Health and Safety ReportVolume 3, Issue 8 - August 2005

Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. While cigarette smoking is the main cause of COPD, studies conducted around the world are showing a link between workplace exposures to harmful dusts, gases, vapours, and fumes and COPD.

COPD is an umbrella term used to describe a group of lung diseases associated with airflow obstruction - insufficient flow of air into or out of the lungs. Emphysema and chronic bronchitis are conditions that are included in COPD, and they may co-exist. COPD is a chronic, debilitating and sometimes fatal disease. Experts predict that with our aging population and the size of the at-risk population growing steadily, the incidence of COPD will likely increase dramatically. The disease is typically not diagnosed until the fifth decade of life (in people aged 40-49 years).

Common signs and symptoms of COPD include a chronic productive cough that's worse in the morning, or an acute chest illness, a greater effort to breathe, shortness of breath and wheezing, especially during exertion and when their condition worsens. As COPD progresses, the person may experience discoloration of the skin, shorter intervals between periods of acute shortness of breath, failure of the right side of the heart, loss of appetite and/or weight loss.

COPD is a progressive and irreversible disease for which there is no cure. The costs associated with COPD affect the family, the healthcare system, and the community. The disease places a profound burden on patients that may include medical emergencies and hospitalizations, work absenteeism and limitations on their activities. The shortness of breath associated with COPD causes significant activity restrictions that interfere with the everyday tasks most people take for granted: dressing, washing, talking and sleeping. Families of the patients are faced with the challenge of providing an increasing level of care, and the difficulty of watching the progression of the disease in their loved ones.

While smoking is the main cause of COPD in Canada - and outdoor air pollution is another - the American Thoracic Society estimated in 2002 that 15 percent of both asthma and COPD worldwide is likely work related. There now appears to be reasonable evidence to support occupational exposures as an independent cause of COPD. This means regulators, employers and occupational health professionals now need to consider what has to be done to reduce relevant exposures.

Researchers have linked COPD to prolonged occupational exposures to airborne contaminants which can cause chronic airflow obstruction, even in non-smokers. However it is difficult to determine the prevalence of COPD because it does not usually appear until mid-life, when the disease is already moderately advanced. This is further compounded by the fact that COPD develops slowly, and current cases of potential work-related COPD likely reflect workplace exposures from the past few decades.

With respect to workplace exposures, people who are exposed to harmful airborne dust, vapours, fumes and gases are most at risk of developing COPD. Work-related respiratory hazards may come in the form of coal dust, silica, cadmium and asbestos in coal mines; fumes from spray paints and welding applications; dusts from food products and textiles; wood dust at construction sites; and other airborne toxins at industrial sites that manufacture leather, rubber and plastics.

What can be done to prevent occupation-related COPD?

Recent reports on studies on COPD offered a number of suggestions. Regulators should take action to reduce workplace exposures through engineering and other hygiene. Health practitioners, workers, and employers need to be made aware of the hazards posed by airborne exposures to harmful chemicals at work. Medical clinicians must determine potential occupational causes for COPD to support early detection and the best opportunity for preventing disability and mortality, and for epidemiological case reporting. Lastly, efforts to reduce tobacco smoking should be accompanied (where appropriate) by initiatives to reduce or eliminate occupational exposures.

Early diagnosis and treatment of COPD are key to slowing the progression of the disease and helping the patient feel healthier.

It's mid-summer and you're probably noticing that bees are especially active these days. It's their favourite season! And just as their numbers start to diminish in the fall, it will be time to be on alert for wasps...

Bees sting - leaving a stinger in your skin. Wasps don't leave a stinger, but their stings tend to cause worse reactions. In general, most stings only cause temporary pain, swelling and skin redness. In more severe cases however, stings can have life-threatening effects, depending on where the sting occurs and what allergies you may have. Being stung in the throat for example, may cause fluid to build up and cause swelling in the tissues around the throat, making in difficult to breathe.

Although rare, the most severe allergic reaction to a sting is anaphylaxis (also called anaphylactic shock). Of those people who die from a severe allergic reaction to a sting, half die within 30 minutes and three-quarters within 45 minutes. This reaction can occur the first time you are stung or with a subsequent sting.

Watch for these symptoms, which tend to appear immediately or up to 30 minutes later:

• Hives, itching and swelling in areas other than the sting site
  
• Swollen eyes and eyelids
  
• Wheezing
  
• Tightness in the chest and difficulty breathing
  
• Hoarse voice or swelling of the tongue
  
• Dizziness or sharp drop in blood pressure
  
• Shock
  
• Unconsciousness or cardiac arrest

What precautions can you take?

Stay away. The best way to avoid getting stung is to avoid insects and be alert for hives or nests, or where insects are gathered, entering and exiting an opening. Stinging insects are also attracted to certain foods and may be found near garbage cans, dumpsters, fallen fruit beneath fruit trees, pet food, and other sources of food residue.

Avoid provoking the insects. Do not swat at them or make sudden movements. Let them fly away, slowly walk away, or gently "blow" away the insect. If you have disturbed a nest and hear wild buzzing, act quickly - protect your face with your hands and run from the area.

Power tools such as lawnmowers, weed eaters and chainsaws sometimes stir up the insects. If you are startled or stung while you are working with these power tools or machinery, you could end up getting injured with much more than a sting!

Let your employers know if you have allergies to insect stings, especially if you work outdoors. Co-workers should be trained in emergency first aid, be aware of the signs of a severe reaction, and know how to use the bee sting kit (self-injectable epinephrine). When working outside, carry a cellular phone in case you need emergency medical help.

Don't be a bug magnet. Reduce your chance of being stung by wearing light-coloured clothes such as khaki, beige, or blue, and long sleeved shirts and long pants. Wear footwear to protect against bees and wasps attacking your bare or sandaled feet. Avoid wearing scented, perfumed products, and make sure the insects can't hide or get tangled in your hair, or in the folds of clothing and towels. Be aware that insect repellent ("bug spray") does not affect these stinging insects.

If you must be near bees or wasps, wear a hat with netting to cover your head, neck and shoulders and tape your pant legs to your boots and socks, and your sleeves to your gloves.

In the event of a sting...

Try removing the sting right away (the venom can still be injected for up to a minute afterwards) by scraping sideways with your fingernail or a credit card, at the narrow end of the sting. You might have to use tweezers if the venom sac breaks off, leaving the sting in the skin. An application of ice (wrapped in a towel to prevent freezing the skin), anti-itch cream and/or an antihistamine pill can help reduce the effects of the sting.

Do not scratch a stung area. Scratching may cause a break in the skin, which could lead to an infection.

If you or a co-worker is stung in the eyes, nose or throat, or exhibit any sign of a reaction to a sting, call emergency medical services right away, even if you're not sure.

If you have experienced a severe allergic reaction to an insect sting in the past, expect a similar or worse reaction the next time. Ask your doctor to prescribe a bee sting kit and carry it with you at all times. If you are hypersensitive to stings, you should also wear a medical alert bracelet.

If you are ever stung multiple times, talk to your doctor; it might be wise to monitor your health over the next few days or weeks.

In an effort to ensure safer working conditions and better protection for farm workers, Ontario's Occupational Health and Safety Act (OHSA) will be extended next summer to cover farming operations. The change, announced in June, is expected to also help reduce workplace injury and fatality rates in the agricultural sector.

The regulation is a result of consultations between the two ministries and farm industry organizations, such as the Labour Issues Co-ordinating Committee (a coalition of 14 commodity and producer groups), the Farm Safety Association, workers, and organized labour. Together, these partners are continuing discussions to develop strategies for dealing with the hazards that are specific to farming.

According to the MOL, while farm safety has improved in recent years, the industry's lost-time injury rate remains high when compared to the rates of forestry, mining, construction, and other high-risk sectors. The Ontario government's new regulation brings farming operations under the OHSA. That means paid farm workers, both domestic and foreign, will now have the same basic health and safety rights already given to other Ontario workers employed in provincially-regulated workplaces: the right to know about workplace hazards to which they are exposed; the right to participate in decisions about health and safety; and the right to refuse unsafe work. In addition, specially trained and certified members of a joint health and safety committee will have the right to stop work in dangerous circumstances.

Under the new Act, farm employers will have legal responsibility for occupational health and safety. They must take every reasonable precaution to protect workers, provide information, instruction and supervision, notify workers and supervisors of workplace hazards, report critical injuries and fatalities to the Ministry of Labour, and cooperate with workplace joint health and safety committees and respond to their recommendations. Only farms operated by self-employed individuals without paid workers will continue to be exempt from the OHSA.

The change will be effective on June 30, 2006. During the one-year transition period, the Farm Safety Association will start a campaign to raise safety awareness and educate farm workers. The Ministry of Agriculture and Food and the Ministry of Labour will provide assistance in these efforts. In addition, the Ministry of Labour's health and safety inspectors, who will be enforcing the new regulation, will receive additional training on agricultural workplaces and hazards in the upcoming year.

To most people who lived through the 70s, Earth, Wind and Fire is the name of a rock band - not a list of occupational hazards. Recent workplace tragedies suggest, however, that the elements can be dangerous. Nature is one beast that the age of technology has yet to tame.

New Brunswick's Workplace Health, Safety and Compensation Commission has issued a hazard alert on environmental conditions that create unsafe working situations. The alert is the result of several incidents, some fatal, that happened during the course of the victims' work. In one incident, a woodcutter died instantly when a large tree was uprooted, knocked down by a strong gust of wind, and struck him on the head. In another, eight workers received electrical shocks when a steel structure they were working on was hit by lightning. And in yet another work-related incident, a worker drowned while attempting to drive across a streambed that had risen significantly because of heavy overnight rainfall.

Wind, lightning and falling trees are just a few of the environmental conditions that can endanger workers. Heavy snowfall hides underlying hazards or causes branches to spring up unexpectedly. Wind can topple towers and cause sudden movement of suspended loads.

Safety experts at the WHSCC warn that the environment can add considerable hazards to workplaces and that it is important to be alert and aware of these dangers. They recommend that employers implement policies, procedures and reporting to deal with any environmental conditions that can negatively impact the health and safety of employees.

The WHSCC also stresses that employees should be alert to dangerous environmental conditions and talk to their supervisors about any concerns they may have. If those concerns are not addressed, or if workers think that environmental conditions are creating dangerous working situations, they have a right to refuse to work.

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