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Job-related deaths in Canada dramatically under-reported: study

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Close to 1,000 Canadians die each year because of their jobs, according to official numbers from Canada’s workers’ compensation agencies. But a new study says that figure is only the tip of the iceberg when it comes to the true extent of work-related deaths across the country.

The study — titled Work-related deaths in Canada — argues the widely quoted statistics from the Association of Workers’ Compensation Board of Canada (AWCBC) should not solely be used as a benchmark for work-related fatalities, as these figures only take into account approved compensation claims.

As a result, thousands of deaths — such as workers exempt from coverage, stress-induced suicides, commuting fatalities and occupational disease — are missing from occupational health and safety statistics, it says.

“This situation is akin to crime statistics only ever including solved homicides, therein leaving the impression that attempted murders, unsolved murders or suspicious deaths are not a concern,” the study’s authors wrote.

Steve Bittle, an associate criminology professor at the University of Ottawa, spearheaded the research. (CBC)

Our notion of what constitutes a workplace fatality is too narrow and it is a mistake to count work-related fatalities through our compensation regimes, says Steven Bittle, an associate criminology professor at the University of Ottawa who spearheaded the research, which was published in November.

Last year, workers’ compensation boards across the country approved a total of 904 claims involving fatalities. About one-third of those cases involved acute accidents, with the rest due to longer-term illnesses from occupational exposure.

Bittle’s team estimates that a more accurate figure hovers between 10,000 to 13,000 deaths annually.

Non-reporting and under-reported fatalities

Depending on the province, between 70 and 98 per cent of the workforce is covered by a public workers’ compensation system. But that means there are well more than two million workers in Canada whose deaths would escape official statistics.

Excluded occupations could include the self-employed, domestic helpers, banking employees and farmers, among others.

The latest AWCBC figures show that in Ontario, only 24 per cent of the approximate 7.1 million working Ontarians are covered by a workers’ compensation regime.

Bittle’s paper also cites a 2015 study from the University of British Columbia that found an average of six fatalities per year that were not on WorkSafeBC’s radar. Many of these cases involved deaths that occurred in hospital, days after the workplace event.

The authors further estimate about 64 farming deaths escape official statistics each year.

The study estimates about about 64 farming deaths aren’t reflected in annual occupational health and safety statistics. (CBC)

Morag Marjerison, a farm-safety consultant based in Brandon, Man., agrees that the dearth of data is problematic. In Manitoba, farm owners and their family members are exempt from mandatory coverage.

“I think it’s really a problem in that we don’t ever see the true picture. Whenever I’m looking at training, trying to educate [farmers], we’re always showing what look like low statistics, when we know that’s not the reality of what’s happening,” she said.

“I think if everyone that works in safety saw the reality of how frequently the same things happen over again and again, attention could be paid to the bigger issues.”

Commuters and bystanders

One of the more contentious elements of Bittle’s study, he admits, is the idea that deaths while commuting to and from work are worth including in workplace-fatality statistics. He estimates there are about 460 commuting deaths a year — and the goal of their inclusion is to start a conversation about some broader issues.

“We live in a culture of presenteeism, where people are expected to be at work — at least culturally expected to be at work, if not through pressures in their workforce — regardless of whether they’re ill or whether the weather conditions are such that they shouldn’t be driving at that particular time,” he said.

The 2013 death of an Alberta intern who was killed while driving home after a 16-hour shift at a local radio station highlighted the potentially dangerous relationship between commuting and workload.

The study also suggests that non-workers who die collaterally could be included, such as a spouse who dies after repeatedly being exposed to asbestos from years of washing their partner’s clothes, or a pedestrian crushed in a scaffolding collapse while walking near a job site.

Suicides: ‘Extreme stresses’

In 2017, a Saskatchewan man employed by a small rural municipality took his own life after struggling with mental-health issues found to have been exacerbated by his work. The province’s WCB partly attributed the death to his employer.

Situations like these are rarely covered, and the study suggests the number of suicide-related claims is drastically underestimated.

The Mental Health Commission of Canada published a study last year that found Canadian employees reported workplace stress as the primary cause of their mental-health concerns.

Bittle believes between 10 and 17 per cent of annual suicides in Canada could be classified as work-related, representing a range of 400 to 800 fatalities each year.

Mara Grunau, executive director of the Centre for Suicide Prevention, agrees that while the links between work and mental health exist, proving it caused a person to take their life is difficult.

“In our culture, we spend hours and hours at work. And the way we feel about work, and the way we interact with the people at work, affects who we are,” she said. “If work is a miserable place to be, it affects other aspects of our life.”

And while there are “many contributing factors” that can lead a person to that point of desperation, Grunau says “the research would not bear out one big, bad thing that is going to absolutely cause somebody to die by suicide.”

Cancer and disease

Ultimately, the study concludes that the single biggest category for underestimation relates to cancer and disease.

Currently, between 500 and 600 approved WCB claims nationwide are the result of occupational disease. But Bittle estimates a figure that is upward of 8,000 deaths.

Amendments to Prince Edward Island’s Workers Compensation Act came into force just last week, giving firefighters presumptive coverage for certain types of cancers and illnesses. P.E.I. was last province to make these changes

Former General Electric worker Sue James has been fighting for compensation for hundreds of retired workers based in Peterborough, Ont., who suffer from what is alleged to be occupational disease. (CBC)

While firefighters’ unions have been successful in their lobbying, other employer groups have not.

Former General Electric worker Sue James has been fighting for compensation for hundreds of retired workers based in Peterborough, Ont., who suffer from what is alleged to be occupational disease due in large part to repeated exposure to industrial chemicals. Her father died of cancer following three decades of working in that plant.

James has successfully lobbied the Ontario government to reopen hundreds of previously denied WSIB claims.

“The burden of proof is so high. I mean, you almost have to have swam in a vat of trichloroethylene or in asbestos in order to get claims. So there’s been a huge resistance … to believe what we’re trying to say happened there,” she said.

Bittle says his report didn’t seek to address how to better gather data, as the objective was to clearly lay out the issue of under-reported workplace deaths.

“What we do say is that, at the very least, there is a leadership role that the federal government could and should take in order to initiate discussions on this very topic.”



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B.C. health official questions value of handing out free naloxone nasal spray

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A pharmaceutical company was handing out free samples of their naloxone nasal spray at a Surrey, B.C., SkyTrain station on Wednesday — but health officials are skeptical about the approach.

Naloxone reverses the effects of opioids and can help prevent overdose deaths.

Since 2012, the B.C. Centre for Disease Control has handed out thousands of injectable naloxone kits as part of a province-wide overdose prevention program.

“We come from different perspectives,” said Dr. Jane Buxton, harm reduction lead for the B.C. Centre for Disease Control.

“We have a pharmaceutical company whose main motive, presumably, is profit. But when we look at a public health program, we want to save lives — that’s our main intent.”

Some have blamed pharmaceutical companies for playing a role in the opioid crisis by downplaying the addiction risks of the drugs.

The province announced a lawsuit against 40 drug companies last August, accusing the wholesalers, distributors and manufacturers of being responsible, in part, for B.C.’s ongoing opioid crisis.

Injecting naloxone provides ‘a very effective, reliable dosage that is absorbed and it works in a quick way,’ Dr. Jane Buxton said. (CBC)

Concentrated form of naloxone 

Aaron Sihota, a community pharamcist who was promoting the nasal spray on behalf of Adapt Pharma — which makes the naloxone nasal spray — says it can help save lives and is much simpler to use than the injectable kits.

“Sometimes, it’s difficult for those who are not health-care professionals to go through the motions of breaking open a glass vial, withdrawing a dose and then injecting it in the right place,” Sihota said.

The one-time use spray kits contain a highly concentrated form of naloxone, roughly 10 times the dosage in a vial, and is administered through the nostril.   

But Buxton said there are challenges with administering the medication through the nose compared to injecting it into a muscle.

“Somebody may have snorted cocaine, for example, in which case it’s not absorbed because the blood vessels can’t carry or there may be damage to the nose internally,” she told Stephen Quinn, host of CBC’s The Early Edition.

The higher dosage may also mean some people will absorb significantly more of the medication, which can lead to withdrawal symptoms, she added.

The injectable naloxone kits include three doses of the medication, although about 60 per cent of people only need one or two.

‘By administering [naloxone] intramuscularly, it’s a very effective, reliable dosage that is absorbed and it works in a quick way,’ Buxton said. 

Buxton also disagreed that the injectable kits are difficult for users to administer.

“We’re not hearing that it’s a problem,” she said.

“We know that the people who are most at risk are the people who use substances and their friends and colleagues — those are the folks who are actually quite comfortable using needles.”

A for-profit pharmaceutical company is handing out free samples of their naloxone nasal spray at a Surrey SkyTrain station on Wednesday but some health officials are skeptical about the approach. 7:16



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No fix for vaping addiction in teens, experts warn

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Matthew Perrone , The Associated Press


Published Wednesday, January 16, 2019 4:18PM EST

WASHINGTON — The nation’s top health authorities agree: Teen vaping is an epidemic that now affects some 3.6 million underage users of Juul and other e-cigarettes. But no one seems to know the best way to help teenagers who may be addicted to nicotine.

E-cigarettes are now the top high-risk substance used by teenagers, according to the latest U.S. figures , which show that Juul and similar products have quickly outpaced cigarettes, alcohol, marijuana and other substances that have been tracked over more than four decades.

The handheld devices heat a liquid solution that usually contains nicotine into an inhalable vapour. Federal law prohibits sales to those under 18, though many high schoolers report getting them from older students or online.

In recent months, government officials have rolled out a series of proposals aimed at keeping the products away from youngsters, including tightening sales in convenience stores and online. In November, vaping giant Juul voluntarily shut down its Facebook and Instagram accounts and pulled several flavours out of retail stores.

But there’s been little discussion of how to treat nicotine addiction in children as young as 11 years old. While some adolescents should be able to quit unaided, experts say many will be hampered by withdrawal symptoms, including anxiety, irritability, difficulty concentrating and loss of appetite.

Physicians who treat young people now face a series of dilemmas: The anti-smoking therapies on the market — such as nicotine patches and gums — are not approved for children, due to lack of testing or ineffective results. And young people view the habit as far less risky, which poses another hurdle to quitting.

The harshness of cigarette smoke often limits how much teenagers inhale, sometimes discouraging them from picking up the habit altogether. That deterrent doesn’t exist with e-cigarette vapour, which is typically much smoother, according to experts.

Kicking any addiction requires discipline, patience and a willingness to follow a treatment plan — something that doesn’t come easily to many young people, experts said.

“Teenagers have their own ideas of what might work for them, and they’re going to do what they do,” said Susanne Tanski, a tobacco prevention expert with the American Academy of Pediatrics. “But we desperately need studies to figure out what’s going to work with this population.”

Since debuting in the U.S. in 2007, e-cigarettes and other vaping devices have grown into a $6.6 billion business. Driving the recent surge in underage use are small, easy-to-conceal devices like Juul, which vaporizes a high-nicotine solution sold in flavours such as creme, mango and cucumber. Despite industry worries of a crackdown on flavours, the FDA has taken no steps to ban the array of candy and fruit varieties that companies use to differentiate their offerings.

E-cigarettes have become a scourge in U.S. schools, with students often vaping in the bathroom or between classes. One in 5 five high schoolers reported vaping in the last month, according to 2018 federal survey figures.

Juul and other brands are pitched to adult smokers as a way to quit smoking, but there’s been little research on that claim or their long-term health effects, particularly in young people. Nicotine can affect learning, memory and attention in the teenage brain, but there’s virtually no research on how e-cigarette vapour affects lungs, which do not fully mature until the 20s.

“It’s frightening for me as a pediatrician because I really feel like there’s this uncontrolled experiment happening with our young people,” Tanski said. “They don’t perceive the harm, and we can’t show them what it’s going to be.”

Tanski and other experts will meet this Friday at the Food and Drug Administration to discuss the potential role for pharmaceutical therapies and non-prescription medications such as nicotine gums and patches.

Regulators acknowledge they are starting from square one: The FDA “is not aware of any research examining either drug or behavioural interventions” to help e-cigarette users quit, the agency noted in its announcement.

The FDA will also hear from researchers, vaping executives, parents and teenagers.

“We want to make sure our voices are heard and that — most importantly — our kids’ voices are heard,” said Meredith Berkman, who plans to speak at the meeting with her 10th-grade son.

Berkman said she first realized her son and his friends were “Juuling” last year when she heard them repeatedly opening and closing his bedroom window. With two other New York City mothers, she formed the group Parents Against Vaping E-cigarettes, which is asking the FDA to ban all e-cigarette flavours.

“Unless the flavours are off the market, kids are going to continue to be seduced by these highly addictive nicotine-delivery systems like Juul,” Berkman said.

Quitting smoking is notoriously difficult, even for adults with access to various aids and programs. More than 55 per cent of adult smokers try to quit each year, yet only about 7 per cent succeed, according to government figures.

Nicotine gums, patches and lozenges are available over-the-counter for those 18 and older, and are occasionally prescribed “off-label” for younger patients. They provide low levels of nicotine to help control cravings. Prescription drugs include Zyban, an antidepressant, and Chantix, which blocks the effects of nicotine on the brain. But neither has shown positive results in teenagers, and both carry worrisome side effects, including suicidal thinking for Zyban and nausea and abnormal dreams for Chantix.

That leaves counselling as the go-to option for teenagers trying to quit cigarettes.

In November, Colorado dropped the minimum eligibility age for its quit-smoking hotline from 15 to 12, in response to the explosion in vaping among students as low as 6th grade. The state’s underage vaping rate is the highest in the U.S., with 1 in 4 high school students reportedly using the products, according to federal data. The state’s over-the-phone and online programs provide free coaching to help users create a quit plan, manage cravings and avoid relapse.

But even counselling has shown only “limited evidence” in helping teenagers, according to an exhaustive review of the medical literature published in 2017.

Still, addiction specialists see growing demand for such programs, particularly group sessions that often have the most promising results.

Addiction psychiatrist Jonathan Avery says he gets four to five calls a week from pediatricians referring patients or asking about treatment options. One of the biggest problems is an education gap — many doctors haven’t heard of Juul and don’t even recognize the vaping devices brought in by parents.

On the other side, teenagers are often “suspicious” when he informs them that they are inhaling a highly addictive substance, said Avery, of New York-Presbyterian Hospital.

About two-thirds of U.S. teenagers do not realize that Juul contains nicotine, according to a recent survey by the Truth Initiative, an anti-smoking advocacy group.

The U.S. Surgeon General, Jerome Adams, hammered that point home in a rare public advisory last month. He said even his 14-year-old son believed that e-cigarette vapour was essentially harmless.

“Youth like my son have no clue what’s in these products most of the time,” he said.

——

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.



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Researchers look at the anticancer potential of cockspur grass

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(Natural News) Cancer is a major health problem brought about by factors like high body mass index, poor diet, sedentary lifestyle, smoking, and alcohol consumption. Researchers continue to search for alternative cancer treatments such as medicinal plants. Their search led them to the discovery of anticancer compounds in various plant species. A recent study by researchers…

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