Canadian Medical Association Journal 1996; 155: 1735-1736
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© 1996 Nancy Robb
"We're never going to see another project of this size here," says the president of the Medical Society of Prince Edward Island. "It's the biggest occupational health and safety job this province will probably ever see. I just wanted to play some part in it."
Cameron, a family physician in Summerside, PEI, doubles as medical adviser to Strait Crossing Inc., the company building the 12.9-km bridge that will span the Northumberland Strait between Borden, PEI, and Jourimain Island, NB.
With about 80% of the Confederation Bridge in place this fall, the "fixed link" is scheduled to open May 31, 1997. Until a similar project is completed in Japan, the $840-million span will hold the title as the longest bridge in the world.
On a cloudy afternoon in mid-September, Cameron leaned against the wall in the first-aid station at the Borden construction site and discussed occupational health issues related to the project. The former head of emergency medicine at Summerside's Prince County Hospital has had an interest in occupational health and safety since he did an elective in offshore medicine during his second year of medical school at Dalhousie University.
At the time he worked with Offshore Medical Associates, which provided medical advisory services to nurses working on the oil rigs off the shores of Sable Island. He drew on that experience to help establish standing orders and treatment protocols for the six nurses who, along with four emergency medical technicians, provide around-the-clock coverage for the more than 2000 people working at the Borden site.
When he took the job, Cameron anticipated he'd see more major traumatic injuries. Industry data had suggested there would be one fatality per kilometre of bridge, but since construction began in 1993 only three employees have died on the job. "Certainly by those standards, we've done very well," Cameron says.
One death was caused by equipment failure and another by human error; an inquest has yet to be held for the third, which occurred last spring. Another employee suffered a very serious injury when oil under high pressure blew out his eye, says Cameron, but "the big surprise is how few big traumas there have been. That was the thing I had been worried about."
It's not difficult to see why potential accidents would cause such concern. The massive reinforced-concrete components are constructed at the 60-hectare Borden site, then moved to sea and installed in sequence by a 96-m-high, two-hulled crane. Each bridge segment includes a pier base that is 35 to 40 m high, a pier shaft 40 to 60 m high, a 190-m-long girder and a drop-in span. "It's built like a giant Lego set," Cameron explains.
During our interview, a pier base was parked at the end of the jetty awaiting the crane. Girder 44 had already been installed, and a few more were lined up near the wharf. "The whole bridge will be connected by the end of November," says Darren Gardiner, the safety coordinator.
Cameron has seen about 50% of employees who have gone through the first-aid station, which usually attracts visits from three or four workers a day. The standing orders and treatment protocols allow the nurses, who have extensive experience in emergency medicine, to handle matters like flushing out eyes, dressing burns and administering medications.
Cameron and the two duty nurses have found that many cases involve abrasions, concrete or metal debris in eyes, sprains, back strain and repetitive-strain syndrome among workers who tie the heavy wire that reinforces the concrete. About one employee a week is sent for emergency care, often for possible broken bones or similar injuries resulting from a fall.
Cameron says the low incidence of major trauma "means the other part of the safety program has been working very well. . . . Safety is very important to most of [the workers]. There's really not a lot of problems getting them to stick to safety rules. They take [their coworkers'] safety personally as well."
Safety manager Wayne James, who oversees the medical unit and seven safety coordinators, says all employees attend an orientation briefing that covers safety attire, equipment and procedures, hazardous materials and back-injury prevention. Other education programs deal with crane-related hazards, first aid, respirators and fall-prevention equipment.
James says the medical team and safety coordinators have also been put through a battery of simulated rescues. One exercise involved removing a worker with a spinal-cord injury from the inside of a pier shaft on the water and transporting him by helicopter to the hospital in Summerside.
In an emergency, he says, a call is made over a designated radio channel and all medical personnel and safety coordinators on duty "converge on the scene. . . . When we do get to the scene, it's the nurse's call. We may argue with them afterwards, but they make the call."
For the nurses and for Cameron, the Strait Crossing project has offered a nice change. "The patients that you see for the most part are healthy," Cameron says. "Occupational medicine and sports medicine are very similar. The type of injuries you deal with are strains, sprains, pulled ligaments and that type of thing."
Employees, he said, "just want to get in, get it fixed and get back to work."