase in reverse driving appeared to caution against it.  It was a report issued through the U.S. National Institute for Occupational Health & Safety.  The report concluded that driving a forklift in reverse may lead to an increased risk of neck problems, primarily because of excessive neck rotation to extreme positions.(1)

Another document was an ergonomic assessment conducted by an ergonomist retained by the employer. After a review of the report, the OHCOW ergonomists were of the opinion that the analysis tool used was not well suited for evaluating the risk of concern, namely the twisting of the back and neck.

Following the review of another report, the OHCOW ergonomists offered an alternative view of the data and performed an evaluation using a more up-to-date analysis tool.

The union also provided the OHCOW ergonomists with various images that they believed to be fair representations of the body postures assumed by their forklift operators when driving in reverse.  The OHCOW ergonomists examined the images with regards to lines-of-sight, back and neck postures, etc.

The OHCOW ergonomists eventually suggested a visit the facility to observe the forklift operations first hand and to discuss with the employer the possibility of collaborating on a more in-depth investigation and analysis of the situation.  Unfortunately, the union was not able to obtain such an invitation.

Over time, the union developed the impression that the feedback from OHCOW, which was being communicated to the employer, was being discounted.  The union requested that the Ontario Ministry of Labour visit the workplace and provide clarity on the issue.  The Ontario Ministry of Labour issued an opinion following their investigation.

OHCOW Impact

Ultimately, the employer was able to implement a reverse driving policy with up to 50% of the driving time in reverse when the forklift is equipped with a 10% swivel seat.  The OHCOW ergonomists were of the opinion that maintaining the status quo of forward-facing driving was the most prudent path for the employer to continue following.  The union conceded that any increase in injuries that may develop as a result of an increased exposure to reverse driving may be the only motivation for the employer to reconsider the new policy.

The OHCOW ergonomists wanted to gain some understanding into how the issue of reverse driving was being viewed through the lens of Ontario’s workplace insurance system.  A search was conducted of the publically available decisions by the Ontario’s Workplace Safety & Insurance Appeals Tribunal.  A ruling in favour of an injured worker had stated the following:

“The act of turning his head to either the left or right and holding it there for the 30-45 seconds required to back up from the warehouse to the loading dock, and then again in backing out of the tractor-trailer after dropping off the load, creates a strain on the neck that is not experienced in day-to-day life. The fact that this activity was repeated in excess of 50 times per shift, 6 shifts per week, over several years, unavoidably increases the impact of this strain, and it is reasonable to conclude that this in itself would aggravate any pre-existing cervical degenerative disc condition.”(2)

Considering the pervasive use of forklifts across North America and globally, there is a surprising scarcity of quality research on the issues of driving forklifts in reverse.  It is hoped that the future will include more published research into this issue that will assist workplaces to make more informed decisions.

(1) NIOSH [2018]. Evaluation of forklift operators’ risk of musculoskeletal disorders. By Lu M-L, Werren DM, Ramsey JG, Brueck SE. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Hazard Evaluation Report 2012-0182-0208- 3300, http://www.cdc.gov/niosh/hhe/reports/pdfs/2012-0182-0208-3300.pdf.

(2) Workplace Safety and Insurance Appeals Tribunal. DECISION NO. 1916/06.  https://www.canlii.org/en/on/onwsiat/doc/2006/2006onwsiat2476/2006onwsiat2476.html

Approach

Background

The worker came to the clinic in 2017 to be assessed for a potential claim for Noise Induced Hearing Loss. At that time the OHCOW NIHL calculator tool was used and the level of loss did not meet WSIB criteria for their NIHL policy, as his loss was below 22.5 dB in both ears once it was adjusted for his age, which was 67 years old at the time of this audiogram.  This patient was however still working and was advised to have another audiogram done as per the suggestion of the audiologist. The worker started his career as an instrument mechanic in the maintenance department of a petrochemical plant and then worked in the building of new plants from 1966 to 1974. He worked alongside construction teams and was exposed to the noise of air tools and heavy equipment and once it was up and running large compressors were used, all of which produced loud noise. He went on to work in the commissioning of a new heavy water plant from 1974 to 1977. This was again a very noisy environment. From 1977 to 2013 he worked as a project designer, inspecting and commissioning petrochemical plants, working for several hours per day out in the field. From 2013 until his retirement in 2019 he worked 4 days per week on contract for an engineering firm mainly inspecting and commission furnaces and compressors in the petroleum and energy sector. He would be exposed to the noise of furnaces, compressors, pumps and steam lines.

The worker came back to OHCOW in January of 2021 for re-assessment of his NIHL, based on two more recent audiograms completed in 2019 and 2020. One just before he retired and the other following his retirement. The audiogram that was done closest to the time he retired and was no longer exposed to noise was input into the OHCOW NIHL calculator tool and was found to have an age adjusted loss in his right ear of 26.75 dB and in his left ear of 24.25 dB.

Intervention / Approach

The OHCOW physician submitted a Physicians Report (form 8) to the WSIB for this patient due to his level of loss and classic notch pattern seen in NIHL. This claim was denied by the WSIB in the fall of 2021. The WSIB used the audiogram from 2019, which was closest to the time he retired in June 2019 but stated that he had insufficient loss as per the WSIB noise induced hearing loss policy 16-01-04. They had calculated his loss from that 2019 audiogram to be 19.25 dB in his right ear and 24.25 dB in his left ear after adjustments for his age and based on bone conduction readings not air conduction, which would not have met the minimum eligibility criteria of 22.5 dB in both ears. They did however determine that the type of loss he had was consistent with noise induced hearing loss. They also estimated that through his employment, based on how long and how often he worked in noise and the associated noise levels provided by the Canadian Centre of Occupational Health and Safety (CCOHS) database and the National Institute for Occupational Safety and Health (NIOSH) database, that he would have been exposed to an 8-hour daily average noise level of at least 86 dB for a period of 41.66 years. As a result, it was felt that his levels of noise exposure meet the WSIB policy criteria of continuous exposure to 90 dB of noise for 8 hours per day, for a minimum period of five years, or the equivalent.

Assistance was given to the patient in the completion of his intent to object form to the denied WSIB claim. This decision was objected to on the basis that his loss, as supported by the audiologist was sensorineural in nature and had no suggestion of any conductive elements. Also, with the potential margin for error with regards to the placement of a bone oscillator and with the pattern of loss showing a notch in the higher frequencies which is typical of NIHL, the bone conduction numbers should not have been used to calculate the level of loss sustained. It was argued that the calculations should have been done solely using the air conduction numbers and therefore should have shown a 26.75 dB loss on the right side and 24.25 dB loss on the left side after the age adjustment is applied.

OHCOW Impact

The WSIB reconsidered the initial decision to deny this Noise Induced hearing loss claim based on the intent to object arguments and had their WSIB audiologist review the audiograms.

The decision was then overturned and the claim for Noise Induced Hearing loss was allowed, with entitlement to health care benefits. This means that the patient will have a lifetime entitlement to hearing aids, including their repair, ongoing maintenance, and replacement when required, as well as batteries and hearing assistive technologies.

This worker’s patience and persistence through a long process paid off in the end, as he is wearing his hearing aides and this has immensely improved his quality of life.

Approach

Background

The worker contacted OHCOW to inquire about assistance for her home workstation.  The worker stated she was experiencing upper extremity and low back discomfort which she attributed to a change in how her duties were performed because of the pandemic.  Previously as a piano and vocal instructor she was moving more during lessons however now that lessons are being taught virtually, she remained seated most of the day.  She is using an adjustable office chair which allows her to move between the piano, laptop, and tablet.  The laptop is positioned on a table and the tablet on the piano bench. Moving between each of the workstations which are at different heights, while ensuring she is in view of the camera was causing her to assume awkward postures. See workstation setup below:

Intervention

The OHCOW Ergonomist had the worker complete a questionnaire to identify the worker’s current discomforts; equipment used; and the daily duties required.  This information allowed the ergonomist to understand the requirement of the job and how the workstation was being used.  In addition to the questionnaire the worker provided pictures of the workstation which assisted in the identification of the hazards.  Once these materials were reviewed a virtual assessment took place.  During this assessment the duties were discussed in detail and solutions to minimize and eliminate the hazards were discussed.  Recommendations were provided following the assessment and the OHCOW ergonomist worked with the equipment provider and worker to ensure proper workstation setup.  The main concern with the workers original setup was that neutral posture could not be achieved due to the multiple surfaces being used, in combination with improper equipment to achieve optimal working postures.  During the virtual assessment the worker expressed the need to stand to instruct students during vocal exercises as well as type notes during instructional periods.  The need to be able to move the workstation was also indicated as it would act as a barrier between students during in-person lessons once they reconvened.  Recommendations included a portable sit/stand workstation, a separate monitor, a compact split keyboard, and a right-handed mouse.  Below is the workers new setup:

OHCOW Impact

Below is a statement from the worker following the implementation of the recommendations:

“I wanted to give you an update on how much your advice has helped me and in turn helped others! What a difference the desk, double monitor, keyboard, etc. has made. I’m actually so much more comfortable at that space now, than I am the desk I would use for personal use.

Additionally, I got asked to be interviewed about all this and there was a 10-minute video put together by our certifying board that has been shared internationally to help others!

Thank you for all this, you have not only helped me but a bunch of other musicians and teachers!”

Below is a link to the video the worker had titled, “The Ergonomics of Online Teaching Studios” for the Royal Conservatory of Music:

https://vimeo.com/theroyalconservatory/review/549037692/2c571cf54c

Background

A worker was experiencing upper extremity and back related discomfort as a result of pushing a student in a wheelchair at a school for sustained periods during daily walks. The worker did not want to let their discomfort become a barrier to the student’s accessibility to daily walks. Previous interventions were unsuccessful in developing an ideal solution that allowed the worker to comfortably push with wheelchair. Past recommended adjustments made to the wheelchair led to the student being put at risk of injury when the anti-tip bars were temporarily removed. A solution was required that could be mutually agreed upon by the student and their parents, the union, the worker, and the school board.

Intervention

An OHCOW Ergonomist analyzed a previous ergonomic report that the schoolboard had completed in order to identify the root causes of the ergonomic hazards that the worker was exposed to while pushing the student in their wheelchair. Previous ergonomic analysis indicated that the force required to push the wheelchair was found to be minimal and low risk. The primary risk factor in this case was the posture that the worker was required to assume for the duration of the push. Anti-tip bars on the back of the wheelchair interfered with the workers stride while pushing the chair and resulted in the worker having to lean and reach forward to avoid stride interference. The handles of the chair were located 36” above the ground and were horizontal, resulting in non-neutral wrist postures while pushing.

An OHCOW ergonomist researched various wheelchair attachments that would allow for the worker to push the wheelchair in a neutral posture while ensuring that the attachment could not endanger the safety of the student. Through discussion with the Health and Safety representative at the schoolboard, the model of the wheelchair was identified.  Ultimately, the OHCOW ergonomist contacted the wheelchair manufacturer to determine if they had any attachments that would satisfy the needs of all stakeholders. The manufacturer of the wheelchair directed the OHCOW Ergonomist to a product called the ‘Ergo Stoller Handle’. This product was height adjustable to allow neutral pushing posture, affordable, easily added/removed as required, and did not pose any safety risks to the student.

OHCOW Impact

The OHCOW Ergonomist’s assessment and recommendations were put into a report that was presented to all stakeholders. Ultimately all stakeholders approved of the solution. The recommendation of purchasing the ‘Ergo Stroller Handle’ will be evaluated for all workers who are required to perform a sustained push of a wheelchair as a proactive solution to minimize exposure to musculoskeletal risk factors.

In addition to meeting the safety requirements of all stakeholders, the solution also serves to meet the accessibility standards of the student according to the Accessibility for Ontarians with Disabilities Act (AODA). Under the AODA, “barrier” means anything that prevents a person with a disability from fully participating in all aspects of society.

The research related to the Rubber Worker Project has continued through 2021/22 as we have tried to gather information that might be relevant to exposures from widening sources.  Given the closure of the Kitchener plants more than 15 years ago, a lot of effort is required, including visits and to the City of Waterloo Planning Department, the University of Waterloo Archives, the Waterloo Public Library Archives, and numerous freedom of information requests to the Ministry of Labour, Training and Skills development.  The highlight of the year, was the organization of a covid-safe outdoor in-person meeting with retirees in late September as well as an individual visit later in the year, to begin mapping plant storage and operations over time.  Other activities included:

• Discussions around the creation of a database for this project, potentially a template for future projects:
  • Aims to link our existing medical, exposure, and literature databases to facilitate future analyses
  • Potential for inclusion of a geospatial component that will allow us to assess a worker’s location and movement through the workplace and how this may contribute to exposure
• Continued updating as well as cleaning and categorizing existing data in the literature Exposure Excel file
• Communications with partners i.e. SOAR, USW and OWA regarding casework, research, workplace information
• Reviewing MOL records for the Goodrich Drive plant looking for problems with e.g. local exhaust ventilation
• Work on a WSIB FOI to obtain compensation claim summary information for Kitchener area rubber workers, with input from a number of additional sources now
• OH research re: other Rubber locations and related FOI requests
• OH/Epi/OccMed research re: salivary gland series
  • Collaborating with the OCRC to conduct analyses estimating the occurrence of salivary gland cancer and other rare cancers among rubber and plastics workers using their updated ODSS cohort.
  • Finalizing occupational exposure history tables for a case series manuscript.
  • Reviewing literature to support the creation of informative, visual exposure diagrams that will connect specific jobs, departments, or occupational title groups with specific exposures experienced by rubber workers.
• Epi explainer to MDs & All staff:
  • Created presentation introducing staff to core concepts and topics in occupational epidemiology, including: (1) introduction to key effect measures, such as incidence rate ratios and risk ratios; (2) overview of data sources available for occupational disease surveillance in Ontario; (3) demystifying statistical concerts such as statistical significance testing and 95% confidence intervals; (4) tips for review and interpretation of epidemiological literature review in case reports.
• OH research & report re: Prostate cancer case files which are challenging due to community prevalence.

OHCOW continues to investigate health issues in a group of over 500 registered workers who were subjected to the mandatory inhalation of finely ground aluminum dust (McIntyre Powder) during the period between 1943 and 1979. These “treatments” were intended to prevent silicosis in gold and uranium mining and milling. Despite being nearly universal in these industries during the period, the unusual and counterintuitive practice was little studied before OHCOW’s involvement.

In 2021-22, our work to provide workers with answers about the consequences of McIntyre Powder exposure prioritized in-depth reviews of existing clinical literature, analysis of MPP miners with common diagnoses, and contributing to the published scientific literature.

Sarcoidosis: An OHCOW systematic literature review on sarcoidosis as an occupational disease was accepted for publication by the prestigious journal CHEST  in June 2021.  https://journal.chestnet.org/article/S0012-3692(21)01093-X/fulltext  In the past, the condition has been considered idiopathic, but a growing literature supports a relationship to environmental factors, including occupational exposures. Application of this research to the consideration of MPP-exposed miners was explored in an OHCOW case series report on 12 miners with definite or probable sarcoidosis accepted or publication by the American Journal of Industrial Medicine in February 2022. https://onlinelibrary.wiley.com/doi/full/10.1002/ajim.23333

Cardiovascular Disease: OHCOW has initiated joint work with the Occupational Cancer Research Centre a study matching data on miners in the Ontario Mining Master File with and Ontario health database records to examine cardiovascular disease diagnoses in MP-exposed versus MP-unexposed miners. Work on the analysis and presentation of the results is ongoing.

Neurological Diseases: A similar OCRC health records matching study initiated by the WSIB after OHCOW publicized the number of registrants suffering from such diseases has previously led the Board to recognize Parkinson’s Disease as an occupational disease caused by McIntyre Powder exposure. In January 2022, the path to compensation was further eased when McIntyre Powder was added to Schedule 3 of the Workplace Safety and Insurance Act regulations. This creates a presumption that whenever an MP-exposed worker is later diagnosed with Parkinson’s Disease, the worker or surviving family members are entitled to compensation. This is the first addition to the schedule since 1994. OHCOW’s work investigating the possible relationship between MP and other neurological conditions such Alzheimer’s Disease and Motor Neuron Disease continues.

Pulmonary Fibrosis: As of March 2022, OHCOW has also begun a systematic review of existing literature regarding pulmonary fibrosis, which is often classified by treating physicians as idiopathic even in workers with significant occupational exposures to substances known to cause lung fibrosis. The goal of this work is to refine, as far as possible, a process for distinguishing cases that are truly idiopathic from those that are likely related to occupational exposures.

Throughout the year, OHCOW has continued to gather medical records for individual medical reviews, to assess individual exposures in occupational hygiene reports and to assist workers and family members in filing claims with WSIB for a variety of conditions (including cancers, neurological, respiratory, cardiovascular, musculoskeletal, and autoimmune disorders) potentially related to exposures in the mining environment.

 McIntyre Powder Project history: Two articles were accepted for publication in New Solutions Journal in 2021-22. These deal with the history of McIntyre Powder – “Trading One Risk for Another” https://journals.sagepub.com/doi/full/10.1177/10482911211037007 – and the lived experience of exposed miners – “Breathe Deep, Boys” https://journals.sagepub.com/doi/full/10.1177/10482911221079056

Running from 2002-2004, the Dryden Weyerhaeuser Paper Mill Recovery Boiler #4 project resulted in the exposure of hundreds of building trades workers to a recurring plume of toxic emissions. At the request of some of the involved unions, OHCOW conducted intake clinics in Dryden and Thunder Bay in November 2004, resulting in the registration of nearly 400 patient files and the filing of 160 health professional reports to WSIB, primarily regarding reported neurological effects. This was followed by the completion of a general report on the nature of the exposures and in-depth assessments on some of the most affected workers.

In 2021, the Dryden Committee of the Thunder Bay District Injured Workers Support Group (TBDIWSG) requested that OHCOW further investigate the RB4 exposures and potential health issues. Nearly 400 letters were sent to the last known address of registered workers, along with approximately 200 attempts to reach workers or next-of-kin by telephone.

Due to the passage of time, confirmed contact was made with less than one-quarter of the workers and families, but this has resulted in the reactivation of over 60 files for further follow-up, as well as contacts from several workers who were not part of the original intake clinic group. In 2021-22, we began the process of collecting information, with over 4000 pages of Ontario Ministry of Labour documents relevant to the Dryden RB4 project reviewed and organized by OHCOW staff, along with over 50 completed individual worker surveys, and the initiation of the process to obtain 20 existing WSIB claim files.

The collection and analysis of information regarding exposures and reported health effects will continue in 2022-23, to be followed by a process to address the findings, including health effects in individual workers related to their careers in the building trades more generally.

The Neelon Casting foundry operated in Sudbury under several owners and names from the mid-1970’s until it was closed in 2007, three years after it was bought by US-based competitor The Affinia Group. After noticing a concerning number of deaths and illnesses from potential occupational diseases on a Facebook group of past Neelon employees, United Steelworkers (USW) Local 2020 Disability Services representative Jessica Montgomery contacted OHCOW in July 2020 for help in providing objective hygiene and medical information and individual assessments to former Neelon workers, who number more than 2,000.

As a result of Local 2020’s efforts through the Facebook group and local media, 279 new occupational disease claims have been made to WSIB by the end of 2021-22. OHCOW has provided information from our past work with individual Neelon workers, organized government inspection records and other historical information gathered by the local union into an electronic library for reference and for sharing with the WSIB and collected more than 125 online work history questionnaires and 60 detailed health histories interviews with past Neelon Casting workers.

In collaboration with Jessica and other USW 2020 staff, we have also organized an advisory committee of Neelon workers to draft a historical exposure report detailing the work processes and conditions throughout the history of the Neelon Casting facility, with drafting led out by Dale and Bob DeMatteo who have developed similar reports on the General Electric and Pebra/Ventra Plastics plants in Peterborough. Release of this report is expected in the Summer of 2022.

OHCOW has been actively engaged with the Peterborough community since 2004, with particular focus on workers at General Electric and Pebra/Ventra Plastics and their families.

Work during this year focused primarily on the assessment of 50 Pebra/Ventra files opened or reactivated during 2020-21. This process identified several diagnostic categories and exposures requiring more detailed investigation. Multidisciplinary teams of OHCOW staff have been working on the following issues, engaging outside experts as needed: female reproductive issues, salivary gland cancer, pancreatic cancer, breast cancer, chronic toxic encephalopathy (CTE), and the identification of endocrine disrupting chemicals (EDCs) and asbestos exposures at the Pebra/Ventra plant.

This year we also initiated detailed follow up contacts with scores of General Electric workers and families to update health and WSIB claims information in order to prepare for a new round of work in the coming year on the individual and common issues arising in the hundreds of occupational cancer and non-malignant lung disease cases from that plant.

For more about our Peterborough work, including reports on exposures at the GE and Pebra/Ventra Plastics plants, visit our website here.