Women's Health Matters

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Workplace Health and Safety

In November 2008, our guest expert in Le Club's Ask the Expert segment was Angela Wrobel, BScN, an occupational health nurse at Women’s College Hospital.

Angela completed her Bachelor of Science in Nursing (BScN) at the University of Western Ontario. After working briefly on a surgical nursing unit, she went into the occupational health field, where she has been working for 23 years.

Angela obtained professional certification COHN(C) through the Canadian Nurses Association in 1989 and has maintained certification since that time.

Through various positions in the field of occupational health she has gained experience in a wide range of activities including: immunization and audiometric testing of City of Toronto fire-fighters; pre-placement screening of new employees; providing vaccination against diseases such as hepatitis, influenza and varicella; and assisting ill and injured employees to return to work on transitional modified work programs.

Angela has worked as an occupational health nurse at Women’s College Hospital in Toronto since 1999. She is a member of the Ontario Occupational Health Nurses Association and is president of the Toronto Occupational Health Nurses Association.

Here are Angela’s answers to your questions on Workplace Health and Safety:

Q: One of my co-workers wears perfume to work and it bothers me because I am allergic to scented products. My organization does not have a scent-free policy, but I have heard that other organizations are moving in that direction. How can I prove that her scented products are making the workplace unsafe for me?

A: Scents can cause health problems. When scented products have been blamed for adversely affecting a person's health, some or all of the following symptoms are reported:

  • nausea
  • dizziness, lightheadedness
  • fatigue
  • headaches
  • weakness
  • insomnia
  • malaise
  • confusion
  • loss of appetite
  • depression
  • anxiety
  • numbness
  • upper respiratory symptoms
  • shortness of breath
  • difficulty concentrating
  • skin irritation

Allergic and asthmatic patients, as well as those with other conditions, report that certain odours, even in the smallest amounts, can trigger an attack.

The severity of these symptoms can vary. Some people report mild irritation while others are incapacitated and must give up many 'normal' activities, like going to public places, to avoid exposure. The only way to confirm your sensitivity is through testing by an allergist or assessment at an Occupational Clinic, such as the one at St. Michael’s Hospital.


Q: I have been a hairdresser for about 10 years. My boss recently asked me to train to be a colourist. I am a little reluctant to take this on because the fumes from the hair dye bother me. I am also worried about the long-term effects of the dyes on my health and whether or not they might be carcinogenic. Do you happen to know about the long-term effects of chemical dyes? If not, where can I find out more?

A: Some of the preparations and products used in beauty salons contain harmful substances that can cause both skin and respiratory problems. Products used for cleaning can also be hazardous. Bleaches, perms, relaxers and hair colours contain ammonium hydroxide. You can obtain a material safety data sheet (MSDS) for each chemical product to learn about its specific acute and chronic adverse health effects. Additionally, the MSDS will provide information on safe handling, including ventilation requirements and personal protective equipment.

Take a list of all hazardous products used in the salon and obtain MSDSs from the manufacturers.

  • Ask chemical suppliers if safer substitutes are available.
  • Ensure you assess all new products before use and that you are trained to use them safely.
  • Store and use all products in accordance with the manufacturer’s instructions.
  • Take care when disposing of surplus and out-of-date stock, following the manufacturer’s guidelines, or return to the manufacturer.
  • If you develop signs of dermatitis or asthma, take suitable action to minimize the problem (e.g. provide barrier creams and wear gloves when handling the products).

Well-designed and well-maintained ventilation systems remove airborne contaminants from the workplace and reduce their hazards. Some workplaces may need a complete system of hoods and ducts to provide acceptable ventilation. Others may only require a single, well-placed exhaust fan.


What are the three major workplace health issues facing women today who are in their 20s and 30s? And how are employers responding to these?

A: Let me give you the top two that I see:

Work-Life Balance: Many young women struggle daily to manage their emerging careers and life outside of the office (health and wellness, babies). Employers are responding by providing attractive work scheduling or flexible work to support this balance. Flexible work arrangements are alternate arrangements or schedules from the traditional working day and week. Employees may choose a different work schedule to meet personal or family needs (for example, flex hours, a compressed work week, reduced hours/part-time, working from a home office). Many employers offer emergency childcare as a back-up for parents whose regular childcare is unexpectedly unavailable. Employers are also building fitness facilities on-site, or they are offering financial assistance for fitness memberships to their employees, to further support worker well-being.

Depression: Major depression occurs in 10 to 25 percent of women – almost twice as many women as men. Many hormonal factors contribute to the increased rate of depression in women – particularly during menstrual cycle changes, pregnancy and postpartum, pre-menopause and menopause, as well as after miscarriage. Ten percent of women will experience depression during pregnancy. It is important to recognize the signs of depression and seek treatment. Employers are recognizing that depression is a serious illness that often requires time off for treatment and sometimes a gradual return to the workplace.


Q: I've heard that women who work in offices (e.g. secretaries, receptionists, administrative assistants) are not covered by insurance if they lift more than 20 pounds. Is this true?

A: This is not true. In Ontario virtually all employees are covered by the Workplace Safety Insurance Board (WSIB). To be eligible for WSIB insurance benefits, you must:

  • Have a worker-employer relationship with an employer covered by the WSIB.
  • Have an injury or illness directly related to your work.
  • Promptly file a claim with the WSIB.
  • Provide all relevant information requested by the WSIB to help them determine your benefits.
  • Consent to having the health-care professional treating you release information about your functional abilities to your employer.

Your workplace insurance (through the WSIB) entitles you to a range of benefits. The benefit most people are familiar with is the replacement of earnings you lose while disabled by workplace illness or injury (benefit for loss of earnings), but a number of other WSIB benefits are available. Check out this link for more information: www.wsib.on.ca


Q: Can you provide information about the increase in stress-related illnesses over the last 10 years? What can workers do to reduce workplace stress?

A: "Workplace stress" is the harmful physical and emotional responses that can happen when there is a conflict between job demands on the employee and the amount of control an employee has over meeting these demands. In general, the combination of high demands in a job and a low amount of control over the situation can lead to stress.

Signs and symptoms of excessive workplace stress include:

  • Feeling anxious, irritable or depressed
  • Apathy, loss of interest in work
  • Problems sleeping
  • Fatigue
  • Trouble concentrating
  • Muscle tension or headaches
  • Stomach problems
  • Social withdrawal
  • Loss of sex drive
  • Using alcohol or drugs to cope 

There is a lot that you can do to manage and reduce stress at work.

Find Ways to Dispel Stress

Get time away. If you feel stress building, take a break. Walk away from the situation. Take a stroll around the block, sit on a park bench, or spend a few minutes meditating. Exercise does wonders for the psyche. But even just finding a quiet place and listening to your iPod can reduce stress.

Talk it out. Sometimes the best stress-reducer is simply sharing your stress with someone close to you. The act of talking it out – and getting support and empathy from someone else – can be an excellent way of blowing off steam and reducing stress.

Find humour in the situation. When you – or the people around you – start taking things too seriously, find a way to break through with laughter. Share a joke or funny story.

Resist perfectionism. No project, situation, or decision is ever perfect, and you put undue stress on yourself by trying to do everything perfectly. When you set unrealistic goals for yourself or try to do too much, you’re setting yourself up to fall short.

Manage your time. If you’re always running late, set your clocks and watches fast and give yourself extra time. If your desk is a mess, file and throw away the clutter. Just knowing where everything is saves time and cuts stress. Make to-do lists and cross off items as you accomplish them. Plan your day and stick to the schedule — you’ll feel less overwhelmed.

Flip your negative thinking. If you see the downside of every situation and interaction, you’ll find yourself drained of energy and motivation. Try to think positively about your work, avoid negative-thinking co-workers, and pat yourself on the back about small accomplishments, even if no one else does.

Prioritize tasks. Make a list of tasks you have to do, and tackle them in order of importance. Do the high-priority items first. If you have something particularly unpleasant to do, get it over with early. Don’t forget to reward yourself after completing a task (go and buy a fancy latte drink if that’s your type of treat). The rest of your day will be more pleasant as a result.

Break projects into small steps. If a large project seems overwhelming, make a step-by-step plan. Focus on one manageable step at a time, rather than taking on everything at once.

Delegate responsibility. You don’t have to do it all yourself. If other people can take care of the task, why not let them? Let go of the desire to control or oversee every little step. You’ll be letting go of unnecessary stress in the process.

Create a balanced schedule. Analyze your schedule, responsibilities and daily tasks. All work and no play is a recipe for burnout. Try to find a balance between work and family life, social activities and solitary pursuits, daily responsibilities and downtime.

Don’t over-commit yourself. Avoid scheduling things back-to-back or trying to fit too much into one day. All too often, we underestimate how long things will take. If you've got too much on your plate, distinguish between the "shoulds" and the "musts." Drop tasks that aren't truly necessary to the bottom of the list or eliminate them entirely.

Try to leave earlier in the morning. Even 10 to 15 minutes can make the difference between frantically rushing to your desk and having time to ease into your day. Don’t add to your stress levels by running late.

Plan regular breaks. Make sure to take short breaks throughout the day to sit back and clear your mind. Also try to get away from your desk for lunch. Stepping away from work to briefly relax and recharge will help you be more, not less, productive.

In addition, some employers have an EAP (Employee Assistance Program), which can be accessed for counselling advice.


We are a poor non-profit organization that is renting space from another organization. We have the use of a photocopier and a laminator in a poorly ventilated room. Is there something we can do, other than moving one of the machines to a different location, to improve the ventilation?

A: In a workplace, ventilation is used to control exposure to airborne contaminants. It is commonly used to remove contaminants, such as fumes, dusts and vapours, to provide a healthy and safe working environment. Ventilation can be accomplished by natural means (e.g. opening a window) or mechanical means (e.g. fans or blowers).

Under the Ontario Occupational Health and Safety Act, employers/owners have a responsibility to take every precaution reasonable in the circumstances to protect workers. This includes providing a ventilation system that replaces air that is exhausted. The replacement air must be free from contamination from any hazardous dust, vapour, smoke, fume, mist or gas.

If your organization has a health and safety representative, he or she should ask the property owner to have a third party engineer and/or HVAC (heating, ventilating and air conditioning) specialist assess the ventilation within your rented space. They will determine whether the ventilation in that room is adequate or not.


Q: What legislation governs the safety and security of the staff that work in Member of Provincial Parliament (MPP) offices? Specifically, what protections are in place to ensure that the "walk-in traffic" doesn't endanger the workers in these offices? Places like Service Ontario have security guards yet MPP offices do not. Why do these places have no such protection? The public does not differentiate between a constituency office and a government office – they consider it one and the same.

A: Almost every worker, supervisor, employer and workplace in Ontario is covered by the Occupational Health and Safety Act and regulations. This is the legislation that governs the safety and security of staff. Its purpose is to protect workers against health and safety hazards on the job. Contact Occupational Health and Safety Inquiries for further guidance:

Province-wide: 1-800-268-8013

Central Region: 416-314-5421 or 1-800-991-7454

Western Region: 905-577-9774 or 1-877-202-0008

Federal workplaces are covered under a different law: the Canada Labour Code.


Q: Hello Angela. I am a community health worker and more specifically, a home visitor. I was interested in a safety class that pertains to my occupation. Do you know of any?

A: First, a risk assessment of the types of hazards you might encounter in your work should be undertaken. Some potential hazards to a home care worker include:

  • potential violence from clients or others
  • exposure to communicable diseases
  • ergonomic issues (e.g. lifting of clients)
  • physical conditions (e.g. poor lighting, cold temperatures, broken stairs, snow/ice on walkways)
  • hazardous chemicals
  • environmental tobacco smoke
  • pets
  • oxygen equipment/tanks

A home care agency is an employer. As an employer, the agency must take every reasonable precaution to protect the health and safety of all its workers, including those providing services in clients' homes. The employer must develop a health and safety policy and programs that address the requirements of the Act, including:

  • establishing joint health and safety committees or designating worker representatives
  • conducting assessments of workplace hazards
  • establishing safe operating procedures for the workplace
  • training workers
  • obtaining and providing workers with health and safety information
  • providing appropriate personal protective equipment
  • ensuring equipment is inspected and maintained

Your employer should provide all workers with training that includes the employer’s and workers' responsibilities for the prevention of violence; how to determine the risk of specific situations; how to leave a risky situation safely; and how to identify, prevent and manage aggressive behaviours.

Beyond one-day workshops, appropriate control measures should be built into the day-to-day protocols of home care service, to protect the safety of home care workers. These could include: a "buddy system"; directions on when to involve police; generic business cards/name tags that provide only your first name, title and organization name; permission for taxi use where entry and exit of a neighbourhood could be a safety issue; notification of police about nighttime services; a computerized client database that flags higher risk environments; scheduling that takes into consideration the neighbourhood and other risk indicators; etc.

For an excellent resource on Health and Safety in the Home Care Environment, check out this link: http://www.wsib.on.ca/


Q: I had a cyst surgically removed from the joint of my wrist in January 2008. In the last three weeks I have noticed two more growths, with one of them in my joint. Can cysts on the hand and wrist result from overusing a computer mouse?

A: Sometimes people develop cysts that are near tendon sheaths – often in the hand and wrist area. The exact cause is unknown, but this may be due to excessive friction of moving parts causing irritation. If there has been a recurrence of the cysts, make an appointment to see your surgeon again. (Answer provided by Joanne Dorion, physiotherapist, Facial Rehabilitation Program.)


Q: I am getting ready to return to work after having rotator cuff surgery (my third). I have been home since June. My surgeon and physiotherapist have requested that the company I work for do a "workstation assessment." What would this entail for my type of injury? Right now my keyboard is on top of the desk and I am on the computer all day-long – one idea was a pull-out keyboard tray. Do you have any other ideas or suggestions?

A: An ergonomic assessment will focus on improving the layout of your workstation, through safe work practices and recommendations for purchase. Because we don’t all have the luxury of an adjustable desk, key adjustments at any workstation must be made in the chair (height, lumbar support, armrests) and in the computer monitor height. The goal is to support your postural comfort so that you are typing/mousing without bent wrists and you are ‘sitting tall,’ with your shoulders dropped and relaxed, your neck in a neutral or comfortable position, your back supported, and your feet firmly on the floor or a footrest.

If your chair is not adjustable, then it is not ergonomic. I recommend a new, fully adjustable chair. A monitor that does not adjust upwards can be placed on computer risers until the appropriate height is achieved.

Adjust the height of your chair so that your forearms are level with your keyboarding surface. If this is not possible, then obtain a drop-down keyboard tray to lower the height of your keyboard.

Adjust the lumbar support of your chair so that the ‘bump’ in the back of the chair sits in the hollow of your back, or at your belt-line. Try not to perch in your chair and always maintain back-to-back contact in your chair without slouching. Support the natural ‘S’ curvature of your spine.

Adjust the armrests so that they barely touch the undersides of your elbows while you are typing. Do not lean on the armrests while typing/mousing – avoid all awkward postures that cause your shoulders to shrug upwards.

Adjust the height of the monitor so that when you look straight ahead, your eyes land on the top row of text on the screen. This is your horizontal line of sight at zero degrees. You should be able to view the monitor comfortably with your neck in a neutral position.

Additionally, eliminate all awkward and prolonged postures, especially at the shoulders. The further a body part is from its neutral alignment, the more awkward the posture. For example, if you frequently use the telephone, consider a cordless headset in order to avoid cradling the phone between your shoulder and ear while multi-tasking at your workstation.


Q: I work in a large organization supervising about 20 staff. One of my staff members has contacted the occupational health department to ask them to do an ergonomic assessment of her workstation. She says she is suffering from wrist pain caused by her workstation. How can she prove that the pain is caused by her workstation? Will I be required to purchase special equipment to modify her workstation?

A: The ergonomic assessment, at the outset, will include observations of the current workstation set-up. This initial observation coupled with the assessor’s questioning will typically reveal whether or not the adverse health effects (wrist pain, for example) are a result of this individual’s workplace set-up. Typically, wrist pain is related to poor wrist posture while typing/mousing (bent wrists), and prolonged wrist contact on hard surfaces.

Ergonomics is 50% workplace design and 50% worker behaviour. The final report will include an assessment of ergonomic risk factors and recommendations. Typically, recommendations include safe work practices for the employee to follow and recommendations for purchase (e.g. a keyboard wrist rest, or a mouse pad with wrist rest).

If you have the resources, you could invite an ergonomist, physiotherapist or safety specialist to provide a workshop on office ergonomics to your staff. This proactive training will help your staff avoid injury and will also send a message that you care about their well-being!


Q: Angela, does the Toronto Occupational Health Nurses Association have a website?

A: No, unfortunately the organization is staffed by a small number of volunteers. However you can obtain information about it and other occupational health groups by visiting the website of the Ontario Occupational Health Nurses Association at


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