1. INDUSTRIAL HEALTH AND SAFETY PROGRAM Enforcement Approach for the Health Care Sector March 23, 2004

2. Today’s Presentation: Occupational health and safety system MOL general enforcement approach in the health care sector

3. Occupational Health &Safety System Workplace Safety and Insurance Board Health and Safety Associations –e.g. Health Care Health and Safety Association Ministry of Labour

4. OHS System - Role of the MOL Committed to the prevention of workplace deaths, injuries & disease by: Setting standards Communicating standards Enforcing standards

5. Enforcing Standards Investigations: –workplace injuries and fatalities –workplace complaints –work refusals –occurrences with no injuries Inspections: –priority workplaces, priority hazards

6. How to enforce standards in priority workplaces.. 4.5 million industrial workers total … Concentrate enforcement on: –Poor performers –Vulnerable workers –Self-reliance not evident Encourage self reliance in other workplaces

7. Priority Workplaces by Sector Group workplaces into sectors –29 industrial sectors Identify priority sectors –Annual risk assessment to allocate field visits by sector Develop sector specific enforcement strategies

8. Health Care Sector Includes: Acute care facilities Long-term care facilities Home care services Group homes Health laboratories Doctor’s offices, clinics Social service organizations

9. Workplace Regulation - Health Care Facilities O. Reg. 67/93 Regulation for Health Care and Residential Facilities –Section 2(1) application to specific types of facilities Comprehensive workplace regulation Written measures and procedures –in consultation with JHSC or H & S representative –to be reviewed annually

10. Health Care Regulation - Coverage Notice of injuries/illnessesCompressed gas cylinders Written measures and proceduresMaterial handling equipment Personal protective equipmentLadders PremisesScaffolds VentilationExplosion hazards HeatingAnaesthetic gases LightingAntineoplastic drugs Hygiene facilitiesFlammable liquids Work SurfacesMaterial handling Restricted/Confined spacesHousekeeping and waste Equipment Electrical equipment

11. Written Measures and Procedures Work practices Working conditions Hygiene practices, facilities Infection control Immunization and inoculation Antiseptics, disinfectants, decontaminants Biological, chemical and physical agents Effects of biological, chemical and physical agents to reproductive, capacity, pregnancy or nursing Equipment use, maintenance and operation Reporting of unsafe equipment, work surfaces Purchasing of equipment Use and limitations of personal protective equipment Handling, cleaning and disposal of sharps and waste

12. Other Regulations That May Apply WHMIS Regulation (O. Reg. 860) X-Ray Regulation (O. Reg. 861 ) Biological and Chemical Agents(O. Reg. 833 ) Designated Substance Regulations Asbestos on Construction (O. Reg. 838) Window Cleaning Regulation (O. Reg. 859)

13. Extended Coverage Workplaces Some workplaces do not fall under a specific workplace regulation such as the Health Care Regulation –e.g. home care services, clinics

14. Key Hazards – Health Care Based on WSIB and MOL data: Sprains and strains due to overexertion Slips,trips, falls Communicable diseases Hazardous substances Struck by objects Patient violence

15. Enforcement Strategy – Health Care Multi-disciplinary approach Risk based criteria to identify individual workplaces to be inspected Internal Responsibility System reinforced with orders

16. Future Directions- Health Care Minister’s Action Group announced –Employers, unions, health and safety system partners, other experts Identify gaps in existing prevention strategies Identify best practices, programs, policies and standards to reduce injuries and illnesses

17. Field visits - health care –number of inspections/investigations –priority firms –priority hazards Appropriate orders, prosecutions, fines Requests for training through HSAs OHS system collects data on the following: –Fatalities, critical injuries, lost-time and no lost-time injuries, occupational illnesses Monitoring Impact