Health and Safety ReportVolume 24, Issue 03

When Martina returns to the office after several months away, her colleagues are glad to see her. She feels refreshed and eager to get back into her routine. Her first day is shorter to help her adjust, but the next day she struggles to concentrate during a team meeting. The noise overwhelms her and she forgets to complete a task assigned to her the day before. By the end of the day, she is exhausted.

Martina is living with an acquired brain injury (ABI). She wants to return for financial reasons, social connection, and a sense of identity. But returning to work after a brain injury is a lengthy process that requires planning, flexibility, and support.

Understanding causes and symptoms

Brain injuries can be traumatic, such as concussions from falls, collisions, or assaults, or non-traumatic, such as those caused by illness, stroke, or lack of oxygen. While some symptoms are visible, many are not. Symptoms can fluctuate from day to day and linger for long periods. Workers may experience fatigue, difficulty concentrating, memory challenges, headaches, sensory sensitivity, or emotional changes. Early recognition of brain injuries and prompt evaluations by healthcare professionals are essential – they can prevent further injury, reduce the risk of long-term effects, and facilitate a safe, gradual return to work.      

The duty to accommodate

Under Canadian human rights legislation, disability (including from a brain injury) is a protected ground. Employers have a duty to accommodate to the point of undue hardship. Accommodation means modifying rules, policies, tasks, or the work environment so a worker can participate fully and without discrimination. Each situation must be assessed individually.

Accommodations may include flexible scheduling, additional breaks, quieter workspaces, or lighting adjustments. Breaking tasks into smaller steps, prioritizing essential duties, and scheduling more demanding cognitive work during peak energy times can also help. Frequent check-ins with a supervisor can identify challenges early, prevent setbacks, and create a supportive environment.

Set workers up for a successful return

Research from the University of Toronto and the KITE Toronto Rehabilitation Institute shows that return-to-work outcomes after a work-related traumatic brain injury are strongly shaped by the workplace. The worker’s age, pre-injury health, and employment history play a role, but a successful return needs workplace support, accommodation, and open communication. Also, returning to full-time duties is not always the end goal. For employers, this means shifting the focus from when a worker can come back full-time to how to best support a safe and sustainable return.

A gradual return to work plan could involve reduced hours, modified duties, or a phased schedule. A trial period can give both the worker and employer time to see how things are going and adjust as needed. Early conversations should focus on understanding the worker’s current functional abilities and any restrictions. While employers are not entitled to detailed medical information, it is a good practice to collaborate with health care providers. Medical clearance may also be required before a worker can return full-time or perform high-risk tasks, such as operating heavy equipment or working at heights. Clear descriptions of job demands can help determine appropriate duties.

Workers who have experienced traumatic brain injury stress the importance of positive relationships with supervisors and co-workers, non-judgmental attitudes, a sense of belonging, and having their efforts recognized. When they feel trusted and understood, they are more likely to speak up about challenges.

It is also important to recognize that returning to work affects more than job tasks. Leaving a controlled home environment and re-entering a busy workplace can significantly affect energy levels. Commuting, noise, social interaction, and time pressures can quickly increase fatigue. Energy management and realistic scheduling are critical.

Reinforce a culture of health and safety

Employers should review the circumstances surrounding the original injury, particularly if it occurred at work. A worker should not return if hazards remain unaddressed and corrective actions need to be taken to prevent injuries to other workers. It is important to establish processes to regularly identify, assess, and control hazards.

Encouraging continuous improvement as part of a strong health and safety culture supports return–to-work outcomes and helps prevent incidents. Workers need to know that their well-being comes first.

When employers plan carefully, communicate openly, and provide support, they improve the likelihood of a sustainable return. And just as importantly, they reinforce a culture of inclusion, safety, and respect, and send a clear message to workers like Martina: your contribution still matters here.

Resources

• Return to Work – Accommodation, CCOHS
• Supporting Workers After a Traumatic Brain Injury (podcast), CCOHS 
• Understanding Traumatic Brain Injury, Ontario Neurotrauma Foundation
• Return to Work Guidebook, Brain Injury Canada
• Return to Work, Concussion Awareness Training Tool (CATT) 

Artificial intelligence (AI) is playing a growing role in workplace health and safety. AI-powered robotics can perform high-risk jobs. Real-time AI monitoring can help with early intervention. AI training simulations can help improve safety skills without the real-world risk. Generative AI can assist in writing safety policies. Consider these steps when introducing AI tools in your workplace.

• Understand the risks and identify hazards. Make sure the AI tool doesn’t introduce new hazards. Tools that manage performance, for example, may increase work pace, resulting in physical strain, stress or burnout. Automation may lead to feelings of job insecurity, which could impact worker mental health. A risk assessment can help you gauge the impact AI could have on workers.
• Address hazards. Take steps to eliminate hazards or reduce risks following the hierarchy of controls. Measures could include prohibiting or limiting the use of AI for certain tasks, changing workflows and processes, and enhanced training.
• Introduce policies and programs. Communicate which AI tools are approved for use in your workplace, how they can be used to improve health and safety, and how they will be monitored. The policy should also state how you will protect personal information, sensitive data, and intellectual property.
• Invite workers to participate. Ask your team for input before choosing new tools. Bring workers into the design process to help shape how AI will be used to make work better, not just faster or more efficient.
• Provide ongoing training. Educate your workers on using AI appropriately and safely. This may include training on how to create specific prompts, and how to verify sources of AI-generated information. Since technologies are always evolving, training should be ongoing.
• Carefully review AI-generated data. Ensure qualified individuals review any content generated through AI. The information should be accurate, up to date, appropriate for your workplace, and align with good practices and legislation.
• Always be cyber safe. Before using any new AI tool, consult cybersecurity professionals to address any weaknesses in your systems.
• Continue to monitor AI. The long-term health and safety impacts of AI are not fully known. Conduct regular reviews to make sure tools are working as intended and are not harming workers’ physical or mental health.

While AI does not replace human judgement, it can be a valuable tool in supporting health and safety across a range of industries when implemented and used appropriately.

Resources:

• Artificial Intelligence (AI) fact sheet, CCOHS
• Artificial Intelligence for Health, World Health Organization
• Artificial Intelligence (AI), Government of Canada

Encore podcast: Four Tips for Improving Workplace Safety with Plain Language

Are jargon and acronyms used everywhere in your workplace? Create a safer and more inclusive environment by using plain language. Here are four tips to get started.

Listen to the podcast now.

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

Get ready to be inspired by expert speakers on the changing world of work at CCOHS Forum, October 28-29 in St. John’s, Newfoundland and Labrador.

Joining us for an unforgettable keynote is Alan Doyle - musician, actor and best-selling author, best known as lead singer of the iconic Canadian band Great Big Sea. Through captivating stories and music, Alan will offer essential life lessons on how to be open to opportunities and cultivate a mindset for excellence.

Psychological health and safety expert Mary Ann Baynton will discuss what the evolution of psychosocial hazards from values-based conversations to operational risk management means for your workplace.

Janet MacEachern, CEO of the Association of Workers’ Compensation Boards of Canada (AWCBC), will explore injury trends and emerging risks across Canada. Janet will discuss how evolving work patterns and environmental conditions may influence injury trends and how a national perspective can help identify risks and support evidence-informed prevention discussions.

Register by June 26, to save $100 and secure your spot.

Stay tuned for more speaker announcements coming soon. For the latest updates, visit www.ccohs.ca/forum.

The National Day of Mourning on April 28 is dedicated to remembering those who have lost their lives or suffered injury or illness on the job.

The day is also an opportunity to renew your commitment to improving health and safety in your workplace and preventing work-related injuries and loss of life.

CCOHS offers resources to help observe Day of Mourning, including social media cards, podcasts and posters.

• Download our poster

To learn more about Day of Mourning, visit www.ccohs.ca/events/mourning.