FIQ (Fédération Interprofessionnelle de la santé du Québec)

Covid-19 : Preventive withdrawal (protective reassignment)

New INSPQ recommendations

On December 22, 2021, the Institut national de santé publique du Québec (INSPQ) updated its recommendations regarding the preventive withdrawal of pregnant workers in the context of COVID-19. With the emergence of the Omicron variant, the INSPQ is tightening the criteria for determining whether an assignment is safe or not. Pregnant workers must be removed from their assignment if the conditions set out on page 27 of the above hyperlinked document cannot be met. 

The FIQ maintains that to be safe during a pandemic, precautionary principles must be applied when assigning or reassigning pregnant workers.

This document answers six questions about the risks of transmission and the impact of the disease on pregnant women’s health, the outcome of the pregnancy and the impact on the newborn’s health. Several information sources were used to answer these questions: recommendations from government organizations, specialty organizations, expert opinions, and original articles of interest published in scientific journals. The answers to these questions leave no doubt as to the significant dangers of this disease, especially for pregnant workers.

The INSPQ also points out that quality masks (ASTM level 1 or above) are effective in blocking aerosols. The FIQ’s Occupational Health and Safety Sector states that only N95 RPDs or superior are effective against aerosols. Moreover, the Administrative Labour Tribunal (TAT) sided with the FIQ’s reasoning in a ruling in March 2021.

Steps for a safe reassignment

Here are the steps for pregnant healthcare professionals to follow a safe reassignment.

A worker who becomes pregnant and does not already have a preventive withdrawal for the pregnant worker and is exposed to hazards must:

  • Analyze the hazards for her work position. She can ask her union for help in identifying the hazards. This help can be crucial, especially in the context of hazards related to COVID-19;
  • Quickly meet with a physician of her choosing to inform them of these hazards. The physician must produce a RPTE certificate after consulting the regional public health authority or institution’s physician. The certificate is the foundation for the right to the preventive withdrawal for the pregnant worker. This step is decisive for the rest of the process.

Once the certificate is submitted, the employer must assign the worker to duties without hazards or else remove her from work.

  • If the employer assigns the worker to duties that are exposed to hazards identified on the certificate, such as risks of contracting COVID-19 for example, then the worker must ask the Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST) to study the matter and to make a statement on the compliance of the assignment.
  • If the employer assigns the worker to duties that have new hazards that weren’t identified on the certificate, the worker must identify these hazards and once again consult her physician to obtain another certificate that specifies these new hazards.
  • If the worker believes she is exposed to hazards despite an assignment that complies with the certificate, she must contact her union and ask the CNESST to investigate it.

A worker who was already on a preventive withdrawal, but the employer decides to return her to her position or offer her a new assignment must: 

  • Analyze the hazards for her work position or her new assignment. She can ask her union for help in identifying the hazards. This help can be crucial, especially in the context of hazards related to COVID-19;
  • Consult the CNESST if it concerns hazards that were already specified on the initial certificate;
  • Recontact the physician to obtain another certificate if there are new hazards.

The CNESST’s decision, which must study the compliance of the assignment, can be reviewed within ten days. A worker who undertakes this process could go without pay if she refuses to work to not be exposed to the hazards. The FIQ can offer financial support in these situations. It is important to contact your local union if you want to take these steps. 

Healthcare professionals who have doubts about the safety of the proposed reassignment must contact their local union.

Frequently asked questions

To learn more about a protective reassignment for the pregnant or breast-feeding worker:

Note :The following documents are used in a normal situation. We feel it is important in the current rapidly evolving context, to give a warning to this effect.