Health and Safety ReportVolume 17, Issue 10

The opioid crisis in Canada continues to grow. Every day across the country, 11 people die from an opioid overdose, devastating individuals, families and communities alike.

Opioids include fentanyl, oxycodone, morphine and hydromorphine. These drugs are prescribed to manage pain, including injuries that have resulted from the workplace. But in addition to influencing pain perception, opioids are drugs that affect the mind, mood and mental processes. These effects can make the user feel euphoric, or high. In addition, illegal drugs with fentanyl added to them are contributing to many of the opioid-related harms and deaths.

While prescribed opioids offer benefits, they also come with risks. The high rates of opioid being prescribed mean that more people are being exposed to its risks and the potential for addiction. According to the Canadian Institute for Health Information, in Canada, 21.3 million prescriptions for opioids were dispensed in 2017, placing Canada among the highest opioid prescribing nations in the world. In 2018, 3.7 million Canadians aged 15 and older used an opioid pain medication. About 10% of those users reported taking the medication in a problematic way: in greater amounts than prescribed or more often than directed, using it to get high and other reasons unrelated to pain relief.

Effects of opioid use
Short-term side effects from opioid use include drowsiness, nausea, vomiting, feeling euphoric, difficulty breathing, headaches, dizziness and confusion. These effects may cause workers to be impaired and unable to perform their job tasks safely. Over the long term, opioid use can lead to increased tolerance, substance use dependence, liver damage, and worsening pain.

An overdose can happen when too much of an opioid is taken. For instance, if a person stops taking the drug for a few days but then starts taking the drug at the same dose they were used to, it may lead to an overdose. Since opioids affect the part of the brain that controls breathing, taking more opioids than the body can handle slows breathing. This overdose can lead to unconsciousness and even death.

Opioids as a workplace issue
Opioid use can potentially affect workplace health and safety in several ways. Its use and misuse tend to be higher in workplaces with lower paid sick leave and job security. This scenario suggests that workers may feel they need to return to work quickly after an injury, and in order to control their pain, they turn to opioid use. The lack of sick leave and job security also may lead workers reluctant to take time off in order seek appropriate treatment and recover.

In some cases, people who use prescription drugs may misuse them, which could lead them to develop dependence on the drugs. It has been noted that prescription misuse for opioids may lead to illegal drug use. As a person develops an addiction, they begin to crave the drug and continue to use it regardless of the harmful effects. This need becomes the focus of their feelings, thoughts and activities. This preoccupation can affect the ability to perform job tasks safely.

There is also the potential for an overdose to occur at the workplace, whether it involves a customer, client, member of the general public, or a co-worker. The safety of the first responder who encounters the product when performing first aid measures or law enforcement duties also becomes a factor.

What workplaces can do
The federal government has taken measures to increase access to treatment and supervised consumption sites, expand public awareness, intercept illegal opioids, and improve public health data to inform effective strategies and preventative approaches. Employers can also play a critical role, including to:

• Focus on preventing ergonomic injuries that can lead to the need for pain medication. These injuries can include slips, trips and falls, plus those caused by lifting, working in awkward positions, performing repetitive manual operations, and pushing and pulling.
• Provide a mechanism for workers to report impairment in themselves or if they suspect impairment in others.
• Address the use of prescription medication in its workplace impairment policy. This policy can include that it is not permissible for workers to offer their prescribed medications to others, even if the other person has a similar prescription.
• Encourage workers to discuss alternative options for pain control with their health care providers.
• Provide education and training on the impacts of opioid use, how to recognize impairment, and how to talk about and address drug use with respect and compassion. Stigma around substance use can prevent people who are struggling from getting the help they need.
• Ensure that first aid responders receive appropriate training and include naloxone kits as part of the first aid response program.
• Develop a return to work program which give workers time to recuperate and adjust before re-assuming full duties.
• Offer employee assistance programs to help workers address drug use issues.
• Offer health care benefits that include access to services such as physical or massage therapy as methods to treat the injury or pain where appropriate.

Resources

• Opioids, Government of Canada
• Opioids in the Workplace fact sheet, CCOHS
• Impairment at Work fact sheet, CCOHS
• Opioids in the Workplace, The National Institute for Occupational Safety and Health (NIOSH)
• Opioids at Work Employer Toolkit, National Safety Council

CCOHS is looking for industrious, committed students in occupational health and safety programs to apply for the 2020 Dick Martin Scholarship Award. The annual, national scholarship is open to all students enrolled in an occupational health and safety course or program at an accredited Canadian college or university, leading to an occupational health and safety certificate, diploma or degree. Programs include mine safety, occupational or industrial health and safety, industrial hygiene, safety management or other related safety degree program.

Two scholarships worth $3000 each will be awarded to one winning university student and one winning college student. A $500 award will also be provided to each of the winning students' academic institutions.

To apply for the scholarship, post-secondary students are invited to submit a 1200-word essay on one of two topics related to occupational health and safety.

• Prevention Essay: Choose a high-risk workplace hazard. How would you work to solve and create awareness about the issue?
• Technical Essay: Research an existing or emerging hazard or risk (coverage may include how to identify, assess and control the risks).

Essays will be judged on the intellectual content, the practical and theoretical value and the presentation and style.

For application rules, criteria, tips and other guidelines visit www.ccohs.ca/scholarship.

If you're not a student, but know one, why not share this with them?

Applications are open until 11:59 p.m. EST, January 31, 2020 and the winners will be announced during Safety and Health Week in May 2020.

A Global Forum on Prevention

The XXII World Congress on Safety and Health at Work 2020: Global Forum for Prevention opens its doors to the world every three years. This time, it is Canada's turn to welcome the global prevention community to the Metro Toronto Convention Centre on October 4-7, 2020.

With the theme of "Prevention in the Connected Age", this is a premier event for occupational health and safety leaders, policy-makers, employers and advocates to stay current with emerging challenges, innovative solutions and best practices in work-related injury and disease prevention.

Call for Abstracts

Participants from around the world are invited to submit abstracts to be a part of this exciting global event. You must submit your abstract by December 15, 2019.

Click here to find out more and visit the Abstract Submission Portal to submit now.

The 2020 World Congress is organized by the International Labour Organization and the International Social Security Association and is co-hosted by the Canadian Centre for Occupational Health and Safety (CCOHS) and the Institute for Work and Health (IWH).

A lack of civility and respect are often at the root of violence, harassment and bullying issues within workplaces. How do you champion and prioritize a civil and healthy workplace before it gives way to a toxic culture ripe with resentment, rudeness, and violence?

A crucial part of any healthy workplace is a workplace violence prevention program that outlines preventive measures against all forms of harassment and violence – including sexual, domestic and workplace. Whether driven by legislation or motivated by doing the right thing, policies and procedures need to be comprehensive, supported by leadership, and underscored by an environment that values respect, consideration and professionalism.

Gain practical knowledge and leave with tools so you can take action to minimize the potential for harassment and violence in your workplace, in this one-day workshop developed by CCOHS. There are a few seats left for the November 18 session and more available for the January 14 session in Mississauga, Ontario.

Learn more and register

If you have ever spilled the toner from a photocopier or laser printer cartridge, you will know what an awful mess it can make. But more than the mess, the tiny particles of toner can be a hazard to your health, becoming released into the air that you breathe. Although a spill like this may not happen often, it's important to know how to clean up safely when it does.

Toner is made of extremely fine plastic particles that can be easily dispersed in the air. While most toners are considered a nuisance dust, the particles may be a respiratory irritant which may aggravate existing lung conditions. Toners may also be an eye irritant. It is best to avoid using a standard vacuum cleaner to clean up spills as a vacuum without the appropriate high-efficiency particulate air (HEPA) filter will cause the particles to become airborne.

While rare, it is also important to use a specialized vacuum to prevent the build-up of static electricity, which may result in an explosion.

In addition, since toner particles are designed to fuse to paper when heated, always use cold water to clean up the mess. Do not use water or a cleaning product that is physically warm or hot. Hot water can also fuse the toner to your skin, clothing, or anything else that it touches.

Clean up steps

1. Protect yourself. Toner is an extremely fine powder. Before cleaning, be sure to put on a disposable facemask and gloves to help reduce the risk of inhaling the powder or having it fuse to your skin.
2. If you are dealing with a large amount of loose toner, scoop it up carefully (try not to make the powder become airborne), place it in a bag, and seal it. Check your local regulations to see if such material is prohibited and dispose of it accordingly.
3. When there is very little toner remaining, you can use a specialized vacuum equipped with a HEPA filter to trap the remaining particles.
4. In the case of carpet or fabric, if vacuuming doesn't remove all the spilled toner, dampen a clean towel with a cleaning fluid to dab up the toner. Using water may stain the carpet. Otherwise, call a copier service technician, especially if there is still a large quantity of powder left.
5. For other surfaces, wet a paper towel with cool water and wipe down the surfaces at the spill site.
6. Check to see if your copier has a cleaning cycle. If it does, use that feature to remove any loose powder that is remaining in the copier.
7. If toner has remained on your hands, rinse with cold or lukewarm water, and use soap as required.
8. If you get any toner on your clothing or other fabric, take the item outside over a trash can and shake the item out carefully while still wearing your facemask. If any toner remains, you can wash the item in a washing machine using cold water to help prevent the toner from staining the item. Also, do not use the dryer or iron the item without being sure all the toner has been removed or else the remaining toner will be permanently affixed.

Be sure to have the toner's safety data sheet accessible for reference. The sheet provides information about its hazards and advice about safety precautions.

CCOHS Resources:

• WHMIS 2015 - Safety Data Sheet (SDS) fact sheet
• Workplace Housekeeping - Basic Guide fact sheet

This month's feature podcast is Supporting Workers with a Comprehensive Return to Work Program. Also, November is Radon Month, listen to Recognizing Radon.

Feature Podcast: Supporting Workers with a Comprehensive Return to Work Program

Sonya Tonkovich from the Canadian Centre for Occupational Health and Safety (CCOHS) shares tips on what should be included in a comprehensive return to work program, and how organizations can support workers returning to work from both physical and mental health related leaves.

The podcast runs 5:56 minutes. Listen to the podcast now.

Encore Podcast: Recognizing Radon

Radon is a colourless, odourless, tasteless gas released when uranium, found naturally in rocks and soil, decays. It is also classified as a known carcinogen and a leading cause of lung cancer among non-smokers. In Canada, radon can be found in new and older homes, public buildings and underground worksites. In this podcast, Dr. Cheryl Peters, Postdoctoral Fellow at Carleton University and Occupational Exposures Lead Scientist at CAREX Canada discusses radon, where it's found, the impact it can have on our health and how we can limit our exposure to it.

The podcast runs for 8:22 minutes. Listen to the podcast now.

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 podcast to your and listen to it at your own convenience or on the go!

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