Health and Safety ReportVolume 12, Issue 8

Smoking indoors is making a comeback. But take a closer look. Are those really clouds of smoke? These days, the chances are good that what you are actually seeing is vapour released from electronic cigarettes. While some are fuming about e-cigarettes and their potential health risks, there is no doubt that the devices are quickly rising in popularity, which can impact a range of public spaces, including the workplace.

What are e-cigarettes?

An e-cigarette is a small battery-operated device made to resemble a traditional cigarette. There are three main parts to an e-cigarette: a replaceable inhaler cartridge that contains a liquid chemical mixture; a heating chamber which turns the liquid into a vapour; and a battery with an LED light at the tip that glows like a cigarette when inhaled. Using an e-cigarette is known as "vaping", referring to the vapour that is produced.

Although they mimic the look and feel of a cigarette, these electronic devices vaporise a solution instead of burning tobacco. The solution may be composed of various amounts of nicotine, propylene glycol, and other chemicals, some of which may be harmful.

Are e-cigarettes legal?

In Canada products that contain nicotine fall within the scope of the Food and Drugs Act, and because they have not been granted a market authorization, they cannot be imported, advertised or sold. E-cigarettes that do not make any health claim and do not contain nicotine may legally be sold in Canada. However, in March 2009, Health Canada issued an Advisory to Canadians not to use e-cigarettes as these products may pose health risks and have not been fully evaluated for safety, quality and efficacy by Health Canada.

In the U.S., the import, sale, advertising and use of e-cigarettes is allowed, although some states have their own regulations in place. In April 2014, the U.S. Food and Drug Administration (FDA) issued a proposed rule that would extend their tobacco authority to cover e-cigarettes. Among other requirements, makers of e-cigarettes would have to register their products, report ingredient listings, and include health warnings. In addition, sales to minors would be banned.

Are e-cigarettes safe?

While e-cigarettes are free of tobacco, most solutions contain nicotine, which is highly addictive, and can affect the cardiovascular system and blood sugar levels, and propylene glycol, which is a known irritant.

In June, a group of 129 physicians, epidemiologists and other experts from 31 countries sent an open letter to the World Health Organization (WHO). They warned that although e-cigarette vapour has fewer toxic components than regular smoke, more than half a dozen studies have shown it can include ultrafine particles damaging to lungs, plus "carcinogens and reproductive toxins, including benzene, lead, nickel, and others." The WHO has been reviewing the existing evidence around electronic nicotine delivery systems (ENDS) - including e-cigarettes. In August 2014, they released a report that called for regulations to end the use of e-cigarettes in public and workplaces. Evidence suggests that exhaled e-cigarette aerosol increases the background air level of some toxicants, nicotine and particles.

When the FDA conducted limited laboratory studies of certain samples, it found significant quality issues that indicate substandard or non-existent quality control processes. Potential issues include inaccurate information on ingredient concentrations, the presence of toxic impurities, and products labelled nicotine-free actually containing nicotine. A Canadian Cancer Society-commissioned study found similar results with misleading labels and products incorrectly labelled as "nicotine-free".

Smoking cessation tool or gateway device?

According to the Conference Board of Canada, the cost to employers for each worker who smokes is estimated to be $4,256, due to reduced productivity and absenteeism. To help employees who want to stop smoking, a number of companies and organizations sponsor or subsidize smoking cessation programs.

Advocates of e-cigarettes say that e-cigarettes provide smokers with a safer alternative to traditional cigarettes, or help them quit altogether. The regulatory classification of e-cigarettes as tobacco products, they argue, would negate their potential to reduce the death and disease caused by smoking.

Others believe that the electronic devices may serve as a gateway to nicotine addiction by luring teen and non-smokers. According to a Canadian Cancer Society-commissioned survey, nearly a quarter of 18-24 year olds have used e-cigarettes, compared to 9% of the general population.

The Canadian Lung Association encourages people to avoid unproven methods, like e-cigarettes, and to quit smoking using proven methods like individual or group counseling, stop-smoking medication and nicotine replacement therapies such as gum, patches, lozenges, and inhalers.

Workplace considerations

All Canadian jurisdictions have a formal law or regulation that restricts smoking in the workplace. Smoking is completely prohibited in Ontario, Nova Scotia, Quebec, Manitoba, New Brunswick and British Columbia workplaces. Some provinces allow a separately ventilated room to be built in the workplace. But should e-cigarettes be counted as smoking?

While they technically do not emit smoke, e-cigarettes do release a vapour into the air. Several substances have been detected in the vapour from e-cigarettes, including nicotine, propylene glycol, flavourings and heavy metal traces. Many Canadian jurisdictions do not have specific legislation that deals with indoor air quality issues. In the absence of such legislation, the "general duty clause" applies. This clause, common to all Canadian occupational health and safety legislation, states that an employer must provide a safe and healthy workplace. Thus, making sure the air is of good quality is the employer's duty.

Until more is known about the short-term and long-term health effects of e-cigarettes, and until they are approved for use in Canada, it is advisable to proceed with caution and to not allow their use in the workplace.

Resources

• 
  
  Electronic nicotine delivery systems PDF, World Health Organization (WHO)
• 
  
  Health Canada Advises Canadians Not to Use Electronic Cigarettes, Health Canada (archived statement)
• 
  
  Electronic Cigarettes (e-Cigarettes), U.S. Food and Drug Administration
• 
  
  Indoor Air Quality Fact Sheet, CCOHS
  
  
• Environmental Tobacco Smoke (ETS): General Information and Health Effects, CCOHS
  
• 
  Ways to quit, Canadian Cancer Society
• 
  
  E-cigarettes - QuitNow, BC Lung Association
  

Hazards of varying degrees exist in all workplaces. Ideally these hazards should be eliminated, controlled at the source or reduced through administrative measures. When all other methods are either not available or impossible to implement, personal protective equipment (PPE), the last level of protection, may be used so that work can continue safely.

Understanding the basics of PPE and its selection can play an important part in developing and maintaining a complete health and safety program.

What is personal protective equipment (PPE)?

PPE is equipment worn by a worker to minimize exposure to specific occupational hazards. Examples of PPE include respirators, gloves, aprons, fall protection, and full body suits, as well as head, eye and foot protection. Using PPE is one element in a complete safety program that should use a variety of strategies to maintain a safe and healthy occupational environment. PPE does not reduce the hazard itself nor does it guarantee permanent or total protection.

PPE should be used:

• when no other control method is possible;


• while other controls are being installed or implemented;


• for emergencies and during maintenance activities;


• for situations where other control methods don't provide enough protection.

How to select PPE

Once the need for PPE has been established, the next task is to select the proper type. Use the following guidelines to help you select the best PPE.

• Match the PPE to the hazard. There are no shortcuts to PPE selection. Conduct a complete hazard assessment and choose the right PPE to match the hazards.



• Get expert advice and shop around. Discuss your needs with an occupational health and safety specialist and trained sales representatives. Ask for alternatives, and check into product claims and test data.



• Involve workers in evaluations. The most common reason for failure of a PPE program is the inability to overcome worker objections to wearing it. Bring approved models into the workplace for trials so workers have the opportunity to evaluate various models.



• Consider the physical comfort of PPE (ergonomics). If a PPE device is unnecessarily heavy or poorly fitted it is unlikely that it will be worn. Use every opportunity to provide flexibility in the choice of PPE as long as it meets required legislation and standards.



• Evaluate cost considerations. The cost of PPE is often a concern and disposable options are not always cheaper in the long term.



• Review regulatory requirements and standards. In Canada, two of the more common standards include the Canadian Standards Association (CSA) and the Bureau de normalisation du Quebec (BNQ).

What else do I need to know?

PPE is the last step in the hierarchy of controls, making it the last level of protection between the worker and the hazard. Therefore, it is especially important that the correct PPE is selected, worn, and maintained. A complete PPE program consists of many steps from the initial workplace assessment to routine evaluation and review. More information can be found in the resources listed below.

More information


Personal Protective Equipment: The Basics, CCOHS e-course


Designing an Effective PPE Program, fact sheet


Personal Protective Equipment, fact sheet


Hazard Control, fact sheet


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When we think of workplace violence, physical assault is usually the first thing that comes to mind, but it is a much broader problem. Workplace violence is any act in which a person is abused, threatened, intimidated or assaulted in their employment; at or away from the workplace. To help organizations address this issue, the Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), in collaboration with Recherche sur les interrelations personnelles, organisationnelles et sociales du travail (or RIPOST, a research group on personal, organizational and social interrelations at work), has launched a web site that offers a practical process for preventing workplace violence in all types of organizations.

Based on ten years of research on violence prevention, the site delivers a five-step process that includes:

1. Securing a commitment from the workplace;


2. Identifying the risk factors;


3. Developing an action plan;


4. Implementing and monitoring the prevention measures; and


5. Evaluating the effects.

It provides possible courses of action, suggestions, tips, and downloadable tools for implementing measures or improving those already in place to ensure more effective violence prevention among people within an organization. The information on the site allows the process to be adapted to any company regardless of size and business sector, or the presence or absence of a union.

Researcher Nathalie Jauvin of the RIPOST group commented on violence in the workplace. "Its impacts are felt at the level of worker and organizational health and are manifested in loss of productivity, absenteeism, and deterioration in the work atmosphere, among other things. To prevent this violence and achieve a successful, participatory process, employers, workers, and their representatives must pool their prevention efforts. The Web site offers answers derived from evidence-based data generated by the latest scientific research."

The website was designed for human resources professionals, individuals involved in the development and implementation of workplace violence prevention programs, union representatives, as well as employees and managers.

Visit the Preventing Interpersonal Violence in the Workplace website.

Additional resources from CCOHS


Violence in the Workplace, fact sheet


Bullying in the Workplace, fact sheet


Violence in the Workplace Prevention Guide


Violence in the Workplace: Awareness, free e-course


Violence in the Workplace: Recognize the Risk and Take Action, e-course

This month's Health and Safety To Go! podcasts feature a discussion on how to prevent the health effects of shiftwork as well as an encore presentation on the potential hazards of confined spaces.

Featured Podcast: Preventing Health Risks Associated with Shiftwork

Dr. Robert Whiting, from CCOHS, discusses various health risks associated with shiftwork and how they can be minimized.

The podcast runs 8:15 min. Listen to the podcast now.

Encore Podcast: Working in Close Quarters

Do you work in confined spaces? Learn about the potential hazards and find out how you can stay safe.

The podcast runs 3:21 min. 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 audio segment to your computer or MP3 player 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.

Workplace Health and Safety Matters is the blog of Steve Horvath, President and CEO of the Canadian Centre for Occupational Health and Safety. In a recent post, Steve shared his thoughts on the recent visit by delegates from the Korean Occupational Health and Safety Administration (KOSHA).

To me, CCOHS' value is reaffirmed when other national health and safety organizations access our information and recognize that our expertise on prevention issues can make a positive impact on their own challenges.

That happened last week when delegates from the Korean Occupational Health and Safety Administration (KOSHA) visited CCOHS to learn about Canada's perspective on health and safety program access for small to medium-sized enterprises (SME). Their concern arises from the fact that 80% of lost-time accidents in Korea occur in small organizations, and wanted more insights as to how CCOHS has improved accessibility by SMEs through its online and social media strategies that involve plain language programs targeted at small organizations in Canada.

Our meeting was extremely fruitful and they left with practical solutions that involve many of our online solutions. We also toured a successful small organization that has implemented progressive health and safety policies. By doing so, the KOSHA delegates were able to see first-hand the results of these strategies, and to talk directly to company management and staff about their successes and challenges.

Thanks to Larry Masotti at Workplace Safety and Prevention Services (WSPS) for coordinating the site visit to Brabender Technologie.

Our initiatives for SMEs have received significant interest from jurisdictions throughout Canada, and now from international organizations because I believe we share similar challenges with awareness and accessibility to SMEs and a similar desire and focus to improve in that respect.

Read Steve's blog, Workplace Health and Safety Matters.