Canadian Occupational Safety

6 Canadian Occupational Safety | www.cos-mag.com WORKPLACE NEWS Pilot program launched to support workers with concussion- related injuries T he Workers' Compensation Board of Nova Scotia has launched a pilot project to determine how to best support workers who have sustained a concussion. The pilot project will deter- mine the appropriate resources needed for concussion management, create a consistent treatment protocol and develop a concussion management pro- tocol. The goal is to improve worker outcomes and helps ensure a safe and timely return to work, the WCB said. "Management of concus- sion or mild traumatic brain injury can be challenging," said Paul Eagan, WCB's chief medical offi cer. "WCB Nova Scotia is com- mitted to working with physicians toward the goal of helping workers recover from their injuries, resume normal activities of daily living and return to or stay at work." The WCB is adopting the same approach that the Nova Scotia Rehabilitation Centre endorses in the management of a concus- sion. These guidelines provide a framework to guide patient diagnosis and manage- ment when returning to work where the risk of re-injury is very low, said Eagan. The majority of patients who sus- tained a concussion are back at work and resume other normal activities within a week or two of the injury. However, when additional services are required, an occu- pational therapist can help make that transition back to normal activities faster and less frustrating for the patient. This can include clinical assessment and treatments, as well as work site visits with the worker and employer to come up with workable solutions. Early intervention in concussion injuries is very important, said Eagan. "The best outcomes following (a) con- cussion are achieved when health-care resources are accessed early, are readily available and are effectively used. A proac- tive approach promotes early involvement of an occupational therapist to identify symptoms and use a problem-solving, practical attitude to symptom management at home and in the workplace," he said. As of Feb. 1, new concussion injuries are directed to three service providers: CORE, Lifemark and CBI. Workers who sustained an injury prior to Feb. 1 and are currently being treated for concussion-related inju- ries will continue with their current service provider and treatment program. The WCB expects about 150 injured workers will be part of the pilot, which is expected to wrap up at the end of this year. CP calls for mandatory, proactive use of inward-facing cameras C anadian Pacific has launched an awareness campaign that highlights the safety benefi ts of the proactive use of voice and video recorders, commonly referred to as inward-facing cameras. It is urging the Minister of Transport to pass new legislation that would maximize these benefi ts. Existing legislation allows for the installation of inward-facing cameras inside the cab of a locomo- tive, but prohibits railways from reviewing and using the footage for proactive safety use. According to CP, effective use of inward-facing camera technology would include the ability for it to be used for investigation after an incident, as well as allowing railways and regulators the opportunity to proactively reduce unsafe behav- iours such as tampering, cellphone use, sleeping and non-compliance with other safety-critical rules and regu- lations before incidents occur. "The use of this technology would immediately enhance a culture of safety and accountability in the rail sector," CP said. "(It) will prevent accidents, further protect communities and possibly save lives." The Transportation Safety Board (TSB) has been call- ing on Transport Canada to mandate this technology since 2012. Current regulations allow inward-facing cameras to be used only by the TSB for post-incident investigation. "Having the ability to use this technology in a proac- tive manner as opposed to only after the fact would allow us to prevent incidents, instead of explaining them," said Keith Creel, CP's president and CEO. "This technology would be another tool in the broader package of rules, regulations and our safety management system suite — each of which protects the public, our employees and the goods we transport for our customers." CP uses inward- facing cameras in 49 of its locomotives in the United States. Other transportation c o m p a n i e s in the U.S. are also using the technology successfully. More than 20,000 transit buses in the U.S. were set up with inward-facing cameras, and over four years, there was a 40 per cent reduction in bus collisions, according to the San Jose State University's Mineta Transportation Institute. Opponents of legislating inward-facing cameras are concerned about how railways would use the informa- tion. They say employees have a right to privacy while at work and recordings would be used for disciplinary purposes. But CP said it is willing to sit down with regu- lators and stakeholders to determine how proactive use is defi ned, given the understanding that the technology must be used to prevent incidents. In a recent omnibus survey conducted by Matchbox/ MARU with 2,500 Canadians, CP found that almost all individuals (97 per cent) agree appropriate actions should be taken against employees that behave unsafely, while 89 per cent agree that employees working in roles that could directly affect their own safety and the safety of others should expect to be monitored. If the legislation is changed, CP is prepared to install inward-facing cameras in every locomotive. "This is a preventative, proactive, behaviour-changing tool the industry should have been allowed to use years ago," said Creel. Serious gaps in emergency transport for rural workers: Ombudsman I njured forestry workers in remote or rural parts of British Columbia must wait — often for many hours — to access air ambulance, reports the BC Forest Safety Ombudsman. "Rural communities today are impacted twice compared to urban cen- tres — fi rst, in reduced access to medical care and again in reduced access to emergency medical transportation," said ombudsman Roger Harris. "For remote communities, as the distance to the nearest medical facility increases, the access to (helicopter emergency medical services) should be enhanced, not reduced." The report, Will It Be There – A Report on Helicopter Emergency Medical Services in BC, indicates that the serious gaps in the provision of emergency medical transport for workers in rural parts of the province threatens the medical out- comes of forestry workers who have little to no guarantee to timely medical response in the event of an emergency. The report refers to a logger working in a remote part of Haida Gwaii in 2014. His leg was crushed by a fallen tree and it took more than fi ve hours to get him to a hospital in Queen Charlotte City — which would have only taken 20 minutes by helicopter. It then took another six hours to get him to a hospital in Vancouver. Not only did his journey take a total of 11 hours, but it included two separate boat trips, a stint riding in a mechanic's vehicle over an unserviced resource road and an hour of waiting before being told that a helicopter was not being sent. "By the time the faller fi nally received appropriate medical attention, he had to have his leg amputated below the knee, a result that might have been avoided had he been transported to a hospital in a timely manner," the report said. The current system falls short when compared to other jurisdictions such as Washington State or Alaska, with similar geography to B.C. These states have legislation to ensure that 99 per cent of their population is within a 60-minute response time to a level 3 trauma centre. The report recommends that the provincial government guarantee timelines for all residents to be able to access level 3 trauma care, similar to other jurisdictions; review the Emergency Health Services Act to allow for fl exibility when it comes to expanding the scope of practice and role of fi rst responders in the transportation of accident victims; and expand the use of hoisting to reduce time to extract and transfer patients to medical facilities. "There are no technical or infrastructure barriers to the delivery of air ambulance within that critical fi rst hour to any resident of B.C., regardless of where they live. The decision by government not to provide that access is a choice," said Harris. "These recommendations support faster care for workers and all residents regardless of where you live in the province. Faster care results in better medical outcomes for the patient — which in turn, results in lower cost to the health-care system."

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