In February of this year, Quebec's workplace health and safety board (CNESST) ordered that health workers in COVID-19 hot zones must wear N95 masks.
According to documents obtained by Radio-Canada's Enquête, this measure was recommended by the board's partner research organization 10 months earlier.
The Robert-Sauvé research institute on health and safety in the workplace — known by its French acronym IRSST — is a private, non-profit organization primarily funded by the CNESST.
The institute offers research-based recommendations to the CNESST and the two organizations share the same board of directors.
Radio-Canada reports that as early as April 2020, the research institute shared the opinion with the workplace safety board that health workers coming into contact with COVID-19 positive patients should all be wearing N95 masks.
These communications were obtained through an access to information request.
On April 9, 2020, the institute told the CNESST that even though the scientific data on airborne transmission was incomplete, N95 masks should be worn as a precaution for health workers.
Last summer, Quebec Director of Public Health Dr. Horacio Arruda ordered that N95 masks be used sparingly and restricted to certain medical interventions such as intubation.
May 19, 2020, the institute wrote a second time to the CNESST, "reiterating the importance of applying the precautionary principle by increasing, not only their level of respiratory protection, but also all direct and indirect protective measures in the workplace."
On Oct. 14, 2020, the institute wrote for a third time of its conclusion that wearing an N95 mask is necessary in any location where there are multiple cases of COVID-19 suspected or confirmed.
Nicolas Bégin, a spokesperson for the CNESST, confirmed in an email that the board solicited these opinions from the IRSST and that, according to these opinions, the scientific data remained incomplete.
Unions pushing for more protection
The debate over whether or not to supply health workers with N95 masks has gone on throughout the pandemic, with one of the province's largest health unions launching a legal challenge to try and force the CNESST to make it mandatory.
The legal challenge, heard before the Quebec Superior Court, demanded that the CNESST order employers to provide health workers with more personal protective equipment (PPE).
The union, the FSSS-CSN, represents around 100,000 workers in the public health network.
Judith Huot, vice-president of FSSS-CSN, said she was shocked to learn that the CNESST's research institute partner had made this recommendation 10 months ago.
"Especially since it comes from the CNESST's own scientific body," she said. "It raises a lot of questions."
Linda Lapointe, vice-president of the province's largest nurses' union, the FIQ, told Radio-Canada that she is "outraged."
"Particularly when we see that, as of April 9, the IRSST recognized a risk of airborne transmission and recommended applying the precautionary principle."
During the first wave of the pandemic, health workers were hit hard by the virus, with one quarter of COVID-19 positive patients coming from the health-care sector.
This represents a risk of contracting the virus 10 times higher for health workers than for the general population.
Since then, the rate of infection for health workers has decreased to 14.6 per cent, but this is still higher than the national average, at 9.5 per cent.