When regulations lag behind science it’s the workers who pay the price
Occupational disease kills more Canadians every year than any other work-related injury, accident or disorder. With no national strategy to prevent or even monitor these diseases, the death toll grows higher
WINDSOR— Christine Paquette didn’t need to be told the clouds of diesel exhaust that were a chronic part of her job were having an impact on her body. She just had to look in the mirror at the end of a long shift.
“I used to come home from work and wash my face, and it would be just black,” said Paquette, a former Canadian Border Services Agency guard who worked at the Ambassador Bridge in Windsor between 2006 and 2013.
A few months into her job, Paquette developed a nagging cough, and started having problems with her thyroid gland. She began to worry about the impact of sitting in a booth, breathing in the fumes from all those idling trucks and cars.
When she quit, she says her cough and thyroid problems went away.
“There was a joke among us that as you walked to the booths, the closer you got, the more dead the trees were. You had to wonder what you were breathing in, with the amount of trucks that come through there in a day,” she said. “When I saw them testing the air quality inside the booths, that’s when I became worried.”
Paquette’s concerns were widely shared. A study by the CBSA union counted more than 50 cases of cancer — predominantly breast, but also testicular, kidney and others — among former and current border guards in the past decade.
Paquette’s aunt, Marie-France Paquette, died from breast cancer while still employed by the border agency. The disease is alarmingly common for women who work at the bridge — 16 times higher than the rate in surrounding Essex County, according to a 2018 study by Jim Brophy and Michael Gilbertson, two Ontario researchers who focused on what they believe is a breast cancer cluster.
While border guards have long worried about their heath, the science around chronic exposure to vehicle exhaust has lagged behind.
Diesel fumes, only listed as a carcinogen less than a decade ago, are now understood to be one of the most common carcinogens in the world, with roughly 897,000 Canadians exposed at work, according to CAREX Canada, a team of researchers based at Simon Fraser University.
Diesel exhaust exposure at work is blamed for 560 cases of lung cancer in Canada each year, according to the Toronto-based Occupational Cancer Research Centre (OCRC), and another 200 estimated cases of bladder cancer.
But while other countries, such as Australia, Finland and Austria, have lowered their acceptable levels of workplace exposure to diesel fumes, Canada’s regulations governing diesel exhaust remain dangerously outdated, the organization says.
OCRC wants Canada to adopt much stronger occupational exposure limits for diesel exhaust — as low as 20 micrograms per cubic metre, down from the current limit of 100 micrograms. That would bring regulations in line with countries such as Finland, but still below more ambitious limits recommended in places such as the Netherlands. The organization also calls for tax incentive programs to encourage companies to get old diesel engine vehicles upgraded to reduce emissions.
When it comes to establishing acceptable guidelines for safe occupational exposure levels, Canada relies largely on a voluntary organization called the American Conference of Government Industrial Hygienists. In some cases, Canadian regulations fall short of that organization’s recommendations, and vary from province to province. Experts say Canada needs to do more to make sure the laws that regulate workplace carcinogens are uniform and as up-to-date as possible.
“Our standards for what’s a safe level of exposure have gone way down over the years. What’s safe today may not considered to be safe in 10 years,” said Paul Demers, the internationally-recognized director of the OCRC.
“Our knowledge of cancer and what constitutes a safe exposure level is constantly evolving. We need to start putting the resources into this, to start doing it ourselves. We don’t really invest enough in establishing what’s causing disease so we can stop it from happening in the first place.”
The Ambassador Bridge is Canada’s busiest border crossing, with more than 20,000 vehicles rumbling across the Detroit River each day. Officers here have long worried their greatest threat isn’t the risk posed by guns, the drug trade or terrorism — but diesel exhaust exposure, and its troubling connection to cancer. The amount of nitrogen dioxide in the air here is as much as five to 10 times higher than many Canadian environments.
“There’s a lot of people who are very worried about it. But it’s kind of the elephant in the room, it’s not openly discussed,” said Ken Turner, the branch president of the Windsor region for the Customs and Immigration Union. “There’s a real culture of fear about speaking up, because people don’t want to lose their jobs.”
Border guards sign a confidentiality agreement with the CBSA not to talk about their work, he explained, which makes many hesitant to speak publicly about their health concerns. Some have developed cancer and not told coworkers, he said, while others have quit or demanded a transfer without explaining why they want to leave.
“When I first started there 25 years ago, I could taste the fumes in the air. Now I just try to put it out of my mind and hope I’m one of the lucky ones,” Turner said. “It’s a terrible way to work, but if you thought about it too much, it
“There’s a real culture of fear about speaking up, because people don’t want to lose their jobs.”
KEN TURNER BRANCH PRESIDENT, CUSTOMS AND IMMIGRATION UNION
would become overwhelming.”
Gilbertson, one of the authors of the 2018 breast cancer study that examined the link between shift work and diesel exposure, said the dangerous combination of shift work — which reduces our natural defences against carcinogens — and diesel exposure has already been flagged in other countries. The International Agency for Research on Cancer (IARC) ranks border guards as one of highest-exposed groups to trafficthe related air pollutants.
At the Ambassador Bridge, air quality tests inside guard booths routinely show nitrogen dioxide levels above 100 to 200 micrograms per cubic metre, which Gilbertson said presents a fivefold risk of breast cancer. He believes the evidence is strong enough that a formal inquiry should be launched.
“This is an extraordinary case,” said Gilbertson, who argues accepted levels for chronic, day-to-day exposure need to be much lower. “The coroners’ office should be investigating clusters of women who have died as part of the border agency … When we look at nitrogen dioxide levels at the bridge, it’s off the Richter scale.”
In the summer of 2019, the CBSA hired a firm to retest air-quality levels inside the booths where officers are stationed. Those results, intended to update tests taken in 2007, which the agency says showed air quality was within acceptable standards, have not been received yet.
If those tests show an increased risk in air quality, steps will be taken to protect mployees, according to agency spokesperson Jacqueline Callin.
“Should there be recommendations stemming from the assessment, the agency will review them in consultation with the workplace health and safety committee and will take all necessary steps to ensure the health and safety of its employees” she said.
The cancer numbers at the Ambassador Bridge suggest a problem that’s too troubling to ignore, say occupational disease experts.
“There’s something serious here,” said Jim Brophy, a University of Windsor adjunct professor who was an expert witness in one border guard’s compensation case.
Ontario’s Workplace Safety and Insurance Appeals Tribunal has often argued it doesn’t see enough evidence linking breast cancer and exposure to diesel fumes on shift work.
Instead, in one wellknown 2018 case — involving a then-43year-old border guard named Barbara Keyes, who developed breast cancer after 21 years at the bridge — the tribunal blamed her family history and exposure to pesticides that would have been sprayed on her family farm when she was a child.
“It’s been a nightmare,” said Keyes, who says she still lives in fear her cancer thing’s wrong here.’ I fought for all the other women who were silent. We’ve had so many people die from cancer, and it’s all kinds. We need to ask what is happening here.”
Jane Mcarthur, a University of Windsor researcher who has also studied the breast cancer issue at the bridge, said the cancer cases can’t be dismissed as “flukes.” Many of the border officers he’s interviewed believe CBSA is aware of a heightened risk — and they believe the health problems have been passed on to their children, too.
CBSA says it takes those concerns seriously, and has an occupational health and safety program to ensure workplace hazards are within acceptable guidelines.
“Women workers often feel that their health in the workplace is very low on the priority list,” Mcarthur said. “They know if that cluster is documented, and that ties in with an association between breast cancer and air pollution, that’s a big pandora’s box in terms of compensation.” The concerns around breast cancer — which killed an estimated 5,000 Canadian women last year and threatened the lives of tens of thousands more — are compounded at the Ambassador Bridge by their connection to shift work, and growing evidence that the two may be linked. Although the studies are not all in agreement, it’s thought that shift work reduces our natural defence against carcinogens, because it disrupts of the body’s sleep-wake cycle.
It is estimated night shift work may be responsible for 470 to 1,200 new cases of breast cancer each year, or as much as five per cent of all breast cancers diagnosed annually in Canada, according to the OCRC.
While Canada’s compensation boards continue to deny cases that draw links between breast cancer and shift work, other countries are recognizing a pattern. For more than a decade, Denmark has been compensating breast cancer sufferers who can prove within reasonable limits that their illness was brought on by night shifts.
In a landmark 2009 decision, the Danish National Board of Industrial Injuries began compensating dozens of women who had worked more than 20 years of night shifts and developed breast cancer. Many of the claims were brought by nurses, and compensation in some cases has been worth upwards of $200,000. Brophy and others say Canada needs to adopt a similar approach.
Canada’s top court has argued provincial compensation boards need to lower the standard of proof used so often to deny breast cancer claims. That came after a notable case in British Columbia, when seven women who worked in a lab at Mission Memorial Hospital all developed breast cancer. They argued their illness was connected to the use of carcinogens in their jobs, including orthotoluidine and falmalin, a component of formaldehyde.
The province’s workers’ compensation board originally denied their applications for compensation benefits, on the grounds their cancers were not occupational diseases. They fought back and, in 2016, the Supreme Court ruled on the side of three of the women, saying that while the expert evidence might not have met a standard of scientific proof, it was enough to link their cancers to their w
The court argued breast cancer claims only need to prove a probable connection to workplace exposure, and that the benefit of the doubt should go to the worker.
Although advocates had hoped that decision would open the door to more successful breast cancer claims, the reality is Canadians still face an uphill battle getting a compensation for the disease.
In Canada, the number of occupational disease claims that are granted to breast cancer victims is still very small. Of the 46 breast cancer claims Ontario’s compensation board received between 2009 and 2018, only 10 were granted.
The concerns around breast cancer go far beyond diesel exhaust or the impact of shift work. In a 2012 breast cancer study that looked at the plastics industry, Brophy and others found a fivefold elevated risk among premenopausal workers — a group much less likely to develop cancer. This included women who worked on moulding machines that heated plastics containing mammary carcinogens or endocrine disrupting compounds.
Employers often remain hesitant to acknowledge a link to health problems, he said. Despite a growing body of evidence to the contrary, breast cancer is still widely regarded as a genetic or lifestyle problem not affected by environmental factors.
“When you look at the big picture of cancer prevention, one of the big gaping holes is occupational exposure, which they never want to acknowledge,” Brophy said. “If you get cancer, the message is, it’s your fault.”
Reporting for this series was produced through financial support from the Michener-deacon Fellowship for Investigative Journalism. “The coroners’ office should be investigating clusters of women who have died as part of the border agency.” MICHAEL GILBERTSON RESEARCHER