Historically, workplace acquired injuries and diseases were considered by employers and governments to be part of the cost of doing business.
Up until the 1970s, the major focus for most unions was to negotiate provisions such as danger pay and higher wages for workers in jobs considered to be hazardous, with little attention paid to eliminating or mitigating those hazards. In the early part of the 20th century, workers’ compensation systems were established to provide insurance for workers injured on the job, but the prevailing view was still that injury and disease went with the work.
In the 1970s, the “internal responsibility” system was incorporated into occupational health and safety (OHS) legislation in BC and the rest of Canada, recognizing a worker’s right to know about workplace hazards, participate in decisions about dealing with those hazards, and refuse unsafe work. Gaining these rights was significant for workers, but in practical terms, the health and safety systems were still employercontrolled and with a focus on compensation rather than prevention.
Over the past 50 years, a focus of the labour movement globally – including for HSA – has been to bring real meaning to workers’ right to know, to participate in hazard identification and control, and to refuse unsafe work. These goals can only be achieved when workers are empowered through effective OHS education and involvement in their workplace health and safety systems. Today there are still many gaps in these systems and injury rates remain unacceptably high.
In the last round of collective bargaining, HSA – along with all other BC health sector unions – negotiated a framework for a new provincial OHS organization. One of the main goals of the BC Health Sector Occupational Health and Safety Society will be to reduce injuries by refocusing sectoral health and safety systems to more meaningfully involve workers.
Here are highlights of some of HSA’s commendable OHS victories over the years that highlight a collaborative and worker-centered approach to health and safety. If this approach is expanded throughout the health and community social service sectors, it would bring about meaningful and much needed change in our fight for safer workplaces.
Reducing workplace injuries for ultrasonographers
In 1994, diagnostic medical sonographer and former HSA President Berthe Hall asked two Workers’ Compensation Board (WCB) board members to hold up apples at arm’s length during her 15-minute presentation to an WCB ergonomics subcommittee. Neither board member succeeded.
“I had a third person holding up a piece of dowelling like a wand—just like technologists are required to do during a scan,” she told HSA’s The Report magazine in 1994. “There were a lot of chuckles. He was having a lot of trouble with it.”
At the time, Hall had been the longest serving ultrasound technologist in the province. But her work caused repetitive stress injuries, and for the last three and a half years of her career, she was placed on long-term disability.
Royal Jubilee Hospital (RJH) OHS steward and Diagnostic Medical Sonographer Carol Petersen explained why occupational injuries are common in ultrasonography. “It is a job of minute movements held with force.” Over the course of a career, these movements happen multiple times a day. “So, what ends up happening is we place abnormal strains on small muscle groups and it cuts off the blood supply to them, and you end up damaging the nerve. And once the nerve becomes damaged, you’ve changed a person forever.”
In 1994, HSA was advocating for improvements to equipment design and caseload to prevent workplace injuries for ultrasonographers. Over the next two decades, HSA made major progress on this serious issue affecting a significant segment of its membership with the help of OHS stewards like Petersen.
Throughout the 1990s, research emerged worldwide that documented the high risk of injury faced by ultrasonographers. Injury claims submitted to WCB were routinely rejected, then approved on appeal. HSA pressured WCB to alter its approach to injury claims, without much success.
Over the years that followed, researchers formed ergonomic guidelines for the profession. And in 2010, HSA approached the prevention department of WCB with a proposal to collaborate on a best practices guide for reducing injuries for diagnostic medical sonographers. The proposal was approved, and WorkSafe BC and HSA agreed to jointly fund the publication. It was published in 2011 and distributed across the province. These guidelines are still in place and endorsed by WorkSafe BC.
Three years later, in 2014, HSA’s Enhanced Disability Management Program (EDMP) notified the chief steward at RJH that there was a problem with workplace injuries in the hospital’s Echocardiology (Echo) Lab.
“We discovered there was a 30 per cent injury rate with the staff in the department. And the department was about 12-14 people,” said Petersen.
An accident investigation was launched with support from HSA head office. A survey was circulated, which received a 90 per cent response rate from staff. The findings were taken to the hospital’s joint OHS committee with the recommendation that a working group be struck to reduce injuries in the Echo Lab.
Petersen sat on the committee alongside the Echo Lab manager, Echo Lab staff members, and OHS representatives from the hospital. The group also looked at practices at Victoria General Hospital.
The working group was successful at reducing the number of injuries in the department. Petersen described a number of changes that were brought about that made this possible.
“When we went into the project thinking, ‘Let’s just have people do fewer cases.’ But the solutions ended up being multi-factorial. There’s a number of things that can be done to make people safer in what they do,” said Petersen.
“We were able to get the staff actively involved with the equipment purchases from an ergonomic grading standpoint,” she said. Ergonomics became an important consideration in equipment purchases.
She said policy changes were implemented around portable exams, which cause challenges to ergonomics. Staff received more support for ambidextrous scanning, “so that all the load was not on one side all the time, so they could relieve ergonomic stresses,” explained Petersen.
Although it disrupted the personal schedules of staff, expanded service hours into the evenings and weekends improved capacity to maintain individualized ergonomic settings on equipment. Additions to the space contributed to similar improvements. “We managed to get some extra space and another site up and running doing cardiac ultrasounds,” said Petersen.
But the process wasn’t a quick fix, she said. “It required some patience and buy-in.” The process required participation from everyone involved, including management and staff, which she said can entail a lot of work.
“Safety culture is on all sides,” she said. “But with enough information we can work together and solve problems and make workplaces safer for people.”
The achievements of the working group had a ripple effect around the province. Its work was used in training sessions for HSA’s OHS stewards, and cardiac sonographers from around BC took interest in the working group’s findings.
Workers’ Compensation claim for Mission Memorial Hospital cancer cluster upheld by Supreme Court of Canada
Beginning in the late 1990s, lab workers at Mission Memorial Hospital began to voice concerns regarding an alarming pattern of cancer diagnoses among staff. A number of cases had emerged within just months of each other. Incineration fumes and air quality in the lab had been the topic of complaints for years. Steward and medical laboratory technologist Bev Banfield identified the problem, and spent years investigating the suspected cancer cluster. This eventually led to workplace compensation claims from HSA members Katie Hammer and Anne MacFarlane, and HEU member Patricia Schmidt.
Banfield’s work was remarkable. As Hammer commented in a 2007 issue of The Report, “She has even collected her own samples when the air ducts were being cleaned and management would not do any testing.”
In 2003, Banfield began a letter-writing campaign to employer representatives about the issue, and HSA entered discussions with Fraser Health Authority (FHA) about conducting a scientific study. The Occupational Health and Safety Agency for Healthcare (OHSAH) was commissioned to investigate the high number of cancer cases in the lab.
The study examined the prevalence of cancer among staff who had worked in the lab since the 1980s. It included 63 people, 11 of whom had cancer. Five of those individuals had breast cancer.
In 2006, OHSAH released a final report that determined that there was in fact a cancer cluster in the lab, but could not determine its cause. The employer, Fraser Health Authority, would spend the next 10 years challenging the workers’ compensation claims made by the members who got sick.
Initially, WorkSafeBC denied that the workers’ cases of breast cancer were occupational diseases. The unions appealed the decision, and the Workers’ Compensation Appeal Tribunal (WCAT) overturned it, approving the claims.
FHA challenged the WCAT’s ruling in the courts and both the BC Supreme Court and BC Court of Appeal sided with the employer on the grounds that HSA and HEU had failed to present evidence of causation.
The unions, with HSA lawyer Tonie Beharrell appearing as lead counsel, appealed to the Supreme Court of Canada.
In a major victory for workers, the Supreme Court of Canada upheld the WCAT decision to approve the lab workers’ compensation claims. The 2016 decision affirmed that as an administrative tribunal, the WCAT had specialized expertise and could apply a standard to measure causation, without having that standard rejected by the courts in favour of a different standard.
The victory was particularly meaningful in light of HSA’s nearly two decades of support for the Canadian Breast Cancer Foundation’s Run for the Cure. HSA began supporting the event in 1996 and continued until 2014, raising awareness about the role of health science professionals in the diagnosis, treatment, and rehabilitation involved in breast cancer. HSA supported members’ participation in the annual important event to support research into breast cancer.
Taking action against workplace violence
In 2005, HSA member and vocational rehabilitation counsellor David Bland was killed by a former patient at his workplace in Richmond. His death brought needed attention to the issue of workplace violence affecting workers in the health care sector.
In 2007, the HSA Board of Directors established the David Bland Memorial Award to commemorate the achievements of members in occupational health and safety, and to draw attention to the pressing issue of workplace violence affecting workers in psychiatric units, hospitals including emergency rooms, residential facilities, and the homes of patients.
Between 2005 and 2012, 3722 workers were injured from violence at work, according to WorkSafe BC statistics. As of 2015, every health authority in BC had received penalties from WorkSafe BC after incidents of violence in health care facilities towards staff. According to HSA Health and Safety Officer David Durning, failure to comply with regulations contributed to the problem.
In December 2014, as two more cases of violence against health care workers in BC came to light, HSA took leadership in the sector and called on the BC Liberal government to organize an emergency violence in health care summit. HSA proposed that the government bring together stakeholders in health care, including health union representatives, frontline workers, health authority management, Ministry of Health staff, and workplace safety experts, to develop long-term solutions to this serious issue.
HSA’s proposal was accepted by the Ministry of Health, and Health Minister Terry Lake convened a summit in April 2015 at a Richmond hotel. The summit gave HSA members an opportunity to provide valuable input into gaps in safety practices.
Responding to infectious disease hazards
When the global coronavirus pandemic hit in 2020, safety protocols in the face of a new workplace hazard became a paramount concern for HSA members and the union as a whole. HSA’s response was swift. It worked quickly to compile resources and information for members. It launched a COVID-19 member hotline, and turned its eyes to the province’s pandemic safety protocols.
During the initial stages of the pandemic, members’ access to PPE, particularly N95 respirators, was top of mind. HSA commented on gaps in the province’s pandemic plan in a March 2020 memorandum addressed to the Ministry of Health and the Health Employers’ Association of BC. It called for immediate engagement with health sector bargaining associations in the ministry’s framework for personal protective equipment (PPE) allocation. HSA also called on the government to include clear language in the framework around the employee’s right to refuse unsafe work.
And at the local level, worksite stewards in healthcare and community social services jumped into action to ensure workplace OHS protocols were effective. Members collaborated closely with HSA staff to protect workers.
The Health Science Professionals Bargaining Association (HSPBA), under the leadership of HSA, commissioned a report on health care workers’ PPE needs in the context of the pandemic. The report, authored by University of Toronto Adjunct Professor Dr. John Murphy, emphasized that the N95 respirator is important protection for workers performing aerosol generating medical procedures (AGMP). And as the Ministry of Health was establishing PPE protocols, HSA urged the government, with success, to recognize the need for fresh masks after change in locations and after breaks.
This work is part of a longer history of union advocacy around PPE standards and protocols. In September 2013, BC health employers applied to WorkSafe BC for an exemption to annual fit testing requirements for N95 masks. HSA opposed the application, and said the cost-saving move would increase members’ risk of exposure to airborne pathogens. The application was unsuccessful.
The COVID-19 pandemic is not the first time HSA has jumped into action in the face of infection disease hazards. When an Ebola virus outbreak hit West Africa in 2014, HSA was concerned about how the disease could become a potential workplace hazard for health care workers. As in 2020, HSA was critical of the lack of participation from workers in the improvement of infection control measures, and spoke out on the gaps in preparedness.
In October 2014, HSA released a survey to members at the five sites the Ministry of Health had designated to treat suspected Ebola cases. Nearly 90 per cent of workers surveyed said they did not feel adequately prepared to deal with an Ebola outbreak.
HSA compiled resources on Ebola as it related to the health care system, and shared these resources with members. The union continued to press the government and the health authorities to improve staff training, communication, and co-ordination, noting that the lessons learned during the Ebola outbreak will play a crucial role in shaping future public responses to infection disease hazards.
As articulated eloquently by HSA OHS Advocate David Durning in a 2014 issue of The Report magazine, “The current outbreak will be brought under control, but the work being done now to establish Ebola standards should set a new benchmark for strong infection control measures for epidemics and outbreaks which are expected to accelerate in the coming years.”