Report finds hospital lab staff could have been exposed to dangerous chemicals ‘for years’
Hospital laboratory staff may have been exposed to dangerous chemicals “for years” because of inadequate health and safety precautions, according to a damning report obtained by The Royal Gazette.
Physician Jeff MacLeod, the report’s author, said it was “highly likely” that an employee at the King Edward VII Memorial Hospital histology lab suffered respiratory and neurological illness after inhaling cancer-causing formaldehyde, as well as another hazardous substance, xylene, over the course of more than a decade.
His February 2021 report revealed that the sick employee made a complaint to management in 2018 and the matter was investigated by the Government, at the request of the Bermuda Hospitals Board, resulting in “a number of important health and safety failings” being found.
Dr MacLeod concluded: “From available evidence … it seems clear that KEMH did not meet its responsibilities for providing a safe work environment for [the employee] and KEMH cannot guarantee that [the employee] was not exposed to hazardous chemicals without adequate safety precautions during the … years of [their] employment.”
The health and safety failings identified by the Government included lack of proper ventilation and inadequate personal protective equipment, as well as a failure to: make training in the use of hazardous chemicals mandatory, provide proper fit testing for face masks, discipline staff for not completing training or wearing personal protective equipment, conduct an adequate risk assessment, and meet National Institute for Occupational Safety and Health recommendations on workplace health surveillance.
Dr MacLeod, who said he was commissioned by the Government’s Chief Medical Officer to prepare the report, listed 18 recommendations from a December 2019 report by the Department of Health which he said “need to be addressed urgently” if not already implemented.
The health ministry refused to comment this week on the health department’s oversight, referring questions to BHB.
A board spokeswoman told the Gazette that it had in 2019 “fully implemented” verbal recommendations made by the Government’s Chief Health and Safety Officer after a December 2018 "walk around“, as well as later recommendations made by environmental health officers from the health department.
She added: “BHB takes health and safety extremely seriously and runs a fully accredited lab.”
BHB:
Were laboratory staff exposed to hazardous chemical fumes due to inadequate health and safety measures, as alleged in Dr Jeff MacLeod’s February 2021 report?
Why was there no designated health and safety officer for the pathology department from March 2017 to August 2018, a gap Dr MacLeod described as “indefensible”?
Does the histology lab have a fume hood?
When was it installed?
How many years did lab staff work without a fume hood after the lab was relocated to its current premises?
Did staff have to share face masks prior to February 2018, as suggested by Dr MacLeod?
What were the dates on which the health and safety recommendations were implemented, including the exact date when hoods and vents were installed in the histology lab?
Ministry of Health:
When did the Department of Health become aware of potential health and safety issues at the lab, what action did it take, what happened as a result of its actions and when did it last check on health and safety at the lab?
The histology lab, which has five staff and is in the pathology department, moved from a purpose-built facility in the hospital to empty office space in the late 1990s.
Dr MacLeod’s report revealed that there was no designated safety officer for the department from March 2017 to August 2018.
He wrote: “In assurance terms this gap is indefensible and suggests a worrying lack of concern for health and safety requirements within the department, as well as the management hierarchy that was responsible for it.”
Once the safety officer post was filled, a formal incident report regarding the sick employee’s complaint was filed in September 2018.
Dr MacLeod said the new health and safety officer recorded that a fume hood for proper ventilation was not installed when the lab relocated and that the staff member “worked with formaldehyde and xylene for years” without a fume hood.
He wrote that the hospital acknowledged that face masks for staff were shared until February 2018, rather than employees being provided with proper fitting individual personal respirators, and he described that as an “understandable disincentive” to wearing one.
The BHB spokeswoman said Dr MacLeod’s report was “independently commissioned outside of BHB as part of a legal case”.
The spokeswoman added: “One person has claimed to be impacted by hazardous chemical fumes in a legal approach to BHB; there has been one complaint in the patient safety system related to this.”
But The Royal Gazette understands that before the employee’s complaint was filed, a nurse from another department raised a concern about lab staff discarding hazardous chemicals into an open-topped bin.
The spokeswoman said BHB’s “process of response” started in 2018 when it contacted the Government’s Chief Occupational Health and Safety Officer and Environmental Health Unit.
“We cannot go into further detail as this is a legal matter but recommendations received have all been implemented.”
The spokeswoman added: “All BHB staff are encouraged to make health and safety reports if they experience or see issues that need addressing.”
She said the lab, along with the whole hospital, was accredited by Accreditation Canada and also had “specialist lab accreditation” with Joint Commission International, based in Illinois.
Neither body has had a physical site visit to the lab since the December 2019 Department of Health report was completed.
The board spokeswoman said JCI was last on site in May 2018 and that it did a virtual “live feed walk-through of the entire lab” in May 2021. AC was last on site in May 2019.
She said accreditation came after "surveys that required the lab to meet stringent quality, health and safety standards in all areas, including in histology“.
The spokeswoman said: “The lab has been fully accredited with JCI for over 15 years and … the complaint referenced was declared as part of the accreditation process, as is required.
“BHB has been accredited by Accreditation Canada since the 1970s and the 2019 process was the 13th on site survey.”
A JCI spokeswoman did not answer specific questions about the alleged serious health and safety failings in the histology lab.
She said the organisation “assesses all reports of concerns relating to patient safety and quality and carefully evaluates whether or not a report describes unsafe conditions or incidents which have reached a patient”.
The spokeswoman added that JCI accreditation was voluntary, hence why it kept some information about healthcare organisations confidential.
She said the body was not a regulator and could not “mandate hospitals”.
Dr MacLeod said he could not comment and referred questions to the Chief Medical Officer. Ayo Oyinloye, the CMO, did not respond to e-mailed requests for comment.
Patricia Gordon-Pamplin alleged in Parliament in March 2020, when she was shadow health minister, that the air quality in the lab was “creating negative impacts on some of the employees” and questioned what action the CMO’s office took after it investigated.
The Opposition politician asked how staff could be “comforted that the results coming from that oversight have been positive” and their health would not be further affected.
She alleged the initial complaint " … resulted in a year-and-a-half investigation and no effective decisions being made to either move staff or implement the recommendations of putting in hoods and vents that would make sure that the employees are safe in their environment”.
A BHB spokeswoman said yesterday: ““Our health and safety processes have been fully reviewed by two accrediting bodies and two government inspectors; we have made improvements and implemented recommendations.
“There are no outstanding issues regarding hoods or ventilation systems.
“We can confirm that we run a safe lab that regularly measures the environment in areas where potentially hazardous chemicals are used. We cannot get into the detail of a document that is not an official report into our lab, but a filing on behalf of a legal case.
“We certainly feel frustrated that we cannot provide a detailed response at this time, but we do have external surveyors and inspectors who visit us regularly and we work within all legislated standards and occupational health and safety requirements.”
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