Dr. Neils Koehncke University of Regina Rob Staudinger, Superintendent PCS Cory Mine Pam Kirstein SK WCB

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1 Dr. Neils Koehncke University of Regina Rob Staudinger, Superintendent PCS Cory Mine Pam Kirstein SK WCB

2 Asbestos Niels Koehncke MD MSc FRCPC Specialist in Occupational Medicine University of Saskatchewan Director, Canadian Centre for Health and Safety in Agriculture Chief Occupational Medicine Officer Ministry of Labour Relations and Workplace Safety

3 Asbestos Asbestos is a Greek word meaning inextinguishable or indestructible In use for centuries Greeks and Romans

4 Asbestos A fibrous mineral Used for insulation, fireproofing and lining because of its excellent heat resistance Significant historical use in automotive and shipbuilding industries Many different types of asbestos

5 Actinolite fibre bundle

6 Asbestos Rock

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8 Asbestos Most current exposure occurs during asbestos removal and remediation Removing / disturbing asbestos material during maintenance, repairs, inspections, etc Asbestos abatement Some countries still using asbestos products frequently

9 Asbestos Containing Materials Cement products Tile (floors, ceiling) Insulation and fireproofing Friction materials (brakes, clutches) Shipbuilding WWII etc

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12 Serpentine Fibres (chrysotile or white asbestos)

13 Amphibole Fibres (actinolite asbestos)

14 actinolite

15 Asbestos Bodies Some fibres in the lung become coated with iron-protein mucopolysaccharide Called Asbestos Body or Ferruginous Body Has a beaded, dumbbell appearance under microscope

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17 Asbestos related diseases Diseases due to asbestos exposure take decades to develop Asbestosis Pleural plaques Cancer Lung Cancer Laryngeal Cancer, GI cancer Mesothelioma

18 Asbestosis Scarring of lung tissue over time due to asbestos fibres Lungs can t expand normally, oxygen uptake also limited Chest x rays (and CT scans) can detect the scarring

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20 Pleural Plaques The pluera is the lining of the lungs between the lungs and the rib cage Pleural plaques are areas of thickening and scarring on the pleura due to asbestos fibres

21 Pleura

22 Pleura Pleura

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25 Pleural Plaques Benign they are of little clinical concern May have very slight effect on lung function or (usually) no effect at all However, the presence of pleural plaques indicates past asbestos exposure They are not cancer nor do they turn into cancer

26 Cancer Asbestos is a carcinogen Lung cancer Mesothelioma Others

27 Cancer Smoking and previous significant asbestos exposure increases your risk of lung cancer much higher than smoking alone

28 Lung Cancer Risk Significant asbestos exposure 5 times higher risk Smoking 10 times higher risk Asbestos exposed smoker 50 times higher risk

29 Mesothelioma Cancer of the pleura Major cause is asbestos Not the same as lung cancer Not the same as pleural plaques

30 Exposure Background exposure to asbestos frequently present very low Risks for disease involve long exposures (years) to higher exposure levels

31 Exposure Risk quantification is challenging Multiple meta-analyses, reviews, studies in peer reviewed scientific literature have attempted determining dose-response relationships Results vary

32 Exposure Helsinki Report: cumulative exposure of 25 fibres/ml-years increase risk of lung cancer by two-fold. The risk appears to be smaller in miners and friction product manufacturers, intermediate in asbestos cement and product manufacturers, and highest in textile workers Lotti et al 2010

33 Exposure 2008 review (Pierce et al) meta analysis of 14 studies Cumulative no effect exposure to crysotile for lung cancer in the range of fibres/ml-years

34 Exposure One consensus that does come up constantly and consistently in the literature: Quitting smoking reduces the risk of cancer significantly (asbestos-related and non)

35 Exposure Designated chemical substance under Sask OHS Regulations (Table 20) Employer must prevent release and protect workers ( section 306) High risk asbestos process: must be less than 0.01 fibre/cc prior to re-entry (Section 344) Other jurisdictions: ACGIH TLV: OSHA PEL: NIOSH REL: 0.1 fibre/cc 0.1 fibre/cc 01. fibre/cc

36 Medical Evaluations Medical evaluations for asbestos exposure include: History Physical Lung function testing Chest X-Ray (possibly CT Scan) Other investigations as necessary

37 Medical Evaluations Asbestos diseases have long latency: decades Medical evaluation after exposure can provide a baseline (and/or identify previous exposure), and can provide information / education on risk and (in many cases, hopefully) reassurance

38 Thank you!

39 Contact Information Niels K. Koehncke MD, MSc, FRCPC Occupational Medicine, University of Saskatchewan 104 Clinic Place, PO Box 23, Saskatoon SK S7N 2Z4 (306) (office) (306) (clinic appointments) (306) (fax)

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41 Rob Staudinger Mill Maintenance Superintendent PCS Cory Division Cory s Current Asbestos Management Plan PotashCorp.com

42 Why is Cory focused on Asbestos Management? 4 Asbestos Related Incidents reported in of these involved employees that did not know ACM was involved in their work. 7 Asbestos Related Incidents reported in of these directly involved employees. 5 of these involved groups not knowing ACM was involved in their work Annual Asbestos audit found ACM in areas where maintenance work and or demolition had occurred without following asbestos safe work procedures.

43 Recent History Of Events at PCS Cory: Annual Asbestos Audit 2010 focusing on Trafford Tile Annual Asbestos Audit in 2011 focusing on Trafford Tile Asbestos Awareness Training with Dr. Koehncke focusing on two trades in 2011 Annual Asbestos Audit in 2012 expanding to include all known ACM s throughout the surface operating facility. Asbestos Awareness Training with Dr. Koehncke in 2014 Annual Asbestos audit in 2014 expanded on 2012 audit to include additional buildings Annual asbestos audit found asbestos containing materials in drywall mud compound, additional floor tiles, base boards, lab countertops and inside concrete block walls as vermiculate insulation.

44 How to move forward with information from the 2014 audit? No incidents or reports have been documented Some individuals started to enter W1 s for previous incidents based on what was found after the audit. Mines branch and WCB made contact to Cory leadership to understand recent W1 s related to asbestos exposure. During surface Occupational Health and Safety Committee monthly meeting a path forward was suggested to meet with individuals from WCB. With assistance from Cory Human Resource department, a meeting was set up with surface OHC, Human Resources, Occupational Health Nurses, Cory Safety and Training departments, Dr. Koehncke as well as WCB individuals. Process was discussed to inform employees that E1 s will be entered for all those employees exposed to asbestos while employed at Cory. Information sessions held discussing Cory s Asbestos Management Plan, Asbestos Awareness presentations from Dr. Koehncke and WCB claims presentation.

45 Where is Cory at now in regards to Asbestos Management January of 2015 new Asbestos Management Plan finalized as well as new Asbestos Abatement Procedures completed. 5 Asbestos Related Incidents reported in Involved employees not knowing that ACM was involved in their work. 1 of the groups was a contractor Cory has been focusing on Labeling, inspection, and training. With the exception of some trafford tile, all friable and non-friable asbestos containing material has been labeled. Placards installed at the entrance of buildings that contain asbestos containing materials. Hired two individuals to support our process for filing E1 s for Cory personnel As of Friday April 1st 154 interviews have been completed and 118 completed packages went to quality control. This process is prior to mailing to WCB.

46 Time Permitting Cory s Asbestos Management Plan

47 Asbestos Management Plan Pipe Insulation Asbestos-containing parging cement is present on pipe fittings. Parging cement is a friable insulation and jacketed with canvas. Photo: Parging cement on pipe elbows.

48 Asbestos Management Plan Pipe Insulation Asbestos-containing preformed insulation (known as mag-block ) is present on straight sections of glycol system pipes. The pipe insulation is friable and jacketed with either canvas, paper, or metal. Photo: Asbestos containing pipe insulation.

49 Asbestos Management Plan Asbestos Cement Products (Transite) Transite board is present as interior fascia on concrete block walls, exterior cladding, interior wall liner, and roofing material. All transite is non-friable. Photo: Asbestos containing transite liner. Photo: Asbestos containing transite tile on interior walls.

50 Asbestos Management Plan Asbestos Cement Products (Transite) Photo: Asbestos containing transite tile on exterior cladding. Siding shown has been damaged, repaired and sealed and in good condition.

51 Asbestos Management Plan Duct Insulation Black mastic present on ducts. Mastic is non-friable. Photo: Air supply duct with black mastic on exterior. Duct is on 3 rd floor of white mill.

52 Asbestos Management Plan MECHANICAL EQUIPMENT INSULATION Black mastic was observed on a tank in the Reagent Room. Mastic is nonfriable. Photo: Armeen T tank covered with asbestos containing mastic.

53 Asbestos Management Plan VINYL FLOOR TILE AND MASTIC Photo: Asbestos containing vinyl sheet flooring found in front entrance to administration building.

54 Asbestos Management Plan VINYL FLOOR TILE AND MASTIC Photo: Asbestos containing 12x12 vinyl floor tile located in reagent control room.

55 Asbestos Management Plan Other Building Materials Brown and grey fireproof coating is present on the electrical cable and cable trays throughout the buildings and determined to be asbestos-containing. The fireproof coating is non-friable. Photo: Brown Asbestos containing fireproof coating on electrical cables.

56 Asbestos Management Plan Other Building Materials Photo: Grey Asbestos containing fireproof coating on electrical cables.

57 Asbestos Management Plan Other Building Materials Blue laboratory countertops in lab area were determined to be asbestoscontaining. The material is non-friable. Photo: Asbestos containing blue lab counter top

58 Asbestos Management Plan Other Building Materials Asbestos-containing mastic is present beneath baseboards on walls in the basement corridor of the administration building. Mastic and adhesives are nonfriable. Photo: Asbestos containing gold mastic beneath baseboards in the basement corridor of the administration building.

59 Asbestos Management Plan Other Building Materials Asbestos containing material has been found to be present as vermiculite. Photo: Vermiculate insulation on interior concrete wall of the brine injection pump house where amphibole asbestos is present.

60 Asbestos Management Plan Steps Required to inform building occupants Surface general series module reviewed every 3 years Annual Audit Service Providers provided a copy of the SGS.

61 Asbestos Management Plan Labeling of asbestos containing materials Labeling will mean posted signs. They should be: Attached directly to materials containing asbestos At the entrance to an area where ACM is present (Placard) or At entrances to areas where asbestos is being cleaned or removed. An appropriate sign displayed at the entrance and around the perimeter of an asbestos clean- up or removal project is shown below. An appropriate label for material containing asbestos would be:

62 Asbestos Management Plan Emergency Release Procedures An unplanned release of ACM can either be major or minor. The minor and major incidents discussed in this section are not planned asbestos abatement projects, but unintentional disturbances of materials containing asbestos. Examples of minor incidents include: puncture of an insulated pipe; contact with an insulated structural beam; and breakage of a corner section of tile or wall panel, where a small amount of material containing asbestos is dislodged or exposed. These minor incidents of fibre release can be treated with standard wet cleaning or HEPA vacuuming techniques. Major incidents of fibre release are very serious. Disturbing a large amount of material containing asbestos may contaminate an entire building with asbestos fibres. In these cases, immediate and thorough procedures are required. Well-trained and properly equipped people must address these situations.

63 Asbestos Management Plan Emergency Release Procedures Each incident of fibre release, whether minor or major should be investigated to prevent similar occurrences in the future. If the incident exposed workers to the extent that it may affect their health, an investigation is required The investigation must be done in consultation with the committee. The report must be given to any worker who was or may have been exposed.

64 Asbestos Management Plan Training Any worker that is required to work on high risk abatement projects as outlines in SOP Asbestos Handling Procedure must successfully complete an asbestos abatement course of at least two days duration. Workers involved in low or moderate risk abatement projects are not required to complete a two day asbestos abatement course but must be competent meaning possessing skills, knowledge, experience, and training to perform a specific duty. A competent worker should at a minimum be trained in the following: health hazards associated with exposure to asbestos; responsibility of workers, employers, contractors and suppliers under the OHS Act; asbestos requirements in the OHS Code; safe work procedures related to the work How to properly wear, use and maintain personal protective equipment that will be used at the work site.

65 SOP Asbestos Handling Procedure Types of Asbestos Abatement Low Risk Abatement Procedure Medium Risk Abatement Procedures High Risk Abatement Procedures Glove Bag Vinyl Floor Tiles Dry Removal Vermiculite

66 SOP Asbestos Handling Procedure Medium Risk Abatement Processes Pre-job Planning Same as Low Risk Pre-job Planning: The boundary of the work area shall be physically restricted by the use of Danger-Asbestos barrier guard tape approximately 10 meters from the removal work area. Conduct a pre-abatement inspection using the Pre-Abatement Inspection Checklist, Appendix III. Form must be submitted to the Asbestos Abatement Manager and Safety Department upon completion.

67 Pam Kirstein, Service Excellence Trainer

68 Asbestos Related Cancer It is well known that a valid relationship exists between exposure to asbestos and certain types of cancers including gastrointestinal, laryngeal, lung and mesothelioma.

69 Depending on the length and intensity of exposure, the interval between onset and the diagnosis of laryngeal or gastrointestinal cancer is generally 10 to 20 years, 10 years for lung cancer and 15 to 30 years for mesothelioma.

70 WCB Policy 11/2003 Injuries Occupational Disease In order to consider an Occupational Disease injury under the Workers Compensation Act 2013, two conditions need to be met. Occupational Disease is defined as a disease or disorder that arises out of and in the course of employment and that results from causes or conditions that are:

71 (i) Peculiar to or characteristics of a particular trade, occupation or industry : or (ii) peculiar to a particular employment. The Definition of an injury includes: a disabling or potentially disabling condition caused by an occupational disease.

72 What constitutes a Workplace Exposure Asbestos exposure occurs when someone inhales or swallows asbestos fibers. The WCB would consider a workplace exposure to have occurred when a worker has been exposed the to airborne asbestos fibers.

73 When to file a claim for Asbestos Exposure In accordance with Section 52 of the WCB Act 2013, an Employer is required to notify the WCB in writing of any injury that prevents a worker from earning full wages or that necessitates medical attention. However, in the case of a latent occupational disease, it is beneficial to submit the E1 to register the incident at time the exposure occurs.

74 Why? This allows the WCB and the Employer to confirm the incident that has occurred and an opportunity to discuss any questions that may arise, in real time. If you wait to report the incident to WCB at the time that your employee seeks medical attention, this may not occur until years after the workplace incident. As such, information will not be as easily available.

75 What Happens Next Once the WCB has confirmed the workplace exposure, a letter is then sent to both the Employer and the Worker acknowledging WCB s record of the incident. If, at anytime in the future, an Occupational Disease is later diagnosed, as a result of the exposure, the incident will then move through the Claim Adjudication process to confirm the diagnosis is consistent with the workplace exposure.

76 General Adjudication Guidelines Gathering of necessary information to determine that the condition or disease has arisen out of employment. When determining cause or origin, consideration may be given to whether there was a specific exposure peculiar to any trade, occupation, industry or employer.

77 Where the exposure is peculiar to a trade, occupation, industry or employer the WCB will review to determine if any non-work related causes exist. Where both work and non-work causes exist the WCB will assess the degree of exposure or effect on the disease by both, and determine based on such things as the latency, progression and nature of the disease, degree of exposure and medical support of the cause, prior to making a decision.

78 Injuries Occupational Disease POL 11/2003 Injuries Occupational Disease PRO 13/2007 Appendix E Asbestos Related Cancer Occupational Disease Reserve POL 05/2014