Peter L. Twohig
On 16 April 2026, 5 thousand long-term care (LTC) employees in 56 services all through Nova Scotia started a strike. A tentative settlement ended the labour motion after eight weeks, one other instance of a prolonged labour dispute in a nursing dwelling. Certainly, a number of the longest strikes in current Canadian historical past have been in LTC.[i]
Putting long-term care employees in Halifax, Nova Scotia, June 2026. Writer picture
I’ve beforehand argued that specializing in nursing dwelling employees opened up new analytical paths and that these provided a possibility to contribute to the revitalization of Canadian working class historical past. My curiosity on this query was impressed by one other Energetic Historical past put up.[ii] Particularly, I noticed the chance to concentrate on teams which might be, largely, and not using a historical past of their very own. This would come with persevering with care assistants (CCAs), the biggest group of caregivers in LTC. Putting CCAs in Nova Scotia earned $18.77 per hour when the dispute started, barely above the provincial minimal wage.[iii]
As Pat Armstrong, a number one scholar of LTC, has repeatedly highlighted, “the situations of labor are the situations of care.”[iv] The labour dispute in Nova Scotia was, then, not solely about wages but in addition the demanding nature of caring work. In the course of the strike, the Canadian Union of Public Staff (CUPE) collected two thousand submissions on its web site Tales of Care that doc the challenges that well being care employees face day-after-day.[v]
One employee famous that “CCAs are over labored and drained.” One other highlighted that the work was “bodily and mentally exhausting” and that it is also “harmful.” Most of the accounts hyperlink the poor pay in LTC to the difficulty of employees retention. This, in flip, results in excessive charges of turnover and ‘working brief’, which is a euphemism for being understaffed. One famous that the “wage hole issues” and that employees will protest with their ft, searching for higher alternatives elsewhere. She added that the poor pays “impacts employees retention and the consistency of assist for weak people.” One other CCA stated “I understand how tough this job will be, what its prefer to be mandated to work double shifts, to work brief handed, to have a piece load that past a single individual’s functionality.”
These tales additionally open a window onto what Eric Tucker just lately described because the ‘third wave’ of occupational well being and security (OHS).[vi] In accordance with Tucker, this wave was characterised by “stubbornly excessive damage charges, rising consciousness of occupational illness … and by the emergence of militant employee well being and security actions.” Tucker helpfully focuses consideration on how concepts about occupational well being expanded within the late 20th century to embody a larger vary of points and extra employees, together with well being care employees.
Regardless of a short flurry of curiosity within the early days of the COVID-19 epidemic, there’s not a lot written in regards to the historical past of occupational well being and security in well being care. Labour and working-class historians have, after all, been attentive to the numerous dangers related to manufacturing unit work and the arduous labour of mining, forestry, and fishing.[vii] Different historians have examined a choose group of occupational illnesses, together with silicosis, black lung, brown lung, and radiation poisoning.[viii] Some have explored the historical past of protecting laws for ladies and youngsters and the historical past of employee compensation legal guidelines.[ix] Past the confines of commercial employees, nonetheless, there are few histories of OHS.
Thanks employees. An indication that has seen higher days however one which was nonetheless hanging on a fence exterior a Cambridge, Massachusetts, hospital in the summertime of 2025. Writer picture.
Proof additionally means that well being care was hardly at the forefront of occupational well being and security within the late Seventies. In accordance with a Nationwide Institute for Occupational Security and Well being research accomplished in 1976, solely 8% of surveyed hospitals in the US met the minimal standards for an efficient well being and security program. Virtually one third of them didn’t have a proper occupational well being program.[x]
In these years, well being care employees grappled with a number of occupational well being points, together with publicity to infectious supplies, toxicological hazards, radiation publicity, and different distinctive issues.[xi] In the summertime of 1978, CUPE accomplished a survey of hospital hazards. It was the primary such research in Canada and it documented the vary of threats to employee well being.[xii]
Newsletters like WOHRC Information shared info and promoted consciousness of the occupational well being hazards confronted by ladies employees. WORHC Information, 6, 2 (April/Could 1984). Schlesinger Library, Radcliffe Institute, Harvard College. Used with the permission of Dr. Jeanne Stellman.
The chance of publicity to pathogens like hepatitis B and HIV captured the eye of employees, and their unions, within the late Seventies and early Eighties. One article discovered that 7% of well being care employees reported a historical past of hepatitis, greater than twice the speed skilled by most of the people, due to publicity on the job.[xiii] The chance of transmission by way of needlesticks or coping with dirty laundry prompted the rise of common precautions, equivalent to sporting gloves when dealing with blood. In 1983, the CDC launched a “Guideline for An infection Management in Hospital Personnel.”[xiv] This was the primary time the CDC addressed this concern, an illustration of the gradual progress of security tradition in hospitals.
In an article printed in Occupational Well being Nursing in 1982, Jeanne Stellman, a distinguished researcher and the director of the Girls’s Occupational Well being Analysis Heart at Columbia College, highlighted the hazards of hospital work. Stellman was an necessary ally to each union and girls’s teams, and an necessary advocate for improved employee security. Within the article she famous that hospital employees had been injured at twice the speed of employees in different service industries. Nevertheless, it was doubtless that the numbers had been underreported, since workers didn’t at all times report their points. Stellman famous that “Staff … are sometimes too busy or untrained or have turn into so accustomed to those accidents that they neither report accidents nor search therapy for them in worker well being providers.”[xv]
Staff, too, needed to change the best way they did duties. Among the many issues recognized had been “inadequate and sloppy rubbish disposal services” and “improper pipetting practices” which uncovered employees to pointless dangers. An American survey discovered that 82% used their mouths when pipetting liquids “no less than often” and half of the respondents had at taken liquid into their mouth no less than as soon as. Staff who routinely used their mouths when coping with samples was a standard apply, and so they had thrice the chance of employees who had not ingested liquids. This concern may have been solved through the use of computerized pipettes however they “weren’t routinely offered or utilized in most hospital laboratories.”[xvi] Employers proved all too prepared to sacrifice employee well being and security if there’s a value concerned however employees, too, wanted to be attentive to their very own work tradition and be sure that they had been performing pretty much as good fellow servants.
An instance of protected pipetting.WOHRC Information, 4,4 (September 1982), 2. Schlesinger Library, Radcliffe Institute, Harvard College. Used with the permission of Dr. Stellman.
The historical past of occupational well being in well being care presents a wealthy alternative to discover the enlargement of occupational well being and security within the late 20th century to embody extra employees and a larger vary of points. Importantly, the efforts of employees and their unions additionally helped to enhance well being and security for different employees too, together with workplace employees and people within the service sector. Cumulatively, inspecting such employees, who’re the biggest a part of the labour drive, will end in new views on the historical past of of occupational well being and security.
Peter L. Twohig writes and reads historical past in Halifax, Nova Scotia. His present analysis is on the historical past of occupational well being since 1950, supported partly by a grant from the Social Sciences and Humanities Analysis Council. His newest e book, The Labour of Care, shall be printed in July 2026 by College of Toronto Press.
[i] For instance, a strike at Parkland nursing dwelling in Edmonton lasted for 4 years on the finish of the Seventies. A strike at Keddy’s Nursing House in Halifax lasted for 16 months over 1983 and 1984. In between these, there have been lengthy strikes in nursing properties throughout Canada. I discover a number of of those strikes in my forthcoming e book The Labour of Care (Toronto: College of Toronto Press, 2026). I’ve written beforehand in regards to the strike at Keddy’s in Twohig, “COVID-19 and the Labour of Care,” Acadiensis 50, 2 (Autumn 2021): 96-114.
[ii] Christo Aivalis, Greg Kealey, Jeremy Milloy, and Julia Smith, “Again to Work: Revitalizing Labour and Working-Class Historical past in Canada,” 21 September 2015. https://activehistory.ca/weblog/2015/09/21/back-to-work-revitalizing-labour-and-working-class-history-in-canada/
[iii] I discover a number of of those teams in The Labour of Care.
[iv] See an interview with Armstrong, at https://www.healthcoalition.ca/the-conditions-of-work-are-the-conditions-of-care-says-pat-armstrong/
[v] CUPE NS, https://storiesofcare.ca/
[vi] Eric Tucker, “Regulating Well being and Security and Capitalist Workplaces: Historical past, Practices and Prospects,” 2023. https://digitalcommons.osgoode.yorku.ca/all_papers/364/
[vii] There are too many high quality research to listing however for a superb current evaluation, see David Rosner and Gerald Markowitz, Constructing the Worlds That Kill Us: Illness, Loss of life, and Inequality in American Historical past (New York: Columbia College Press, 2024).
[viii] For an early historic account, see George Rosen, “On the historic investigation of occupational illnesses: An Aperçu,” Bulletin of the Institute of the Historical past of Drugs, 5, 10 (1937), 941-46. See additionally David Rosner and Gerald Markowitz, eds., Dying for Work: Staff Security and Well being in Twentieth Century America (Bloomington: College of Indiana Press, 1987); Alan Derickson, Black Lung: Anatomy of a Public Well being Catastrophe (Ithaca: Cornell College Press, 2014); and Robert Emil Botsch, Organizing the Breathless: Cotton Mud, Southern Politics, and the Brown Lung Affiliation (Lexington: College Press of Kentucky, 2014); Christopher C. Sellers, Hazards of the Job: From Industrial Illness to Environmental Well being Science (Chapel Hill: College of North Carolina Press, 1997).
[ix] See David von Drehle, Triangle: The Hearth that Modified America (New York: Penguin, 2011) and Kate Moore, The Radium Women: The Darkish Story of America’s Shining Girls (London: Simon & Schuster, 2016). Greenlees argues that on the flip of the twentieth century, cotton factories in Britain and the US, which employed massive numbers of ladies, had been “the primary manufacturing unit environments the place questions on well being at work and the forces that decided them got here to the fore.” Janet Greenlees, When the Air Grew to become Vital: A Social Historical past of the New England and Lancashire Textile Industries (New Brunswick: Rutgers College Press, 2019), 2. On compensation, important research would come with Eric Tucker, Administering Hazard within the Office: The Regulation and Politics of Occupational Well being and Security Regulation in Ontario, 1850-1914 (Toronto: UTP Press, 1990); Julia Moses, The First Fashionable Threat: Office Accidents and the Origins of European Social States (Cambridge: Cambridge College Press, 2018); Robert H. Babcock, “Blood on the Manufacturing facility Flooring: The Staff’ Compensation Motion in Canada and the US,” in Raymond B. Blake and Jeffery A. Keshen, eds., Social Material or Patchwork Quilt: The Growth of Social Coverage in Canada (Peterborough: Broadview Press, 2006; Michael J. Piva, “The Workmen’s Compensation Motion in Ontario,” Ontario Historical past, 67 (1975), 39-56.
[x] Hospital Occupational Well being Companies Examine. U.S. Division of Well being Training and Welfare, Public Well being Service, NIOSH, Division of Technical Companies, Vol. 1-7. Cincinnati, Ohio, 1976 and Robert Lewy, “Prevention Methods in Hospital Occupational Drugs,” Journal of Occupational Drugs, 23, 2 (February 1981), 109.
[xi] Robert Lewy, “Prevention Methods in Hospital Occupational Drugs,” Journal of Occupational Drugs, 23, 2 (February 1981), 109.
[xii] “The Hazards of Hospital Work,” Well being Alert, 3, 1 (October 1978), 1.
[xiii] “Well being and Security within the Scientific Laboratory,” Girls’s Occupational Well being Analysis Heart Information, 1,1 (Jan/Feb 1979), 2-3.
[xiv] “CDC’s new personnel well being guideline praised,” Hospital Worker Well being, 2, 9 (September 1983), 113
[xv] Jeanne Stellman, “Security within the Well being Care Business,” Occupational Well being Nursing, October 1982, 7. On Stellman, see Amanda Lauren Walter and Elizabeth Faue, “Within the Shadow of Tragedy: Jeanne M. Stellman and the Work of the Girls’s Occupational Well being Useful resource Heart,” Journal of Girls’s Historical past, 34, 1 (Spring 2022): 93-114.
[xvi] “Well being and Security within the Scientific Laboratory,” Girls’s Occupational Well being Analysis Heart Information, 1, 1 (Jan/Feb 1979), 2-3.
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