Miners in Northern Ontario who’ve been diagnosed with workplace-related chronic obstructive pulmonary disease (COPD) say they’ve faced an uphill battle trying to get compensation from the Workplace Safety and Insurance Board (WSIB).
That’s according to the work of Sherry Mongeau, a researcher with the School of Rural and Northern Health at Laurentian University, who presented the results of her doctoral thesis on Jan 20 during the 2023 edition of CROSHCon.
The annual research showcase is hosted by the Sudbury-based Centre for Research in Occupational Safety and Health (CROSH). This year’s theme was “Resetting the Dial on Workplace Climate.”
"It gives a deeper understanding of previously identified issues of living with COPD and suggests why individuals act in the way they do,” Mongeau said of her study.
“It brings awareness that the main challenges for occupational COPD are workplace hazards, a lack of early detection, and the constraints toward recognizing COPD as an occupational disease.”
Smoking has traditionally been pinpointed as the main cause of COPD, a group of lung diseases, including chronic bronchitis and emphysema, that make it difficult for people to breathe.
But more recent research suggests that occupational dust can be a contributing factor, and underground miners are among those affected.
“We do know that COPD does cause physical and mental suffering,” Mongeau said. “It impacts the patient's quality of life, it limits their functions within their family, and it really influences the whole family's functioning.”
For her qualitative study — “Chronic obstructive pulmonary disease (COPD): the impact of occupational hazards in the minerals industry” — Mongeau interviewed 16 underground miners between the ages of 54 and 83 who worked in mines in Sudbury, Timmins, Kirkland Lake, and Matachewan, who had all been diagnosed with COPD.
She additionally spoke with four worker compensation representatives and four physicians.
Qualitative research involves collecting non-numerical data — such as participant stories — to get better insight into a topic.
The miners told Mongeau that COPD is “exhausting,” and many said they have to halt activities like shovelling snow or walking after a short period just to catch their breath.
“‘It’s like having an elephant on your chest,’” one told her, as though he could never get enough air.
When it came to applying for worker’s compensation, some participants said they’d been told they didn’t qualify, since they were also smokers, while others said their doctor simply didn’t want the hassle of filling out the paperwork.
If they did fill out the paperwork, some said the claim was rejected anyway, because they hadn’t been “exposed enough,” based on the formula devised by the WSIB to determine if a worker qualified, Mongeau said.
“‘How exposed do you have to be?’” one man asked, according to Mongeau. “‘I worked in the mine for 22 years. Do you have to die in order to be compensated?’”
Mongeau said study participants made it clear that, without a worker advocate and a physician who supported them, navigating the worker compensation process was nearly impossible.
Participants’ claims had dragged on for years and some are still fighting for their claim to be recognized.
One participant finally had his claim approved, only to be compensated with a paltry $3.
“My participants shared very emotional and passionate stories about their experiences as an underground mineral worker who was diagnosed with occupational COPD and the compensation claim process,” Mongeau said.
“And what I can tell you is even though I did telephone interviews, I could hear the emotion coming through my interviews, and in fact there were a couple of the workers who actually were quite emotional that they broke down.”
At the close of her study, Mongeau came to several conclusions.
One is the importance of taking a patient’s occupational history in making a diagnosis. Learning that a patient has worked in a mine could help a physician make the connection between their occupation and COPD, she said. Because the illness has a long latency, many miners are diagnosed long after they’ve retired.
It would also help for physicians to have better training in occupational-related illnesses like COPD, Mongeau said.
“Smoking status reduced the number of referrals for compensation made by general practitioners, resulting from a lack of understanding that the combination of cigarette smoking and occupational exposures greatly enhanced the occupational respiratory illnesses,” Mongeau said.
“Health-care providers were really only focused on the fact that the worker previously smoked and would not consider occupational exposures as a compounding factor for developing COPD.”
Mongeau said change is coming on this front: there is an initiative underway to revamp medical school curricula to include information on occupational illnesses such as COPD. The goal is to create more awareness of this issue amongst newer generations of physicians.
She also called for more worker education. Public health agencies need to actively promote smoking cessation programs, she said, while employers need to make available information about the compensation claims process.
There are people, particularly union representatives, who will help employees navigate the compensation system, she said. But workers are often in the dark on the process until they are ready to make a claim, which can be a tedious and overwhelming experience.
“Employers need to provide employees with better training; they need to have a tool that allows the employee to understand the worker’s compensation claim process,” Mongeau said.
“[Workers] don't necessarily understand all the steps that are involved. [Employers] certainly need to provide more education; advocacy is huge.”