Health and Safety Report
Volume 9, Issue 10

In the News

Prescription for Reducing Work Absences Among Canadian Nursesprint this article

In a sector where there is a high risk for worker disability, health care workers in Canada have the highest rate of lost-time claims and work absence than any other sector in the country. This is especially true for nurses who experience high rates of prolonged absences, 14% of whom in 2005 were absent from work for 20 days or more due to illness or injury. A recent study from the Institute for Work and Health (IWH) suggests that creating non-violent and supportive health care workplaces may help reduce prolonged work absences among nurses.

Health-related worker absence is a costly problem that creates a financial burden in compensation costs and lost productivity, in addition to the impact it represents to worker health. And it is on the rise. In the last ten years the length and costs of absences have increased and, with an aging workforce likely to experience evermore chronic conditions, will continue to do so.

The study

The study, Examining the Impact of Worker and Workplace Factors on Prolonged Work Absences Among Canadian Nurses, was published in the August 2011 issue of the Journal of Occupational and Environmental Medicine. It collected information on 11,762 female, direct-care Canadian nurses from Statistics Canada's 2005 National Survey of the Work and Health of Nurses. Factors related to nurses' personal health and their workplaces were examined relative to three categories of work absences: none, short-term (one to 10 work days) and prolonged (11 or more work days).

The impact of the following worker health factors were considered in the study:

  1. pain-related multimorbidity (concurrent chronic conditions)

  2. depression

  3. work-related and non-work-related pain severity

  4. pain-related work interference

Seven workplace factors were considered:

  1. organizational culture, autonomy at work

  2. respect and support at work

  3. physical assault or emotional abuse by a co-worker, patient or visitor

  4. job insecurity

  5. unionization status

  6. facility type

  7. employment status


The IWH study shows that the biggest effect on the length of nurses' work absences are worker health factors such as pain that interfered with the ability to work, more severe pain, depression and having a higher number of chronic health conditions (such as arthritis, migraine and back pain). Although workplace-related factors have a smaller effect overall, emotional or physical abuse at work by co-workers or patients/visitors, and disrespectful and unsupportive work environments contribute to prolonged absences.

The study not only looked at the impact that worker and workplace factors had on absenteeism among nurses; it examined the relationship between the two. The combined effect of worker and workplace factors is the most distinctive finding in this study. For example, pain-related work interference, the factor most strongly associated with prolonged absences among nurses, appears to be a result of both worker and workplace factors. The degree to which pain interferes with work may depend not only on a nurse's pain level, but also on the demands, both physical and social, of the work environment. Respect and support at work also serve as connections between the worker and workplace factors. Nurses who perceived more respect and support from their co-workers or supervisors reported lower levels of work-related pain severity and were less likely to report depression, and therefore less likely to have prolonged work absence.

What employers can do to help reduce long absences

The study's findings and IWH Adjunct Scientist Dr. Renée-Louise Franche, a clinical psychologist at Vancouver General Hospital who led the study, suggest a number of ways in which health care organizations can help decrease health-related work absence among nurses:

  • Implement or augment violence prevention programs. Among those in the 2005 Statistics Canada nurses' survey that were included in this study, 57 per cent reported being emotionally abused at work and 31 per cent reported being physically assaulted at work during the previous year.

  • Address respect, support and organizational culture. This includes nurses' feelings of control over their practice and autonomy at work, as well as their relationships with doctors and co-workers.

  • Focus disability management practices on workers who are still on the job but struggling with multiple physical and mental health conditions.

  • Offer pain management and programs that address depression, focusing on the work environment. Although the workplace doesn't have full control of workers' pain and depression, it can help deal with issues by offering self-management approaches. For example, more workplaces are offering relaxation and meditation courses, and these could be extended to include strategies on how to manage symptoms and episodes at work.

Read the study in the Journal of Occupational and Environmental Medicine (vol. 53, no. 8, pp. 919-927)

Visit the Institute for Work and Health website.

Alerts & Bulletins

An Essential Workplace Hazard Action Toolprint this article

OSH Essentials can help you build your workplace hazard action plan

The workplace can be fraught with all types of hazards - ergonomic, physical, and safety to name a few - that can harm your employees or make them ill. If you want to improve the health and safety of your workplace, taking action on workplace hazards is a good place to start. CCOHS has created OSH Essentials a new online tool to help you build your workplace hazards action plan.

OSH Essentials

With OSH Essentials you can easily navigate a step-by-step process to help you identify, asses and control workplace hazards, to keep your workplace healthy and safe.

This interactive online tool provides you with practical information to help recognize, assess and control hazards in your workplace. Checklists guide you through the steps of reviewing workplace activities, identifying potential hazards, and learning relevant legislation by key sections. Choose from suggested control measures to create your final action plan that will help address the risks in your workplace.

Currently there are ten OSH Essentials topics from which to choose, with more already in the works:

  1. Excessive Noise

  2. Incorrect Lighting Levels

  3. Manual Materials Handling: Musculoskeletal Disorder Prevention

  4. Manual Materials Handling: Seated Work

  5. Slips and Trips

  6. Working Alone

  7. Working in Hot Indoor Environments

  8. Working in Hot Outdoor Environments

  9. Working on Ladders

  10. Workplace Violence

When you purchase an OSH Essentials topic, you instantly gain access to it over the web and for the next 30 days.

Access Legislation

If you need access to Canadian legislation related to your topic, OSH Essentials provides a summary and detailed lists of relevant federal, provincial and territorial legislation. You can select from two Legislation options:

  1. Federal plus one jurisdiction of your choice ($20 for 30-day access)

  2. Federal plus all jurisdictions ($25 for 30-day access)

All OSH Essentials content is developed and reviewed by CCOHS' team of technical specialists.

Learn more about OSH Essentials as well as details about each topic.

Tips & Tools

Getting Ready to Label it GHSprint this article

It's been talked about, speculated upon and anticipated for several years, and now the Globally Harmonized System for Classification and Labelling of Chemicals (GHS) is closer than ever to becoming a reality. The exact date is not known; however with regulations for implementing GHS drawing closer, chemical suppliers are beginning to prepare for the change. The challenge they face is figuring out how to transition to the new system while still complying with the existing Workplace Hazardous Materials Information System (WHMIS) regulations.

In Canada, supplier labels require:

  • hatched border,

  • WHMIS hazard symbols,

  • product and supplier identifier,

  • risk phrases,

  • precautionary measures including first aid, and

  • reference to the MSDS.

Getting started

To start moving toward the GHS system, the first thing you should do is familiarize yourself with GHS hazard classification criteria, as this forms the basis for the whole GHS system. For many WHMIS classes, there is a direct correlation between current WHMIS hazard classes and the GHS hazard classes. For example, WHMIS Class D2A (Carcinogenicity) correlates very well with the GHS class for Carcinogenicity. Hazard statements have been identified for each GHS class. In instances where the GHS class criteria line up with the WHMIS class, consider using the GHS hazard statements ("May cause cancer." Or "Suspected of causing cancer.") as risk phrases for your WHMIS label now.

Precautionary statements

There are five different types of suggested precautionary statements: general, prevention, response (including fire, accidental release and first aid), storage and disposal. When available, the GHS precautionary statements can help to fulfill the requirement for WHMIS precautionary measures. Just be aware that you may need to supplement the GHS precautionary statements as they are not fully developed for some hazard classes. For example, for Gases under Pressure, there is only one storage phrase offered, and there are no phrases for prevention, response or disposal. You can supplement precautionary phrases by consulting the full list of these phrases (for all GHS hazard classes) and/or with your own phrases. For the Gases under Pressure example mentioned above, a phrase such as "Keep away from heat." (from another GHS class) may be appropriate.

To reduce translation costs, all GHS phrases are available in French as well as many other languages.

Stay WHMIS-compliant

To be WHMIS-compliant, remember that supplier labels must use WHMIS elements such as WHMIS hazard symbols, a WHMIS hatched border and a reference to the MSDS. You should note that GHS pictograms etc. cannot be used on labels in Canada at this time. However, you can move closer to GHS by adopting GHS language for the risk phrases and precautionary measures in your WHMIS labels now.

GHS Resources

GHS Purple Book - Annex 3 (PDF), United Nations

OSH Answers fact sheet on GHS, CCOHS

Free demo of CANLabel online tool: creates compliant supplier and workplace labels (GHS phrases used for OSHA and WHMIS labels)

WHMIS After GHS: An Introduction, free CCOHS e-course

WHMIS After GHS: How Suppliers Can Prepare, free CCOHS e-course

WHMIS After GHS: Preparing for Change, CCOHS publication

MSDS ->SDS reference poster, CCOHS

Partner News

Take Our Kids to Work™print this article

On November 2nd more than 200,000 grade nine students across Canada will head off to work with their parents for Take Our Kids to Work™. This annual, national program from The Learning Partnership gives young people a chance to job shadow their parent or another adult at work for a day, to get an up close glimpse of work life. In addition, the entire community of parents, teachers and employers has an opportunity to get involved in the career development of young Canadians.

Something for Everyone

Students: Spending a day in the workplace can help highlight the importance of getting an education and provide practical insights into the skills required in today's workplaces. Students can explore career options in practical ways. They may even develop a better appreciation for their parents' roles in earning a living and supporting their families.

Employers: Take Our Kids to Work allows organizations to demonstrate their commitment to the education of young people as the workforce of the future, and highlight the range of jobs within the organization. Participation can also help enhance employee morale and boost community spirit and workplace pride among employees.

Parents: The program provides parents with an opportunity to share an experience with their child that can be a starting point for further career discussions. It's a chance to introduce their child to their workplace and co-workers. Parents can help enrich the experience for their child by making efforts to talk before, during and after the visit.

Keep the kids safe at work

It is important that young people receive information about health and safety prior to their workplace visit. They need to know and understand their rights and responsibilities for jobs they may hold now and in the future. Parents need this same information and to be aware of the work that their children are doing. They should ask questions about the health and safety concerns and how they are being addressed in the workplace.

Teachers should encourage all participants in the Take Our Kids to Work program to commit themselves to a safe day. On forms, include a section demonstrating that students have read and discussed materials on health and workplace safety before participating.

In preparation for Take Our Kids to Work, workplaces should conduct an inspection prior to the day with a view to youth workplace safety. One of the first things employers should do on Take Our Kids to Work day is hold workplace orientations with the students that focus on health and safety issues relevant to that environment. Students should be supervised all day while they are at the workplace site and should only be allowed to undertake tasks and experiences for which they have been properly oriented. In the work environment, students should be encouraged to speak up about health and safety concerns, ask questions, and comment on situations they observed during the day.

More information

Visit The Learning Partnership website to register your participation, download resources and posters, and learn more about the Take Our Kids to Work program.

Young Workers Zone from CCOHS offers resources for young workers, parents, employers and teachers to help young people be healthy and safe at work.

Learn about the Teaching Tools Resource Manual.

Watch the free webinar: Help Your New Workers Stay Safe.
Length: 1 hour

Listen to the free podcast Keeping Young Workers Safe.
Length: 19 minutes

Health and Safety To Go

Prolonged Sitting and Workplace Violence print this article

CCOHS produces free monthly podcasts on a wide variety of topics designed to keep you current with information, tips and insights into the health, safety and well-being of working Canadians. You can download the audio segment to your computer or MP3 player and listen to it at your own convenience...or on the go!

This month's edition of Health and Safety To Go! features Prolonged Sitting: The Risks of Sitting Too Long. The podcast highlights the health issues surrounding prolonged sitting at work, and what workers can do to avoid the risks of sitting too long.

The podcast runs 3:55 minutes. Listen to the podcast now.

Encore podcast: Violence and Harassment in the Workplace

In this podcast Jessie Callaghan, Senior Technical Specialist at CCOHS, discusses workplace violence and harassment - how to protect your employees, tips for prevention and the requirements under Ontario Bill 168.

The podcast runs 7:13 minutes. Listen to the podcast now.

See the complete list of podcast topics. Better yet, subscribe to the series on iTunes and don't miss a single episode.

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The Health and Safety Report, a free monthly newsletter produced by the Canadian Centre for Occupational Health and Safety (CCOHS), provides information, advice, and resources that help support a safe and healthy work environment and the total well being of workers.

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