Law, responsibilities and guidance

Infection hazards are covered by the same occupational health and safety laws that cover falls, chemicals and machinery, plus a layer of public health law and professional guidance that is specific to infectious disease. This lesson explains who must do what, which rules apply in different settings and how guidance documents fit in.

The Canadian framework

In Canada, occupational health and safety is mainly provincial and territorial. Each jurisdiction has an act and regulations, enforced by its ministry or compensation board: for example, the Occupational Health and Safety Act in Ontario, the Workers Compensation Act and OHS Regulation in British Columbia, the OHS Act and Code in Alberta and the Act respecting occupational health and safety in Quebec, enforced by the CNESST. Federally regulated workplaces, such as banks, airlines, interprovincial transport, telecommunications and federal government departments, follow Part II of the Canada Labour Code and the Canada Occupational Health and Safety Regulations. About one in ten Canadian workers is federally regulated.

Every jurisdiction places a general duty on employers to take every precaution reasonable in the circumstances to protect workers. That general duty covers infection hazards even where no specific regulation names them. Most jurisdictions also require a written hazard assessment, worker training, the provision and use of protective equipment, joint health and safety committees or representatives, and the right of workers to know about hazards, to participate and to refuse unsafe work.

Specific Canadian rules

Some provinces have regulations aimed at infection hazards in particular settings. Ontario's Regulation 67/93, Health Care and Residential Facilities, requires employers in hospitals, long-term care homes and similar facilities to develop written measures and procedures, in consultation with the joint committee, covering hygiene, safe use and disposal of sharps, protective equipment and immunization, and to train workers on them. Ontario Regulation 474/07 requires safety-engineered needles in most health care settings. Alberta's OHS Code has a part on health care and industries with biohazardous materials, including sharps and exposure procedures. British Columbia's OHS Regulation has requirements for biological agents, including exposure control plans for workers at risk of exposure to infectious materials. Several other provinces have similar sharps rules.

Public health law

Provincial public health acts give medical officers of health the power to investigate outbreaks, require reporting of certain diseases and issue orders, including orders that close premises or exclude people from work or school. Some diseases are reportable: laboratories and physicians must notify public health, which then traces contacts. Long-term care homes, hospitals, child care centres and schools must usually report suspected outbreaks to public health and follow its direction. Personal service settings, such as tattoo, piercing and aesthetics businesses, are regulated and inspected by public health in most provinces; in Ontario, Regulation 136/18 under the Health Protection and Promotion Act sets infection prevention requirements for them. The Public Health Agency of Canada coordinates national guidance and surveillance, and the Quarantine Act covers travel-related measures at the border.

Guidance and standards

Much of the detail of infection prevention is in guidance rather than law. The Public Health Agency of Canada publishes national guidelines on routine practices and additional precautions and on specific diseases. In Ontario, Public Health Ontario's Provincial Infectious Diseases Advisory Committee (PIDAC) publishes best practice documents on cleaning, hand hygiene, reprocessing and routine practices, which inspectors and courts often treat as the expected standard of care. CSA Group publishes standards that are widely referenced, including CSA Z317.2:24 on special requirements for heating, ventilation and air-conditioning in health care facilities, CSA Z8000 on planning and design of health care facilities, and standards on reprocessing medical devices. Professional colleges, such as those for nurses, dentists and physicians, publish their own infection control standards that members must follow. Guidance is not usually law in itself, but regulators can cite it as evidence of what a reasonable employer would do under the general duty.

Federal rulemaking after COVID-19

During the COVID-19 pandemic, provinces relied on their general duty clauses, public health orders and guidance rather than new occupational health regulations. Several provinces have since updated guidance on respiratory infections and ventilation, and federally regulated workers gained ten days of paid medical leave under the Canada Labour Code in December 2022, a change partly prompted by the pandemic's lessons about workers coming to work sick. Lesson 7 covers sick leave rules in more detail.

Who must do what

Recording and reporting work-related infections

When a worker gets an infection from work, it may be an occupational disease for compensation purposes. Employers must report lost-time injuries and occupational illnesses to the provincial compensation board (for example, WSIB in Ontario, WorkSafeBC in British Columbia and WCB Alberta) within the time limits in each province, and in Ontario employers must also give written notice of occupational illnesses to the ministry and the joint committee. Compensation boards have accepted claims for COVID-19, tuberculosis and bloodborne infections acquired at work, but each claim depends on the evidence that the infection came from work. Needlestick and blood exposures should be reported to the employer and recorded even if no infection follows, so that the worker's claim is protected if they later become ill.

# A simple annual review checklist for an infection prevention program (illustrative).
items = {
    "written program or exposure control plan reviewed this year": True,
    "hazard assessment covers all job categories": True,
    "safer sharps evaluated with front-line input": False,
    "training records current for all exposed staff": True,
    "vaccination offered and declinations documented": False,
    "exposure reports investigated within 24 hours": True,
    "outbreak plan tested in the past 12 months": False,
}
done = sum(items.values())
print(f"{done} of {len(items)} items complete ({done / len(items):.0%})")
for item, ok in items.items():
    if not ok:
        print("follow up:", item)

4 of 7 items complete (57%)
follow up: safer sharps evaluated with front-line input
follow up: vaccination offered and declinations documented
follow up: outbreak plan tested in the past 12 months

A checklist like this is not a legal requirement in itself, but it helps a small employer or a committee check that the main elements are in place and identify what to fix before an inspector, an outbreak or an exposure finds the gaps.

Rights of workers

Workers have three basic rights under Canadian occupational health and safety law: the right to know about hazards, the right to participate in health and safety, and the right to refuse work they believe is dangerous. For infection hazards, the right to know means training on the infections they may meet, the controls in place and how to report exposures. The right to participate is exercised through the joint committee or representative, which should review infection prevention procedures, outbreak plans and exposure reports. The right to refuse applies to infection hazards too, but tribunals have generally held that a hazard that is a normal part of the job, such as caring for patients with infections in a hospital, does not justify refusal when the employer has reasonable controls in place. Refusals are most likely to succeed where controls are missing, such as no protective equipment, no training or no ventilation in an isolation room. Employers must not punish workers for raising concerns or using these rights in good faith.

Whatever the jurisdiction, the practical lesson is the same: a workplace that listens to concerns, fixes gaps quickly and explains its controls rarely faces refusals or complaints about infection hazards, and it catches problems before they cause harm.