Protecting Workers from Heat Stress and Heat-Related Illnesses

Submitted as part of Heat Stress Consultations, to Health, Safety and Insurance Policy Branch, Ministry of Labour, Immigration, Training and Skills Development on September 18, 2023.

The Decent Work and Health Network (DWHN) is an organisation of health providers, public health professionals, and health policy experts. Our province-wide network advocates for improved working conditions as a means to achieve better health outcomes, and has been doing so since 2014. We are writing today in regards to Heat Stress Consultations under the Occupational Health and Safety Act.

Heat is increasingly a threat to health and productivity in workplaces across Ontario. Heat impacts a range of workers and workplaces, including steel mills and smelters; outdoor occupations such as construction, app-based delivery workers, agriculture and road repair; as well as indoor settings such as restaurants, laundries and warehouses. Workers who perform strenuous labour, often earn low wages, or have limited control over their working conditions, and are at the highest risk of heat-related illness. In many of these settings it is becoming increasingly difficult for workers to maintain a healthy  body temperature that is essential to the safety of affected workers and others around them, particularly as we experience the expanding effects of climate change. 

Heat can cause a range of harmful effects on workers. Impacts of heat on the body include dehydration, loss of concentration, irritability, and difficulty doing various tasks. It can also cause illnesses such as edema (swelling), rashes, cramps, exhaustion, syncope (dizziness and fainting), kidney damage and, most seriously, heat stroke, coma and death. The mental health impacts of working in stressful environments are also worsened by heat. There may also be unexpected medical expenses for workers.  

Businesses and industries are also negatively impacted as workplace-related illnesses contribute to workers compensation claims, a reduction in productivity through fewer employees and the costs of recruiting and training new employees. 

All of these harmful health impacts can be prevented with evidence-based improvements to workplace equipment, infrastructure and administration. These improvements must be supported with regulations that protect the health of all workers in Ontario.

Given the significant and widening impact heat has on health, we support the creation of heat stress regulations as it has become clear that the future of work must be adapted to the impacts of climate change. However, in order to close gaps in health equity, our organization believes that changes need to be made to the proposed heat stress regulations under the OHSA to ensure that all workers, including migrant agricultural workers who feed our communities are protected in extreme weather. 

The proposed regulations under the OHSA, like most other parts of employment law, are complaints-driven. This puts the onus on the worker to advocate for their health and safety rather than the employer taking responsibility for ensuring a healthy work environment. For low-wage workers, especially those who lack immigration status such as migrant agricultural workers, there is a fundamental power imbalance between the employer and worker. A complaints-driven process is a significant barrier to protecting workers from heat stress and heat related illnesses. 

We recommend the following changes to and expansion of the proposed heat stress regulations.

Foundational policies

1. Paid medical leave: All workers must have ten employer-paid sick days so that they can prevent and recover from heat-related illnesses. Workers must be able to access their paid sick leave without the employer requiring a medical certificate or doctor’s note.
2. Permanent Resident Status: Ontario must actively advocate to the federal government for permanent resident status for all migrants, which includes migrants working in heat-impacted settings such as agriculture, hospitality and construction. Permanent resident status enables migrants to advocate for better workplace standards and obtain access to other rights. 
3. Hazard pay: Workers that continue to work in settings with heat exposure, including but not limited to outdoors or semi-outdoor settings such as greenhouses, must be provided with access to hazard pay during heat warnings from Environment Canada. 

Workplace standards

1. Enforced Health and Safety Regulations: Adequate inspections and enforcement by health and safety inspectors is essential, particularly when temperatures rise. There must also be a process in multiple languages through multiple channels for anonymous complaints; this is essential for the protection of all workers in Ontario, including migrant workers. 
2. No exemptions: The Employment Standards Act exemptions that apply for farm workers should be removed. This should apply not only to heat stress regulations, but also other minimum workplaces standards related to wages, overtime pay and limits on hours. 
3. Regulate migrant farmworker housing: Occupational Health and Safety Act, including new heat stress regulations, must also apply to migrant farmworker housing. For migrant farmworkers, housing is part of their workplace and is controlled by the employer. All migrant farm worker housing must have air conditioning and maximum allowable temperature; Ontario must advocate for an enforceable national housing standard in line with proposals made by migrant workers themselves.
4. Health and Safety Committees: Health and Safety Committees should be required for all industries and employers, without exemptions.
   
5. Simple methods to determine heat stress: To determine heat stress in workplaces, simple tools must be used such as the “Humidex-based heat stress calculator” developed by the Occupational Health Clinics for Ontario Workers where employers or employees enter the temperature and humidity into an online calculator to determine humidex which then can be managed as per guidelines. 
6. Engineering controls: If a risk cannot be eliminated or substituted, engineering controls are the next step. This includes adequate ventilation, air cooling, fans, shielding and insulation. Power assists and tools can also be used to reduce the physical stress on workers. Cool, shaded and/or air conditioned space should be mandated to be readily available. 
7. Administrative controls: These include rest, shade and breaks. There must be a mandatory 10 minute paid break in a cool shaded area, every 2 hours during heat and humidity warnings added to regulations; heat stress related breaks must be paid at regular wages. Additional measures must be created by joint health and safety committees. 
8. Water: Water should be available to workers at all times with no cost to workers along with opportunities to replace electrolytes lost during heat exposure (sweating).
9. Personal equipment: Personal protective equipment must be mandated as an employer responsibility.
10. Information sharing: Employers must be required to share their complete heat stress management protocols in writing with the Ministry of Labour and with workers. Information shared with workers must be available in all languages used by workers in each workplace, including migrant workers. 
11. Training: All migrant farm workers in Ontario should have mandatory annual paid training on whether their work will pose a hazard to their health and safety. This training must be provided by healthcare or worker organisations and not by employers. The training must include a section on complaints processes that workers can utilise as outlined above. 

The measures noted above will help ensure that all workers experience work conditions that help prevent heat related illnesses, injuries, and death. We welcome the Ontario government devoting attention to heat stress as we are seeing the impacts of heat on the workers in our communities and in the clinics and hospitals we work in. 

We ask that specific attention be given to migrant workers as they are often put at greater risk of heat-related illnesses due to lack of permanent resident status. As emphasised in the 2023 Ontario Provincial Climate Change Impact Assessment, heat stress has a disproportionate impact on migrant workers. We support the changes proposed by the Migrant Workers Alliance for Change (MWAC): Protecting Workers from Heat Stress and Heat-Related Illnesses. It is essential that they are granted permanent resident status in order to better protect their health. 

Sincerely,

Sarah Shahid
Coordinator, Decent Work and Health Network

Dr. Monika Dutt
Public Health and Preventive Medicine Physician
Family Physician, Ally Centre of Cape Breton

Edward Xie, MD MSc CCFP(EM) DTM&H
Emergency Physician
Assistant Professor, Department of Family and Community Medicine, University of Toronto

On behalf of the Decent Work and Health Network