Workplaces

The best approach to prevent contamination by inhalation is to comply with public health measures and with workplace health and safety control measures. In the following illustration (Figure 2), each slice of cheese (or barrier) represents a layer of defense against the spread of respiratory viruses. The “Swiss Cheese” model recognizes that no single measure is enough to prevent the inhalation of respiratory viruses because each measure (slice) has imperfections (holes). If one slice fails, the next slice may be effective in stopping the virus. The more slices (layers of control) there are in place, the less likely the holes will be “aligned” to let the virus through, and the more likely these multiple measures will work to protect workers and prevent contamination.

The layered approach for the prevention of COVID-19 and other airborne viruses in the workplace

In other words, the more layers there are, the better. Layers include public health measures such as vaccination, respiratory etiquette, hand washing, surface disinfection, etc. Moreover, workplace health and safety control measures include remote work, physical distancing, adequate ventilation, including HEPA filtration of indoor areas when necessary, and wearing a surgical mask for protection or a respirator (for better lateral protection). (See Figures 2 and 3).

Workplace Health and Safety Control Measures

Source: https://www.ccohs.ca/covid19/controls-infographic/index.html

Legal occupational health and safety obligations for both employers and workers must be applied in the context of infectious contaminants such as COVID-19 and other viruses and bacteria (e.g. tuberculosis). Here is a summary of these obligations:

Employer

Every employer has the obligation to protect the health and ensure the safety and physical well-being of their workers. The Act respecting occupational health and safety (AOHS) requires every employer to take the necessary measures to achieve this (Section 51). To do so, the employer must implement methods for the identification, correction and control of risks.

Additionally, the employer must inform the workers of the risks related to their work and ensure that the workers have the appropriate training, supervision and coaching so that every person has the skills and knowledge required to perform the work assigned to them safely.

Worker

Workers have the obligation to protect their own health, ensure their own safety or physical well-being, and make sure that they do not endanger the health, safety or physical well-being of other persons found in the workplace (Section 49 of the AOHS). To do this, they must comply with the rules and measures implemented they same way that they comply with the other rules in force in their workplace. Workers must also participate in the identification and elimination of risks of work accidents and occupational diseases in their workplace. If they see risks, they must inform the health and safety committee (if there is one), their superior, the employer’s representative, or the prevention representative.

• For more information: https://www.cnesst.gouv.qc.ca/en/prevention-and-safety/covid-19/covid-19-toolkit 

Signs and posters reiterating the importance of the necessary preventive measures such as respiratory etiquette, hand hygiene, mask usage, and physical distancing should be posted in strategic areas.

Identification of symptoms and case management:

• In English: Measures in Effect for Nunavik | Nunavik Regional Board of Health and Social Services (nrbhss.ca)
• In French: Gestes pour limiter la transmission des maladies respiratoires infectieuses | Gouvernement du Québec (quebec.ca) et Aide-mémoire — Pour protéger notre santé et celle des autres (quebec.ca)

Washing your hands – Simple and effective / Le lavage des mains – Simple et efficace:

• In English: Washing hands | Gouvernement du Québec (quebec.ca)
• In French: Lavage des mains | Gouvernement du Québec (quebec.ca)

Protect the health of others! How to put on a mask / Protégez la santé des autres! Comment mettre un masque:

• In English: Protect the health of others! How to put a mask (gouv.qc.ca)
• In French: Comment mettre un masque (gouv.qc.ca)

How to Properly Put on and Take off a Disposable Respirator:

• In English How to Properly Put on & Take off a Disposable Respirator, 2010-133 | NIOSH | CDC 
• In French: ASSTSAS | Protection respiratoire – Rappel des étapes clés pour utiliser votre APR N95 [B33]

Guidelines published by the CNESST, the INSPQ and the Government of Quebec

In the context of the declaration of the state of emergency, Dr. Marie Rochette, Director of Public Health of the NRBHSS, has the authority to implement different measures in order to protect the Nunavimmiut. Therefore, the guidelines for Southern Quebec from the CNESST (Commission des normes, de l'équité, de la santé et de la sécurité du travail), the INSPQ (Institut national de santé publique du Québec) and the Government of Quebec do not necessarily match the health measures recommended by the Department of Public Health in Nunavik. This is because the organizations mentioned above adjust their recommendations based on the epidemiological situation in the regions of Quebec located south of the 55th parallel, which might be different from the situation in Nunavik.

• CNESST  (Commission des normes, de l'équité, de la santé et de la sécurité du travail). COVID-19
  • Toolkit: https://www.cnesst.gouv.qc.ca/en/prevention-and-safety/covid-19/covid-19-toolkit
• INSPQ  (Institut national de santé publique du Québec), September 2021.
  • Recommandations générales pour les milieux de travail, hors milieux de soins : mesures de prévention de la COVID-19 : Recommandations générales pour les milieux de travail, hors milieux de soins : mesures de prévention de la COVID-19 | INSPQ
• Government of Quebec:
  • About the measures in force: https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/measures-in-force/about-the-measures-in-force
  • Guidelines for Educational childcare services in the context of COVID-19 pandemic: https://www.quebec.ca/en/family-and-support-for-individuals/services-de-garde-educatifs-a-lenfance-dans-le-contexte-de-la-covid-19/
  • Guidelines specific to education (COVID-19): https://www.quebec.ca/en/education/guidelines-education-covid#c110274

Airborne transmission of COVID-19

• Science, August 2021. Airborne transmission of respiratory viruses: https://www.science.org/doi/10.1126/science.abd9149
• British Medical Journal, August 2020. Two meters or one: what is the evidence for physical distancing in COVID-19? Two meters or one: what is the evidence for physical distancing in COVID-19? (bmj.com)
• British Medical Journal, December 2021. Visualizing SARS-CoV-2 transmission routes and mitigations. The diagram shows the different pathways that can be taken by the virus that causes COVID-19 when it transfers between two people. The darker the color, the higher the estimated risk: https://www.bmj.com/content/375/bmj-2021-065312

Physical barriers

• Indoor Air, June 2021. Quantifying the effectiveness of desk dividers in reducing droplet and airborne virus transmission. https://onlinelibrary.wiley.com/doi/full/10.1111/ina.12950

For other information and instructions from the Department of Public Health of Nunavik

• Coronavirus | Nunavik Regional Board of Health and Social Services (nrbhss.ca)