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CSA Z1003.1-2018

Psychological health and safety in the paramedic service organization


This is the first edition of CSA Z1003.1, Psychological health and safety in the paramedic service organization.

This Standard provides paramedic service organizations and other key stakeholders with guidance on good practice for the identification and assessment of hazards and management of psychological health and safety (PHS) risks for paramedic service organizations and the promotion of improved psychological health and safety.

This Standard builds on CAN/CSA-Z1003-13/BNQ 9700-803/2013, Psychological Health and Safety in the Workplace and provides a systematic approach to the management of PHS hazards and their related risks for paramedic service organizations and offers practical, relevant guidance to help protect and promote the psychological health and safety of workers in Canada.

In addition to following the structure of CAN/CSA-Z1003/BNQ 9700-803, this Standard is compatible with other management system standards, and the Plan-Do-Check-Act (PDCA) approach.

The Standard is an evidence-informed document that encompasses existing CSA Standards, government policy documents, peer-reviewed research articles, and non-peer-reviewed materials. The source materials are primarily from Canada, but a few from other countries have been included. Unlike an academic publication, in-text citations are not included with the Standard; a complete list of resources can be found in Annex J.

This Standard was commissioned by the Paramedic Association of Canada (PAC) and supported through funding from the Ontario Government’s Occupational Health and Safety Prevention and Innovation Program (OHSPIP).


1.1 Purpose

This Standard provides paramedic service organizations and other key stakeholders with requirements and guidance on good practice for the identification and assessment of hazards and management of psychological health and safety (PHS) risks for paramedic service organizations and the promotion of improved psychological health and safety.

This Standard is applicable to any paramedic service organization that seeks to

a) establish a program to eliminate and/or minimize workplace PHS risks to paramedics and other workers of the organization;

b) enhance psychological well-being;

c) implement, maintain, and continually improve a program for PHS;

d) assure itself of its conformity with its stated PHS policy; and

e) demonstrate conformity with this Standard.

1.2 Exclusions

This Standard is aimed at the employer (i.e., the paramedic service organization) and provides guidance at an organizational level. It does not provide guidance on the diagnosis and treatment of workplace-related mental health problems of workers.

While similar risk factors exist for other categories of first responders (i.e., firefighters, police officers) and public safety officers, workers in paramedic service organizations face unique issues directly associated with the nature of the care they deliver. Their exposure to trauma is different from other first responder and public safety workplaces. While this Standard could be used by other first responder organizations as a model for the development of PHS programs, the guidance provided in this Standard is specific to paramedic occupational environments.

It is not within the scope of the PPHS Standard to provide requirements for equipment and vehicle design, equipment standards, workplace ergonomics, personal protective equipment (PPE), or emergency management programs.

1.3 Guiding principles

This Standard is based on the following guiding principles:

a) legal requirements associated with psychologically healthy and safe workplaces applicable to the organization will be identified and complied with as a minimum standard of practice;

b) psychological health and safety is a shared responsibility among all workplace stakeholders and commensurate with the authority of the stakeholder;

c) the workplace is based on mutually respectful relationships among the organization, its management, its workers, and worker representatives, which includes maintaining the confidentiality of sensitive information;

d) individuals have a responsibility towards their own health and behaviour;

e) a demonstrated and visible commitment by senior management for the development and sustainability of a psychologically healthy and safe workplace;

f) active participation with all workplace stakeholders;

g) organizational decision making incorporates psychological health and safety in the processes; and

h) a primary focus on psychological health, safety, awareness, and promotion as well as the development of knowledge and skills for those persons managing work arrangements, organization, processes, and/or people.

Activities associated with this Standard, specifically related to planning, data collection, and evaluation requirements, are to be conducted in a psychologically safe, confidential, and ethical manner.

Note: In support of developing guiding principles and values consistent with their mission and vision and local environment, paramedic service organizations should consider the following:

a) occupational and operational stressors for paramedic workers can have a significant impact on their lives, personal and professional relationships, potentially affecting co-workers, patients, families, and friends. Paramedic service organizations should take an integrated, holistic, and broad approach, including how to involve family members where applicable. Prevention strategies should be part of a support continuum and include all of those individuals who could be impacted (family could include other significant individuals outside of the workers’ immediate family members (e.g., partner, significant other, care-taker, etc.);

b) paramedic service organizations need to consider strategies to identify hazards and workplace factors and risk assessment to control risk at the organizational, team, and worker level. Some workplace factors and inherent risk are part of the paramedic role. Strengthening protective measures can help to mitigate the impact of the hazards where and when they occur and can promote psychological health and safety on many levels; and

c) mental health difficulties can affect a paramedic worker at any point in his/her career. The paramedic service organization should consider the psychological health and safety of the workers at all times in their career (e.g., recruitment, operational service, promotion, return-to-work, and leaving the service).

1.4 Terminology

In this Standard, "shall" is used to express a requirement, i.e., a provision that the user is obliged to satisfy in order to comply with this Standard; "should" is used to express a recommendation or that which is advised but not required; and "may" is used to express an option or that which is permissible within the limits of this Standard.

Notes accompanying clauses do not include requirements or alternative requirements; the purpose of a note accompanying a clause is to separate from the text explanatory or informative material.

Notes to tables and figures are considered part of the table or figure and may be written as requirements.

Annexes are designated normative (mandatory) or informative (non-mandatory) to define their application.

Content Provider
CSA America, Inc. [CSA]


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