The goal of this study was to determine whether it is feasible to use intake interviews at community health centres in Ontario to gather workplace exposure information.
We currently do not have a systematic way to determine what occupational disease risks and injury hazards workers are exposed to at a regional level. This information is needed to help identify and monitor the health needs and health status of the population and help inform long-term prevention efforts.
We can gain insight into workers’ potential exposures from sources such as environmental information reported by companies to the National Pollutant Release Inventory of Environment Canada, samples of individual workplaces by inspectors or consultants, and from gross data that we collect from imports, exports and manufacturing data. However, it is difficult to incorporate these data into a monitoring system at the population level. Incorporating self-identified workplace exposure information into patients’ medical charts at community health centres would allow doctors or researchers to identify potentially at-risk workers and to broadly monitor exposure prevalence within the local population.
We developed a brief survey that asks questions on present-day work exposures, risks, and incidents such as chemicals, airborne particulates, vibration, heavy lifting, and slips, trips and falls. The survey was distributed at five Community Health Centres (CHCs) in Ontario. Working patients filled out the survey and their answers were entered into their electronic medical records.
We also used interviews to explore clinicians’ concerns around any challenges they may face in asking the questions (such as the time required) and whether patients are able to understand and answer the questions (for example, questions on duration and intensity of exposure), in order to determine if adding these exposure questions to an existing clinical process is feasible.
Clinicians currently ask questions about a patient’s work when they suspect their health concern may be related to an occupational exposure. This study did not show feasibility or clear clinical purpose for routinely asking questions about workplace exposure.
Major themes that arose from this study were the importance of clinician and administrator buy-in, the perceived importance of occupational exposures by physicians and patients, and the perceived relevance of occupational exposures to presenting clinical health problems.
Funding for this study was received from the Canadian Cancer Society Research Institute and Canadian Institutes of Health Research:
Kramer, D.M., Holness, D.L., Lightfoot, N.E., Kudla, I., Arrandale, V., Wells, R.P. Completing the Picture: Collecting workplace exposure information from community health clinics’ patients. Canadian Cancer Society Research Institute (CCSRI) and Canadian Institutes of Health Research (CIHR): Prevention Research Grant. $369,680.
Feasibility of clinicians asking patients about their exposure to occupational hazards: An intervention at five primary care health centres
Asking Clients at a Community Health Center About Their Occupational Exposures: A Knowledge Transfer Feasibility Case Study
