We are aware that exposure to occupational carcinogens such as asbestos, nickel, silica, benzene and diesel engine exhaust can be hazardous to workers’ health. However, there are complex factors that encourage — or prevent — workplaces from changing their processes and procedures to reduce workers’ exposures to carcinogens. The objective of this study was to understand what encourages workplaces to reduce worker exposures to carcinogens. We explored the connection between awareness of the impact of hazards in the workplace and the pressures for change that come from the community, the unions, the academic experts, and politicians. We wanted to investigate whether heightened social awareness and community pressure can encourage workplace-level change. We believe that what we learned about the process of moving from awareness to taking action will have broader implications for many communities and for cancer prevention in general.
This study took place in the cities of Sarnia and Sudbury. They are industrialized smaller cities in Ontario with higher rates of some occupational diseases (such as mesothelioma, lung and nasal cancers during certain times) compared to other Ontario cities (see figure of incidence rates of some cancers). Over time, there has been heightened media attention and community pressure on workplaces to reduce workers’ exposures in both cities, specifically in the petrochemical industry in Sarnia and the mining industry in Sudbury. Through interviews and focus groups we will explore the changes related to occupational and environmental health and safety that have taken place in workplaces over the past decade, the major pressures that have led to these changes, the social and economic consequences, and the potential for future change and improvement (see figure of the conceptual framework for the study).
Part I: Sarnia
Data collection was completed in fall of 2014. Interviews were done with labour representatives, community members, local politicians, and industry representatives. Two focus groups were completed – one with community members and one with industry representatives. Interviewees responded to questions regarding awareness, leadership, social and organizational networks, skills and resources, individual and community power, shared values, beliefs and opinions, and perseverance. We also looked at what each group thought was necessary for change (fulcrums of change).
The analysis was completed in the winter of 2015, and a manuscript has been published. The study found that in Sarnia in the late 1990s, there was a community- and union-led battle for the recognition of the health effects of exposure to asbestos in the workplace, and a demand for compensation for affected workers.
The City of Sarnia took action and achieved change:
- Increased awareness throughout the community and industry
- Workers’ compensation is now awarded with greater ease, resulting in better lives for workers and their survivors
- A hospice was created
- An OHCOW became permanently established in Sarnia
- Accelerated exposure reductions in industry resulting in healthier workplaces
Lessons learned on how change can be achieved:
- A clear message that is backed by credible research is needed, such as “Asbestos causes lung cancer and mesothelioma”
- It is important to have leaders and champions for change who are backed by supportive organizations to provide power and perseverance
- Empowering people or the community can be successful
- Timing is important
- It is important to have favourable economic factors and other external conditions
Part II: Sudbury
Part II of the study focused on Sudbury. It examined the pressures that led to reductions in occupational exposures in the mining sector, and improvements in environmental conditions in the city. What led to these changes? Was it an increase in community awareness of the illness and death among miners, pressure from the unions to improve occupational health and safety in the mines, or the efforts from experts who provided knowledge on the occupational and environmental impact of the mining sector? Changes may also have come from industry, government, legislation that reinforced compliance and improvements (e.g. the Ham Commission, changes in the Occupational Health and Safety Act, and the recent Ministry of Labour Mining Review), and from the introduction of alternative technologies.
As a result of union action and policy change (The Occupational Health and Safety Act, 1980), the mining environment is safer and cleaner today. However, these outcomes came with “collateral damages.” Workplaces modernized and mechanized resulting in fewer workers needed to produce even more product than before. From a high of 25,000 workers to around 6,000 today, union membership in Sudbury has shrunk, negatively impacting its power to advocate for future changes.
The decline in the proportion of miners in the Sudbury workforce has also led to changes in community awareness and solidarity with the miners. We have looked at this relationship from the Labour/Industry side, and subsequently looked to the community, environmentalists, and unions to talk about the transformation of Sudbury from a town dominated by mining into a city with a small mining sector, a significant service sector (healthcare, education and civil service), and an ongoing re-greening process.
The complete results are available here.
- Sarnia study (New Solutions, 2015): From Awareness to Taking Action: The Community of Sarnia Mobilizes to Protect its Workers from Occupational Disease
- Sudbury study (Work, 2017): From Awareness to Action: Sudbury, mining and occupational disease in a time of change
- Sudbury study (Journal of Community Engagement and Scholarship, 2018): Dimensions of community change: How the community of Sudbury responded to industrial exposures and cleaned up its environment
- Sarnia and Sudbury comparison (SAGE Research Methods Cases, 2018): Iterative method of analysis of 90 interviews from two communities: Understanding how Sudbury and Sarnia reduced occupational exposures and industrial pollution
- Timeline of community awareness and action in Sarnia
- Incidence of select and all invasive cancers in Ontario, Lambton and Sudbury
- Conceptual framework for the Awareness to Taking Action Study
- Poster on the Awareness to Taking Action Study
Funding for this project was granted by the Canadian Cancer Society Research Institute:
Kramer D, Holness DL, Bradley M, Koné Péfoyo A, Kudla I, Lightfoot N. From awareness to behavior change: exploring the impact of heightened awareness of workplace exposures in Sarnia and Sudbury. Canadian Cancer Society Research Institute Innovation Grant. 2014-2016. ($197,733.50)
Desre M. Kramer (Occupational Cancer Research Centre)
D. Linn Holness (Centre for Research Expertise in Occupational Disease and St. Michael’s Hospital)
Mayor Mike Bradley (City of Sarnia)
Anna Koné Péfoyo (Cancer Care Ontario)
Nancy Lightfoot (Laurentian University)
Irena Kudla (St. Michael’s Hospital)
Emily Gross (Occupational Cancer Research Centre)