Identifying and Monitoring Trends in Occupational Disease

Introduction:

This podcast is brought to you by the Canadian Centre for Occupational Health and Safety.

Chris:

Hello and welcome to CCOHS podcasts. Occupational diseases are health conditions, such as cancer, musculoskeletal disorders, and respiratory diseases that are caused by exposure, to hazardous substances, hazardous workplace environments, or as part of work activities.

Recognizing and preventing occupational disease presents unique challenges and requires the elimination or reduction of hazardous exposures and the control of risks.

Today we are speaking with Paul Demers, the Director of the Occupational Cancer Research Centre, and Professor with the Dalla Lana School of Public Health at the University of Toronto, about occupational disease, and the work he and his team are doing to identify and monitor trends in work-related diseases.

Welcome Professor Demers.

Paul Demers:

Hi, thanks for having me here today.

Chris:

What is the occupational Research Center?

Paul Demers:

We are a research centre based at Ontario Health, which is a provincial agency here in Ontario, and we're funded by both the Ministry of Labour Training and Skills Development, as well as the Ministry of Health.

While, although we're called the Occupational Cancer Research Center our work is really much broader than that. We look at a wide range of occupational diseases. We are unique in Canada and do research on the causes of occupational disease and prevention. As well as tracking of patterns and trends with our surveillance program.

Although we're primarily focused on Ontario, we work with researchers across Canada and across the world really, on a wide variety of different projects.

Chris:

What is occupational disease?

Paul Demers:

Well, broadly, occupational disease is a health problem caused by exposure to workplace health hazards, and include chemicals, physical agents, biological agents, psychological exposures like stress, as well as other factors like night shift work. Some rare diseases are only caused by work. Things like mesothelioma caused by asbestos and silicosis, which is, of course, just caused by silica, but most occupational diseases occur among more common diseases that have a variety of causes that include work. As one of them.

Chris:

Do you have a sense of the impact of Occupational disease on the workforce?

Paul Demers:

Yeah, it's a much bigger impact than people generally think. For example, when we think about lung diseases, we often think about cigarettes and smoking and other things, but it's important to know that approximately 15 percent of all lung cancers are caused by things at work and the same is true for both Chronic Obstructive Pulmonary Disease and Asthma. Now, you know, lung cancer is the most common fatal cancer in Canada. COPD is the fourth leading cause of death and Asthma impacts ten percent of all Canadian adults. So, when you talk about 15% of each of these, it really adds up to a lot of cases of disease.

Chris:

Can you tell us about the occupational disease surveillance system ODSS?

Paul Demers:

It's the largest occupational disease surveillance program in Canada and really, one of the largest in the world. It links the records of almost 2.3 million people in Ontario, with all of our electronic health records in the province. And with this system were able to look at the risk of disease in in hundreds of different occupations and industries. It really is a very big system in that way. And it gives us the power to look at dozens of different types of cancer and chronic diseases. For example, most recently we've begun to look at patterns of opioid-related harms as well as Covid-19 infections and hospitalizations. So, it really gives us that power to look at a wide range of important health issues.

Chris:

Why was it created?

Paul Demers:

What we know a lot about occupational disease through studies conducted around the world, but that doesn't really tell us much about the situation here in Ontario or in local area.

We developed the ODSS to generate the data to target prevention efforts towards high-risk groups and also to support workers compensation. Really. We did this because numbers can be a powerful tool for driving change in these areas, but these tools work much better when they're really focused in on the population that we're really worried about.

Chris:

What has the surveillance data revealed?

Paul Demers:

Well, we certainly see a lot of things. Many things that we expected such as increased risks of lung cancer in construction, and mining, and trucking. Where we've seen it before because of exposure to asbestos or diesel exhaust, or crystalline silica.

We also see chronic obstructive pulmonary disease in a wide variety of industries where there is exposure to dust fibers and fumes. And we're also able to look at, kind of, smaller industries such as bakery workers, where we see increased risks of asthma and dermatitis, which we expect because of exposure to flour and similar things in that industry.

However, were also able to look at other groups where we might not necessarily know what the risks are. And we see things that we would not necessarily have suspected. Things such as an increased risk of breast cancer among both men and women in healthcare, increased risks of asbestos related disease and educational services workers or asthma and dermatitis among people exposed to cleaning agents, in the workplace.

Chris:

Is the information you've collected applicable for other provinces and territories or is it only for Ontario?

Paul Demers:

Well, it really is applicable to any place with similar working conditions to Ontario which is certainly the rest of Canada, you know, and probably the United States and probably many other places in the world. However, I do think it's good, where possible, to generate local data which is why we developed this surveillance system here; but it certainly reflects that, and we publish our results in journals that are read around the world.

Chris:

Are there plans to include other provinces and territories?

Paul Demers:

Yeah, we had a meeting a just before the COVID pandemic of groups from across Canada to discuss how we can improve occupational disease surveillance. There's currently a pilot project underway at the University of Manitoba and researchers that we work closely with the University of British Columbia are also trying to get a project going in that province.

This will really allow us to look at some of those industries that are maybe unique to a particular area or more common in a particular area. For instance, we don't have a large fishing industry here in Ontario, but they do in British Columbia. But also, things like agriculture and mining vary from province to province because they're different crops that are harvested, there are different things that are being mined. So, it is useful to have projects in other parts of Canada.

Chris:

Who is the target audience?

Paul Demers:

It really is pretty broad and goes from people in regulatory or compensation agencies, people in health and safety organizations, representatives of unions and employers. Even health and safety activists, healthcare providers and others. The data we generate is free to access by all who are interested and certainly that includes any concerned workers. But we also hope that it gets to and is used by people who are able to really generate change in the workplace. We really want this data to be used for prevention and compensation and improving things in those areas.

Chris:

Are there some final thoughts on occupational disease that you would like to leave us with today?

Paul Demers:

Well, I'd like to say that really right now only about 5% of occupational disease is recognized by doctors or the workers compensation system. There's a growing interest across Canada in preventing occupational disease because even seeing that 5%, we see how important it is. But our goal in doing this is to raise awareness around this, increasingly recognition of this as a major problem and hopefully generating change. So, I think this is a very important area to focus on.

Chris:

Thank you very much Professor Demers.

For more information on occupational disease and the Occupational Disease Surveillance System, you can visit www.occupationalcancer.ca.

More information can also be found at w-w-w.ccohs dot c-a and searching occupational disease