Pinnacle Enterprises Canada
Healthcare Safety Info-eLink™

"Dedicated to Promoting Healthcare Occupational Health and Safety Management Excellence and Safe Patient Care"


To achieve high quality safe patient care, improving the quality of occupational health and safety in healthcare must be a priority. My goal in this effort is to provide a high quality comprehensive user-friendly website with well-organized Internet links to credible sources of health and safety information primarily related to healthcare. Healthcare Safety Info-eLink™ is a not-for-profit service offered by Christopher Lipowski for occupational health and safety professionals who are committed and dedicated to advancing safe working conditions in healthcare as well as in all other occupational sectors.


Maximize Efforts to Improve Safe Patient Care in Hospitals through improving Healthcare Workplace Health and Safety Conditions and Practices. To close the gap between best practice and common practice by encouraging hospitals to reach levels of quality and safety that are comparable to those of the best high-reliability organizations.


Data on the Canadian workforce has consistently indicated that healthcare workers are at greater risk of workplace injuries and more mental health problems than any other occupational group Health Canada. In the U.S. for example:

Health Care is the second-fastest-growing sector of the U.S. economy, employing over 12 million workers. Women represent nearly 80% of the health care work force. Health care workers face a wide range of hazards on the job, including needlestick injuries, back injuries, latex allergy, violence, and stress. Although it is possible to prevent or reduce health care worker exposure to these hazards, health care workers actually are experiencing increasing numbers of occupational injuries and illnesses. Rates of occupational injury to health care workers have risen over the past decade. By contrast, two of the most hazardous industries, agriculture and construction, are safer today than they were a decade ago, NIOSH.

In addition to this unacceptable situation, many patients suffer preventable care-related adverse events (AEs) during hospitalization. AEs among hospital patients are unintended injuries or complications resulting in death, disability or prolonged hospital stay that arise from health care management. A study in 2004 funded by CIHI and the Canadian Institutes of Health Research found that 7.5% of adult medical or surgical patients suffered adverse events in hospital, about one third of which were deemed preventable. Although most patients recover within six months, each year between 9,250 and 23,750 Canadian adults experience a “preventable” adverse event in hospital and later die, according to the study, Baker et al. 2004. The Institute of Medicine's "To Err is Human: Building a Safer Health System" reported: "The human cost of medical errors is high. Based on the findings of one major study, medical errors kill some 44,000 people in U.S. hospitals each year. Another study puts the number much higher, at 98,000." IOM. In Canada, healthcare acquired infections or nosocomial infections, affect more than 220,000 people annually resulting in excess of 8,000 deaths in Canadian hospitals each year. Therefore, patient safety in Canadian healthcare organizations has become an increasingly important topic and led to the creation of the Canadian Patient Safety Institute (CPSI). A study by the CPSI estimated the economic burden of adverse events in Canada in 2009-2010 was 1.1 billion dollars. This estimate did not include the direct costs of care after hospital discharge, or societal costs of illness, such as loss of functional status or occupational productivity. To address the issue of identifying strategies for improving patient care, much valuable effort has been focused on application of new technologies, developing better communication and coordination among clinicians, and creation of a patient adverse (sentinel) event information database to be shared by hospitals for learning purposes, Canadian College of Health Service Executives - ppt. However, a growing body of research indicate that healthcare worker health and safety conditions are not just an important but an essential factor associated with the quality of patient care, Yassi, A. For example, OSHA (U.S.) reports that workplace safety also affects patient care. OSHA recommends hospitals develop a health and safety management system with a holistic approach that integrates patient safety and employee safety programs, Safety and Health Management Systems: A Road Map for Hospitals. Dr. Lucian Leape endorses OSHA Programs on Health Care Worker Safety: "Many of us in medicine have long recognized that hospitals can be dangerous places not only for patients who are at risk of experiencing a medical error or an adverse event, but also for nurses, physicians, and other health care workers", National Patient Safety Foundation. The 2004 Canadian Adverse Events Study suggested, "The greatest gains in improving patient safety will come from modifying the work environment of healthcare professionals, creating better defenses for averting adverse events and mitigating their effects", The Role of Healthcare Environments in Shaping a Safety Culture - Lowe, G.S. The Joint Commission published a monograph recently stating that greater awareness of the potential synergies between patient and worker health and safety activities is required, Improving Patient and Worker Safety. One major step that healthcare institutions can take toward championing patient and healthcare worker safety, according to the monograph, is becoming a high-reliability healthcare organization (HRO) -- described as "systems operating in hazardous conditions that have fewer than their fair share of adverse events". The monograph also identifies functional management systems and processes, strategies and tools that have been used to successfully integrate health and safety activities. A report by The Lucian Leape Institute presents details on healthcare safety challenges. Therefore, efforts to increase the quality of hospital occupational health and safety conditions and practices can be expected to have a direct positive impact on patient safety outcomes and an overall reduction in healthcare costs, Nichol, K.
One strategy to achieve sustainable healthcare safety performance excellence is to implement an "Integrated Healthcare Safety Management System", a holistic approach that manages patient and staff safety programs together. Since the first step toward solving a problem is to understand it and knowledge is essential for advancing meaningful safety improvement initiatives to their maturity, this web service was founded to provide a simplified and efficient means of accessing credible, useful healthcare occupational, environmental and patient safety information.
Christopher Lipowski, CRSP


Healthcare Safety Info-eLink™ Founded and managed by Christopher J. Lipowski, CRSP,
Senior Occupational Health and Safety Specialist / Healthcare Management Consultant,
first and former McGill University Health and Safety Officer - is dedicated to the memory of Z.J. Lipowski, M.D. author of The Theory of Attractive Stimulus Overload and Affluence, Information Inputs and Health.

LinkedIn - Christopher Lipowski, CRSP

Occupational Health and Safety Services


“Why do we chose to work in healthcare? Because it gives us a chance to make a difference in the lives of others during our short time on earth. If enough of us do that, we will make this world a better place for our children and grandchildren.”
~ Quint Studer

The Quality Worklife-Quality Healthcare Collaborative defines a healthy healthcare workplace as: A work setting that takes a strategic and comprehensive approach to providing the physical, cultural, psychosocial and work/job design conditions that maximize health and well-being of healthcare providers, quality of patient outcomes and organizational performance. “A fundamental way to better healthcare is through healthier healthcare workplaces. “It is unacceptable to work in, receive care in, govern, manage and fund unhealthy healthcare workplaces.

“Many healthcare leaders are reluctant to commit to the goal of “High-Reliability“ because they regard it as unrealistic, unachievable or a distraction from their current serious fiscal and regulatory pressures. One of the important roles for policymakers and stakeholders is to encourage, persuade and demand that healthcare organizations embark on this journey. The Joint Commission also encourages and invites them to join us on the journey to High-Reliability, because all patients deserve safe care.”
~ Mark R. Chassin, M.D., FACP, M.P.P., M.P.H. President and Chief Executive Officer, The Joint Commission

“Workplace safety is inextricably linked to patient safety. Unless caregivers are given the protection, respect, and support they need, they are more likely to make errors, fail to follow safe practices, and not work well in teams.”
~ National Patient Safety Foundation, Lucian Leape Institute.

"Culture clearly announces every day to every worker whether safety is a key determines the extent of casualties, trauma disorders, stress claims and compensation paid...and it dictates whether elements of a safety system succeed or fail. The goal is to change your companyís culture until safety becomes an internal value that is incorporated in every plan, decision, and work activity. In the new safety culture, every employee will know that the only way to do anything is safely."
~ Dr. Dan Petersen

“Unsafe acts are like mosquitoes. You can try to swat them one at a time, but there will always be others to take their place. The only effective remedy is to drain the swamps in which they breed. In the case of errors and violations, the "swamps" are equipment designs that promote operator error, bad communications, high workloads, budgetary and commercial pressures, procedures that necessitate their violation in order to get the job done, inadequate organization, missing barriers, and safeguards . . . the list is potentially long but all of these latent factors are, in theory, detectable and correctable before a mishap occurs.”
~ Dr. James T. Reason.


College of Physiotherapists of Ontario - Code of Ethics: (commitment to act with honesty and integrity)

International Code of Ethics for Occupational Health Professionals (pdf)

National Association for Healthcare Quality - Code of Ethics and Standards of Practice

Professional Ethics For the OHS Professional
Dr. Peter Strahlendorf (ppt)

(and associated noteworthy information

Managing Fatigue in the Workplace (Fatigue in the workplace: causes, consequences, and best practices for managing risks.) - (NSC Webinar - May 17-2017)

Manual Material Lifting: a pain in the neck, back - "In Ontario, ergonomic interventions are legislated only for those in the health care sector and are especially limited in scope; They do not take into account injuries caused by repetitive, awkward or forceful work" - (Workers Health and Safety Centre of Ontario Federation)

Pushing & Pulling - Handcarts: Operators should be trained on appropriate body positioning for the type of cart and load being handled} - (CCOHS)

Materials Handling: Heavy Lifting - (U.S. OSHA)

Diseases directly transmitted by rodents: Worldwide, rats and mice spread over 35 diseases - (CDC)

Diseases directly transmitted by rodents - (CDC)

CDC expands search for rats and people infected with Seoul virus (STAT - Boston Globe Media)

Statement from Dr. David Williams, Ontario's Chief Medical Officer of Health, on Seoul Virus Infection to rat exposure in Ontario (Ministry of Health and Long-Term Care)

Occupational exposure to pesticides and other biocides and risk of thyroid cancer (Occup Environ Med. 2017 Feb 15. - PubMed)

How early life experience is written into DNA by Moshe Szyf - McGill University - (TED Presentation)

Mitochondrial Genetics and Epigenetics; Novel paths linking air pollution and human disease - (Harvard School of Public Health)

Mitochondria as a Target of Environmental Toxicants - Joel N. Meyer, Nicholas School of the Environment, Duke University (pdf)

Report warns of rise in drug-resistant tuberculosis (Center for Infectious Disease Research and Policy Academic Health Center, University of Minnesota)

Hospital Sinks May Be Awash in 'Superbugs' (MedlinePlus, 2017)

Drug-resistant 'nightmare bacteria' show worrisome ability to diversify and spread (Harvard T.H. Chan School of Public Health)

A Nevada woman dies of a superbug resistant to every available antibiotic in the US - (STAT - Boston Globe Media)

No Antibiotic In The U.S. Could Save This Woman. We Should All Be Worried. - (, Inc.)

The Review on Antimicrobial Resistance (MAY 2016)

Antibiotic / Antimicrobial Resistance (CDC)

NDM-1 Superbug - Dr. R V S N Sarma, MD., MSc (Canada) FIMSA, Senior Consultant physician

'Superbug' found in Pennsylvania patient highlights dangers of antibiotic resistance - Harvard Chan School of Public Health

13 Cases of 'Superbug' Fungal Infection in U.S. (CDC)

Clinical Alert to U.S. Healthcare Facilities - Global Emergence of Invasive Infections Caused by the Multidrug-Resistant Yeast Candida auris - healthcare-associated infections with high mortality (CDC)

Yellow Fever — Once Again on the Radar Screen in the Americas - Catharine I. Paules, M.D., and Anthony S. Fauci, M.D. (March 8, 2017DOI: 10.1056/NEJMp1702172)

WHO publishes list of bacteria for which new antibiotics are urgently needed

Avian Influenza A (H7N9) Virus (CDC)

Robotic Surgical Tools Tough to Keep Clean - Findings suggest better cleaning procedures, more monitoring of instruments would help (MedlinePlus / NIH)

Contaminated Devices Putting Open-Heart Surgery Patients at Risk (CDC)

The role of epigenetics in genetic and environmental epidemiology - Christine Ladd-Acosta1 & M Daniele Fallin (Future Medicine - Epigenomics)

Epigenetic Effects of Cadmium in Cancer: Focus on Melanoma - Mario Venza et al (Curr Genomics. 2014 Dec; 15(6): 420–435)

Burnout Among Health Professionals and Its Effect on Patient Safety - Audrey Lyndon, PhD (Agency for Healthcare Research and Quality)

Suicide Among Physicians Is A Public Health Crisis - Amitha Kalaichandran (

National Academy of Medicine Launches 'Action Collaborative' to Promote Clinician Well-Being and Combat Burnout, Depression, and Suicide Among Health Care Workers (The National Academies of Sciences, Engineering, and Medicine)

The Systems Engineering Initiative for Patient Safety Center for Quality and Productivity Improvement (University of Wisconsin System)

Macroergonomics in Healthcare Quality and Patient Safety - Carayon P et al (Rev Hum Factors Ergon. 2013 Sep 1;8(1):4-54)

Indoor Particulate Matter (U.S. EPA)

Ultrafine Particles : Efficacy of N95 Respirators in Conditions Representative of Human Breathing (IRSST)

Printer Emitted Particles: Are they safe? (Center for Nanotechnology and Nanotoxicology, T.H. Chan Harvard School of Public Health)

Printing, Photography and Reproduction Industry - Gordon C. Miller (Encyclopaedia of Occupational Health and Safety -ILO)

Future Care for Canadian Seniors: A Primer on Nursing Supply and Demand (The Conference Board of Canada - 2017)

ISO 45001, Occupational health and safety management systems - Requirements (ISO)

Ontario Bill Proposes to Create "Health and Safety Management System" under OHSA - Chelsea Rasmussen (Dentons)

Health and Safety Management Systems for Healthcare (Ontario Public Services Health & Safety Association)

ISO 45001 Occupational Health and Safety Management Systems Information Guide - (NSF International Strategic Registrations USA)

National Guidelines for the Prevention of Nosocomial Invasive Aspergillosis During Construction/Renovation Activities - National Disease Surveillance Centre (pdf)

Noise and neurotoxic chemical exposure relationship to workplace traumatic injuries: A review (Journal of Safety Research - Volume 60, February 2017, Pages 35–42)

Asbestos-Linked Cancer on the Rise (Carcinogens in the News - CAREX Canada)

New cases of mesothelioma and asbestos-related lung cancer in one year cost $1.9B (Institute for Work & Health)

National Safety Council survey finds workers in high-risk jobs are afraid to report safety issues. 41 percent of employees working in healthcare settings, said they were afraid to report safety issues.

Work Disability Prevention Management System Standard Development Project (CSA Group)

Back pain at work: Preventing pain and injury ( Mayo Foundation for Medical Education and Research)

Physical Strength Assessment in Ergonomics (CDC)

Aging and MSD: Strategies for older workers (University of Waterloo - The Centre of Research Expertise for the Prevention of Musculoskeletal Disorders)

CSA-Z412-00 (R2016) - Guideline on Office Ergonomics

Ergonomics for Healthcare Environments by T. Springer - (Knoll)

Participatory Ergonomics Programs – 9 keys to success - (Humantech Inc.)

Workplace psychosocial and organizational factors for neck pain in workers in the United States (Wiley Online Library)

Radon in the workplace (Ontario Ministry of Labour)

Mold remediation in a hospital - Toxicol Ind Health. 2009 Oct-Nov; 25(9-10):723-30 (NCBI)

Mucormycosis - (CDC)

Legionnaires' Disease -
Use water management programs in buildings to help prevent outbreaks (CDC)

About Ebola Virus Disease (CDC)

Healthcare Exposure to Zika and Infection Control - (CDC)

Guillain-Barré syndrome (NIH)

Causes of Guillain-Barré syndrome (NHS - UK)

Role of Campylobacter jejuni Infection in the Pathogenesis of Guillain-Barré Syndrome, An Update - (BioMed Research International; Volume 2013 (2013), Article ID 852195)

Global Guidelines for the Prevention of Surgical Site Infection (NCBI)

Nurses' uniforms: How many bacteria do they carry after one shift? (J Public Health Epidemiol. 2012 Dec; 4(10): 311–315)

The Potential for Airborne Dispersal of Clostridium difficile from Symptomatic Patients (Oxford Journals Volume 50, Issue 11)

Indoor Air Quality - The role of HVAC Systems in Healthcare Facilities

Indoor Air Pollution: An Introduction for Health Professionals (EPA)

Ozone Safe Practices (WorkSafe BC)

Microbiomes in the Built Environment - (EPA) - YouTube

Nontuberculous Mycobacterium Infections Associated with Heater-Cooler Devices: FDA Safety Communication (October 15, 2015)

Are Hospital Floors an Underappreciated Reservoir for Transmission of Clostridium Difficile and Methicillin-resistant Staphylococcus aureus?

The Joint Commission - Environment of Care (EC) Chapter Revision Effective January 9, 2017

Understanding the Role of Contaminated Air in Healthcare Acquired Infections (Webinar) - Infection Control Today

Z316.5-15 Fume Hoods and Exhaust Systems Standard - (CSA)

Laboratory Ventilation Codes and Standards - (Siemens Industry, Inc.)

Effects of work practices and upper body movements on the performance of a laboratory fume hood - Ahn, K. et al.,J. Chem. Health Safety (2016)

NIOSH Study Finds Widespread Use of Scavenging Systems to Control Waste Anesthetic Gases During Medical Procedures, but Other Recommended Controls Lacking

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016 - (pdf)

Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies (R.C. Travis et al - JNCI J Natl Cancer Inst (2016) 108 (12)

A research university's rapid response to a fatal chemistry accident: Safety changes and outcomes (Journal of Chemical Health and Safety)

Latest Edition of NIOSH Manual of Analytical Methods
(5th edition) Now Available - (NIOSH)

Workplace Violence in Health Care - A Critical Issue With a Promising Solution (JAMA)

Formaldehyde Confirmed as Known Human Carcinogen -
The National Academies of Sciences, Engineering, and Medicine

U.S. OSHA's Final Rule to Protect Workers from Exposure to Respirable Crystalline Silica

Workers Exposure to Sewage - (Work Safe Alberta)

Guidance for Reducing Health Risks to Workers Handling Human Waste or Sewage - (CDC)

Health and Disease Information for the General Public

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Last updated April 2017

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