Author: Samira Prasad

The Queen’s Park Briefing looks at the Ontario government’s plans to have an occupational exposure registry in place by 2025 to track workers’ exposure to disease-causing elements at work. This follows a MAP report by Dr. Linn Holness and Janet Brown on the current occupational disease landscape in the province.

Dr. Sean Rourke spoke with Medscape News about the concerning rise in syphilis cases in Canada, and ways in which we can reduce the spread. Since 2017, the rate of infectious syphilis increased by 166% overall nationwide, according to the Public Health Agency of Canada (PHAC).

News release from the Ontario Labour, Immigration, Training and Skills Development Newsroom

The Ontario government is protecting and supporting workers by committing to create Canada’s first-ever Occupational Exposure Registry to track harmful exposure levels, help diagnose workplace diseases faster, improve worker compensation, and reduce costs to the healthcare system. The registry will help address many of the 41 recommendations resulting from the province’s first-ever review of the occupational illness landscape, released in a report today.

“While Ontario has one of the strongest health and safety records of any jurisdiction anywhere, too many workers are falling through the cracks when it comes to occupational illness,” said David Piccini, Minister of Labour, Immigration, Training and Skills Development. “Under the leadership of Premier Ford, our government will leave no stone unturned to ensure we have the best science and data needed to protect workers and make room for everyone’s voice at the table as we build a stronger system that works for everyone.”

Many workplace illnesses currently go undiagnosed or unreported because of the delay between exposure and symptoms, making it difficult to identify occupational disease risks and for workers to get financial support when they fall ill. The new registry would include comprehensive exposure records, identify at-risk workers, help with earlier diagnoses, and potentially contribute to expanding the list of presumptive illnesses in Ontario to improve worker compensation.

“Through our government’s Your Health plan, we are building a healthcare system that better provides Ontarians with the right care, in the right place,” said Sylvia Jones, Deputy Premier and Minister of Health. “With this innovative, first-of-its-kind Occupational Exposure Registry, our government is making it easier for workers across the province to connect to the care and support they need, when they need it.”

In addition, Ontario is creating an Occupational Illness Leadership Table made up of industry experts and worker advocates to guide the implementation of the report’s recommendations. The table will include some of the province’s foremost medical voices along with representatives from workplace health and safety groups to ensure the province keeps pace with advancements in medical science and technology and delivers for workers.

To build the Occupational Exposure Registry, which is expected in 2025, the Ministry of Labour, Immigration, Training and Skills Development is working with the Occupational Cancer Research Centre (OCRC) to collect and analyze data from existing Ministry industrial hygiene records. The Ministry and OCRC are also working with healthcare providers and industry associations to gather new data and catalogue past and current occupational exposures across Ontario’s hundreds of thousands of workplaces.

“The Ontario Federation of Labour (OFL) has long advocated for greatly increased recognition of occupational diseases by Ontario’s workers’ compensation system,” said Patty Coates, OFL President. “A government commissioned study by Dr. Paul Demers recently found that less than 10 per cent of Ontarians with occupational cancers ever get compensated. The OFL welcomes the government proposal to establish an occupational disease registry as a first step towards moving on other key recommendations in the Demers report, such as increasing the number of cancers recognized for workers’ compensation.”

The Occupational Disease Landscape Review report was authored by Dr. Linn Holness and Janet Brown of the MAP Centre for Urban Health Solutions at St. Michael’s Hospital in Toronto, a site of Unity Health Toronto, and an internationally recognized research organization. The 58-page report includes recommendations on workplace prevention and monitoring of occupational disease, healthcare delivery and ways to strengthen connections within the system.

In addition to the Registry, work is underway to deliver on the report’s recommendations, including the development of a web-based Silica Control Tool that will assist in detecting and monitoring workplace silica exposure in the construction and mining industries.

Drs. Nav Persaud and Aisha Lofters‘s latest op-ed in The Conversation looks at making preventative health care equitable and accessible in Canada. “Focusing on the needs of those who are treated unfairly could ultimately lead to improvements for everyone,” says Dr. Persaud.

Following a review done last year by Dr. Linn Holness and team, Ontario is launching a new plan to track job-related illnesses. CBC highlights some of the report’s key recommendations.

MAP has welcomed several new scientists and investigators this year, read more about them below. You can browse all of our scientists here.

Dr. Mikaela D. Gabriel (Italian & Mi’kmaq of Ktaqmkuk; she/her) is a clinical and counselling psychologist (in supervision) and researcher exploring Indigenous health and wellbeing, urban cultural connection, and housing transitions for Indigenous Peoples in Canada. Read her full bio here.

Dr. Benita Hosseini (she/her) is a researcher working on identifying effective and affordable treatments for COVID-19 so they can be more accessible and available in community settings. Read her full bio here.

Dr. Mohammad Karamouzian (he/him) is an infectious disease epidemiologist who is passionate about global equity in health and social justice. Read his full bio here.

Dr. Aaron Orkin (he/him), both a physician and researcher, explores the intersection between public health and clinical medicine. Read his full bio here.

Dr. Saadia Sediqzadah (she/her) is a practicing psychiatrist whose work is rooted in social justice and advocacy. Her research focuses on the intersection of health economics, decision science and severe and persistent mental illnesses. Read her full bio here.

MAP also welcomes Dr. Ambreen Sayani as an affiliate scientist, you can read her bio here.

Dr. Kamran Khan’s company BlueDot was featured in The Globe and Mail’s recent article about Canada’s top growing companies. BlueDot tracks and forecasts outbreaks of infectious disease using a combination of data analytics and human intelligence. It is a a subscription-based product with clients across the public and private sectors, from governments to airlines to pharmaceutical makers.

Dr. Aisha Lofters spoke to CBC about how at-home HPV testing could significantly boost early detection. This is one of the recommendations in a recent CMAJ guideline on equitable preventative care which she co-authored.

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Dr. Nav Persaud spoke to The Globe and Mail about the new set of recommendations published in CMAJ designed to improve health care for people who face barriers in accessing it; as well as the new online tool that individuals can use to find out if they should speak to health care providers about prioritized screening.

Publication de nouvelles lignes directrices exhaustives pour la promotion de l’équité en matière de santé au Canada

Le D^r Nav Persaud a accordé un entretien au Globe and Mail au sujet des nouvelles recommandations publiées dans le Journal de l’Association médicale canadienne (JAMC) et qui sont destinées à améliorer les soins de santé pour les personnes qui rencontrent des obstacles pour y accéder. Il a également parlé du nouvel outil en ligne permettant de savoir si une personne doit s’adresser à un prestataire de soins de santé pour obtenir un dépistage prioritaire.

From Unity Health Toronto, by Marlene Leung

A new comprehensive national guideline outlines 16 preventive care recommendations to promote health equity for people experiencing disadvantages due to racism, sexism and other forms of discrimination.

The guideline, published in the Canadian Medical Association Journal, includes recommendations for increased screening for certain cancers and heart conditions, blood testing for tuberculosis (TB), and patient self-testing for diseases like HIV and HPV. These preventive care measures are intended to detect a medical condition or disease before it progresses to a more serious stage.

Some of the key recommendations in the study include:

• Prioritizing colorectal cancer screening for patients aged 45-74
• Offering HPV self-testing for people eligible for cervical cancer screening
• Screening for TB infection in people with other risk factors, including recent immigration to Canada from a country with high rates of TB
• Screening for depression and providing appropriate support to adolescents and adults
• Screening for risk factors for poverty in all families with children, and connecting families in need with resources and supports
• Connecting patients to primary care with automatic enrollment in a primary care practice
• Removing costs and barriers for medical tests, treatments and counselling

While preventive care is already part of our health system, many people experiencing marginalization face barriers accessing this care, says Dr. Navindra Persaud, study-co-lead and Unity Health Toronto family physician and Canada Research Chair in Health Justice.

“We’re hoping people will pay more attention to the actual specific actions that can be taken to promote health equity,” he said. “Even though inequities are rooted in systemic issues, there are things that healthcare institutions and healthcare providers can do on a day-to-day basis to achieve fairness when it comes to health outcomes.”

Persaud said while the recommendations are aimed at achieving fairness and equity in health outcomes, many of these recommendations will also improve efficiencies.

For example, the common method of screening for HPV and cervical cancer is via Pap tests that are conducted by a physician during a doctor’s appointment. During the appointment, the physician collects a sample from the patient and sends it to the lab. The results are sent back to the physician, who then communicates the results back to the patient.

By offering patients the option of self-testing and sending their sample to a lab, the process is made easier for patients who may not be able to come in to clinic. It can also address disparities in who gets cervical cancer screening, said Persaud.

“It’s an example that demonstrates that when we focus on health equity, we can actually improve the system in ways that benefit everyone,” he said.

Streamlining the process for TB testing via a single blood test, rather than a multi-step skin test, will also improve efficiencies, he added.

Persaud notes these preventive measures are already available to patients, it’s just a matter of redeploying resources and focusing on groups that have been underserved.

“The resources are already there, but there are people who are not receiving these life-saving interventions,” he said. “It’s really about using what we already have more appropriately and more fairly.”