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Better recognition of occupational cancers can aid prevention too: report

Worker working near radioactive materials
New policies, resources to identify workplace clusters and a scientific review panel are among changes needed to update Ontario’s workers’ compensation system says a new report.

The recommendations are part of a recently released reportUsing scientific evidence and principles to help determine the work-relatedness of cancer completed by Dr. Paul Demers, director of the Occupational Cancer Research Centre (OCRC). The independent review, first promised in spring 2018, was eventually requested by the Ontario Ministry of Labour, Training and Skills Development in January 2019. The review report, completed in January, comes after sustained pressure from affected workers, their families and their unions who have long said the province’s system of compensating work-related cancers is outdated and unfair.

Report mandate and key findings

The review set out to examine three main areas: using scientific evidence in determining work-relatedness of occupational cancer claims, particularly cases with multiple exposures; best practices in other jurisdictions; and scientific principles to inform occupational disease policy.

Previous research estimates there are 3,000 occupational cancers in Ontario each year, of which only 400 compensation claims are filed by workers, with only 170 claims accepted by the Workplace Safety and Insurance Board (WSIB). Of cancer claims filed between 2009 and 2018 (not including claims related to the firefighter presumptions) less than half (41.5 per cent) were accepted.

While Ontario’s acceptance rates for work-related cancer claims (2.9 per 100,000 workers) are in line with other Canadian jurisdictions, they are well below European Union nations whose rates range from 4.7 in Belgium to 15.1 in Germany.

Why are so few occupational cancers recognized and compensated in Ontario? The report identifies a number of factors including:  
  • Lack of recognition by primary care providers  
  • Poor investigation of workplace cancer clusters
  • Rigid policies based on legal principles requiring absolute certainty of work-relatedness (although compensation law does not require that work be the only causal factor) 
  • Reliance on outdated scientific evidence which fails to recognize that most cancers are now understood to have multi-causal factors and stages, and that many workers also face multiple hazardous exposures at work.

The report notes, “While our knowledge of what causes cancer has greatly increased and continues to do so, the sophistication with which we approach attribution in workers’ compensation has not always kept pace.”

Need to act on recommendations

The report acknowledges the many challenges involved in recognizing and compensating work-related cancers and offers recommendations “to support the WSIB’s efforts to improve evidence-based decision-making.”

The report makes recommendations in four key areas including:
  • Updating presumptive lists and cancer-relevant policies based upon current scientific knowledge (eg. Acknowledging exposures to multiple carcinogens; clarifying the role and weighting of non-occupational exposures and possible additive effects; creating an independent, standing Scientific Review Panel)
  • Enhancing scientific capacity including more capacity, especially within MLTSD, to investigate workplace cancer clusters
  • Improving access to exposure data for compensation and to inform prevention efforts (eg. more collection of exposure-related data by MLTSD inspectors and better sharing of data between MLTSD and WSIB)
  • Enhancing medical education to improve disease recognition.

Health, safety and workers’ compensation advocates want to see the recommendations implemented quickly. Thanks to high profile investigative reporting of cancer clusters at GE’s Peterborough facility and among former Kitchener area rubber workers the public is also more aware of the need for change.  

Addressing historic exposures and their related illnesses is critical but so too are the lessons they offer to help protect workers today said Marty Warren, United Steelworkers District 6 director and a former rubber worker in a press release, “Recognition of work-related cancers is the first necessary step to preventing them in the future.”

The Ontario Federation of Labour (OFL) is also calling for swift action on the report wanting some policy changes in place by Labour Day. They are also pressing for a review of all previously denied cancer claims and want the province to restore and fully fund an independent review panel with worker, employer and scientific representation much like the former Occupational Disease Panel.

The need for these reforms and others are well documented in a groundbreaking 2017 report jointly produced by the OCRC and Cancer Care Ontario on the burden of occupational cancer in Ontario. That report offered a set of recommendations upon which to develop a blueprint for occupational cancer prevention in the province including: the need for more protective occupational exposure limits; free, public workplace exposure registries and exposure surveillance systems; and expanded coverage of the Designated Substances Regulation to include construction project employers and workers.

The report also acknowledged a training standard for the workplace hazardous materials information system (WHMIS), could help ensure workers receive consistent, high-quality training, especially beneficial for those working with or exposed to carcinogens.

Related articles and resources:

The Uncounted: a series on occupational disease in Canada produced through financial support from the Mitchener-Deacon Fellowship for Investigative Journalism

Recognizing occupational cancer claims – what will it take?

Occupational Health Clinics for Ontario Workers

Occupational Cancer Research Centre

CAREX Canada

The Workers Health & Safety Centre assists workplace prevention efforts with training programs and information services aimed at raising awareness about hazardous exposures, including those which can contribute to the burden of cancer, and targeting prevention at the workplace level.

WHSC offers a host of essential and legally required programs including Joint Health and Safety Committee Certification Training and WHMIS. Several of these programs are also offered through our virtual classroom training.

Workplace representatives will also want to check out WHSC training programs on Documenting Health and Safety and Occupational Hygiene Monitoring. Be sure to download our recently updated health and safety documentation tools, essential resources for recording workplace exposures and investigating illnesses.

To learn more: 
Call: 1-888-869-7950