President`s Message

OEMAC
Occupational and Environmental Medical Association of Canada
LIAISON
Fall
2008
INSIDE
THIS
ISSUE
President’s Message
President’s
Message...................1
OEMAC Conference
Speech - Incomin
President..................2
Recommendation
For Female Workers
During Pregnancy:
An Ergonomic And
Medical Approach....3
OEMAC Nomination
Committee Report....8
The 26th Annual
Scientific Conference
Highlights.................9
Obituaries...............10
The Meritorious
Service Award..........11
The Mastromatteo
Oration....................12
Canadian Board
of Occupational
Medicine
CBOM.....................13
OEMAC’s 26th annual meeting at the fantastic Chateau Frontenac in Quebec City
in October marks a coming together of the Quebec and Ontario Industrial Medical
Associations in, reflecting a comprehensive representation of Occupational Medicine
in Canada.
Indeed we now can truly maintain that OEMAC is the voice of occupational medicine in
this country. My thoughts as your outgoing president include many diverse issues.
OEMAC in Quebec
OEMAC requires more Quebec representation both in membership and in active
participation from our colleagues in Quebec. Quebec occupational doctors are involved
with leading edge medicine and we will all benefit from their input as well as fellowship.
This year’s Annual Scientific conference in Quebec City will give us more opportunity
to increase and re-establish old friendships and make new ones with our Quebec
colleagues. For all of us across Canada, the Annual Scientific Conference draws us
together but what holds us together is our mutual interest in occupational medicine
and the professional and personal fellowship we enjoy.
The largest and most important issue facing OEMAC is engaging and growing
membership. A large country, a small population, diversity in languages and culture
results in an OEMAC membership of less than 250, and a small Board of Directors
and Executive. Unity and representation of occupational medicine in Canada becomes
challenging. OEMAC needs to look at expanding its Board of Directors to encompass
individual provincial and territory representation and extend representation to other
groups who, in one way or another, practice occupational medicine. Examples that
come to mind include physicians involved with the military, RCMP, regulatory roles
(marine and aviation medicine, insurance, government and others). OEMAC’s standing
committees need to be more active and representative of our membership and include
representation of occupational doctors who want to be involved. I can assure members
your input is rewarded many times over- “Busy Occupational Doctors Need
Apply!”
As the voice of occupational medicine, we need to speak out for our membership to
government and regulatory agencies, the CMA and the public - Canadians need to hear
our voices.
Most recently CMA has recognized OEMAC’s voice by only accepting OMSOC as
representative of occupational medicine in Canada. (CMA Board governance changes
that relegate OEMAC to status of special interest group). OEMAC will not accept
OEMAC
1-866-513-9925
www.oemac.org
Continued on Page 2
Copyright © 2008 Occupational and Environmental Medical Association of Canada
this marginal role. OEMAC members and those eligible for membership in OEMAC represent by far the bulk of practicing occupational
medicine physicians in Canada. OEMAC has been at the CMA table for years representing occupational medicine at the National
Medical Organization (Committee of the Affiliates) and more recently at the Council of Health Care and Promotion – in both roles
providing major input to CMA decision makers.
OEMAC needs to be heard in academia with members in teaching and leadership roles in educational spheres both inside and
outside educational institutes. Education in occupational medicine, be it through attending individual courses, weeklong courses,
the printed or other media information or formal part time/full time academic studies, is what distinguishes and separates us from
other medical colleagues. OEMAC needs to be the voice of occupational medicine in Canada to support and encourage those training
programs and recognize that Canadian training is amongst the best in the world. We need to speak out if we see a falling off of
programs or a lack of programs in Canada. We, in a way, uniquely represent the needs of Industry in Canada when it comes to
occupational medicine. Today in Canada some important occupational medicine educational programs are shrinking and in some
regions there are no programs.
In closing I ask each of you to pause and consider what you can do for OEMAC this coming year. Individual efforts are what makes
an organization such as ours operate and the more individuals contributing their efforts on behalf of OEMAC the more successful
OEMAC will be. Call us at 905-849-9925 to tell us your role or to ask us how to help.
It has been a privilege to serve as your President.
Dr. John Quinn
Message du président
La 26e réunion annuelle de l’ACMTE qui s’est tenue au magnifique Château Frontenac, à Québec, en octobre a été un événement
fédérateur pour les Associations de médecine du travail du Québec et de l’Ontario, témoignant de la représentation actuelle de la
médecine du travail au Canada. Nous pouvons maintenant affirmer que l’ACMTE est vraiment la voix de la médecine du travail au
pays. Toutefois, à titre de président sortant, je me permets de vous faire part de quelques commentaires.
L’ACMTE au Québec
La représentation québécoise au sein de l’ACMTE doit augmenter, tant du côté des adhérents que de la participation active de nos
collègues du Québec. Les médecins du travail québécois ont recours à des technologies de pointe et nous pourrions tous profiter
de leur savoir-faire et de leur collaboration. La conférence scientifique annuelle de cette année à Québec représente une belle
occasion de créer ou solidifier des liens avec nos collègues québécois. Non seulement la conférence se veut-elle un événement qui
rassemble nos membres de partout au Canada, mais elle constitue également un forum qui unit ceux qui partagent notre intérêt
commun envers la médecine du travail et la camaraderie de notre groupe tant au niveau personnel que professionnel.
Or, l’acquisition de nouveaux membres est actuellement le plus important défi de l’ACMTE. En raison de la vaste superficie de
notre pays, de sa population relativement peu nombreuse et de sa diversité linguistique et culturelle, nous comptons moins de
250 membres ainsi qu’un conseil d’administration et un comité de direction composés de très peu de personnes. Il devient donc
difficile d’assurer l’unité et la représentation de la médecine du travail au Canada. L’ACMTE doit trouver des moyens d’élargir son
conseil d’administration afin d’assurer la représentation, d’une part, des provinces et des territoires et, d’autre part, de différents
groupes qui travaillent dans le domaine de la médecine du travail. Qu’on pense notamment aux médecins de l’armée, de la GRC, ou
d’instances réglementaires comme la marine, l’aviation, les sociétés d’assurance, le gouvernement, etc. Les comités permanents de
l’ACMTE doivent être plus actifs et plus représentatifs des membres de l’association et faire en sorte que les médecins du travail qui
désirent s’engager puissent en effet jouer un rôle actif. Croyez-moi, même si vous pensez être trop occupés, l’engagement auprès
de l’ACMTE est à la fois enrichissant et valorisant.
Comme nous sommes la voix de la médecine du travail, nous devons faire connaître la position de nos membres aux gouvernements
et agences de réglementation, à l’AMC et au public. Il nous appartient de communiquer avec les Canadiens.
Récemment, l’AMC a écouté l’ACMTE en acceptant uniquement l’OMSOC à titre de représentant de la médecine du travail au Canada.
(Les changements au niveau de l’exercice des pouvoirs du conseil d’administration de l’AMC relèguent désormais l’ACMTE au statut
de groupe d’intérêt.) Ce rôle marginal est inacceptable pour L’ACMTE. Les membres de l’ACMTE et les professionnels qui pourraient
être membres de notre association représentent de loin la majorité des médecins pratiquant dans le domaine de la médecine du
travail au Canada. De plus, l’ACMTE représente la médecine du travail auprès de l’AMC depuis des années (au sein du comité des
affiliés de l’organisation médicale nationale) et, plus récemment, au Conseil canadien de la santé, deux avenues qui nous confèrent
une forte représentation auprès des décideurs de l’AMC.
Continued on Page 3
Copyright © 2008 Occupational and Environmental Medical Association of Canada
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L’ACMTE doit se faire entendre auprès des universitaires en recrutant des membres du corps professoral ainsi que des meneurs
en matière d’éducation, non seulement dans le domaine de l’éducation, mais dans différentes sphères d’activités. L’éducation en
matière de médecine du travail, que ce soit par le biais de cours individuels, de cours d’une semaine, de matériel écrit ou diffusé
par d’autres médias, ou de cours magistraux à temps partiel ou à temps plein, nous distingue de nos autres collègues du domaine
médical. L’ACMTE, au nom de la médecine du travail au Canada, se doit d’appuyer et d’encourager de tels programmes de formation.
La formation canadienne est l’une des meilleures au monde et nous devons veiller à préserver les programmes offerts. Il est donc
impératif de réagir si nous observons une détérioration de la qualité des programmes ou l’insuffisance de tels programmes au
Canada. D’une certaine façon, nous représentons les besoins de l’industrie canadienne en ce qui a trait à la médecine du travail.
Cela dit, nous assistons actuellement à une remise en question de certains programmes éducatifs importants en médecine du travail
au Canada et, dans certaines régions, aucun programme n’est offert.
Je conclurai en vous demandant de prendre un moment pour penser à ce que vous pourriez faire auprès de l’ACMTE cette année.
Les efforts individuels sont essentiels au fonctionnement d’une organisation comme la nôtre. Plus nous sommes nombreux à y
contribuer, plus les efforts de l’ACMTE seront fructueux. Appelez-nous au 905-849-9925 pour discuter de façons de vous engager
qui vous intéresseraient ou pour savoir comment vous pourriez participer.
Dr John Quinn
OEMAC Conference Speech - Incoming President
Colleagues and friends,
It is with great pride and honour that I accept and move forward into the position of presidency of the Occupational & Environmental
Medical Association of Canada. This organization has been helping physicians become educated in the field of occupational medicine
for decades and is now the networking focal point for physicians in our field. We continue to work closely with our affiliate organization,
the Canadian Board of Occupational Medicine to maintain the highest standards for the Canadian occupational physician.
We have always been able to rely on OEMAC to put forward a high level scientific assembly and this year is no exception. I would
like to thank the organizining committee headed by Dr. Mylene Trottier for a truly comprehensive and amazing program.
Coupled to the conference we now have a first rate website that will lead us to an array of information to enable us to function
strongly in our many areas of interest in the occ med field.
The other tool of learning and networking is the Liaison newsletter that has been renewed and will be seen quarterly under the new
leadership of Dr. Oscar Howell our first vice president. We intend to showcase the project papers of our successful CBOM candidates
with one paper in each edition if possible. We will always be looking for papers on subjects pertinent to our members to include in
this publication. The Liaison is a vehicle for news and practical information to the working occupational physician.
Our Board is now discussing the wisdom of having specialized interest societies within the wide field of occupational medicine join us
on the board. These groups may include the insurance physicians, the aviation physicians, the marine physicians, and the physicians
with Royal College fellowships, Francophone physicians to name a few being considered. By augmenting our Board in this manner
we may then truly represent the full spectrum of occupational physicians and perhaps enhance our membership goals.
I take on the challenge of the presidency of this organization knowing full well that I am continuing to work with a very fine and
powerful team of experts on my executive.
As mentioned, our first vice president is Oscar Howell who is a now famous occupational physician in Newfoundland Labrador who
has taken on the job of organizing and running a major part of the health care system in that province.
Our second vice president is the very able Dr. Noel Kerin, an occupational physician well known throughout Ontario and a staunch
supporter of injured workers rights. It was my personal privilege to train with Noel when doing our masters degree at McGill.
Our new treasurer is Dr. Sidney Siu, a highly trained occupational physician with training as an Industrial Hygienist and toxicologist.
Sidney brings a great breadth of knowledge to the table and it is always available for his insight and extensive network throughout
our field.
Continued on Page 4
Copyright © 2008 Occupational and Environmental Medical Association of Canada
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Our newest face to the executive is Dr. Avi Whiteman, an occupational physician from Montreal. We
welcome him and look forward to his valuable input.
MARK YOUR
CALENDARS
October 18-20, 2009
The last member of our medical executive team is Dr. John Quinn. I have now worked with John for
eight years. It continues to be a personal pleasure as I have listened to John’s efforts on our behalf
when describing his representation of OEMAC at a multitude of events. He has done an exceptional
job of leading us through some difficult times and will now help the organization with his wealth of
experience. Thank you Dr. Quinn.
And last but not least the most important member of our executive team, Ms. June Hylands. As
most know, June is our executive director. We rely heavily on June’s services to organize us and
keep us focused on our main mandate of education and communication in this very fascinating
field of occupational & environmental medicine. We as an organization thank you, June, for all your
hard work and dedication.
I look forward to communicating with you throughout the coming months. If any of you wish to
connect on any issues facing you with regard to your involvement in occupational medicine please
do not hesitate to call, email or contact me directly or through OEMAC’s office and I will get back
to you right away.
At this time I would like to announce that OEMAC officially congratulates Quebec City on its 400th
anniversary and finally, as your new president, I invite you to continue to enjoy the conference, the
beauty and excitement of this historic city and look forward to seeing you next year in Ottawa for
the 2009 conference.
Thank you,
Dr. Howard Hamer
1 Rideau Street, Ottawa
Join us in Ottawa, Ontario,
for the 27th Annual General
Meeting and Annual
Scientific Conference of
the Occupational and
Environmental Medical
Association of Canada
Located in the heart of
Canada’s capital next
door to the Parliament
Buildings, the landmark
Fairmont Château Laurier
is a magnificent limestone
edifice with turrets and
masonry reminiscent of a
French château.
Registration will be
available shortly at
www.oemac.org
The Planning Committee
would like to hear
from you. What topics
would you like to have
included for 2009?
Please email your
suggestions to
[email protected]
Président reçu
Chers collègues et amis,
C’est avec grand plaisir que j’accepte la nomination à la présidence de l’Association canadienne
de la médecine du travail et de l’environnement. Depuis plusieurs décennies, notre organisation
met à la disposition des médecins de nombreuses ressources sur la médecine du travail afin de
leur permettre d’élargir et d’approfondir leurs connaissances. Au fil des ans, l’Association est
devenue le principal forum de réseautage des médecins œuvrant dans notre domaine. De plus,
nous collaborons étroitement avec notre affiliée, la Commission canadienne de la médecine du
travail et de l’environnement, dans le but de maintenir les normes les plus élevées qui soient pour
les médecins du travail au Canada.
L’ACMTE a toujours su organiser des conférences scientifiques de haut niveau et cette année en est
un autre bel exemple. Le programme est varié et vraiment intéressant. J’aimerais remercier le comité
organisateur ainsi que le Dr Mylène Trottier qui a orchestré le tout. J’aimerais également souligner
que la philosophie de l’ACMTE de travailler avec d’autres organisations a été mise en œuvre pour
organiser cette conférence. Je profite donc de cette occasion pour remercier l’AMRPSTQ qui a été
un partenaire de première classe tout au long de l’organisation de la conférence de Québec.
L’Association vous offre différents outils, dont un excellent site web qui donne accès à une panoplie
de ressources visant à nous aider à exceller dans le domaine de la médecine du travail. Le bulletin
Liaison est un autre outil de formation et de réseautage. Liaison a été revampé et sera publié sur
une base trimestrielle sous la direction du Dr Oscar Howell, notre premier vice-président. Nous
comptons y présenter les travaux des candidats qui réussissent l’examen de la CCMT, au rythme
d’un projet par bulletin, si possible. Nous serons donc toujours à la recherche de travaux qui
pourraient intéresser nos lecteurs. L’objectif de Liaison est d’offrir aux médecins du travail des
renseignements pratiques et des nouvelles qui vous concernent.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
4
J’espère que l’ACMTE pourra, dans un avenir rapproché, élargir le conseil d’administration pour y inclure des membres des sociétés
spécialisées reliées au vaste domaine de la médecine du travail. Le conseil de direction et le conseil d’administration discuteront
de l’inclusion de ces groupes au cours des prochains mois. Nous espérons inclure, entre autres, des médecins spécialisés dans le
domaine maritime ou aéronautique, des médecins membres du Collège royal, des médecins francophones, etc. En augmentant nos
effectifs, nous serons mieux équipés pour représenter les différents types de médecins du travail et nous pourrons alors peut-être
songer à élargir nos objectifs.
J’accepte la présidence ainsi que tous ses défis sachant très bien que je suis entouré d’un conseil de direction constitué d’experts
chevronnés.
Oscar Hoswell, notre premier vice-président, est un médecin réputé dans le domaine de la médecine du travail à Terre-Neuve.
Il a accepté l’importante tâche d’organiser et de diriger une des principales composantes du système de soins de santé dans sa
province.
Notre second vice-président est le Dr Noel Kerin, un médecin du travail bien connu en Ontario et ardent défenseur des droits des
travailleurs blessés. J’ai eu le privilège d’étudier avec Noel lorsque nous avons fait notre maîtrise à l’Université McGill.
Notre trésorier est le Dr Sidney Siu, un médecin du travail chevronné qui est à la fois hygiéniste industriel et toxicologue. Nous
bénéficierons sans aucun doute de son savoir exceptionnel, de sa disponibilité, de ses conseils et de son réseau de connaissances
dans notre domaine.
Le Dr …… est un nouveau membre du conseil de direction cette année.
Le dernier membre de notre équipe de direction est le Dr John Quinn. Je travaille avec John depuis 8 ans et j’y prends toujours
autant plaisir. Il a vanté les bienfaits de notre organisation à maintes reprises lors de différents événements et il a été indispensable
lors des moments plus difficiles de notre organisation. Son expérience inouïe continuera d’être un atout majeur. Merci Dr Quinn.
Enfin, la personne la plus importante au sein du conseil de direction, Madame June Hylands. Comme la plupart d’entre vous le savez,
June est notre directrice générale. Elle est essentielle à l’organisation de nos activités et nous aide à nous concentrer sur notre
principal mandat d’éducation et de communication dans ce domaine fascinant qu’est la médecine du travail et de l’environnement.
Merci, June!
Je compte communiquer avec vous de temps à autre au cours des prochains mois. Si vous désirez me contacter pour discuter de
quoi que ce soit en ce qui a trait à vos activités dans le domaine de la médecine du travail, n’hésitez pas à m’appeler ou à m’écrire,
directement ou en communiquant avec June, et je vous répondrai dès que possible.
Au nom de l’ACMTE, j’aimerais féliciter la ville de Québec à l’occasion de son 400e anniversaire. J’espère que la conférence saura vous
plaire et que vous profiterez pleinement de la beauté, des attraits et des célébrations en cours dans cette ville riche en histoire.
Au plaisir de vous revoir à Ottawa pour la conférence de 2009!
Merci,
Dr Howard Hamer
OEMAC
Occupational and Environmental Medical Association of Canada
The OEMAC Board of Directors
express their gratitude to...
Dr. Jeremy Beach for acting in the capacity of President and most recently as Chair of the Board.
Dr. John Quinn will move into the position of Board Chair.
Dr. Alice Dong who has completed her term as Chair of the Meritorious Service Award Committee.
Dr. Sol Sax will replace Dr. Dong as Chair.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
5
Recommendation for Female Workers During
Pregnancy: An Ergonomic and Medical Approach
Dr. Sidney Siu, MD, FRCPC, FCCBOM, DABOT
President and Medical Director, SRS Consultants Inc.
Carrie Taylor Van Velzer, M.Sc., CCPE, CPE
Principal Ergonomist, Taylor’d Ergonomics Incorporated
Corresponding Author:
Dr. Sidney Siu, MD, FRCPC
827 Richmond Street,
London, Ontario N6A 3H7
Phone Number: (519) 858-4694
Fax Number: (519) 828-4692
E-mail Address: [email protected]
Biographical Notes:
Dr. Sidney Siu
Dr. Siu of SRS Consultants is a qualified Medical Doctor in the Province of Ontario. He is a Specialist in Occupational Medicine with
the Royal College of Physicians and Surgeons in Canada and with the American Board of Preventative Medicine in the United States.
He has been certified as an Independent Medical Examiner by the American Board of Independent Medical Examiners. He is also a
Certified Toxicologist by the American Board of Toxicology. He is a Fellow of the American College of Occupational and Environmental
Medicine and the Canadian Board of Occupational and Environmental Medicine. He is also a Certified Industrial Hygienist by the
American Board of Industrial Hygiene which qualifies him to review and assess occupational exposure including air sampling
results.
Carrie Taylor Van Velzer
Carrie Taylor Van Velzer is the principal Ergonomist for Taylor’d Ergonomics Incorporated, a consulting group based in Cambridge,
Ontario. She holds a Master of Science degree in Human Biology, and a Bachelor of Science in Human Kinetics, both from the
University of Guelph. Carrie has attained her Certified Professional Ergonomist status in both the USA and Canada. She has worked
in the field of ergonomics since 1989. Carrie leads a team of seven Ergonomists, working in many industries, including automotive,
food, health care, high tech, and offices.
Abstract:
Potential adverse outcomes in pregnancy resulting from exposure to occupational and environmental contaminants have been
extensively studied. With recognition of the hazards, and proper engineering controls, these adverse outcomes will soon be an
issue of the past. The effect of physical work during pregnancy has also been studied, but the results and recommendations are
somewhat less apparent. Physicians have been providing “Doctor’s notes” for pregnant workers upon request, most of the time
without objective medical evidence or scientific basis for their recommendations. This paper reviews the available medical literature
on the potential health effects of physical work on pregnancy, and makes ergonomic recommendations to assist the pregnant worker
and her physician in minimizing the risk of musculoskeletal injury and adverse reproductive outcome.
Introduction:
In the 21st century, the numbers of males and females in the work force are equalising; as of the year 2000, approximately 46.6%
of workers in the U.S. were female 1. Of the approximately 59 million female workers in the U.S., 38 million were of childbearing
age1.
Adverse reproductive outcome from heavy exposure to various contaminants, occupationally and environmentally, has been
documented in detail in standard occupational medicine text books 1, 2, 3, and will not be dealt with in this paper.
Many studies have been published on physical working conditions and their relationships to possible adverse pregnancy outcomes.
A literature search on Pub Med with the keywords of physical work, pregnancy outcome yielded 70 articles among which, after
review of the title, only 32 papers investigated the relationship between physical work and pregnancy outcome, of which 25 were in
English. Additional searches in ergonomic and occupational health publications yielded additional papers. While some of the studies
yielded negative results, most of the studies showed some adverse association with heavy labour 4, 5, 6, 7, 8, 9.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
6
One recent meta-analysis study, published in April 2000 by Ellen L. Mozurkewich 10, showed that “physically demanding work” was
significantly associated with pre-term birth (OR 1.22), small for gestational age (OR 1.37), hypertension and pre-eclampsia (OR
1.60). “Physically demanding work” was defined as heavy and/or repetitive lifting or load carrying, manual labour, or “significant
physical exertion”. Prolonged standing (OR 1.26), shift work, night work (OR 1.24), and highly cumulative work fatigue score (OR
1.63) were found to be associated with pre-term birth. Prolonged standing was defined as standing for more than three hours per
day. Work fatigue evaluation was described by Nicole Mamelle et al in 19864 using five parameters: posture, working on industrial
machines, physical exertion, mental stress, and physical work environment, a semi-quantitative scoring system. These five elements
were rated as either “high” or “low”. The following criteria were used to define “high” exposure:
1) Posture in standing position for more than three hours per day.
2) Working on an industrial conveyer belt, independent work on an industrial machine with strenuous effort or vibration,
continuous or periodic physical effort.
3) Carrying loads of more than 10 kilograms.
4) Routine work, various tasks requiring little attention without stimulation
5) At least two of the following three elements; significant noise level, cold temperature, wet atmosphere and manipulation
of chemical substances.
M. J. Saurel-Cubizolles9 indicated that employed women did not have an elevated risk of pre-term birth, in comparison with unemployed women. However, a moderately elevated risk of pre-term birth was observed for women working more than 42 hours a
week; standing more than six hours per day; or for women with low job satisfaction.
The impact of shift work upon pregnancy has not been well addressed by occupational health professionals.
Current Medical Guidelines:
In 1984, the Counsel on Scientific Affairs for the American Medical Association produced a guideline for various types of work during
pregnancy.11 Weight limits for repetitive lifting for various gestation periods were suggested. Until 20 weeks gestation, repetitive
lifting of weights over 23 kg was permitted. Between 20 and 24 weeks gestation, lifting of 11-23 kilograms were allowed. Beyond
24 weeks gestation, a limit of 11 kilograms was suggested. No new recommendations have been provided by the American Medical
Association (AMA) in 199912. Commonly accepted ergonomics guidelines, which will be discussed later in this paper, would suggest
lower thresholds than those suggested by the AMA in 1984.
The Reproductive Hazard Management Guideline for the American College of Occupational and Environmental Medicine published
in 1996 did not really address the issue of physical work13.
Ergonomics Effects of Pregnancy on the Worker
From an ergonomics perspective, the additional demands of pregnancy affect a worker both biomechanically (due to the additional
weight load and the changes to her musculoskeletal system) and physiologically (due to the additional weight and physiological
demands imposed by the fetus).
Biomechanical loads on the spine increase as the worker’s center of gravity shifts forward in the second and third trimester. This
effect is similar to carrying a load in front of the body; as the load dimensions increase, the moment around the lumbar spine
increases. The risk of back injury for a pregnant worker is further exacerbated by increased laxity in the ligaments supporting the
low back14.
General Ergonomics Guidelines and Recommendations for Pregnant Workers
Very specific manual materials handling (lifting, lowering, pushing, pulling, and carrying) guidelines are available to protect nonpregnant workers, eg. Snook and Ciriello, 199115, NIOSH Manual Handling Guidelines, 199316. These guidelines suggest weight
limits for various combinations of handling frequency, heights, distances, and reaches. For many employers, evaluating, designing,
and retrofitting work stations to meet these guidelines represents a significant effort. A more simplistic approach was proposed by
OSHA (Federal Register, 2000)17, using a checklist of “signal risk factors”. The OSHA screening tool cites the following “signals”:
- Lifting more than 75 lbs (34 kg) at any one time, or
- Lifting more than 55 lbs (25 kg) more than 10 times per day, or
- Lifting more than 25 lbs (11.4 kg), below the knees, above the shoulders, or at arms length, more than 25 times per day.
Most companies could benefit by using the guidelines suggested by OSHA for the non-pregnant worker. More restrictive lifting
guidelines for pregnant workers are clearly warranted from a biomechanical perspective, but may seem unreasonable for some
companies who are already struggling to meet the less stringent OSHA guidelines.
At a minimum, medical restrictions should account for the fact that the pregnant worker is “lifting” and “carrying” the additional
weight gained through pregnancy.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
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Detailed recommendations for pregnant workers come from an article published in the International Journal of Industrial Ergonomics
in 1998 by S. Morrissey18. He reviewed various ergonomics risk factors, and provided general recommended limits or designs to
mitigate the physiological and biomechanical loads placed on pregnant workers. Some of the most practical recommendations from
Morrissey are as follows:
- Limit continuous standing to two hours or less, and provide footrests and floor matting
- Provide a means to alternate between sitting and standing
- Limit forward reaches to less than 40 cm
- Eliminate reaches above shoulder level
- Restrict lifting and lowering to less than 10-15 kg, less than 12 times a day
- Eliminate exertions below waist height
- Limit work weeks to a maximum of 40 hours
- Try to avoid rapidly rotating shifts and night work
However, these recommendations do not distinguish between the different stages of gestation.
Women in the later stages of pregnancy have an “obstruction” in front of their torsos, increasing the demands on their shoulder
muscles by forcing the worker to reach forward continuously to use the hands. This effect is similar to forcing a worker to continually
stand back from the work station. A study published by Lee et al19 reported a 12.6 cm difference in torso depth between pregnant
(32 weeks) and non-pregnant subjects. General ergonomics guidelines for standing work for the non-pregnant worker suggest
that:
- One-handed reaches should kept within 46 cm (18”) forward or sideways from the midline of the body (Eastman Kodak
Company, 2004)20.
- Two-handed reaches should be kept within 36 cm (14”) forward and 46 cm (18”) sideways from the midline of the body
(Eastman Kodak Company, 2004)
Recommended reach envelopes for seated work are smaller, as the torso is not as mobile and the hips are more fixed:
- Frequent reaches should be kept within 36 cm (14”) forward and 40 cm (16”) sideways from the midline of the body
(Eastman Kodak Company, 2004)
To accommodate a pregnant worker specifically, a very simple approach would be to reduce the recommended forward reach
envelope by the worker’s increase in torso depth; women with larger forward growth should be more restricted in forward reach. As
a rule of thumb, using a 13 cm increase in torso depth, the reach guidelines for pregnant workers might be suggested as follows:
- Standing one-handed work within 33 cm
- Standing two-handed work within 23 cm
- Seated work within 23 cm
Another common work “accommodation” for pregnant workers is to “allow sitting or standing”. This recommendation, while wellintended, is often poorly executed. In fact, providing a chair at a typical standing work station can substantially increase the risk of
injury. Most standing work stations do not allow sufficient leg clearance for a worker to sit with the legs under the work surface and
the arms at a comfortable height above it. Conveyors, fixtures, boxes or containers, and other obstacles often require the worker
to either lower the chair such that the arms are working at or above chest height, or to straddle the obstacle, increasing the reach
to the work surface. Either of these adaptations increase shoulder demands and the risk of injury. Therefore, while “sitting and
standing” are warranted to reduce the risk of varicosity or back pain, caution must be exercised to implement the suggestion from
a practical and safety point of view.
Prolonged sitting is commonly associated with an increased risk of low back pain, particularly amongst pregnant workers in office
settings. Therefore, particular attention should be paid to providing and properly adjusting an office chair. The study published by
Lee et al.19, reported that pregnant workers preferred a sloped seat pan, allowing a larger hip angle. They also tended to hold their
upper arms further from their bodies, and lean forward, in order to compensate for the increased forward reach due to larger torso
depth. Adjustable lumbar support, would also particularly benefit the pregnant worker.
Physiologically, energy demands increase as body weight increases, and a pregnant worker is also required to metabolically support
the demands of the growing fetus. The extra circulatory demands of the placenta place an increased load on the cardiovascular
system. Therefore, restrictions against “heavy” work and overtime can be a logical precaution. The definition of “heavy” work,
however, is a complex issue. Ergonomists can use tools to estimate the metabolic demands of various jobs, based on the tasks
(weight, duration, distances, frequencies, etc) and the body weight of the user (i.e. the individual for which one designs in order
to protect a majority of workers). These assessments are most commonly conducted in order to implement heat stress prevention
programs. Under heat stress conditions, workers performing heavier work need more heat recovery time than workers on lighter
jobs (American Conference of Governmental Industrial Hygienists)21.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
8
Energy expenditure analysis is a complex process. How to protect pregnant workers from metabolic loads is not clear; some degree
of control over energy demands should be available to the pregnant worker, and pregnant workers must be coached to take breaks
as they feel they need them.
Pregnant workers are known to report higher rates of carpal tunnel syndrome (CTS)22. Therefore, workers who are exposed to
recognized risk factors for CTS, including forceful or repetitive wrist movements, should be protected with work restrictions.
In the booklet published by The International Labour Organization in 2004, “Healthy Beginnings; Guidance on Safe Maternity at
Work”23, the document recommended (No. 191) avoiding compulsory night shifts if “incompatible with pregnancy or breast feeding”,
but provided no other specific recommendations for physical work.
Guidance for Physicians Asked for Work Restrictions for Pregnant Workers
In summary, the following guidance can be suggested for physicians seeking to protect the interest of pregnant patients:
- Limit manual handling tasks to well within ergonomics guidelines, accounting for the additional weight “lifted” by the pregnant
wor ker. In the absence of ergonomist support, the following thresholds (derived from the OSHA screening tool and accounting for approximately 20-30 lbs of weight gain) could be used:
o Do not lift more than 45 lbs (20 kg) at any one time, or
o Do not lift more than 25 lbs (11.4 kg) more than 10 times per day, or
o Do not lift more than 5 lbs (2.2 kg), below the knees, above the shoulders, or at arms length, more than 25 times
per day.
- Limit reaches to within ergonomics guidelines, correcting for the pregnant workers’ increased torso depth, as follows:
o Keep standing one-handed work within 33 cm
o Keep standing two-handed work within 23 cm
o Keep seated work within 23 cm
- Limit continuous standing work to 2 hours. Where feasible, provide an option to sit. Provide footrests and matting for standing work.
- Limit exposure to work requiring repetitive or forceful wrist movement.
- Prevent any contact stress in the wrist area (i.e. do not rest wrists on hard surfaces)
- Interrupt seated work with frequent breaks.
The above guidelines should be applied to an uncomplicated pregnancy after the first trimester.
If a worker has a pre-existing medical condition, e.g. hypertension, diabetes, or chronic back pain, individualized assessment by an
occupational physician should be conducted for specific and additional recommendations.
References
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
LaDou, Joseph. Female Reproductive Toxicology. Current Occupational & Environmental Medicine, Fourth Edition. 2007; Chapter 25:390.
Rom, William. “Environmental & Occupational Medicine.” 3rd Edition, 1998. Chapter 18.
Zenz, Carl. “Occupational Medicine, Principle and Practical Applications.”
Mamelle N, Laumon B, Lazar P. Prematurity and Occupational Activity During Pregnancy. American Journal of Epidemiology. 1984;v119, n3:309-322.
Nicholls JA, Grieve DW. Performance of Physical Tasks in Pregnancy. Ergonomics. 1992;v35,n3:301-311.
Ahlborg, Gunnar. Physical Work Load and Pregnancy Outcome. JOEM. 1995;v37,n8:941-944.
Gawad A, Badawy A, Baghdadi L, A. El., Wehady A. Occupational Physical Activity and Pregnancy Outcome. European Journal of Obstetrics & Gynecology and
Reproductive Biology. 2001:41-45.
Banerjee S, Dey TK and Chatterjee P. Estimation of Risk of Pregnancy Wastage Due to Lifting of Heavy Weight During Pregnancy. Indian Journal of Occupational and
Environmental Medicine. 2002;v6,n1:13-15.
Saurel-Cubizolles MJ, Zeitlin J, Lelong N, Papiernik E, Di Renzo GC, Breart G. Employment, working conditions, and preterm birth: results from the Europop
case-control survey. 2003:395-401.
Mozurkewich EL, Luke B, Avni M, Wolf FM. Working Conditions and Adverse Pregnancy Outcome: A Meta-Analysis. Working Conditions & Pregnancy Outcome.
2000;v95, n4: 623-635.
“Effect of Pregnancy on Work Performance,” JAMA. April20, 1984;v251,n15, 1995-1997.
American Medical Association. Report 9 of the Council of Scientific Affairs, (A-99).
Fedoruk, M. Joseph. ACOEM Reproductive Hazard Management Guidelines. JOEM. 1996; 38:83-90.
Oxorn, Harry. Human Labour and Birth 4th Edition. Appleton-Century-Croft. 1980: Chapter 5.
Snook, S., and Ciriello, C. The design of manual handling tasks: Revised tables of maximum acceptable weights and forces. Ergonomics 1991: 34(9): 1197-1213
National Institute for Occupational Safety and Health A Work Practices Guide for Manual Lifting, Tech. Report U.S. Department of Health and Human Services:
Cincinnati, Ohio 1991.
Occupational Safety & Health Administration (2000). Federal Register, Part II, 29 CFR Part 1910, Ergonomics Program; Final Rule. Washington: Occupational
Safety & Health Administration
Morrissey, SJ. Workplace design recommendations for the pregnant worker. International Journal of Industrial Ergonomics. 1998: 383-395.
Lee, Y, Her, L, Tsuang, Y. A comparison of sitting posture adaptations of pregnant and non-pregnant females. International Journal of Industrial Ergonomics. 1999: 391396.
Eastman Kodak Company Kodak’s ergonomic design for people at work, second edition. New Jersey: John Wiley & Sons, 2004.
ACGIH Worldwide TLVs and BEIs based on the documentation of the threshold limit values for chemical substances and physical agents & biological exposure indices.
Cincinnati: ACGIH Worldwide. 2004.
Simmons, B, Bosch, J. A Special Health Report from Harvard Medical School: Hands, Strategies for strong, pain-free hands. 2006:27.
Paul, Jane. Healthy beginnings: Guidance on safe maternity at work. 2004.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
9
OEMAC
Member of the Occupational and Environmental Medical Association of Canada
OEMAC
NOMINATION COMMITTEE REPORT - 2008
The Nominations Committee is charged with the nominating and election process of all directors,
board members, committee members and executive members. The committee is composed of past
presidents of OEMAC and is customarily chaired by the immediate past president.
The following individuals are recommended for appointment for 2008 – 2009
Executive Committee:
These individuals will move into the first year of a two-year term.
1. President – Howard Hamer
2. 1st Vice President – Oscar Howell
3. 2nd Vice President – Noel Kerin
4. Secretary – Avi Whiteman
5. Treasurer – Sidney Siu
6. Past President – John Quinn
Board of Directors:
1.
2.
3.
4.
5.
6.
7.
British Columbia & Yukon – Ray Copes (2006-2008). Will serve again 2008 – 2010
Alberta & NWTs – Alice Liu – Shum (2007 – 2009.)
Sask/Man/Nunavit - Niels Koehncke (2006 – 2008) Will serve again 2008 – 2010
Ontario - Joel Andersen (2006 – 2008) Will serve again 2008 – 2010
Ontario – Maureen Cividino (2007 – 2009)
Quebec – Mylene Trottier (2007 – 2009)
Maritimes - Ken Mitton (2006 – 2008) Will serve again 2008 – 2010
The Past President ( Dr. John Quinn) will remain as Chair of the Board until 2010
The Nominating Committee is pleased to recommend this slate to the Board and the membership.
Respectfully submitted,
Jeremy Beach
Nominating Committee Chair
Copyright © 2008 Occupational and Environmental Medical Association of Canada
10
OEMAC
26th Annual Conference
Quebec City - October 2008
Quebec City’s 400th Anniversary and the beautiful Chateau
Frontenac provided the perfect venue for OEMAC’s 26th
annual conference. The Scientific Programme included
the following topics – Practical Tools for Occupational
Physicians / Outils practiques pour les médecins du travail;
Workers: Health and Toward Action / Travailleurs: à
l’action et en santé; Pregnancy in the Workplace / Travail
et grossesse; Shift Work, Health and Sleep Problems /
Horaires non conventionnels, santé et troubles du sommeil
OEMAC would like to to take this opportunity to thank the
following for making the conference such a success.
Our thanks to association des médecins du réseau
publique en santé au travail du Québec (AMRPSTQ)
for collaborating with OEMAC in developing the
Scientific Programme
Our thanks to the Scientific Committee
Dre Myléne Trottier, Chair , Institut National de santé
publique du Québec
Dre Christine Chevalier , Direction de santé publique et
d’Evaluation de Lanaudiére
Dre Joan Mason , CSSS Jeaune Mance, Montréal
(Centre de santé et de services sociaux)
Our thanks to the Scientific Advisors
Dr. Robert Simard
Dre Lise Goulet
Dr Stéphane Caron
Dr. Howard Hamer
Our thanks to the sponsors and exhibitors:
Gold Sponsors
• Canadian Institutes of Health Research (CIHR)
• GlaxoSmithKline
• Ministère de la santé et des services sociaux Québec
• Pfizer Canada Inc.
• Wyeth Pharmaceuticals
Silver Sponsors
• Commission de la santé et de la sécurité du travail
(CSST)
Exhibitors
• Association des médecins du réseau de la santé
publique en santé au travail du Québec (AMRPSTQ)
• CPM Health Centres
• Gamma-Dynacare Medical Laboratories
• GlaxoSmithKline
Copyright © 2008 Occupational and Environmental Medical Association of Canada
11
Obituaries
Dr. William Keith Campbell Morgan
Deceased March 23 2007
Dr. Clifford Rodney May
Deceased July 6 2008
It is a great honour to be asked to write a tribute to my mentor.
Dr. W. K. C. Morgan or Chief, as he was affectionately referred
to by the residents, often terrorized the house staff quizzing
them not only on the finer points of respiratory medicine but
also of the arts and English language. He expected a high level
of knowledge, expertise and compassion. He was patient/
worker focused and his patients loved and respected him.
Dr. C. Rodney May was born and raised in Newbury in Berkshire
and educated there at St Bartholomew’s School. After
graduation from Medical School he spent some time in general
surgery and orthopaedics but with the outbreak of the Korean
War, he joined the Royal Navy and served for 4 years in Japan,
Korea and Malaysia. While in Singapore he became interested
in occupational medicine through his activities in HM Dockyard
and on leaving the Royal Navy decided to take this up as a
career, commencing as Area Medical Officer with the railways
division of the British Transport Commission. After obtaining
his DIH (Lond) in 1958, he moved on through progressively
more senior posts in the Simon Engineering Group as SMO and
STC/ITT as CMO.
In 1968, Dr. May emigrated to Canada to take a post as Director
of Industrial Hygiene with the Alberta Government. He later
moved to Nova Scotia and from there to Ontario as Assistant
Deputy Minister for Occupational Health & Safety (OH&S) for
over 5 years, and then returned to the UK back to STC/ITT/
ICL as Head of Health Services. In 1982 he returned to Canada
working in the oil industry, then back to Alberta OH&S for 5
years and subsequently to the University of Alberta. Following
“retirement” he joined the Alberta Workers’ Compensation
Board for 11 years.
To most clinicians, researchers and legal profession; Dr. Morgan
was renowned and well respected in the Occupational Medicine
field. He authored and contributed to over 50 textbooks and
more than 170 articles. His expert opinion was widely sought
out in the area of pneumoconiosis.
His accomplishments were many including; Professor of
Medicine and Chief, Pulmonary Diseases Section, West Virginia
University in Morgantown; Emeritus Professor of Medicine
at the University of Western Ontario; Past President of the
Canadian Thoracic Society, Meritorious Service Award of the
Occupational and Environmental Medical Association of Canada
(2000) and the OMA Life Membership Award 2004.
With Dr. Morgan’s passing, it is indeed the “end of an era;
he was a fierce competitor and articulate campaigner for that
which he knew to be the truth.” He left his mark (wit and
penmanship) on the books of occupational medicine.
Sent in by Hellyer, Deborah [mailto:[email protected]]
Over the years his main interests were toxicology, substance
abuse and the problems of mental health in industry. He was
active in professional societies, promoted the establishment of
the FRCPC (OM) and Canada’s first OHNC for nurses. He held
assistant professorial posts at Dalhousie, and the Universities of
Alberta and Toronto, and was one of the first of the Governors
of the Canadian Council for OH&S. He always maintained that
he had multiple interests but no particular or special talents,
and would never admit to that incredible memory which always
amazed his colleagues. His most outstanding talent was his
ability to reduce the most complex of problems to a simple
understandable form.
Congratulations
Since July 2006 entry to Royal College training programs in
occupational medicine has been through Internal Medicine.
In both 2007 and 2008 the Occupational Medicine Section
of the Alberta Medical Association has offered a stipend to a
number of residents in Internal Medicine Programs in Alberta
to encourage residents to attend the OEMAC meeting. This
years recipients of the stipend, pictured here with Jeremy
Beach from the University of Alberta at the conference
reception, were (from left) Matt Lauzon (University of Calgary),
Kerri Johannson (University of Calgary), and Jesse Pewarchuk
(University of Alberta). Ramona Hrimiuc (University of Alberta)
was the fourth recipient (not shown).
Copyright © 2008 Occupational and Environmental Medical Association of Canada
12
Meritorious Service Award 2008
The Meritorious Service Award is OEMAC’s official recognition of individuals who have made exemplary contributions
to the growth and development of occupational and environmental medicine. Fields include contributions to OHS
legislation, worker health and safety, research, education and professional bodies. The award is presented in the
form of individual plaques which are presented at the banquet held at each annual OEMAC conference.
The recipient of the OEMAC Meritorious Service Award for 2008 is
Dr. Gilles Thériault MD, DrPH
Gilles Thériault qualified in medicine at Laval University in 1966 and worked for three years as a general family doctor in TroisRivières, Québec. From 1970 to 1973, he was a post-graduate trainee at Harvard University, Boston, where he obtained a Master’s
Degree in Industrial Health (1970) and a Doctor of Public Health degree (1973). Upon his return, Dr. Thériault worked as advisor to
the Québec Provincial Deputy Minister of Health and Social Affairs for three years. Thereafter, he joined Laval University as Assistant
and Associate Professor where he developed a graduate program in occupational health. In 1982, Dr. Thériault joined McGill
University, where he became Professor in 1989 and held successively the functions of Director of the School of Occupational Health
(1983-1993), Chair of the Department of Occupational Health (1993-1995) and Chair of the Joint Departments of Epidemiology,
Biostatistics and Occupational Health (1996-2001) of the Faculty of Medicine. After a one year sabbatical leave, Dr. Thériault
returned to McGill University as professor of Occupational Health and Epidemiology. He is the author of several publications and book
chapters in occupational medicine and occupational epidemiology. His major field of research is the epidemiology of occupational
diseases and occupational cancer. He has presented papers and has been guest speaker at many scientific conferences. He currently
assumes the coordination of the graduate program in occupational health sciences at McGill University and has adapted the Master
Degree Program into a distance education on line offering.
MARK YOUR CALENDARS
OCTOBER 18-20, 2009
Join us in Ottawa, Ontario, for the 27th Annual General Meeting and
Annual Scientific Conference of the Occupational and Environmental
Medical Association of Canada
À inscrire à votre agenda
Nous vous invitons à la 27e assemblée générale et conférence scientifique
annuelle de l’Association canadienne de la médecine du travail et de
l’environnement qui se tiendra à Ottawa, en Ontario
Located in the heart of Canada’s capital next door to the Parliament
Buildings in Ottawa, the landmark Fairmont Château Laurier is a
magnificent limestone edifice with turrets and masonry reminiscent of a
French château.
Registration will be available shortly at www.oemac.org
1 Rideau Street, Ottawa
Copyright © 2008 Occupational and Environmental Medical Association of Canada
139
Mastromatteo Oration
The Mastromatteo Oration is an honour conferred on an individual who has made a sustained and significant contribution to
Occupational Health in Canada.
The first oration was presented by Dr. Ernest Mastromatteo, a distinguished physician, who has made numerous contributions to
the evolution of Occupational Health. Because of the impact of Dr. Mastromatteo’s influence on Occupational Health both in Canada
and beyond, the Oration carries his name.
The Mastomatteo Oration for 2008 was presented by Dr. Tee Guidotti who spoke on Lessons Learned.
The slides from Dr. Guidotti’s lecture can be viewed on our website www.oemac.org
Tee L. Guidotti is retiring from his positions as Professor and
Chair of the Department of Environmental and Occupational
Health in the School of Public Health and Health Services, The
George Washington University Medical Center, Washington
DC, and Director of the Division of Occupational Medicine and
Toxicology in the Department of Medicine, School of Medicine
and Health Sciences. Prior to taking this position in 1999, he
was for 15 years Professor of Occupational and Environmental
Medicine and Director of the Occupational Health Program in
the Department of Public Health Sciences at the University
of Alberta in Edmonton, Canada. In 1996 he was named a
Killam Annual Professor. He is a physician with training in
internal medicine, pulmonary medicine and occupational and
environmental medicine. He holds both Royal College and CBOM
fellowship in occupational medicine and board-certification
in the three specialties in the US. His research interests
include occupational and environmental lung diseases, air
quality studies, and inhalation toxicology. He is best known in
occupational medicine for his work on the occupational health
problems of firefighters and oil and gas workers.
Dr Guidotti is the author or coauthor of over 200 publications
and has edited four books, including Science on the Witness
Stand and the Canadian Guide to Health and the Environment.
Dr. Guidotti is the Editor in Chief of Archives of Environmental
and Occupational Health: An International Journal. He chaired
the committee of the American Thoracic Society that in 2004
revised the diagnostic criteria for non-malignant asbestosrelated lung disease. He is a Past President of the American
College of Occupational and Environmental Medicine and the
Association of Occupational and Environmental Clinics and
also has served on the Boards of Directors of the Occupational
and Environmental Medical Association of Canada (which has
honoured him with a Meritorious Service Award), the Canadian
Association of Physicians for the Environment, and the Alberta
Federation of Labour Occupational Health Clinic, and the
International Commission on Occupational Health, where he is
currently a candidate for Vice President.
Tee L. Guidotti Professeur et directeur du département de
santé au travail et d’écosalubrité de l’École de santé publique et
des services de santé du Centre médical de l’Université George
Washington à Washington, DC., et directeur de la division
de médecine du travail et de toxicologie au département de
médecine de l’École de médecine et des sciences de la santé
depuis 1999, Tee L. Guidotti a récemment décidé de prendre sa
retraite. Pendant 15 ans, il a aussi été professeur de médecine
du travail et de l’environnement et directeur du programme de
santé au travail du département des sciences de santé publique
de l’Université de l’Alberta à Edmonton. En 1996, il a été
nommé professeur annuel Killam. Sa formation médicale inclut
la médecine interne, la médecine pulmonaire et la médecine du
travail et de l’hygiène du milieu. Il est boursier du Collège royal
et de la CCMT en médecine du travail et il est accrédité dans
les trois spécialités aux États-Unis. Ses recherches portent
principalement sur les maladies pulmonaires reliées au travail
et à l’hygiène du milieu, à la qualité de l’air et à la toxicologie
par inhalation. Il est reconnu dans le domaine de la médecine
du travail pour son travail concernant les problèmes de santé
des pompiers et des travailleurs de l’industrie pétrolière.
Le Dr Guidotti est l’auteur ou co-auteur de plus de 200
publications en plus d’avoir révisé quatre livres, dont Science
on the Witness Stand et Canadian Guide to Health and the
Environment. Il est également rédacteur en chef de Archives
of Environmental and Occupational Health: An International
Journal. Il a présidé le comité de l’American Thoracic Society
qui a révisé les critères de diagnostic des maladies pulmonaires
bénignes liées à l’amiante en 2004. Il a été président du
Collège américain de médecine du travail et de l’environnement
et de l’Association des cliniques de médecine du travail et
de l’environnement. Il a également été membre du conseil
d’administration de l’Association canadienne de la médecine
du travail et de l’environnement (qui lui a décerné une
mention honorifique de mérite), de l’Association canadienne
des médecins pour l’environnement, de la Fédération des
cliniques de santé au travail de l’Alberta et de la Commission
internationale sur la santé au travail, dont il est actuellement
candidat à la vice-présidence.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
14
Canadian Board of Occupational Medicine
CBOM
The Canadian Board of Occupational Medicine was established to “encourage the study, improve the practice
and elevate the standards of occupational medicine throughout Canada.” It is incorporated federally to certify
competence of those physicians with special knowledge of occupational medicine. Physicians interested in applying
for certification will find all the information on eligibility requirements and an application form on our web site
(www.oemac.org). Examinations are held once a year usually in the fall in either English or French.
Congratulations to the 2008 Successful Examinees
The Canadian Board of Occupational Medicine is pleased to announce that the following physicians have demonstrated special
knowledge in Occupational Medicine to the satisfaction the Board through written and oral examinations
Dr. Jonathan Davids - Certificant of the Canadian Board of Occupational Medicine (CCBOM)
Dr. Bindu Kumar – Certificant of the Canadian Board of Occupational Medicine (CCBOM)
Dr. William Livingstone – Associate of the Canadian Board of Occupational Medicine (ACBOM) and Certificant of the
Canadian Board of Occupational Medicine (CCBOM)
Dr. Douglas Margison – Certificant of the Canadian Board of Occupational Medicine (CCBOM)
Dr. Deborah Parachin – Certificant of the Canadian Board of Occupational Medicine (CCBOM)
An Associate of the Canadian Board of Occupational Medicine (ACBOM) has completed a written examination in which they have
demonstrated satisfactory knowledge of occupational health principles.
A Certificant of the Canadian Board of Occupational Medicine (CCBOM) has at least three years of relevant experience and has
successfully completed both an oral and a written examination.
A Fellow of the Canadian Board of Occupational Medicine (FCBOM) has at least five years of relevant experience, has successfully
completed both an oral and a written examination, and has prepared and defended a research report which has contributed to the
state of the art in occupational medicine.
CBOM Memorial Lecture 2008
The CBOM Memorial Lecture was established in 1991 to honour the memory of those who have lost their lives in Canada by reason
of occupational injury or disease. The Lecturer is a Canadian or landed immigrant, licensed to practice medicine in a province or
territory of Canada with an established profile in occupational and/or environmental medicine.
Our thanks to the CBOM Memorial Lecturer for 2008 Dr. Jean-Paul Robin who spoke on the subject of beryllium.
Copyright © 2008 Occupational and Environmental Medical Association of Canada
15