Health and Safety ReportMay 2010 - Volume 8, Issue 5

It's no secret that demanding, stressful jobs can lead to increased risk of heart disease. However until recently, research in this area mainly focused on men. Now a study of female nurses conducted over a 15 year period has found that high pressure jobs can increase women's risk of heart disease.

Danish researchers studied the effect of work pressure and job influence on the development of ischaemic heart disease in women. Ischaemic (or ischemic) heart disease (IHD) is characterized by reduced blood supply to the heart, and is a common cause of death in Canada, the United States, Europe and other countries around the world.

In 2005, almost a third of all Canadians deaths were caused by cardiovascular disease, and 54% of these deaths were due to IHD.

In this study, researchers from Denmark assessed the impact of work pressure on the heart health of more than 12,000 female nurses by asking them: "What is the work pressure/work speed at your work: much too low, a little too low, suitable, a little too high, or much too high?"

The nurses were all aged between 45 and 64 in1993 when they were first questioned about daily work pressures. Their health was then tracked for 15 years using hospital records.

Results of the study

The bottom line conclusion of the study was that nurses who self-reported their work pressure as "too high" had increased risk of IHD compared to nurses who reported their work pressure to be "suitable." This risk was significant in younger nurses (under 51 years of age). The lower risk observed among the "older" nurses may be due to the fact that other risk factors (for example, cholesterol levels and obesity) become relatively more important with increasing age. Or, it might be that the older nurses had retired from their jobs and were no longer exposed to work pressures.

Other findings included:

• 60% of the nurses reported work pressure to be "much too high" or "a little too high".


• Nurses who reported work pressure to be a "little too high" were 25% more likely to develop IHD compared with those who said their work pressures were "suitable".


• Those who reported their work pressure to be "much too high" had a 35% greater risk of developing IHD compared to those reporting "suitable" work pressure, after considering the effect of other risk factors such as smoking status and lifestyle.

The Canadian Heart and Stroke Foundation says that when your life is stressful, it can be difficult to lead a healthy lifestyle. This is because instead of being physically active to relieve stress, some people respond by overeating, eating unhealthy foods, consuming too much alcohol or smoking - reactions that can increase the risk of developing heart disease and stroke.

The Denmark study adds to the previous body of evidence which suggests that excessive psychological demands at work can have harmful effects on cardiac health, but is one of very few studies that demonstrate the effect in women. The researchers suggest that their results are important for the primary prevention of heart disease and that more research is needed to identify exactly which factors contribute to the perception of high work pressure.

Additional resources

Psychosocial work environment and risk of ischaemic heart disease in women: the Danish Nurse Cohort Study, published in Occupational Environmental Medicine

Coping with Stress (PDF), Heart and Stroke Foundation and the Canadian Mental Health Association

WORK, STRESS AND HEALTH: the Whitehall II study (PDF)

In August 2006 a machine operator was killed when the skid steer loader he was driving tipped into a manure pit, capsizing and submerging him. He had been pushing manure with the skid steer loader from the barn into a manure pit. The steel pipe barricade usually in place to prevent the skid steer from tipping into the pit had been damaged earlier and removed for repair.

The position of the machine arms suggested the operator was unable to exit the cab at the front, and that he may not have been aware the emergency exit was through the back window of the machine. Nova Scotia Labour and Workforce Development issued an alert to raise awareness of the safety issues involving working with and around skid steer loaders.

A skid loader or skid steer loader is a compact, engine-powered machine with lift arms to which a variety of labour-saving tools can be attached. Although they are sometimes equipped with tracks, skid steer loaders are typically four-wheel drive vehicles with the left-side drive wheels independent of the right-side drive wheels, making them extremely maneuverable.

The features that make these machines so effective and agile also put workers at risk of rollover and run over incidents, and expose them to other risks of injury. For example, the operator's seat and controls are located between the lift arms and in front of the lift arm pivot points, placing the operator close to the lift arms' zone of movement. Because skid steer loader operators must enter and exit through the front of the loader and over the bucket, there is always the risk that if they don't exit or enter properly, a foot or hand control may be activated and may cause movement of the lift arms, bucket, or other attachment.

Here are some tips to help you work safely with or around skid steer loaders:


Before you start

• Ensure that you are trained in all aspects of the equipment - operating procedures and safety features.


• Be familiar with and follow the manufacturer's instructions.


• Regularly inspect and maintain the skid steer loader.


• Clear the area of bystanders before you start work.


• Ensure rollover protective structures and safety screens are in place at all times.

Tips for safe operating

• Enter and exit the loader safely - only when the bucket is flat on the ground, or when the lift arm supports are in place.


• Before leaving the operator's seat,


• lower the bucket to the ground,


• set the parking brake, and


• turn off the engine.


• Operate the loader from inside the operator's cab; never from the outside.


• Work with the seat belt fastened and the restraint bar in place.


• Never permit passengers on skid steer loaders.


• Never use a skid steer as a work platform.


• Don't exceed a loader's rated operating capacity. Overloading can make a skid steer unstable.


• Always make sure that attachment locking devices are in place to prevent an attachment from breaking free and causing harm to the operator or a bystander.


• Never place any part of the body or limb under raised loader arms. If you must carry out repairs with the loader arms raised, be sure to lock the arms in place.

Tips for safe travelling

• When travelling or turning, keep the arms lowered and the bucket as low as possible to keep the loader stable.


• Keep the attachment level while raising the loader arms.


• Travel straight up or down slopes, with the heavy end of the machine pointed uphill. Never travel across a slope.


• Operate on stable surfaces only to prevent ground or earthen walls from collapsing, causing the loader to tip, and/or bury the operator.


• Road travel with a skid steer loader is not recommended.

More Information


Read the full alert from Nova Scotia Labour and Workforce Development, Occupational Health and Safety

Skid Steer Safety Fact Sheet, Farm Safety Association Inc.

Preventing Injuries and Deaths from Skid Steer Loaders, NIOSH

With most working adults spending much of their waking hours on the job, the workplace environment can have a profound impact on the mental health and well-being of workers. A new website has been developed - The Workplace Mental Health Promotion: A How-To Guide - to provide both employees and employers with the tools and resources they need to create a healthy workplace. Developed by The Health Communication Unit at the Dalla Lana School of Public Health, University of Toronto, in partnership with the Canadian Mental Health Association, the site educates employees who lack understanding of mental illness, empowers individuals experiencing mental illness to seek the support they need, and informs employers on how to create a mentally healthy workplace.

The financial cost associated with mental illness to the Canadian economy is an estimated $51 billion per year in lost productivity and health care expenses. And with one in five Canadians experiencing mental illness, there has been a growing demand to address stress, mental health and mental illness in the workplace.

Many organizations throughout Canada recognize the need to create a mentally healthy workplace and adopt mentally healthy practices and policies. However, with 84 per cent of organizations without processes in place to address significant changes in employee productivity or behaviours, many do not know where to begin in developing a healthy workplace plan.

This free how-to guide addresses these concerns by providing high-quality, research-based, practical tools to improve the health of individuals and organizations. It offers useful information on the issues surrounding mental health and outlines how to create a mental health promotion plan for your organization.

Visit the Workplace Mental Health Promotion: A How-To Guide website.

More information

Canadian Mental Health Association

The Health Communication Unit, University of Toronto

New Orientation for New Workers Handbook


Starting a new job can be overwhelming with so much to learn and information to process. As an employer, you are responsible for ensuring that your workers are prepared for the job before they start working. Statistics show that in Canada new workers have higher rates of injury, especially during the first six months on the job. One of the best ways to prevent accidents is through effective orientation and training.

The new guide from CCOHS, Orientation for New Workers, can help you do just that by putting important health and safety information into the hands of the new workers who need it most. "New" can mean workers who are new to the organization or who have transferred from another department (of any age), as well as all young workers under the age of 25.

The guide provides new workers with an overview of their health and safety rights and responsibilities, hazard recognition, hazard control, preparing for emergencies, occupational health and safety programs and who to contact for additional help. It is also a tool that employers can use as part of their workplace-specific orientation training program.

New workers will learn about potential hazards they may encounter in the workplace and how they can help protect themselves and their co-workers. They can use the guide as a reference tool to look up facts and examples of hazards and controls, and make notes.

Health and safety orientation should also include on-site workplace-specific training by the employer on the policies and procedures specific to the job and workplace. This guide is not a substitute for job-specific training that all new workers should receive from their employer.

Learn more about Orientation for New Workers

Every month new free podcast episodes are added to the Health and Safety to Go program. The most recent episodes discuss the importance of keeping active at work, how orientation programs can help keep new workers safe and tips to help ease the effects of shift work on workers' health. You can listen now or if you can download to your MP3 player and listen when it is most convenient for you.

Keeping Active at Work Listen now.

CCOHS discusses the importance of keeping active at work and how organizations can encourage their employees to get started on a journey to a healthier self, and a healthier workplace.
Length: 2:43 minutes

New Workers: Orientation is Key Listen now.

Len Hong, President and CEO at CCOHS, discusses how to keep new and young workers safe on the job by having a formal orientation program in place.
Length: 9:38 minutes

Improving the Lives of Shift Workers Listen now.

CCOHS shares tips on how organizations and individual workers can take steps to ease the effects of shift work on their health.
Length: 5:03 minutes

You can see a complete listing of all podcasts on the CCOHS website.