Occupational Health Services

Your business, your unique health concerns

DC provides customized occupational health programs and fitness for duty testing services to organizations across North America including in the oil and gas, energy, construction, mining, manufacturing, healthcare, and transportation sectors. At DC, all of your needs are met through a single provider, ensuring consistencies in protocols and procedures across the board and minimizing the administrative work required on your end. Providing Quality Health Assessments for over 30 years. 

Medical Surveillance Programs

Assessments are customized to suit the job category/exposure/business unit (ex. Field Employees Fit for Duty Medical Protocol) for your company’s personnel. This form will be provided to all clinics where this examination will be conducted to ensure consistency of the fitness for duty determinations. We have detailed below the components of a standard DC physical exam, performed by a physician or nurse.

  • Comprehensive health history questionnaire

  • Vision assessment that includes near vision acuity, depth perception, peripheral vision, and colour vision screening

  • Calculation of Body Mass Index (BMI) and neck circumference, two screening tools for obesity and obstructive sleep apnea

  • Cardiovascular assessment

  • Respiratory assessment

  • Psychological assessment

  • Hearing assessment

  • Head-to-toe musculoskeletal assessment

  • Structured neurological assessment, including an upper and lower reflex and back fitness evaluation, and an assessment of balance and coordination

  • Other testing as required (ex. chest x-rays, blood tests)

  • Employee Fitness Determination report

+ Audiometric Testing

Audiometric testing provides objective, quantifiable results, which are important in the ongoing management of worker hearing acuity. Equally important, is the education provided regarding hearing loss prevention and conservation. Counseling related to noise exposure, testing results, the importance of hearing protection, and employee responsibilities is provided.

Our audiograms are performed by certified technicians using regularly calibrated and maintained audiometers. This service includes an otoscope exam of the ears. Prior to administering the audiogram, the technician will establish and review the employee’s hearing health history. Abnormal findings are sent to a physician or audiologist for review.

+ Hearing Surveillance Program

A full hearing surveillance program would include employee education and training on hearing conservation to ensure employees are aware of their role in minimizing the impact of noise exposure, as well as an analysis of test results and comparison with previous results to establish trends, results tracking and record keeping, employee/employer notification of pending tests, and statistical summaries to assist your organization in evaluating the effectiveness of its hearing conservation program. We use software called HearTrax to facilitate a full hearing surveillance program. Key components of this program are:

  • Analysis of audiogram results using a comprehensive hearing conservation data management system
  • Results tracking and centralized system for record keeping
  • Recurring or periodic testing and employer notification of pending tests
  • Employer notification when workers are due for testing and reports for those that are not in compliance
  • Comparison of past and current results to establish trends among individuals, within occupations, between different departments, or between different work sites
  • Statistical summary reports (by the company, by site, and by department) to help evaluate the effectiveness of the employer’s Hearing Surveillance Program and the need for further noise control
  • 10-year summaries to identify long-term progress of hearing conservation efforts
  • For employers who operate in multiple provinces, we can develop a customized program for a worksite in each province (regulatory requirements vary by province)

+ Abnormal Results

If the results of an audiometric test indicate an abnormal audiogram or abnormal shift, DC’s Occupational Health Team will securely forward the audiometric results, as well has the worker’s hearing health history questionnaire, to our Medical Director for review and confirmation of findings. DC’s Occupational Health Team will then communicate the Medical Director’s conclusions to the worker verbally as well as in letter format within 30 days of testing. With the worker’s consent, DC’s Occupational health Team will also forward the worker’s audiometric testing records to the worker’s primary care provider to facilitate further investigation. Where applicable, when a potential safety concern has been identified, such as the worker’s ability to hear normal conversation and/or bells/whistle/alarms, DC’s Occupational Health Team will communicate this to your company’s designated personnel.

Standard monthly reports can be provided on a monthly basis.

+ Chest X-Rays

Chest x-rays are a valuable diagnostic screening tool for respiratory disorders and injuries and are required in some provinces for certain exposures (ex. Silica). We can arrange baseline and periodic chest x-rays for employees/candidates to help diagnose respiratory issues and identify disease or illness early on, should this be required as part of the respiratory surveillance program.

Our chest x-ray services include the following:

  • Ready access to chest x-rays
  • Copy of the posterior-anterior view and a radiologist’s report
  • Interpretation by a radiologist and review by a physician

+ Fitness to Wear a Respirator Test

To ensure that your organizations' workers are fit to wear a respirator (prior to mask fit testing), each worker will complete a respiratory questionnaire administered by a registered nurse, that will help determine if the worker is free from mental and physical conditions that may preclude him or her from wearing a respirator. The result of the questionnaire (in conjunction with the result of the PFT) will be considered when the fitness to wear a respirator determination is being made. Upon completion of the review, the worker may be deemed:

  • Fit to wear
  • Fit to wear with limitations/recommendations
  • Unfit to wear

Where limitations are identified or there is a significant medical history (ex. history of facial dermatitis), further physician interpretation may be warranted. The physician will then make a determination or recommend next steps.

+ Pulmonary Function Test

The Pulmonary Function Test (PFT) includes a spirogram conducted by a qualified pulmonary function technician, using equipment that are regularly calibrated and maintained to our exacting standards. This testing measures the employee’s respiratory performance and overall lung health while also helping to determine their fitness to wear a respirator. Our PFT service also includes a comprehensive lung health medical history that covers several key areas, including occupational and non-occupational related exposures, significant symptoms that may indicate silicosis, pneumoconiosis, asbestosis or cancer, past and current medical diagnosis of respiratory disease, and the worker’s smoking history. A physician review would also be conducted.

+ Mask Fit Test

If the worker is deemed fit to wear a respirator, DC’s mask-fitting technician will educate the worker on the respirator he or she will use. The technician will then fit the worker to the appropriate mask for the environment in which they will be working, using quantitative or qualitative mask fit testing (quantitative recommended). The procedures we follow meet the requirements outlined in CSA Standard Z94.4-02.

We recommend that mask fit testing is repeated for every new type of tight-fitting respirator the worker may use and should be repeated for any worker that has a change in their physical condition that could affect its fit. The physical changes could include significant weight gain or loss, facial scarring or changes in facial structure.

+ Physical Abilities Tests

In addition to the musculoskeletal assessment conducted during the medical exam, this service includes a physical abilities test (PAT) for each job position that requires physically demanding work. We help you prevent injuries by matching your employee’s physical abilities with the demands of the job. Instead of using a canned approach to testing with preset protocols or enlisting your employees in a “boot camp” that determines fitness for duty based on exercises like chin-ups and pushups, we ensure the custom testing protocol we develop is based on the bona fide occupational requirements of the job. This maximizes defensibility, should you be challenged in court – something that becomes more likely in a depressed economy as workers fight for their jobs. Our methodology is scientific, peer-reviewed and evidence-based. That means you can trust it, and us.

Our testing protocols consider physical demand level and frequency (ex. occasional or constant) of the tasks involved. For example, the individual must be able to lift 85 lbs. over the shoulder on an occasional basis 0-33% of the workday. We test the individual’s physical capability to complete job-specific tasks through a variety of exercises that reflect the physical characteristics of the tasks.

Once developed, the protocol is provided to the clinicians in our network to ensure consistency at all locations where your candidates are being tested. Administered by qualified medical professionals, the physical capabilities of your candidate or worker will be tested through specific job simulation tasks based on the bona fide requirements of the job.

During the evaluation, DC objectively evaluates the candidate’s ability to perform all essential tasks safely and efficiently. With one-on-one supervision, we measure and monitor the individual’s response to exercise (ex. blood pressure and heart rate) throughout the process.

After a PAT is performed, the individual is either successful at meeting the job’s physical demand requirements or not. For the latter, we indicate the areas where the candidate was unsuccessful and identify areas of limitation so you can make fully informed decisions about whether or not you can accommodate the individual.

DC’s network of expert kinesiologists and physiotherapists can also review your existing physical demands analysis (PDA) for consistency and completeness prior to the development of your testing protocols if requested.

+ Physical Demands Analysis

A Physical Demands Analysis (PDA), also referred to as Job Demands Analysis or Physical Demand Profile, is a comprehensive assessment of the job position including: essential functions, physical demands (ex. lifting, carrying, pushing, pulling), positional tolerance (ex. stooping, kneeling, crouching, crawling, walking, sitting, standing, balance), force requirements and task frequency. Medical examiners should have these when performing pre-placement health assessments to better understand the physical requirements of the position applied for. PDAs allow the examiner to make informed decisions related to fitness for duty and any workplace accommodation that may be required. For example, if the examiner notes that the worker has limited above shoulder range of motion they can refer to the PDA to determine of above shoulder reaching is an essential job demand.

We can typically cover at least 2 PDA's in a single day and possibly 3 depending on complexity and travel requirements between job sites if needed. PDA report development and validation with the employer usually take several hours the following day.

+ Biological Monitoring (Coal, Silica and Asbestos Testing)

Controlling and monitoring worker exposure to harmful substances is imperative in maintaining a secure and safe working environment. Failure to detect potential adverse changes in worker health results in subsequent delays in initiating medical intervention which may complicate recovery.

Harmful Substance means a substance that, because of its properties, application or presence, creates or could create a danger, including a chemical or biological hazard, to the health and safety of a worker exposed to it (ex. AB OHS Explanation Guide).

Medical surveillance programs are proactive exposure-specific initiatives that monitor the effectiveness of workplace safety precautions over time. They allow for early detection and intervention where required through baseline and periodic health screening. Through aggregate data, employers are able to identify trends among groups of workers who share common occupational exposure risks. Once data is analyzed, employers can better evaluate the effectiveness of their exposure control plan. Where concerns are identified, workplace practices, including engineering and administrative controls should be re-evaluated and improved upon wherever possible. Every reasonable precaution must be taken to promote worker safety.

DC’s medical surveillance programs aid our clients in meeting regulatory requirements regarding medical monitoring programs for exposed workers.

+ Determining Medical Fitness for Duty

DC utilizes Standard Operating Procedures (SOPs) when evaluating candidate pre-placement medical files. SOPs are a set of standards/instructions created by a business to help workers carry out routine operations. Their purpose is to achieve efficiency, quality output and uniformity of performance while reducing miscommunication and failure to comply with industry regulations.

+ File Review and Escalation Process

  1. Independent review by DC Occupational Health Team Nurse, considering SOPs
  2. Consultation with a colleague (if applicable)
  3. Consultation with Supervisor/Manager
  4. Consultation with Medical Director

+ When Further Evaluation is Required

If in the opinion of the medical examiner, or upon review by DC’s Occupational Health team, areas requiring further information are identified that may impair the candidate/employee’s ability to operate within a safety-sensitive position, a Request for Medical Information (RFMI) will be issued to the candidate/employee and/or the candidate/employee’s primary care provider with consent. A position is considered safety sensitive when impaired performance, for whatever reason, could result in a significant incident affecting the health or safety of employees, customers, customers’ employees, the public, property, or the environment. Please note that the candidate/employee’s Acknowledgement Form which allows for the candidate’s/employee’s consent to disclose confidential information must be included with each request. The results of the requested investigation will be used for health and safety purposes to determine the candidate/employee’s fitness and/or ability to perform his/her employment duties, and if applicable, assist in any necessary accommodation. When assessing candidate/employee work ability, risk, capacity, and tolerance must be considered.