Overview

From April 1, 2023 to March 31, 2024, the Ministry of Labour, Immigration, Training and Skills Development (MLITSD) conducted a musculoskeletal disorder (MSD) prevention campaign to address the hazard of MSDs in health and community care workplaces.

This campaign aimed to ensure that workplaces were taking all precautions reasonable in the circumstances to protect workers from developing MSDs and included education, awareness and enforcement. Online resources were available to assist workplaces to set up or improve their MSD prevention programs.

Education, outreach and awareness

We began by focusing on education, outreach, and awareness. We partnered with the Public Services Health and Safety Association (PSHSA) and the Centre of Research Expertise for the Prevention of Musculoskeletal Disorders (CRE-MSD), to provide training and education to employers. The goal was to help employers comply with the requirements under the Occupational Health and Safety Act (OHSA) and its regulations prior to focused inspections.

To prepare workplace parties, we provided information and compliance assistance resources, including:

  • holding a joint webinar to launch the campaign on April 12, 2023
  • additional webinars on MSD-related topics during the campaign

The Public Services Health and Safety Association (PSHSA) mentioned the campaign in 7 of their monthly newsletters and the PSHSA, along with CRE-MSD and MLITSD, posted periodic updates on social media to help with awareness of the campaign.

Inspectors provided links to compliance assistance resources in field visit reports where applicable. Inspectors also referred workplace parties to the health and safety partners for compliance assistance and training as appropriate during the enforcement phase.

Enforcement phase

Beginning June 1, 2023, inspectors conducted focused inspections of workplaces to check that employers were complying with the OHSA and its regulations. Inspectors checked for compliance with the OHSA and applicable regulations, such as the Health Care and Residential Facilities Regulation. As a result, inspectors:

  • conducted 775 field visits with 192 support role activities
  • visited 606 workplaces
  • issued 987 orders and requirements

“Support role activities” means that a professional services staff (such as a hygienist, ergonomist or engineer) or another inspector accompanies an inspector on a field visit to provide professional support and/or expertise.

Background

MSDs consistently represent a large contributor to lost-time injuries in the health and community care sectors. In 2021, there were approximately 3,500 MSD-allowed claims registered with WSIB (lost time and no lost time combined) which represented an accident cost of over $17 million and resulted in workers losing over 70,000 days from work. This amounts to an average of about $5,000 and 20 days lost from work per claim.

MSDs can be related to both:

  • client handling (such as lifting, transferring, and repositioning clients)
  • non-client handling causes (such as handling heavy bags of linen or garbage, pushing carts, moving furniture, etc.)

Full report

Workplace inspection campaigns

Inspection campaigns are part of our compliance strategy. We announce to the sector, in advance, that we will be conducting a campaign. Individual workplaces are not notified in advance. The results of the campaign are typically posted online within 90 days. Inspectors’ findings may impact the number and level of future inspections of individual workplaces.

Inspectors may also refer employers to health and safety associations for compliance assistance and training.

Focus of the campaign

Inspectors checked that workers were protected from MSD hazards when:

  • moving clients, such as performing client lifts or when repositioning clients in bed
  • toileting, bathing, showering clients and performing other client handling activities
  • responding to circumstances such as client falls, fire alarms, evacuations
  • manually handling materials and moving objects from one area to another, such as laundry
  • performing heavy housekeeping tasks such as moving furniture

At the workplaces visited, inspectors checked that the employer was taking precautions reasonable in the circumstances for the protection of workers. Inspectors also checked that workers had received appropriate instruction, information and supervision related to MSD hazards.

At workplaces where the Health Care and Residential Facilities regulation applies, inspectors checked that the employer had:

  • established written measures and procedures in consultation with the joint health and safety committee (JHSC) or health and safety representative (HSR). Examples of written measures and procedures to prevent MSDs involving client handling include:
    • safe work procedures for each type of client lift, transfer, and reposition
    • client mobility assessments and documentation of status
    • use of assistive devices
    • safe storage and maintenance of lift equipment and other mobility devices
    • pre-use inspection of assistive devices
  • reviewed the measures and procedures at least annually, and revised these as required considering current knowledge and practice related to MSD prevention
  • provided training to workers on client handling and manual materials handling

Inspectors took appropriate action if contraventions were found under the OHSA or its regulations. This included issuing orders to comply with requirements of the OHSA and regulations made under the OHSA.

Inspection activity summary

Visits to workplaces

Most frequently issued orders

A total of 589 orders were issued under the OHSA. The most frequently issued OHSA orders involved employers’ failure to:

  • take reasonable precautions for the protection of a worker [s. 25(2)(h)] — 194 orders or 19.7% of the total orders and requirements issued during the campaign
  • maintain equipment, materials and protective devices in good condition [s. 25(1)(b)] —156 orders or 15.8% of the total orders and requirements issued during the campaign
  • provide information, instruction and supervision to a worker [s. 25(2)(a)] — 61 orders or 6.2% of the total orders and requirements issued during the campaign

A total of 378 orders were issued under O. Reg. 67/93: Health Care and Residential Facilities. Orders were issued under the following sections (among others):

  • materials, articles or things shall be placed so that they will not tip, collapse or fall and can be removed without endangering a worker [s. 103(2)] — 67 orders or 6.8% of total orders issued during the campaign
  • the measures and procedures for the health and safety of workers shall be reviewed at least once a year [s. 9(2)] — 65 orders or 6.6% of total orders issued during the campaign
  • the employer shall reduce the measures and procedures for the health and safety of workers established under section 8 to writing [s. 9(1)] — 46 orders or 4.7% of total orders issued during the campaign

Observations

The results of this campaign indicate that workplace parties need to improve compliance with respect to MSD prevention. Key aspects to focus on include:

  • assessing the risk of MSDs and putting measures and procedures in place to address the risk
  • reviewing the measures and procedures regularly so that they stay current
  • training, re-training and supervising workers to ensure that they are aware of the risks of MSDs and the measures in place to reduce the risks of MSDs
  • having equipment available to reduce the risk of MSDs such as client lifting equipment and carts as well as training workers on how to use the equipment safely
  • regularly inspecting the equipment and maintaining the equipment in good condition
  • addressing the safe handling of clients, including clients with bariatric care needs and of clients who have fallen

MSDs related to client handling and manual materials handling remain a hazard in health and community care workplaces. The risk of MSDs can be reduced by assessing hazards, putting measures and procedures in place to address the hazards, training and supervising workers and taking corrective action based on any reported incidents. When these steps are taken, the risks for workers are reduced.

Conclusion and next steps

Demonstrated leadership and dedication by employers to MSD prevention will help to address the risks for workers of developing MSDs. Employers, supervisors, workers, joint health and safety committees and health and safety representatives must continue to work together to identify and control MSD hazards related to client handling and manual materials handling. A key to workplace health and safety in Ontario is the Internal Responsibility System (IRS). Workplace parties are encouraged to work together to identify and control all hazards.

The results of this campaign show that some employers are not fully meeting their health and safety responsibilities under the OHSA and its regulations for MSD prevention. This includes establishing measures and procedures for worker safety and training and supervising workers. This also includes providing appropriate equipment, training workers how to use the equipment, and ensuring that the equipment is inspected and maintained.

The results of the campaign confirm the need to continue to focus on MSD prevention in health and community care workplaces.

Help for employers

Please contact our health and safety partners, including the PSHSA, for more information, resources, and tools.

For more information please contact the Ministry of Labour, Immigration, Training and Skills Development Health & Safety Contact Centre: