(SARS)
Erna Bujna and Lisa McCaskell
CONTENTS
Why Are Hospitals Vectors of Contagion, Not Havens of Health? ... 6 The Directives ... 6 Lack of Transparency ... 7 Directives Were Incomplete ... 9 Detailed Directives at Last... 10 The First Directives for High Risk Procedures ... 10 Late Directives for Fit Testing and Respirator Program ... 11
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4 Emerging Infectious Diseases
Directives Did Not Address Workers Other than Nurses and Doctors, Nor Other Potentially Vulnerable Workplaces ... 12 Employers Interpreted Directives Differently ... 14 Interpretations Placed on Directives by Individual Facilities ... 14 Directives Were Confusing, Changing Rapidly, the Changes Were
Neither Highlighted nor Explained ... 15 Concerns Other than Worker Health and Safety and Public Safety... 17 Sunnybrook and Women’s Hospital ... 17 Occupational Health and Safety Act ... 17 The Role of Joint Health and Safety Committees... 19 The Role of the Ministry of Labour... 21 Events and Issues that Should Have Triggered Ministry of Labour
Enforcement Activities ... 22 Chronology of Events Involving the Ministry of Labour ... 23
Health and safety are important in any workplace. But in a healthcare environment, they are doubly important. If workers are not protected from health and safety hazards, patients and the public are not protected either.
It’s that simple. If workers are not told how to protect themselves, they cannot do so. If unions are left out of the process, they cannot play a role in helping our members get the information they need. Healthcare workers and their patients died as a result of the SARS crisis. (March 2003, SARS I.) The Ontario Public Services Employees Union (OPSEU) represents 113,000 members, including more than 28,000 healthcare workers. Of these, approximately 15,000 work in hospitals, most of them members of regulated health professions, such as respiratory therapists, x-ray technol- ogists, laboratory technologists, physiotherapists, occupational therapists, diagnostic imaging technologists, speech therapists, and many others.
OPSEU members are also cleaners, office and clerical workers, and other nonregulated healthcare workers.
The Ontario Nurses Association (ONA) is the union that represents 48,000 registered nurses and allied health professionals working in a variety of settings across Ontario. ONA represents about 21,500 members in the regional municipalities of Durham, York, Peel, Halton, and the City of Toronto, the region most directly affected by SARS.
The Workplace Safety and Insurance Board has received 160 claims for compensation from healthcare workers who actually exhibited symp- toms of SARS and another 98 from healthcare workers who were exposed, but did not develop symptoms.
Both OPSEU and ONA members were either directly or indirectly affected by SARS. Both unions had many members who contracted SARS. Two ONA members died as a result of workplace SARS exposure.
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Presentation to the Commission to Investigate SARS 5
In our positions, both authors educate and respond to our members’
health and safety concerns. During SARS, our workload increased signif- icantly. We were inundated with calls for help from our members. We were asked to review the directives and to provide advice and guidance.
We did this in hazard alerts and advice on the union websites and in correspondence with union representatives. Representatives of both OPSEU and ONA participated in biweekly teleconferences with the Ontario Hospital Association, the Ministry of Health, and the Ministry of Labour.
During the crisis we heard many frightening stories from staff and from members who risked their own safety and health in order to care for their patients. Many of those workers believe that more could have been done to protect them.
SARS, along with other virulent diseases, is a health and safety matter, one that we believe was handled poorly by many employers, by the Ministry of Health, and by the Ministry of Labour. Every worker in the province of Ontario has a right to a safe workplace.
Although both workplace parties have an obligation to ensure that work is done safely, employers have the greatest responsibility under the Occupational Health and Safety Act (OHSA). Section 25 of the Act states that employers must alert workers to workplace hazards and that they must take all precautions reasonable in the circumstances to protect workers from those hazards.
The Ministry of Labour enforces the OHSA. Under Section 54 of the Act, the Ministry has the power to enter any workplace at any time without warrant or notice. If the Ministry’s inspector finds that an employer is violating the OHSA, the inspector can issue orders for the protection of workers and the employer can be prosecuted.
For years there have been reports about the high rates of injury and illness among healthcare workers. Despite these reports, we have wit- nessed a lack of enforcement and the unwillingness of the Ministry of Labour to exercise its powers under the OHSA to deal with health and safety problems within the healthcare industry. If SARS had suddenly plagued private industry, we believe the Ministry of Labour’s response would have been much different. In our experience, at least since the mid-1990s, the healthcare sector has been a low enforcement priority of the Ministry. Why is this? Perhaps it is because healthcare workers are caregivers — their focus is on patient care not on protecting or caring for themselves. In the past, they have rarely refused unsafe work or even complained about unsafe conditions. They work in a building (the hospital), which is thought to be the safest place to take someone who is ill or injured, so why wouldn’t it also be the safest place to work. It should be! But it isn’t. In industry, for example, construction workers know their work is really dangerous. Health and safety issues are real
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6 Emerging Infectious Diseases
to them and are something they know they must be concerned about.
Why is it that in health care, the industry with one of the highest rates of injury and illness, workers, employers, and the public do not have this same awareness?