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Recent reports of SARS (Severe Acute Respiratory Syndrome) in several provinces are causing concern among CUPE members delivering front line public services in our communities. Our union is monitoring the situation and is closely involved with public health officials to ensure CUPE members receive the most current and accurate information available.

This Hazard Alert is being issued to offer additional information and guidance beyond that being provided by Public Health, Health Canada, the World Health Organization and employers. The Alert explains what we currently know about SARS, what your rights are under the Occupational Health and Safety and compensation legislation and what CUPE locals should demand from employers.

What is SARS and how is it spread?

SARS is a respiratory illness commonly known as atypical pneumonia. Experts believe it is caused by a new cold-related virus. The illness has been reported in individuals in Asia, North America and Europe. Currently, infectious disease experts believe that close contact with an infected individual is needed for the virus to be spread from one person to another. The most likely route of transmission is through exhaled droplets and bodily secretions from an infected person. So far, the majority of reported occupational cases have been health care and hospital workers who have cared for SARS patients.

How many CUPE members have been affected?

As of March 31, 2003, eight CUPE members have been diagnosed with SARS. They include three hospital workers and four paramedics who had been dealing with patients at the Scarborough Grace Hospital in Toronto and one paramedic in British Columbia.

In addition, there are hundreds of CUPE members, including hospital workers, paramedics, social service workers and others, who have been quarantined because of possible exposure to SARS.

What are the symptoms and how contagious is SARS?

The main symptoms of SARS are high fever (over 38o C or 100.4o F), dry cough, shortness of breath or breathing difficulty. SARS could also be associated with other symptoms including headache, muscular stiffness, loss of appetite, confusion, rash and diarrhea.

Who is at risk for occupational exposures?

Health care workers, ambulance paramedics, acute and long-term care workers, community care workers and social service workers dealing with or caring for an individual with SARS are at greatest risk for contracting SARS. However, any worker in direct contact with the public is at risk of exposure to SARS. That is why CUPE is calling on employers to take all reasonable precautions and support joint health and safety committees to take proactive steps to prevent the spread of the disease.

What can be done to minimize the risk?

The most effective way to control and prevent the spread of SARS is by preventing exposure. Workplace joint health and safety committees should review how transmission might happen in order to determine the best control measures. Control measures will vary depending on the work.

CUPE locals should be aware of the following control measures:

Health care

Health Canada and the World Health Organization recommend the following in health care situations where there is the potential for disease transmission:

1. Respiratory protection and eye protection or face shields

  • N95 masks must be worn during all patient contact. N95 masks filter the air before it is inhaled. They are different from surgical masks. Surgical masks are designed to prevent the respiratory secretions of the person wearing the mask from entering the air. The “N95” is a government rating that means the masks block about 95 percent of particles that are 0.3 microns in size or larger. For example, these masks meet the Centre for Disease Control and Prevention guidelines for protection against tuberculosis. Locals should insist that only masks or respiratory protection that meets the N95 rating or higher be provided to CUPE members.
  • Masks should be changed whenever they become wet or according to the manufacturer’s recommendations.
  • Eye protection or face shields are recommended where there is the possibility of body fluids or secretions splattering or spraying.
      2. Gloves
      • Gloves should be worn for patient contact.
      • Hands should be washed when the gloves are removed.
      • Gloves should not be reused or washed.
      3. Gowns
      • Health care workers should use long sleeved gowns where there is direct contact with SARS patients or their environment.
      • Gowns must be removed before leaving the patient’s room.
      4. Hand washing
      • Hands should be washed before and after contact with a patient, after contact with body fluids and secretions and after contact with items potentially contaminated with respiratory secretions.
      5. Footwear
      • Only footwear that can be decontaminated should be worn
      Cleaning and handling linens

      Precautions should be taken and proper personal protective equipment provided for workers cleaning rooms and surfaces and handling potentially contaminated linen. Rooms and all surfaces should be cleaned with a broad-spectrum disinfectant that is certified to kill viruses. The product must be properly diluted and used according to recommended precautions. Patient linens should be prepared on site for laundry staff. Appropriate personal protective equipment must be worn and linens should be placed into biohazard bags.

      Other sectors

      Agencies and government have not yet provided adequate guidance for workers outside of the health care sector. Joint health and safety committees have a leadership role to play in assessing particular work situations and demanding adequate protection for members. All employers with workers who deal with the public must seek advice from Public Health authorities, Ministries of Health and other experts regarding measures to protect the safety and health of workers.

      What should CUPE Locals demand from employers?

      Employers have very specific legal duties to protect workers under provincial and federal health and safety legislation. Employers must provide training and personal protective equipment and clothing to workers exposed to the threat of SARS.

      Workers must be consulted about workplace situations that could lead to exposure to SARS, and the workplace measures that are in place to control exposures. As such, members are urged to bring health and safety concerns to the employer’s attention. Employers should be asked what precautions, if any, members and other workers should be taking to prevent infection.

      If workers are not satisfied with the response, the CUPE local union representative on the joint health and safety committee should request an emergency meeting of the joint committee to address workers’ concerns.

      What is the role of Joint Health and Safety Committees?

      CUPE believes that joint health and safety committees should be proactive in addressing potential workplace hazards, and that consultation with workers is the best way to address health and safety concerns. The potential threat posed by SARS may require an emergency committee meeting to review existing infection control policies and procedures. It could also provide an opportunity to recommend and develop new infection control procedures. Committees should also consider the following:
      • Is it necessary to wear respiratory protection when dealing with the public?
      • Are protective clothing, gowns, goggles or face shields required?
      • Are facilities available to wash your hands after contact with individuals ill with SARS?
      • How will clients be screened before providing service?
      What rights do workers have to refuse unsafe work?

      Provincial and federal occupational health and safety legislation provides workers with the right to refuse work they believe will endanger themselves or other workers. Some provinces (including Ontario) and some sectors under federal jurisdiction (including airlines) limit the right to refuse work.

      Ontario health care, emergency response and education workers do not have the right to refuse work if their refusal endangers another person or the hazard is part of their work. Health care workers do have the right to refuse if their refusal does not endanger another person and the employer has not taken steps to deal with the hazard. can be found on the CUPE website. In any event, workers are encouraged to consult with their appropriate legislation for details.

      What happens to my pay if I can’t go to work?

      Workers should not suffer financially because they have contracted SARS or been exposed to the threat of SARS. Workers who are quarantined should not suffer a loss of pay nor should their sick leave or vacation entitlement be affected.

      Similarly, workers who have had shifts cancelled due to department closures should not suffer a pay loss nor should they have to use lieu time or vacation time to make up for lost shifts. If the event that your pay is docked, contact your steward or union executive.

      Should a workers’ compensation claim be filed?

      CUPE recommends that a workers’ compensation claim be filed if members have been diagnosed with SARS, are suspected of being infected with SARS, are quarantined at home because of contact with someone with SARS or have been sent home because their workplace has been closed due to SARS.

      In Ontario, workers should file a claim with the Workplace Safety and Insurance Board as soon as possible. You can do so by calling 1 800 567 2483 or 416 344 3842 and asking to file a claim. You can also submit a Form 8 or Form 6, or enquire about a new form that covers workers who are in quarantine.

      In other provinces, workers should file a claim with their respective Workers’ Compensation Board.

      Where can I find more information?

      CUPE National will continue to monitor the SARS outbreak. Information on CUPE’s website will be updated as it becomes available. Additional resources on SARS can be found online at the following sites:

      Health Canada:

      City of Toronto Public Health Department:

      World Health Organization:

      CUPE members will continue to work to ensure that public services are delivered and that employers take all precautions to protect workers.

      CUPE will continue to offer advice, provide opinions and expertise on SARS to ensure our communities and our members will be healthy and safe.