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Toronto, Canada

Pefoyo A.J.K.,University of Toronto | Genesove L.,Ontario Ministry of Labour | Moore K.,University of Toronto | Del Bianco A.,University of Toronto | And 3 more authors.
Journal of Occupational and Environmental Medicine | Year: 2014

Objective: The ongoing presence of asbestos in products used across workplaces in Canada reinforces the importance of occupational exposure surveillance. This study evaluates the usefulness of the Ontario Asbestos Workers Registry.Results: The incidence of exposure started to decrease around 1990; but about 2000 workers were still exposed annually until 2006. Results showed large geographical disparities. Unexpectedly, workers from industries other than construction reported exposure.Methods: The study includes 30,829 workers aged 15 to 80 years. Researchers reported on the data quality and analyzed the proportions of workers exposed by industry, and standardized rates by geographic areas and over time.Conclusions: The Ontario Asbestos Workers Registry is a useful but challenging source of information for the surveillance of asbestos exposure in Ontario. The registry could benefit from well-defined surveillance objectives, a clear exposure definition, systematic enforcement, regular data analyses, and results dissemination. Copyright © 2014 by American College of Occupational and Environmental Medicine.

Ghajar-Khosravi S.,University of Toronto | Tarlo S.M.,University of Toronto | Tarlo S.M.,Li Ka Shing Knowledge Institute | Liss G.M.,University of Toronto | And 7 more authors.
Canadian Respiratory Journal | Year: 2013

Background: Asthma is a common chronic condition. Work-related asthma (WRA) has a large socioeconomic impact and is increasing in prevalence but remains under-recognized. Although international guidelines recommend patient education, no widely available educational tool exists. Objective: To develop a WRA educational website for adults with asthma. Methods: An evidence-based database for website content was developed, which applied evidence-based website design principles to create a website prototype. This was subsequently tested and serially revised according to patient feedback in three moderated phases (one focus group and two interview phases), followed by face validation by asthma educators. Results : Patients (n=10) were 20 to 28 years of age; seven (70%) were female, three (30%) were in university, two (20%) were in college and five (50%) were currently employed. Key format preferences included: wellspaced, bulleted text; movies (as opposed to animations); photos (as opposed to cartoons); an explicit listing of website aims on the home page; and an exploding tab structure. Participants disliked integrated games and knowledge quizzes. Desired informational content included a list of triggers, prevention/control methods, currently available tools and resources, a self-test for WRA, real-life scenario presentations, compensation information, information for colleagues on how to react during an asthma attack and a WRA discussion forum. Conclusions: The website met the perceived needs of young asthmatic patients. This resource could be disseminated widely and should be tested for its effects on patient behaviour, including job choice, workplace irritant/allergen avoidance and/or protective equipment, asthma medication use and physician prompting for management of WRA symptoms. ©2013 Pulsus Group Inc. All rights reserved.

Arrandale V.H.,University of Toronto | Liss G.M.,University of Toronto | Liss G.M.,Ontario Ministry of Labour | Tarlo S.M.,University of Toronto | And 4 more authors.
American Journal of Industrial Medicine | Year: 2012

Background: Workplace exposures that can potentially cause both allergic occupational contact dermatitis (AOCD) and occupational asthma (OA) are not clearly identified. Methods: Occupational contact allergens (OCAs) were identified using North American Contact Dermatitis Group (NACDG) data. Reference documents and systematic reviews were used to determine whether each OCA had been reported to potentially cause OA. The presence or absence of a sensitizer notation in occupational hygiene reference documents was also examined. Results: The 10 most common OCAs were: epoxy resin*, thiuram, carba mix, nickel sulfate*, cobalt chloride*, potassium dichromate*, glyceryl thioglycolate, p-phenylenediamine*, formaldehyde* and glutaraldehyde*. Seven (indicated by *) were determined to be possible causes of OA. Information on sensitizing potential from OH reference materials contained conflicting information. Conclusions: Several common OCAs can also potentially cause OA. Inhalation and dermal exposures to these agents should be controlled and both OA and AOCD should be considered as possible health outcomes. Increased consistency in sensitizer notations is needed. © 2011 Wiley Periodicals, Inc.

Liss G.M.,University of Toronto | Liss G.M.,Ontario Ministry of Labour | Buyantseva L.,University of Toronto | Luce C.E.,Ontario Workplace Safety and Insurance Board WSIB | And 3 more authors.
American Journal of Industrial Medicine | Year: 2011

Background: The health of workers in health care has been neglected in the past. There are few reports regarding occupational asthma (OA) in this group, and work-exacerbated asthma (WEA) has rarely been considered. Methods: We examined the frequency of claims for OA and WEA allowed by the compensation board in Ontario, Canada for which industry was coded as "health care" between 1998 and 2002, to determine the frequency of OA and WEA, causative agents, and occupations. Results: During this period, five claims were allowed for sensitizer OA, two for natural rubber latex (NRL), and three for glutaraldehyde/photographic chemicals. The two NRL cases occurred in nurses who had worked for >10 years prior to "date of accident." There were 115 allowed claims for WEA; health care was the most frequent industry for WEA. Compared to the rest of the province, claims in health care made up a significantly greater proportion of WEA claims (17.8%) than OA (5.1%) (odds ratio, 4.1, 95% CI 1.6-11.6; P=0.002). The rate of WEA claims was 2.1 times greater than that in the rest of the workforce (P<0.0001). WEA claims occurred in many jobs (e.g., clerk), other than "classic" health care jobs such as nurses, and were attributed to a variety of agents such as construction dust, secondhand smoke, and paint fumes. Conclusions: WEA occurs frequently in this industrial sector. Those affected and attributed agents include many not typically expected in health care. The incidence of OA claims in this sector in general was low; the continued low number of OA claims due to NRL is consistent with the successful interventions for prevention. © 2011 Wiley-Liss, Inc.

Chung D.A.,Workplace Safety and Insurance Board WSIB | Yang R.,Ontario Ministry of Labour | Verma D.K.,McMaster University | Luo J.,Digit Compass
Journal of Occupational and Environmental Hygiene | Year: 2015

This article outlines a hierarchy of data required for retrospective exposure assessment for occupational disease of an individual worker. It then outlines in a step-wise manner how trend analysis using a relatively large exposure database can be used to estimate such exposure. The process of how a large database containing exposure measurements can be prepared for estimating historic occupational exposures of individual workers in relation to their illnesses is described. The asbestos subset from a large government collected air monitoring database called Medical Surveillance (MESU) was selected to illustrate the cleaning and analysis processes. After unidentifiable values were removed, the cleaned dataset was examined for possible sources of variability such as changes to sampling protocol. Limit of detection (LOD) values were substituted for all non-detectable values prior to the calculation of descriptive statistic using left censored analysis methods (i.e., maximum likelihood estimation (MLE), Kaplan Meier (KM), and simple substitution). The JoinPoint Regression Program was used to perform trend analysis and calculate an annual percentage change (APC) value for the available sampling period. An asbestos case study is presented to illustrate how the APC can then be combined with more recent job and/or process specific exposure data to estimate historic levels. The MESU asbestos dataset contained 1,610 samples from 1984-1995. An average of 17% of this data was left censored. The asbestos air sampling methods in Ontario changed around 1990. LOD values of 0.06 f/cc and 0.02 f/cc were substituted for LOD values pre-and post-1990, respectively. The annual mean fiber levels for the MLE method were an average of 44% lower than KM and substitution methods. The corresponding APC for MLE method was-6.5% and-7.7% for KM and simple substitution. The findings of this paper illustrate how the temporal trend of an exposure databases can be used to efficiently estimate historic contaminant levels in the presence of limited historical information. © 2015 Copyright © 2015 JOEH, LLC.

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