Protecting workers from second-hand smoke
Heather Crowe never dreamt she’d be the focus of a Health Canada promotional campaign on
second-hand smoke. She also didn’t think at age 57 she’d be battling lung cancer her doctor says is smoking related. Heather Crowe has been a non-smoker all her life.
For more than 40 years though, often working 12-hour shifts six days a week, Crowe supported herself and her daughter as a waitress. Last August her doctor found a fist-sized tumour in her chest that was advanced and inoperable.
This fall, Ontario’s Workplace Safety and Insurance Board (WSIB) awarded Crowe compensation citing second-hand smoke as the primary cause of her lung cancer. Since 1986 the WSIB reports five claims have been filed for health effects from exposure to second-hand smoke, three have been accepted.
Many studies have documented the health risks associated with second-hand smoke but Crowe’s case and those likely to follow will focus further attention on second-hand smoke as a deadly occupational health hazard.
A body of research by scientists, medical organizations and government health agencies agree that second-hand smoke, also known as environmental tobacco smoke or passive smoking, causes a multitude of health effects. For adults the dangers include heart disease, lung cancer, nasal sinus cancer and respiratory ailments. For infants and children, damaging health effects include sudden infant death syndrome, lower birth weight, and various respiratory illnesses including bronchitis, pneumonia and middle ear disease.
More recent studies show strong links between second-hand smoke and cervical and breast cancer, stroke, and miscarriages in adults. Children are at increased risk for asthma, decreased lung function, cystic fibrosis, and cognitive and behavioural problems. Health Canada estimates second-hand smoke kills more than 4,000 Canadians each year, one-third of these are in Ontario.
What makes second-hand smoke so dangerous is its mixture of some 4,000 substances, more than 50 of which are known to cause cancer in humans and animals. Sidestream smoke that curls off the end of a burning cigarette contains higher concentrations of the same toxic materials that smokers inhale directly.
Both the U.S Environmental Protection Agency and more recently the International Agency for Research on Cancer have declared second-hand smoke a human carcinogen.
Additional studies indicate workers routinely exposed to second-hand smoke have a 20 per cent increased risk of developing lung cancer, while others suggest the risk for food service workers could be increased by up to 50 per cent.
Canadian researchers recently confirmed a dose-response relationship between exposure to second-hand smoke and the development of lung cancer. They found when the number of ‘occupational smoker years’ (the number of smokers in the workplace multiplied by the worker’s years of service) reaches 26, the risk of lung cancer has doubled. Some workers in the study had triple the risk.
Understanding the public health costs associated with smoking, governments have pumped millions of dollars into public awareness and smoking cessation campaigns, yet they have been slow to provide protection to workers involuntarily exposed to tobacco smoke on the job.
In Ontario and across the country a patchwork of legislation, bylaws and company policies exist to protect workers against second-hand smoke. Ontario’s Smoking in the Workplace Act 1989
restricts smoking to 25 per cent of the total floor area of a workplace, yet does not require designated smoking rooms to be enclosed or separately ventilated. Since 1988 workers under federal jurisdiction have relied upon the Non-Smoker’s Health Act
for protection, which restricts smoking in federal workplaces to ventilated, designated smoking areas.
Smoking is banned in provincial government workplaces in British Columbia, Saskatchewan, Ontario, New Brunswick, Nova Scotia, Newfoundland and the Northwest Territories with limited protection in Quebec.
British Columbia has shown the most promise. Under its occupational health and safety regulations, British Columbia had committed to providing smoke-free environments for the majority of its workplaces, with short-term partial exemptions for hospitality, long-term care and correctional facilities. After a successful court challenge by provincial liquor licensees and following comprehensive public hearings, the newly amended regulation, which took effect May 2002, requires employers to prohibit smoking or provide designated smoking rooms that are structurally separate and equipped with non-re-circulating ventilation systems. Workers can legally refuse to work in smoking areas and those who choose to do so can be exposed for no more than 20 per cent of a 24-hour period.
While the B.C. regulations are among the most progressive in Canada, do ventilated smoking areas adequately protect workers against second-hand smoke? Medical evidence suggests optimal ventilation systems cannot completely remove second-hand smoke. The American Society of Heating, Refrigerating and Air Conditioning Engineers in 1999 amended its ventilation standard for indoor air quality by removing reference to a ‘moderate amount of smoke’. The standard now only applies to non-smoking buildings.
Workers however have been creative and persistent in clearing their workplaces of second-hand smoke. Flight attendants were among the first to call for smoke free environments on flights.
Many like Bob DeMatteo believe strict interpretation and enforcement of the Occupational Health and Safety Act
(OHSA) could completely eliminate second-hand smoke from the workplace. DeMatteo, health and safety coordinator with the Ontario Public Service Employees’ Union (OPSEU) reports that 10 years ago complaints by Sault Ste. Marie jail guards about levels of second-hand smoke led the Ministry of Labour to investigate. When no orders were issued, the union appealed. The adjudicator agreed the workers had reason to believe the levels of smoke were dangerous and could reasonably expect protection under the general duty provisions of the OHSA. Within two years the employer was ordered to reduce levels in the jail to that of a non-smoking building. In the end, the employer chose to prohibit smoking in the jail altogether and provided tobacco education and smoking cessation programs to inmates and workers alike.
Dan Ublansky, executive director of the Toronto Workers’ Health and Safety Legal Clinic says, “Under the Act
workers should expect equal protection against second-hand smoke as they would against any other toxic substance. Now that the WSIB has acknowledged the link between second-hand smoke and lung cancer it’s no longer an issue the Ministry of Labour can ignore.”
For many workers though both the issue and the air they breathe at work are hazy. Ted Mansell, Canadian national health and safety coordinator for the Service Employees’ International Union (SEIU), says his members employed as mutuel clerks at racetracks across Ontario are forced to work in smoking areas because racetracks are exempt from many municipal bylaws. “With each city and town we’re faced with a different set of bylaws. Why should workers in one town have greater protection than workers in another. We need a provincial regulation to protect all workers against second-hand smoke regardless of their workplace.”
Shirley Egan couldn’t agree more. A member of the Canadian Auto Workers (CAW) Local 444, Egan is the fulltime health and safety representative at the Windsor Casino. Casinos are exempt from Windsor’s smoking bylaw. “We’ve seen a steady increase in the number of compensation claims for respiratory problems,” she reports. “And what’s more our members’ doctors are indicating that prolonged exposure to second-hand smoke is likely the cause.”
With release of the Romanow Report proposals for Canada’s health care system and with 18,000 members in the hospitality industry, the CAW is calling on all levels of government to ban smoking in all workplaces.
Other activists are involved at the grassroots level by pressing for protection through municipal bylaws. A longtime activist and fulltime ergonomic representative for CAW Local 444, Rolly Marentette says, “My first concern is protecting workers’ health. That commitment doesn’t stop at the plant gate.” As chair of the Windsor-Essex Council on Smoking and Health, Marentette joined with others in securing implementation of a 100 per cent non-smoking bylaw in Tecumseh, a Windsor suburb.
Hundreds of Canadian municipalities have adopted smoking bylaws and a growing number are extending that ban to restaurants and bars but not without the vehement opposition of owners. Each bylaw debate is accompanied by the legitimate concerns of business owners who fear the loss of smoking customers will translate into lost revenues and staff layoffs. A report conducted for the Nova Scotia government, which reviewed experiences in many jurisdictions with smoking bylaws, concluded that despite initial revenue declines lasting one or two months, there is no long-term impact on the bottom line.
Dr. Pete Sarsfield is leaving nothing to chance. The Medical Officer of Health for the Northwestern Ontario Health Unit has set January 1, 2003 as the date by which all indoor workplaces and public places in the district must be 100 per cent smoke-free. After a comprehensive region-wide public and organizational information campaign on the risk of second-hand smoke including mailing postcards to 30,000 residents encouraging them to pressure local politicians to enact a smoke-free bylaw, Sarsfield is using powers under the Health Protection and Promotion Act
(HPPA) which authorizes and obliges the Medical Officer of Health to respond to demonstrable health hazards in order to limit exposure. Those businesses that have not provided a plan to go smoke-free will be ordered under the HPPA to go smoke-free in January.
Central labour bodies like the Ontario Federation of Labour (OFL) and the Canadian Labour Congress (CLC) have considered the smoking issue for some time striking a balance between the need to protect workers against second-hand smoke while protecting the rights of some 4,000 workers in tobacco manufacturing and another 46,000 employed in related industries, all the while being mindful of those workers who choose to smoke.
The OFL passed its smoke-free workplace policy in 1986. The CLC recently endorsed a policy paper on labour and tobacco which supports: legislation restricting smoking in workplaces or achievement of the same through discussion and negotiation between workers and their employers acknowledging the pre-eminent right of workers to be protected from toxic exposures; negotiated employer-paid smoking education and cessation programs and separately ventilated rest areas; restrictions on advertising and tobacco sales to minors and the use of tobacco revenues to fund community-based education programs. The CLC further calls upon the government to provide just transition programs to secure comparable alternative employment for all impacted workers regardless of their sector along with income support, retraining and related assistance.
Heather Crowe, while battling the devastating effects of cancer treatment, has found the courage to fight for others. She recently supported the efforts of Tecumseh advocates in their bylaw debate. Working with Physicians for a Smoke-Free Canada, she’s calling on the federal, provincial and territorial ministers of labour to ban smoking in their workplaces without exception. In a letter to them she states, “I want to be the last person to die from second-hand smoke at work….Exceptions for bars and restaurants only devalue the health and safety of bar and restaurant workers like me. Waiters and waitresses do not have second-class lungs and there is no reason that we should continue to have second-class protection for our health.”
For additional information on second-hand smoke see the Resource Lines
hazard bulletins in the publications section of the Workers Centre website.