OHS Canada Magazine

LTC facilities failed to train workers on medication hazard: Union


By Mia Jensen, Local Journalism Initiative Reporter

After a leave of absence, Tara Fennell returned to her job earlier this year as a personal support worker at a local long-term care facility, a position she has held for years.

But not long into her return, she made an alarming discovery.

A simple sign posted on one of her residents’ doors soon led to the realization that she, and potentially thousands of other PSWs across the city, may have been unknowingly exposed to highly toxic medication and waste, without proper training or protection, for years.

“I was very angry, and I was scared, and very, very, very concerned,” said Fennell.

The sign on the door had informed her that the resident was taking cytotoxic medication, a type of drug that is used to inhibit or prevent cell function. Cytotoxic drugs are most commonly used for chemotherapy in the treatment of cancers, but they can also be used to rheumatoid arthritis, multiple sclerosis, and certain skin conditions like psoriasis.

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But while the medications themselves can be lifesaving for patients, their toxicity means they need to be handled with extreme caution.

This was not the case at a number of long-term care facilities across Sudbury, according to Fennell’s union, Mine Mill Local 598/Unifor.

In a release, the union accused Greater Sudbury facilities of failing to provide staff with essential education and equipment to ensure safe management of cytotoxic residents.

“There is no safe level of exposure, and some of these people have been working for 20, 25 years, some of them daily,” said Fennell.

The potential harmful effects of mishandling cytotoxic medication and waste can be significant.

Exposure can increase the likelihood of genetic mutations, potentially leading to growth of tumours in healthy cells. Pregnant women and people trying to conceive are also at considerable risk, as exposure can lead to spontaneous abortion, stillbirth, infertility and growth and developmental abnormalities in infants exposed in utero.

Other risks include irritation of the eyes, skin and mucous membrane, as well as nausea, headaches, dizziness and hair loss. In some cases, exposure can lead to liver disease and cancer.

Fennell said the full health repercussions on local workers may not be known for another 10 to 15 years.

“People are now looking back,” said Fennell. “Like women who have gone through multiple miscarriages, stillborn babies, people that have various cancers right now. They’re just being notified. They had no way of knowing they’re exposed to something that could have caused it. They could just think it was the card they got dealt.”

Fennell, who is now leading the Mine Mill’s Cytotoxin Project, said the facilities’ failure to protect their workers is indicative of a broader problem in the province.

“There’s no legislation in Ontario in regards to cytotoxic medications,” she said. “So oftentimes, unless you’re held to the wire, there were minimal precautions offered, and policies buried within hundreds of policies, they weren’t really in place.”

Mine Mill president Eric Boulay said the organization intends to continue putting resources and time behind the project, which includes notifying all 900 of their currently active members working in long-term care homes.

He said it’s unlikely that facilities will face any consequences unless a change takes place at a provincial level.

“The Ministry of Labour has gone in and cited (local facilities) several times, but there’s no monetary fine for that,” he said. “Until legislation is actually in place, they can only enforce what’s there for now. The fact that two other provinces (Saskatchewan and British Columbia) already have legislation on this definitely speaks to the importance of it. That’s what we’re hoping to change.”

The union did not specify which local facilities were cited, or which are considered possible sites of exposure.

The facilities listed that currently employ their members include long-term care homes Elizabeth Centre, Finlandia Nursing Home, St. Joseph’s Villa, and Villa St. Gabriel Villa, as well as retirement homes Walford on the Park and Sudbury Finnish Rest Home.

Finlandia Village CEO David Munch confirmed in a statement that it was notified by the Ministry of Labour that their policies and procedures needed improvement. He said the organization is “taking every action available to resolve the current situation.”

“We have quickly implemented new safety measures including appropriate personal protective equipment and safe handling procedures of hazardous waste,” said Munch. “We are committed to the health and safety of all our staff and residence and look forward to continued good communication with our staff to bring this to the forefront for action and resolution.”

St. Joseph’s Health Centre – which operates both St. Joseph’s Villa and Villa St. Gabriel Villa – did not specify if it received any citations.

“We strive to create a nurturing care environment for our residents, and a safe and healthy work environment for staff,” said president and CEO Kari Gervais in a written statement. “We will work closely with our Joint Occupational Health and Safety Committee, together with the Ministry of Labour, to address any findings and review our processes to ensure we meet best practices and applicable legislation.”

The union is encouraging all current and past members to get in touch if they believe they may have been exposed, in order to file the necessary paperwork to WSIB and have their documents put on record.

“I just want to get the message out to our members, and even all healthcare workers in the city,” said Boulay. “There’s many long-term care facilities, home health services, even just the general public if they were taking care of a loved one that was on one of these medications. They could also be affected.”