Occupational health

Québec Survey on Working and Employment Conditions and Occupational Health and Safety (EQCOTESST): Summary Report

In recent decades, the world of work has undergone a number of major transformations, which in turn have had considerable impact on both work organization and employment relationships. These changes have often been introduced for economic reasons in the context of increasingly globalized markets. However, it is becoming more and more apparent that they sometimes have negative impacts on workers’ health and safety. This survey was carried out as part of Québec’s Minister of Labour’s responsibility for conducting a study of changes in working conditions in Québec every five years, in collaboration with the organizations concerned, with the ultimate aim of influencing the future course of public policy (see section 11 of the Act respecting the ministère du Travail, R.S.Q., c. M-32.2). A better knowledge of working and employment conditions and how they relate to the health and safety of Québec workers is vital to providing strategic support for orienting occupational health and safety…

Presence of asbestos fibres in indoor and outdoor air in the city of Thetford Mines: estimation of lung cancer and mesothelioma risks

In the autumn of 2007, the Association des victimes de l'amiante du Québec (AVAQ – a Québec association for asbestos victims) and the Ministère du Développement durable, de l'Environnement et des Parcs du Québec (MDDEP – Québec ministry of sustainable development, the environment and parks) published studies on the asbestos concentrations measured in indoor and outdoor air in Thetford Mines. The findings motivated the public health authorities in Chaudière-Appalaches and Estrie to request the assistance of the Institut national de santé publique du Québec (INSPQ – Québec institute of public health) to conduct an assessment of the risk of lung cancer and mesothelioma of the pleura in this population.

Asbestos is divided into two families: amphiboles (crocidolite, amosite, tremolite, actinolite and anthophyllite) and serpentines (chrysotile). The three main diseases associated asbestos exposure are asbestosis, lung cancer and mesothelioma of the pleu…

Presence of asbestos fibres in indoor and outdoor air in the city of Thetford Mines: estimation of lung cancer and mesothelioma risks - Summary

In the autumn of 2007, the Association des victimes de l'amiante du Québec (AVAQ – a Québec association for asbestos victims) and the Ministère du Développement durable, de l'Environnement et des Parcs du Québec (MDDEP – Québec ministry of sustainable development, the environment and parks) published studies on the asbestos concentrations measured in indoor and outdoor air in Thetford Mines. The findings motivated the public health authorities in Chaudière-Appalaches and Estrie to request the assistance of the Institut national de santé publique du Québec (INSPQ – Québec institute of public health) to conduct an assessment of the risk of lung cancer and mesothelioma of the pleura in this population.

Asbestos is divided into two families: amphiboles (crocidolite, amosite, tremolite, actinolite and anthophyllite) and serpentines (chrysotile). The three main diseases associated asbestos exposure are asbestosis, lung cancer and mesothelioma of the pleu…

Asbestos: Current Knowledge on the Exposure and Diseases of Workers and the General Population in Québec from 2003 to 2009

This document reports on the Québec data acquired since 2003 on asbestos exposure and asbestos-related diseases, both among workers and in the general population. However, the aim is not to update the knowledge on asbestos as such. This report also summarizes the status of the Québec surveillance system for asbestos exposures and asbestos-related diseases, which will be introduced by the Institut national de santé publique du Québec (INSPQ), as a result of the adoption of the Policy concerning the increased and safe use of chrysotile asbestos in Québec.

The most recent data (2004) on environmental exposure to asbestos in outdoor air identified no asbestos fibres in Montréal and in the city of Québec. However, in Thetford Mines, the average airborne asbestos concentration was 0.0043 fibre/ml (f/ml) by transmission electron microscopy (TEM). This concentration was 215 times higher than that obtained in the air outside buildings involved in litigation regarding the re…

Reference framework for screening and medical surveillance in occupational health: Summary

By its very nature, screening is characterised by administering a test to presymptomatic or early symptomatic individuals who may benefit from a more effective intervention if it is performed before the usual time of diagnosis.

Far from being a trivial intervention, screening can lead to significant consequences to the people screened. Therefore, before offering screening to workers, its effectiveness and the predominance of benefits over disadvantages must be demonstrated at the population level. Furthermore, screening should have the recommended characteristics in order that the expected benefits can be observed in practice.

Approaches using algorithms or flowcharts are generally meant to be sequential. Our approach had to be flexible and allow for compromises. The proposed approach involves three key decision-making nodes, which must generally be addressed in a sequential manner. Generally speaking, a satisfactory response to one of them is required before moving…

Comité d'experts sur le dépistage et la surveillance médicale en santé au travail

Cancer risk assessment for workers exposed to nitrosamines in a warehouse of finished rubber products in the Eastern Townships (Québec, Canada)

This risk assessment was undertaken at the request of Dr. Louise Soulière, director of public health and evaluation at the Agence de la santé et des services sociaux de l'Estrie.

The objective of this work is to assess whether workers in a warehouse of finished rubber products in the Eastern Townships are at risk of contracting cancer because of the presence of nitrosamines in the workplace ambient air and, in the case of a non-zero risk, to suggest a threshold limit not to be exceeded in order to make the risk negligible.

The methodology used involves estimating workers' exposure to nitrosamines in the warehouse; assessing the carcinogenic potential for humans of the main nitrosamine molecules found in that environment; estimating the dose-cancer excess relationship based on epidemiological studies published so far and estimating the cancer risk associated with such exposure. This will allow suggesting an occupational exposure limit aimed at preventing the type of c…

Effects of workplace noise exposure during pregnancy: Systematic review with meta-analysis and meta-regression - Abstract

Objectives
To summarize the available scientific information on the effects of workplace noise exposure during pregnancy. The studied effects on pregnancy are: spontaneous abortion (SA), stillbirth (SB), congenital anomalies (CA), preterm delivery (PTD), low birth weight (LBW), small-forgestational- age (SGA) infant, pre-eclampsia (PE) and gestational hypertension (GHT). The effect of workplace noise during pregnancy on the child's hearing is also addressed.

Method
First, two bibliographic searches, one in Medline and the other in Embase, were performed to identify the original epidemiological studies that evaluated the effects of workplace noise on pregnancy. Studies published in French or in English between 1970 and August 2008 were selected. The bibliographies of the articles and the personal files of the author completed the list of the articles for consultation. There was no systematic search for unpublished material. The presen…

Nunavik Inuit Health Survey 2004 : Hearing Loss and Dental Health

Hearing loss

Hearing problems are widespread in Nunavik with one quarter of adults having hearing loss in both ears. Men have three times more hearing loss than women (36% vs. 12%) and these problems are found to increase with age; more than half the adults over age 45 suffer from a hearing loss in both ears. Prevalence of hearing disability (as defined by World Health Organization) was 7.6% in Nunavik in 2004, which is one of the highest of the regions of the world surveyed to date.

Comparing men and women, hearing ability is similar in the youngest age group, but at age 30-44, men already show a greater deficiency compared to women. In the oldest age group (45 and over), three out of four men suffered bilateral hearing impairment compared to one out of four women. If we assume that hearing loss in women is primarily due to age and factors other than noise exposure, we can observe the deleterious effect of noise in the male population. Frequent hun…

Descriptive Epidemiology of the Principal Asbestos-Related Diseases in Québec, 1981-2004

While awaiting the introduction of the future surveillance system for asbestos exposures and their related diseases, we created the descriptive epidemiological portrait of two of these health problems, malignant mesothelioma and asbestosis. It was constructed using the data from statutory databases available at the ministère de la Santé et des Services sociaux: the Fichier des tumeurs du Québec (tumour registry) for cancer incidence, the Fichier des décès (death registry) for mortality and the Med-Echo registry for asbestosis hospitalizations. Finally, the international comparisons of malignant mesothelioma incidence rates were made using the electronic database of the International Agency for Research on Cancer.

The study area is the Province of Québec. The incidence rates, mortality and hospitalization at the regional level (health region) were compared. The time trends of incidence rates, mortality and hospitalization were analyzed. Standardized rates using the direct met…

The Use of Chrysotile Asbestos in Quebec

In 1997, in light of international developments with respect to asbestos, the ministère de la Santé et des Services sociaux (Québec's department of health and social services) set up the Comité aviseur sur l'amiante (asbestos advisory committee) to make recommendations concerning appropriate measures for informing the public about the asbestos situation in Québec and protecting public health in this regard. To carry out this mandate, the committee conducted a number of studies. These were synthesized in three documents that may be consulted on the website of the Institut national de santé publique du Québec (INSPQ) (De Guire et al., 2003; Lajoieet al., 2003; De Guire & Lajoie, 2003).

In 2002, the Québec government adopted a Politique d'utilisation accrue et sécuritaire de l'amiante chrysotile (Policy concerning the increased and safe use of chrysotile asbestos). As the name indicates, the objective of this policy is to increase the…