Over the past decade, infectious diseases have gained prominence in Ontario health care facilities due to a number of outbreaks, including norovirus, clostridium difficile (c.difficile) and influenza.
In Ontario, more than 500,000 people work at more than 6,000 hospitals, long-term care homes, retirement homes and other workplaces in the health care sector.
Employers have a responsibility to control hazards in the workplace. These hazards may include exposure to infectious agents.
From November 1 to 30, 2011, Ministry of Labour inspectors conducted a blitz of hazards affecting prevention and control at health care workplaces in Ontario. Inspectors checked on compliance with the Occupational Health and Safety Act (OHSA) and its regulations.
The goal was to:
In 2010, more than 1,150 health care workers filed infectious disease claims that were approved by the Workplace Safety and Insurance Board (WSIB).
In November 2011, Ministry of Labour inspectors conducted 116 visits to 100 health care workplaces and issued 192 orders under the OHSA and its regulations.
The three most commonly issued orders involved violations of:
Inspection blitzes are part of the province's Safe At Work Ontario compliance strategy. They are announced to the sector by the ministry in advance, although individual workplaces are not identified in advance. Results are posted on the ministry's website. The blitzes raise awareness of workplace hazards and promote compliance with the OHSA and its safety regulations.
On October 25, 2011, more than 400 workplaces participated in the Ministry of Labour and Public Services Health and Safety Association joint webinar to raise awareness about the blitz.
Inspectors' findings may impact the frequency and level of future inspections of individual workplaces. Inspectors refer employers to health and safety associations for compliance assistance and training.
Inspectors focused on the following key priorities:
Employer duties: Inspectors checked employers' compliance with the OHSA, including compliance with an employers' duty to take all reasonable precautions to protect the health and safety of workers from infection hazards. They also checked that employers are reporting occupational illnesses to the Ministry of Labour, trade union (if any) and the workplace's Joint Health and Safety Committee (JHSC).
Safe work practices: Inspectors checked that employers had developed practices such as respirator fit-testing, safe use and disposal of sharps, maintenance of ventilation systems, and cleaning and disinfection, for the protection of workers from infection hazards. They also checked that workers are following safe work practices and use required personal protective equipment, and that employers and supervisors are inspecting the workplace for infection hazards.
Personal protective equipment and safety devices: Inspectors checked that personal protective equipment, such as gloves, eye protection and respirators, are being properly used by workers and maintained by employers. They also checked that workers have access to appropriate and required hygiene facilities and that workers are safely handling and using safety-engineered needles.
Worker information, education and training: Inspectors checked that workers are aware of infection hazards in the workplace and are trained in the safe handling, storage, use, disposal and transport of infectious agents. Inspectors also checked that workers have appropriate information, instruction and supervision to protect their health and safety.
During the blitz in November 2011, ministry inspectors issued orders at a rate of 1.66 per workplace visit.
|Infection Prevention and Control Blitz Activity
November 1 – 30, 2011
|Number of Workplaces visited||100|
|Total visits[ 1 ]||116|
|Orders (all types)||192|
|Orders per visit||1.66|
|Stop work orders per visit||0.0|
Orders were issued under the OHSA and the following regulations:
The chart below includes the top five most frequently issued orders during the November 2011 blitz:
|Reason for order||Number of orders||Percentage
of total orders issued
|Employer duty to take reasonable precautions to protect worker
[OHSA S. 25(2)(h)]
|Employer duty to perform at least an annual review of health and safety procedures Health Care Reg. S. 9(2)]||18||9.5%|
|Employer duty to ensure equipment, materials and protective devices provided are maintained in good condition [OHSA S. 25(1)(b)]||9||4.52%|
|Employer duty to prepare and review at least annually a written occupational health and safety policy and develop and maintain a program to implement that policy [OHSA S. 25(2)(j)]||9||4.52%|
|Employer duty to develop, establish and implement written measures and procedures for worker health and safety of workers in consultation with HSR or JHSC (if any) [Health Care Reg. S.8 and 9(1)]||7||3.52%|
Orders were also issued to employers for failing to:
WSIB data and the results of the blitz reinforce a need for employers to ensure the continued protection of workers from exposure to infectious diseases in the workplace.
Infection prevention and control requires a hierarchy of controls. This is determined through a risk assessment of potential hazards. These controls include:
The blitz results indicate a need for employers to provide appropriate and required control measures – in particular for worker information education and training in infection control.
Orders issued under the Health Care regulation indicate improvements are needed for employers to:
A key to workplace health and safety in Ontario is the internal responsibility system (IRS). A well functioning IRS means supervisors, workers, JHSC and HSRs all have key roles to play in taking responsibility for health and safety in the workplace. Workplace parties are encouraged to work together to identify and control infection hazards in the health care sector.
During routine workplace inspections, inspectors will continue to focus on hazards involving infectious agents in health care workplaces. Infection prevention and control continues to be a key priority in the Ministry of Labour's Health Care Sector Plan.
For more information on identifying, preventing and controlling workplace hazards, please contact our safety partners.
[ 1 ]Refers to the total number of individual visits MOL inspectors made to all workplaces during this blitz.