Questions and answers – respiratory infectious diseases and COVID 19

In accordance with the Direction de la santé publique’s recommendations, it is no longer mandatory to self‑isolate for 5 days following exposure to or infection with COVID‑19.

Steps for limiting the spread of respiratory infectious diseases (COVID‑19, influenza, etc.) are summarized on the Steps for limiting the spread of respiratory infectious diseases web page.

The CNESST is not responsible for determining who must self‑isolate or for how long.

If warranted by the circumstances, in particular the length of the absence or its repetitive nature, an employer may request a document, such as a medical certificate.

To prevent the spread of the virus, workers are advised to use their judgement before going to hospitals and medical clinics (public or private).

In the event that an employer asks a worker to leave during their shift to obtain a medical certificate or to comply with any other requirement, their travel time should be paid. Under the Act respecting labour standards, a worker is deemed to be at work if their travel is required by their employer and any time worked must be paid.

If the worker remains available to the employer and performs their work, for example by teleworking, while waiting for the document attesting to their medical condition to be issued, they must be paid during this time.

Wearing a quality mask, maintaining a minimum distance between people in the workplace and physical barriers are no longer mandatory, but they are still recommended to prevent respiratory infectious diseases (COVID‑19, influenza, etc.).

As a precaution, wearing a mask and hand hygiene (washing hands with soap and water or using a hand sanitizer with at least 60% alcohol) are highly recommended, especially in the presence of respiratory symptoms, when interacting with people at risk or for tasks where people are required to gather in a confined space.

It should be noted that, under their right to manage, an employer may require their staff to comply with additional preventive measures, including wearing a quality mask in the workplace.

In this context, the CNESST proposes additional preventive measures to workplaces in its Workplace Guide to Sanitary Standards (in French only) that can be included on a voluntary basis, in whole or in part, in the preventive measures plan. Workplaces may decide to put them in place to increase worker protection depending on the circumstances, for example:

• if multiple positive COVID-19 cases or several cases of respiratory infection (e.g. flu) are confirmed in the workplace
• when the absenteeism rate is high
• when in close contact with co‑workers or clients
• when recommended by Public Health (e.g., press conference, public advisory)

The proposed additional measures are summarized in a table.

Telework has no longer been mandatory since February 28, 2022.

The organization of work and the arrangements for telework are part of the employer’s right to manags (in French only). Telework is strongly recommended if the worker has a fever or respiratory symptoms in order to reduce the chances of infecting their co‑workers.

Information and awareness‑raising tools are available on the Work remotely page.

The CNESST is the government body in charge of administering the occupational health and safety plan. In terms of prevention, it is responsible, in particular, for ensuring compliance with the Act respecting occupational health and safety (AOHS) and its regulations and ensuring the management of occupational health and safety by workplaces.

Inspectors intervene in workplaces, in particular in the following cases:

• to ensure compliance with the AOHS and its regulations
• when the right to refuse to work is exercised in accordance with the AOHS
• a complaint
• a serious work accident

They may also require, where applicable, hazardous situations to be corrected and verify compliance with the AOHS and the regulations. Thus, they may intervene to check whether the employer has put in place the preventive measures required to protect the health and safety of workers.

To support workplaces in the management of occupational health and safety, the CNESST has developed awareness‑raising and information tools. These tools were developed by the CNESST in collaboration with employers and trade unions and in partnership with the Direction générale de la Santé publique and the Institut national en santé publique du Québec (INSPQ) in order to address the concerns of workplaces in various sectors of activity regarding the measures to be put in place to prevent the spread of the virus.

• Workplace Guide to Sanitary Standards (in French only)
• Guide to health recommendations in public and private residential and health care facilities (in French only)

Prevention‑inspection inspectors also provide support to address concerns and provide information to workplaces, in particular on employers’ and workers’ obligations with respect to the preventive measures that must be put in place to reduce the biological risk associated with respiratory infectious diseases that may affect workers’ health. For this service, you must contact the CNESST’s general number and ask to speak with an inspector on call at 1 844 838‑0808, option 1.

Yes, an employer must take the necessary measures to protect the health and ensure the safety and physical and psychological well‑being of workers, as provided for in section 51 of the Act respecting occupational health and safety (AOHS). To do this, the employer must take measures to identify, control and eliminate this biological risk. Here are some examples of preventive measures the employer can take to reduce these risks:

• Encourage telework in hybrid mode, where possible
• Develop a procedure for excluding workers who have symptoms of respiratory infectious diseases from the workplace
• Encourage physical distancing of at least 2 metres
• Encourage the use of effective physical barriers at certain work stations (e.g., when there is brief contact with several people)
• Make quality masks available and ask people to wear them when interacting with vulnerable workers or for tasks where people are required to gather in a confined space
• Provide, if deemed appropriate by the employer in collaboration with workers, designated spaces for workers whose health is vulnerable, such as people who have a chronic disease or are immunosuppressed
• Promote handwashing and respiratory etiquette (cough and sneeze into a tissue or your elbow)
• Prepare a plan for increased preventive measures in anticipation of periods of high transmission. Additional measures are proposed in the CNESST’s Guide to Sanitary Standards in French only)

Workers should be informed of the risks and the preventive measures taken to reduce and control them.

In accordance with section 49 of the AOHS, workers must take the necessary measures to ensure their health, safety or physical or psychological well‑being and ensure that they do not endanger the health, safety or physical or psychological well‑being of other people at or near their workplace.

Suppliers, subcontractors, partners and clients have been informed by the employer of the measures implemented in the company and have been made aware of the importance of complying with these measures :

Basic Public Health hygiene measures

• Wash your hands often with warm running water and soap for at least 20 seconds.
• Use an alcohol‑based disinfectant if you do not have access to soap and water.
• Observe hygiene rules when you cough or sneeze.
• Cover your mouth and nose with your arm to reduce the spread of germs.
• If you use a tissue, throw it away as soon as possible and then wash your hands.
• Avoid direct contact for greetings, such as handshakes, and use other practices instead.
• Respect physical distancing.

For more information, please consult the COVID‑19: Occupational health factsheets produced by our partner, the Institut national de santé publique du Québec.

Yes, an employer can take additional preventive measures. They can ask a worker not to report for work if they represent a risk of contamination for other workers and deny them access

Vaccination status is personal and confidential information. A worker is not required to disclose this information.

A worker may voluntarily show their vaccination status to their employer. The employer must keep this information confidential.

Workers must take the necessary measures to ensure their health, safety or physical or psychological well‑being and see that they do not endanger the health, safety or physical or psychological well‑being of other people at or near their workplace. A worker who is experiencing symptoms should contact their employer to inform them of this.

The employer must ask the worker about the risk factors underlying the need for isolation. If the employee refuses to comply, the employer may inform them that administrative or disciplinary action may be taken.

For more information, go to the Government of Quebec’s COVID‑19 page.

In conclusion, it is important to note that the employer must take all the necessary measures to protect the health and ensure the safety and physical and psychological well‑being of the worker (s. 51, AOHS). They may choose the means they will use to comply with this obligation.

Workers whose health is vulnerable are not prohibited from working. The INSPQ has developed recommendations (in French only) to protect workers who are likely to develop complications as a result of a COVID-19 infection because of their age or a chronic disease.

Workers who are likely to develop complications as a result of an infection can talk to their employer to find out how their work environment can be modified.

Section 32 of the Act respecting occupational health and safety (AOHS) provides for the possibility for a worker who is exposed to a contaminant to be assigned to tasks where there is no exposure. For this to happen, the worker must provide their employer with a medical certificate attesting that exposure to the contaminant is hazardous for them because their health shows signs of being adversely affected. Their employer must assign them to other tasks where they are not exposed to the hazard. If the employer cannot assign them to other tasks, a request for preventive withdrawal may be made to the CNESST.

However, this recourse requires a medical assessment confirming that the worker’s health has been adversely affected. In the case of COVID‑19, the change in the worker’s state of health means that they are already infected with the virus. This recourse provided for in section 32 of the AOHS is not appropriate in the case of COVID‑19.

In addition, if a worker who has COVID-19 believes that they were infected as a result of or in the course of their work, they may be entitled to compensation under the Act respecting industrial accidents and occupational diseases (AIAOD).

For any COVID-19 claim, the worker must consult a doctor to obtain a medical certificate confirming the diagnosis.

A worker can file a complaint or report a hazardous situation. The complaint will be processed in order to assess the risk and determine if corrective and control measures need to be put in place. To do this, the worker must call the CNESST’s general number and ask to speak with an inspector on call at 1 844 838‑0808. This recourse is voluntary and confidential.

A worker has the right to refuse to perform work if they have reasonable grounds to believe that the performance of that work would expose them to a danger to their health, safety or physical or psychological well‑being or may expose another person to a similar danger, as provided for in section 12 of the Act respecting occupational health and safety (AOHS). The worker may not, however, exercise their right under section 12 if their refusal to perform the work puts the life, health, safety or physical or psychological well‑being of another person in immediate danger or if the conditions in which the work is performed are normal in the type of work they perform, as provided for in section 13 of the AOHS.

Should a worker refuse to work, a CNESST inspector will promptly determine if there is any danger and will make sure that the procedure set out in the AOHS has been followed, i.e., that the worker has notified the immediate superior, the employer or their representative, and has informed the union association representative or the safety representative, as applicable.

Furthermore, the AOHS also provides for preventive withdrawal for pregnant or breastfeeding women through its For a Safe Maternity Experience (in French only) (SMEP) program and aims to ensure that pregnant or breastfeeding workers can continue to work safely.

Section 12 of the Act respecting occupational health and safety (AOHS) provides that a worker has the right to refuse to perform work if they have reasonable grounds to believe that the performance of that work would expose them to a danger to their health, safety or physical or psychological well‑being or may expose another person to a similar danger

The reason given here cannot justify a right of refusal because it is not related to the conditions the work is performed in, but rather to the medical condition of a third party. The situation is not related to the workplace. The criteria to exercise a right of refusal are not met.

With respect to occupational health and safety, the INSPQ has defined groups of workers who have a higher risk of developing complications related to COVID‑19.

The lists of personal conditions at risk of complications from COVID-19 can be found in the interim recommendations published by the INSPQ:

• For workers with a chronic disease (in French only)
• For immunosuppressed workers (in French only)

Workers who are likely to develop complications as a result of an infection can talk to their employer to find out how their work environment can be modified.

If in doubt, the person should consult their doctor.

Pursuant to section 45.1 of the Regulation respecting occupational health and safety (ROHS), the CNESST requires RPE used in the workplace to be certified by NIOSH. However, administrative guidelines may allow for exceptions.

The CNESST accepts the use of RPE from other approval frameworks in accordance with their approval framework and the manufacturers’ guidelines. The RPE authorized in workplaces is as follows:

• Approved by NIOSH (other types of RPE)
• Certified by the CSA under Program 7204‑01, 7204‑02 and 7204‑0
• Approved by Health Canada when a quality monitoring mechanism involves a competent external laboratory (e.g., IRSST)

The employer must take the necessary measures to protect the health and ensure the safety and physical and psychological well‑being of the worker as provided for in section 51 of the Act respecting occupational health and safety.

Some RPE that provides equivalent protection may, for example, require additional training and very likely additional fit testing to ensure a proper seal. A proper seal is necessary to limit infiltration that may expose the worker to the coronavirus or other contaminants in the air. It should be noted that the same fit test is valid when the manufacturing process is identical, regardless of the origin of the RPE certification. This information can be obtained from the manufacturer.

In some cases, technical solutions to reduce worker exposure (e.g., water abatement, ventilation and containment) or administrative measures (e.g., distance) may be implemented. These solutions must be prioritized before resorting to the use of personal protective equipment. Following the implementation of these solutions, workers may no longer be required to wear RPE to protect themselves from contaminants in the air.

Wearing a quality mask is no longer mandatory. However, it is still recommended, especially when interacting with vulnerable workers and for tasks where people are required to gather in a confined space. Under their right to manage, an employer may require their workers to wear a quality mask in the workplace.

For health care workers, see the question What are the minimum protective equipment requirements for workers in health care settings?

To protect workers from respiratory infectious diseases such as COVID‑19, the following quality masks can be used:

1. Medical masks that comply with standard ASTM F2100 or EN 14683 Type IIR
2. Any respiratory protective equipment (RPE) with a particulate filter as defined in the standard Selection, use and care of respirators (CSA Z94.4‑18), such as an N95 or P100 respirator

Protective eyewear is optional. However, it may be required to comply with current regulations or in some workplaces, when performing some tasks.

Masks with a window allow people to see workers’ lips. This type of mask makes it easier for people who are hard of hearing to understand. It also promotes speech development in children during their development. For these masks to be acceptable, they must meet the same quality criteria applicable to quality masks without windows. The criteria are as follows:

• Standard ASTM F2100 (all levels are acceptable for general workplaces)
• Standard EN 14683, Type IIR

At this time, health care workers are required to wear a disposable N95 mask or respiratory protective equipment (RPE) that provides superior protection if they work in a health care setting with users at high risk of COVID-19 or with suspected or confirmed COVID‑19. To ensure that the performance of this RPE is optimal, a respiratory protection program including a fit test and training on how to wear and maintain it must be implemented. RPE may, however, be necessary in cases where workers are already using particulate‑filtering respirators (e.g., N95 or P100) to protect themselves from another contaminant in the workplace. Note that these respirators will also protect workers from the COVID-19 virus.

The Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST) requires all health care workers (health care, maintenance, security, etc.) working in the same room as a user at high risk of COVID 19 or with suspected or confirmed COVID-19 to wear an N95 respirator or respiratory protective equipment (RPE) that provides superior protection.

Measures for users at low risk of COVID‑19

• For all health care settings, unless otherwise directed by the employer, a medical mask is not required when performing tasks in the same room as a user at low risk of COVID‑19.
• Protective eyewear is optional. However, it may be necessary for other considerations, such as when there is a risk of being splashed by bodily fluids.

Additional measures for users at moderate risk of COVID‑19

• For all workers, appropriate personal protective equipment for the level of risk is provided and worn:
  • an ASTM F2100 Level 2 or EN 14683 Type IIR medical (procedure) mask that must be worn.
  • Protective eyewear is optional. However, it may be necessary for other considerations, such as when there is a risk of being splashed by bodily fluids.

Additional measures for users at high risk of COVID-19 or with suspected or confirmed COVID‑19

• For all workers (health care, maintenance, security, etc.) working in the same room as a user at high risk of COVID-19 or with suspected or confirmed COVID‑19:
  • Appropriate personal protective equipment for the level of risk is provided and worn:
    • N95 respirator RPE that provides superior protection;
    • protective eyewear (safety goggles or visor that covers the face down to the chin or RPE with integrated eye protection);
    • non‑sterile long‑sleeved gown (single use or washable). Provide a waterproof gown if there is a risk of contact with bodily fluids such as vomit;
    • non‑sterile single‑use gloves that fit snugly and cover the wrists;
• Workers who are required to perform tasks with this equipment are adequately trained to use RPE and a fit test is done before RPE is used.
   
• To avoid contaminating the work environment when removing personal protective equipment, it must be removed in accordance with the recommended procedure [see ASSTSAS (in French only) or PHAC (in French only) document (pp. 188‑189)]. By using the correct technique to remove the equipment, the worker can also avoid contaminating themselves.

Additional precautions if entering a room where aerosol-generating medical procedures are performed - user at high risk of COVID-19 or with suspected or confirmed COVID‑19:

• The equipment already required (protective eyewear, long‑sleeved gown and gloves), an N95 respirator or RPE that provides superior protection are worn if entering a room where aerosol‑generating medical procedures (AGMPs) are performed. Workers who are required to perform these procedures are adequately trained to use RPE and a fit test is done before RPE is used;
• Procedures are limited to those that are absolutely necessary. Indications for care are reassessed as needed or a medical assessment is carried out to see if an alternative care solution is possible;
• Perform these procedures in a single‑patient room and keep the door closed. Limit the number of people present during the AGMP and immediately afterwards as much as possible;
• Consider adding further measures to temporarily improve ventilation, including opening a window, turning on the bathroom exhaust fan and adding a high efficiency air filter;
• After an AGMP, the required wait time must be observed in accordance with the ventilation characteristics of the room (number of air changes per hour for an elimination rate of 99.9%) before entering the room without the required personal protective equipment. If the number of air changes is unknown, a wait time of around six hours is recommended;
• For more information, refer to the document Aerosol‑generating medical procedures in suspected or confirmed cases of COVID‑19 (in French only) produced by the Institut national de santé publique du Québec (INSPQ).

A decision support tool (in French onnly) regarding the minimum mask requirements for workers in health care settings is available to identify the level of risk that each user represents.

No, a non‑certified homemade face covering or non‑medical mask is not equivalent to a medical or procedure mask. Recent studies have shown that the filtration efficiency of face coverings varies greatly (from negligible to acceptable) from one model to another and can decrease following multiple wash cycles.

Although the features of KN95 and NIOSH‑certified N95 masks are very similar in terms of their performance criteria (e.g., filtration efficiency and breathability), there are differences between a KN95 mask and an N95 mask in the design of the straps (around the ears rather than at the back of the head) and in the consistency of the characteristics of the mask materials. In these circumstances, the prerequisites for using these masks (successful fit test) are only very rarely met. Thus, these masks do not meet the requirements to be used as a replacement for N95 masks. Nor can they be used by workers as a replacement for medical masks in the workplace. Indeed, these masks are not quality masks given the variability of several models in terms of their filtration capacity.

No. However, some CNESST‑approved First Aid in the Workplace course service providers offer hybrid training, i.e., an online theory component (8 hours) and an in‑person practical component (8 hours), since it is essential in order to learn the manoeuvres, while respecting the guidelines issued by the public health authorities.

Only organizations recognized by the CNESST as a service provider can offer the First Aid in the Workplace course.

Consult the provincial list of organizations that offer the first aid in the workplace course (in French only).

If there are no workers on site and if none of the workers has to come to the establishment at any time (e.g., to drop off documents, pick up equipment, pick up a car, etc.), a first aider does not have to be present.

Yes. You have the right to be absent from work if you are sick. While you are absent, your employment relationship is protected.

Total sick leave must not exceed 26 weeks over a period of 12 months.

If you have been working for your employer for at least 3 months, the first 2 sick days you take during a calendar year (January 1 to December 31) are paid. They may not be deferred from one year to the next or be replaced by an indemnity.

Beyond these first 2 days taken annually, the Act respecting labour standards does not require an employer to pay a worker while they are absent. It is the employer’s choice to grant a higher number of paid days of absence.

Go to the Non–work related illness or accident page for more information.

Yes. If you have been working for your employer for at least 3 months, you are entitled to a total of 2 days of paid leave per calendar year (January 1 to December 31) for any of the following reasons:

• to fulfil family obligations relating to the care, health or education of your child or your spouse’s child
• to fulfil family obligations as an natural caregiver with a relative or another person owing to their state of health
• in the event of a non–work‑related illness or accident
• for organ or tissue donation
• following domestic or sexual violence or a criminal offence

These days may be divided into hours if authorized by the employer.

They may not be deferred from one year to the next or be replaced by an indemnity.

Beyond the first 2 days taken annually, the Act respecting labour standards does not require an employer to pay a worker while they are absent. It is the employer’s choice to grant a higher number of paid days of absence.

Yes, workers who become infected with COVID-19 as a result of or in the course of their work may be entitled to the usual benefits and services provided under the Act respecting industrial accidents and occupational diseases (AIAOD).

For any claim received on or after March 1, 2023, the worker must consult a health professional to obtain a medical certificate confirming the diagnosis and submit a claim.

The worker’s claim will then be processed according to the usual parameters. The worker must inform their employer as soon as possible.

The worker must demonstrate that they came into contact with the virus as a result of or in the course of their work. The work connection must be demonstrated in a preponderant manner.

Staff in the health network must submit a document to the CNESST that shows a positive COVID-19 test result. The document must come from a designated test centre or a laboratory in the health and social services network.

In the event of a claim for the death of a worker who contracted COVID-19 as a result of or in the course of their work, the CNESST may pay death benefits to the worker’s family (spouse and dependants). To be entitled to the worker’s death benefits, the worker’s spouse, child or other dependant must complete the Worker’s claim form. The beneficiary must complete the form within 6 months of the worker’s death or within 6 months of the date on which it is brought to their attention that the worker’s death may be work related.

Once the claim has been accepted, the worker could claim, in particular, the reimbursement of expenses for medical assistance (e.g., medication), travel expenses, accommodation expenses, etc.

To do this, the worker must complete the Application for reimbursement of expenses (in French only) form online.

If they become unable to work, they may be entitled to an income replacement indemnity.

No, only the worker who contracts the disease because of their work can be compensated.

Yes, a worker who was vaccinated against COVID‑19 in the course of their work and who develops an injury after getting the vaccine may be entitled to the benefits provided for in the Act respecting industrial accidents and occupational diseases (AIAOD).

For any claim, the worker must consult a doctor to obtain a medical certificate that specifies the diagnosis of the injury that resulted from vaccination.

The worker must inform their employer as soon as possible.

In particular, the worker must demonstrate in a preponderant manner that the vaccine was administered as a result of or in the course of their work. Furthermore, the causal relationship between the injury and vaccination must also be demonstrated in a predominant manner.

The CNESST’s decision will take into account the particularities inherent to each claim.

As with any other type of employment injury, a worker who wishes to receive compensation following a work accident must complete the Worker’s claim form online.

The INSPQ has updated its recommendations for pregnant or breastfeeding workers. They no longer refer to the pregnant worker’s vaccination status.

It is the employer’s responsibility to find out what the public health recommendations are and to ensure they are complied with.

It should be noted that the worker is not required to inform their employer of their vaccination status and their previous infections with the COVID-19 virus and the employer cannot require them to do so.

• To request a reassignment to tasks that are not hazardous, a pregnant or breastfeeding worker must:
  • Consult the professional who is providing their pregnancy care or postnatal care as quickly as possible;
  • Obtain a reassignment or preventive withdrawal certificate for a pregnant or breastfeeding worker;
  • Submit the reassignment or preventive withdrawal certificate to their employer.
• The employer must then reassign the worker in accordance with the recommendations in the Reassignment or preventive withdrawal certificate for a pregnant or breastfeeding worker (in French only).
• The employer may offer a reassignment at any time during the worker’s pregnancy or while they are breastfeeding. They may reinstate the worker in their position at any time if the hazards the position presented have been eliminated.
• If the employer is unable to offer the worker a reassignment, they may opt for preventive withdrawal.

The CNESST reiterates the importance for workers to receive the care and treatments required by their condition. It encourages the search for reasonable ways to ensure access to medical assistance and to meet the needs of workers.

Teleconsultation, in accordance with the guidelines provided by professional orders, is a solution that will continue to be allowed.

When appropriate for workers’ situation and condition, the CNESST accepts that they may have remote treatments or consultations provided they comply with the rules issued by professional orders.

For the attendance register, it is recommended that clinics and care providers obtain an email from the worker confirming their participation in a virtual session.

Documents can be sent by mail to the following address:

CNESST C. P. 1200, succ. Terminus Québec (Québec) G1K 7E2

Yes, it is still possible for workers and employers to contest a decisionn.

The CNESST encourages workers and employers to register on the Mon Espace CNESS (in French only) secure site. This will ensure that all communications with the CNESST are done safely.