Occupational Medicine 2008 58(6):443-444; doi:10.1093/occmed/kqn065
© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Occupational medicine in Canada
Ron House1,2
1 Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
2 Department of Occupational and Environmental Health, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
e-mail: houser{at}smh.toronto.on.ca
 |
What work takes place in your country?
|
|---|
Canada, a country of 10 provinces and 3 territories with a population
of 32 million, is one of the world's wealthiest nations in terms
of per capita income. Its economy is now dominated by the service
sector which employs about 75% of working Canadians. However,
the primary resource sector remains important especially the
oil, mining, agriculture and forestry industries. There is also
a significant manufacturing base, in particular in Quebec and
Ontario with the aeronautics and automotive industries being
especially important.
|
What are the key occupational diseases?
|
|---|
Information about occupational disease is obtained mainly from
workers’ compensation data, although occupational disease
is significantly underreported [
1]. The majority of claims are
for repetitive strain injury, noise-induced hearing loss, skin
disease, respiratory disease and cancer, in particular lung
cancer and mesothelioma due to previous asbestos exposure. In
industry, the main problems dealt with are musculoskeletal disorders
and psychiatric problems affecting work.
|
How is occupational health provided?
|
|---|
Most of the full-time corporate positions in industry have been
eliminated in the last 15 years. Some full-time positions are
still present in compensation boards, government and academia.
Most physicians now provide services to a number of companies
either as independent practitioners or under the aegis of an
occupational health service company. Also, for many years there
have been some worker-controlled clinics [
2].
|
Who provides the services?
|
|---|
There are about 60 specialists in the country who have completed
Royal College of Physicians and Surgeons of Canada training
and certification. They provide leadership in the field but
many services are still supplied by non-specialists.
|
How is occupational health represented?
|
|---|
The Occupational Medicine Specialists of Canada is an organization
composed of specialists that was formed in 2006 to facilitate
interaction of specialists including their interaction with
the Royal College. The Canadian Board of Occupational Medicine
is made up mainly of non-specialists and provides basic certification
for those lacking Royal College eligibility. The Occupational
and Environmental Medical Association of Canada (OEMAC) is the
umbrella organization to which most practitioners (specialist
and non-specialist) belong and it has served as the target population
for the only large survey of Canadian occupational physicians
previously reported [
3]. The 2007 OEMAC directory listed 199
members.
|
What legislation do you have that impacts on the provision of occupational health?
|
|---|
Occupational health falls mainly under provincial jurisdiction
with each province and territory having its own occupational
health and safety act. The general scope of the legislation
is similar but the provinces and territories may differ in the
regulations for specific exposures, operations or industries.
Federal legislation applies to employees of the federal government
and federal corporations as well as some industries that fall
under federal jurisdiction such as international and interprovincial
transportation and shipping. This decentralization has impeded
the development of large national organizations such as the
Health and Safety Executive in the UK and the National Institute
for Occupational Safety and Health in the USA.
|
What about research and education?
|
|---|
In the last few years, there has been increased opportunity
for provincial research funding through the research agencies
associated with the compensation boards in Quebec, Ontario,
Manitoba and British Columbia. Alberta's Heritage Fund may also
be used for occupational health research. Federal funds are
available through the Canadian Institute for Health Research,
although there is no section earmarked for occupational health.
There are only two Royal College approved specialty training
programs at the University of Alberta and the University of
Toronto. In 2006, the Royal College changed the training requirements
so that 3 years of initial training in core internal medicine
is now required before entering occupational medicine training.
The Royal College is currently evaluating other routes of entry,
although core competencies will have to be achieved regardless
of the training route [
4].
|
What has your country contributed to the advancement of the specialty?
|
|---|
Canada has made a significant contribution to many areas of
research especially in occupational asthma, contact dermatitis
and respiratory disease due to silica and asbestos. The Universities
of Toronto and Alberta have developed excellent training programs
and their graduates should provide national and international
leadership in the future. St Michael's Hospital, which is the
main site for clinical training at the University of Toronto,
has developed a large clinic for assessment of complex occupational
medicine problems using a multidisciplinary team approach and
evaluation of extended outcomes including return to work and
quality of life. This program is a model for training in clinical
occupational medicine and provides excellent data for applied
research.
|
References
|
|---|
- Thompson A. The consequences of underreporting workers’ compensation claims. Can Med Assoc J (2007) 173:343–344.
- Yassi A. The development of worker-controlled occupational health centers in Canada. Am J Public Health (1988) 78:689–693.[Abstract/Free Full Text]
- Holness DL, House RA, Corbet K, Kosnik R. Characteristics of occupational medicine practitioners and practice in Canada. J Occup Environ Med (1997) 39:895–900.[CrossRef][Web of Science][Medline]
- House R. Core skills in occupational medicine. Can J Gen Intern Med (2008) 3:82–84.
CiteULike 
Connotea 
Del.icio.us What's this?
Top
What work takes place...
What are the key...