Occupational asbestos exposure and development of gastro-intestinal cancers: Proposal instructions

Closing date: May 31, 2021 at 5:00 p.m. (EST)

To express interest and obtain an application form, please email grants@wsib.on.ca.

Section 1: Funding overview

The objective of the WSIB Grants Program is to enhance workers’ compensation system outcomes by supporting innovative proposals that are aligned to the WSIB’s strategic mandate.

This is accomplished through highly practical, expert research studies and training initiatives delivered by professional individuals and organizations that address current and emerging challenges, and strengthen Ontario's workers' compensation system now and in the future.

Systematic review grants support research issues of immediate relevance to occupational health and safety, and may help to answer key questions in workers' compensation. Outcomes from systematic reviews may be considered by the Workplace Safety and Insurance Board (WSIB) into determine whether the scientific evidence meets the recommended standards for scheduling, policy development or for adjudicative support in case-by-case decision-making reviewing the issue entitled for claims among workers.

Section 2: Funding opportunity

The WSIB is interested in one award for a systematic review of the scientific evidence examining if occupational asbestos exposure causes gastro-intestinal cancers.

Specifically, the review must address:

  • Gastro-intestinal cancers and the individual cancers (i.e. cancers of the esophagus, stomach, small bowel, colon and rectum)
  • Individual types of asbestos (i.e. chrysotile, crocidolite, amosite, tremolite, actinolite and anthophyllite) where possible
  • Identification of 
    • Any dose-response relationships
    • Interdependent causes or synergistic relationships 
    • Subgroups of workers who have an increased risk of developing gastrointentinal cancers and/or any of the individual cancers
  • Examine any evidence for a minimum interval (latency) between the first exposure to asbestos and the diagnosis of gastrointestinal cancer and/or any of the individual cancers

The review must follow established principles for conducting systematic reviews.

Refer to Proposal Instructions Appendix C for detailed requirements for the systematic review.

Required outputs

For the purpose of this research competition, a systematic review is considered to be a review of a clearly formulated question that uses systematic and replicable methods to identify, select and critically appraise all relevant scientific research, and to collect and analyze data from the studies that are included in the review. Methods used should also minimize bias and ensure results are reproducible. Statistical methods such as meta-analyses should be used, if appropriate, to analyze and summarize the results of the included studies.  A rationale and the appropriate supporting analysis should be clearly identified to validate the inclusion or exclusion of meta-analytic techniques.

This information may be considered by the WSIB to determine whether the scientific evidence meets the recommended standards for scheduling, policy development or for adjudicative support in case-by-case decision-making.

Eligibility criteria

1. Who can apply to the WSIB Grants Program?

The research team will require a minimum of three (3) team members including:

  • At least one member with a Doctorate in Epidemiology
  • At least one member who has formal training in toxicology or industry hygiene (Masters Level or PhD)
  • At least one member of the team must have demonstrated experience conducting systematic reviews including meta-analyses related to disease etiology

Expert researchers affiliated with an eligible applicant organization: 

  • Publicly funded universities or colleges 
  • Public hospitals with a specialized research area 
  • Not-for-profit or registered charitable organizations with the capability and capacity to conduct research 
  • Canadian non-governmental organizations with the capability and capacity to conduct research 
  • Other organizations that have the capability and capacity to conduct research and are not privately owned and operated may also be eligible for a WSIB grant. 

Private organizations are not eligible to apply for a WSIB research grant as a Project or Secondary Lead. Private organizations may be identified as a partner or collaborator of an eligible applicant organization. 

2. What legislation guides the WSIB Grant Program?

Proposals must be consistent with Section 159(5) of the Workplace Safety and Insurance Act, which provides the WSIB with the authority to offer grants for the purposes of research, training and investigations  in amounts and subject to such conditions as the Board considers acceptable.

3. What is the duration of the grant funding for this initiative? What is the maximum funding limit per year for this initiative?

One grant will be awarded in the amount of $150,000 for a term of up to 12 months.

Refer to Appendix B for detailed funding use restrictions.

Project team descriptions

Project Lead

The Project Lead must be based in or formally affiliated with an eligible host organization (university, college, hospital, research institute or other qualified not-for-profit organization).

The Project Lead is responsible for managing and monitoring the proposed activities, including administrative and financial responsibility for the grant. The Project Lead is not eligible to receive salary support from a WSIB grant.

Secondary Lead (Co-Lead)

The Secondary Lead shares responsibility for the grant and, in most cases, should be able to assume Project Lead responsibilities as necessary. The Secondary Lead is not eligible to receive salary support from a WSIB grant.

Co-applicant

Co-Applicants may or may not have a formal affiliation with the project host organization, but will take responsibility for specific administrative and scientific aspects of the project. Co-Applicants are not eligible to receive salary support from a WSIB grant.

Project Personnel 

Project Personnel include undergraduate and graduate students, postdoctoral fellows, research assistants, technicians, programmers, analysts, etc., who may contribute to the activities of the Project Lead. Project Personnel may receive salary support or honoraria from the grant in keeping with the funding use restrictions.

Collaborator

The project may include collaborators who are central to the project and not otherwise identified in the categories above. Their role in the proposed activities is to provide a specific service (e.g., access to equipment, training in a specialized technique, statistical analysis, access to a patient population, etc.). Collaborators may be eligible to receive project funds for specified services or resources if it can be demonstrated that their contribution is essential to the work being undertaken and not otherwise available to the project team. Project advisory committee members are generally viewed as collaborators and may not be eligible to receive grant funds for the time they may contribute to the project.

Evaluation and selection process

The current funding initiative is a competitive process and all applicants are required to submit a detailed proposal for consideration of funding. Each application will undergo a rigorous multi-stage review process designed to assess scientific credibility, transparency and accountability, and emphasize relevance to the funding objective and workers’ compensation system. 

  • Stage 1: Peer review by external experts to ensure the validity of the research project and design. Applications that fail peer review will not proceed.
  • Stage 2: Relevance review by an internal panel of WSIB staff to ensure alignment to the funding objectives and requirements. This review may happen concurrently with Stage 1 in order to address questions regarding methodology and outputs.
  • Stage 3: Final funding decision by WSIB Grant Advisory Committee, including the project sponsor.

Refer to Appendix A for detailed requirements of the evaluation criteria.

Managing and measuring progress

WSIB grant recipients will be required to regularly report on their progress to ensure we can support the recipient in early identification and removal of barriers.

The successful applicant will be required to complete a final report as a condition of funding, which will be subject to a peer-review. Responses to the peer review comments must be provided to the WSIB, and for substantive peer review issues, corrections to final report may be required. Additionally, a requirement to present the overall findings of the systematic review to WSIB management will occur following the peer review of the final report. 

The final report delivered to the WSIB will be in electronic format and published within the WSIB Reference Centre.  

Refer to Appendix C for detailed requirements of the final report.

Submission instructions

Carefully review the information in the application form and provide comprehensive answers to the application questions. 

Email a PDF copy of your completed form to grants@wsib.on.ca. Please ensure the package is complete, including all sections and required signatures, and adheres to the established page limits.

Deadline for the proposals is May 31, 2021 at 5pm (ET).

Proposals received after the deadline will not be included in the application and selection process. Incomplete proposals will not be accepted.

Appendices

Please include references in this section. Please attach and number the additional pages and clearly identify the section that the pages belong to.

Program contact information

If you have questions regarding the WSIB Grants Program, please contact us by email at grants@wsib.on.ca.

The WSIB appreciates the time and effort it takes to submit a proposal. Thank you for your dedication to Ontario’s workers’ compensation system.

Appendix A

Proposal evaluation criteria

Proposals will be evaluated based on criteria and considerations aligned to the following categories: 

  • Workplan and accountability 
  • Scientific merit
  • Research design and methodology
  • Experience of the research team
  • Budget
  • Project risk assessment

The major emphasis of the evaluation will be on the project’s ability to deliver clear outcomes that align to the required objectives and can be successfully communicated at the end of the project.

The evaluation process also considers reputational risk to the WSIB. This assessment is inclusive of any partners or collaborators identified in the proposal.

Appendix B

Additional considerations

Funding restrictions

Grant recipients are prohibited from using WSIB funds (“Funds”) for the following purposes; and therefore, applicants should ensure the costs outlined below are not included in a proposal to the WSIB Grants Program:

Salaries and stipends

The Funds may not be used towards salary support for any Key Research Team Member who is a full-time researcher, a full-time faculty member of a college or university, a full-time educator, trainer or healthcare professional. However, Funds may be used to provide salary support for other project team members such as coordinators, statisticians, and technical and other support staff. All positions will be reviewed and further clarification may be required prior to accepting the budget. Funds may only be used towards direct salaries, not charge out rates (i.e. the amount paid to an employee and specified in the Budget). The WSIB reserves the right to set a ceiling on its contribution to salaries on a classification basis.

If the person for whom support is being requested is a full-time employee of the Grant Recipient, the Funds may be used towards a salary value based on the number of days or part days that the individual will work on the Project and that such amount will not exceed a reasonable amount based on the Grant Recipient’s regulations, policies, or guidelines.

If a person is to be employed on a contract basis, then Funds can be used towards compensation calculated on an hourly, daily, weekly or monthly basis. The Funds may only be used towards compensation received by the employees and may not include an allowance for overhead and/or benefits.

The Funds may be used towards a salary contribution for Graduate students and postdoctoral fellows engaged on the Project, provided such amount will not exceed an amount determined by following normal university or college regulations, policy or guidelines.

Employee benefits

No more than 20% of salaries can be used towards the cost of benefits for employees (e.g., E.I./U.I.C., C.P.P., health benefit coverage), but not in respect to any key research team member who is a full-time researcher, a full-time faculty member of a college or university or a full-time educator, trainer or healthcare professional.

Indirect or overhead costs

The Funds may not be used towards capital expenditures, overhead costs, maintenance costs, and other incidental expenses. Please contact the Grants Team for approval of questionable IT hardware or software purchases prior to submitting your budget. 

Publications, reports and memberships

The Funds may not be used to purchase subscriptions to or individual copies of scientific journals, computer manuals, books or other publications. The Funds may not be used towards membership fees to societies. However, the Funds may be used towards reasonable costs incurred in the publication of research results, which includes printing material for presentation at conferences, (with acknowledgement of the WSIB) to the extent explicitly set out in the proposed budget and approved by WSIB.

Conferences

No more than $1,500 of the total Funds may be used to support knowledge and dissemination at a conference (registration and/or publication fees). The funds may not be used towards travel, or accommodation for conferences.  

Personnel hiring

The Funds may not be used towards costs associated with hiring of project personnel, including advertising and travel costs.

Hiring of consultants

Funds may not be used towards consulting fees. If additional expertise is required to fulfill a study objective and an external expert is hired for this purpose (i.e. a statistician), the expert should be included as a part of the project personnel and their role and salary clearly outlined, if it is not being completed by the study lead.

Administration fees

The Funds may not be used towards administration or tuition fees.

Materials and supplies

The Funds may not be used towards materials and supplies, including office supplies, at a fixed rate; they may only be used on an “as used basis”.

Entertainment and hospitality

The Funds may not be used for entertainment or hospitality of any kind (and for greater certainty, the Funds may not be used for the purchase of alcohol).

Incidental expenses or gifts

The Funds may not be used towards costs associated with any incidental expenses while traveling, such as tips, dry cleaning, and long distance calls; or gifts, including gifts for investigators, research staff, or participants.

Purchasing equipment

No more than 10 per cent of the total Funds may be used towards equipment purchase expenditures. Provided an equipment purchase is explicitly included in the proposed budget and approved by WSIB, any equipment purchased with the Funds becomes the property of the grant recipient.

Travel, meals and hospitality expenses

Grant recipients shall comply with the terms of the Travel, Meal and Hospitality Expenses Directive (the “Directive”) published by the Government of Ontario (or in any addenda or successor policies associated therewith), as though the Recipient’s personnel were employees of a government ministry.  For greater certainty, any WSIB funds budgeted by the Recipient for travel, meals or hospitality must not exceed the amounts permitted in the Directive for employees of government ministries. Where the Directive requires ministry approval for an activity or expenditure, the Recipient shall seek approval from WSIB.

The WSIB, at its discretion, may require terms that are more strict than those of the Directive as a requirement of awarding a grant.

Conflicts of interest

The applicant organization must acknowledge if there is a perceived, potential, or actual conflict of interest (a “Conflict of Interest”) associated with the proposal. The applicant organization must also promptly inform the WSIB in writing if a Conflict of Interest becomes known at any time.

A Conflict of Interest includes, without limitation, the following:

  • situations, circumstances, or conduct that could give a grant candidate an unfair advantage during the proposal selection process or compromise the ability of the candidate to perform its obligations under a contract with WSIB
  • the offer or giving of a benefit of any kind, by or on behalf of a grant candidate to anyone, employed by, or otherwise connected with, WSIB, and
  • additional circumstances described in WSIB’s Code of Business Ethics and Behaviour 

The WSIB reserves the right to:

  • solely determine whether any situation or circumstance constitutes a Conflict of Interest
  • require grant candidates participating in the proposal selection process to declare any Conflict of Interest
  • disqualify grant candidates from the proposal selection process due to a Conflict of Interest, and/or
  • prescribe the manner in which a grant candidate should resolve a Conflict of Interest in order to avoid disqualification.

Confidentiality and Freedom of Information

The information submitted in connection with this proposal may be disclosed by the WSIB in accordance with FIPPA (the Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.F.31, as amended).

Intellectual property rights

A component of the Grant Agreement will be provisions that provide the WSIB with a non-exclusive, perpetual and irrevocable right to use, reproduce, display and distribute copies and prepare derivative works of all material produced from the grant activities. The WSIB may do so in any manner it considers useful or helpful to the administration of the Workplace Safety and Insurance Act.

Grant agreement

Successful applicant organizations must complete a grant agreement satisfactory to the WSIB (“Grant Agreement”) prior to receiving grant funds.

Appendix C

Funding objectives – Guidance to researchers

Detailed requirements

The systematic review should specifically evaluate whether there is evidence for an association between occupational exposure to all and by each form(s) of asbestos (i.e. chrysotile, crocidolite, amosite, tremolite, actinolite and anthophyllite) and the development of gastrointestinal cancer and for each of the gastro-intestinal cancers individually (i.e. cancers of the esophagus (ICD-9 150, ICD-10 C15), stomach (ICD-9 151, ICD-10 C16), small bowel (ICD-9 152, ICD-10 C17), colon (ICD-9 153, ICD-10 C18, C19) and rectum (ICD-9 154, ICD-10 C20)). NOTE: For the remainder of this appendix, please note that the term “gastrointestinal cancer” refers to both the group of cancers as well as the individual cancers of the esophagus, stomach, small intestine, colon and rectum.  As well, the term “asbestos” refers to all types together as well as refers to each individual type, which includes chrysotile, crocidolite, amosite, tremolite, actinolite and anthophyllite.  

The systematic review shall include: 

  • All analyses, results and discussion presented for gastrointestinal cancer, by individual cancer, for asbestos and by type/form of asbestos, where available/appropriate.
  • Description of the toxicokinetics and toxicodynamics of asbestos in humans
  • Examination of the epidemiologic evidence for risk of developing gastrointestinal cancer in asbestos-exposed workers as described above
  • Identification of any subgroups of workers with occupational asbestos exposure who have an increased risk of developing gastrointestinal cancer (e.g., those involved in particular tasks, were employed during specific time periods, were exposed to specific forms of asbestos, or had different routes of exposure, etc.)
  • Identification of exposure-response relationships, such as increasing risk of developing gastrointestinal cancer with increasing duration, frequency and/or intensity of exposure, or whether there is a minimum threshold of exposure below which no elevation in gastrointestinal cancers were reported
  • Identification of the presence of any interdependent causes or synergistic relationships with other risk factors (e.g. smoking or other occupational exposures, like X- or gamma-radiation) with occupational exposure to asbestos in the development of gastro-intestinal cancer
  • Examination of any evidence for a minimum interval (latency) between the first exposure to asbestos and the diagnosis of gastrointestinal cancer
  • Determination of whether a causal relationship can be established for any of the specified gastrointestinal cancers with occupational asbestos exposure based on the available scientific evidence, using accepted principles for assessing causation 

Final report 

The final draft report is due within 12 months of the Effective Date of Agreement, and will be subject to a peer-review as arranged by the WSIB. The final report will need to address peer-reviewer comments and be delivered within 2 (two) months of receipt of peer-reviewer comments. (It is estimated that the peer-review of the final draft report will take approximately 4 weeks.)

The final report should include the following elements:

a)    Executive summary

b)    Lay language summary (i.e. short summary describing the project and findings in simple, non-technical language suitable for sharing with a wider audience)

c)    Background and Scope;

  • outline of the research questions and project description 
  • information about each of the gastrointestinal cancers, and their respective ICD codes (9th and 10th revisions), that were considered in the review; should provide details on non-occupational risk factors, latency, incidence, and prevalence rates, if available
  • information about the toxicokinetics and toxicodynamics of asbestos in humans
  • summary of asbestos exposures encountered in different occupational settings (e.g., mining industry, foundry, manufacturing, etc.) 
  • summary of previous reviews and meta-analyses for each of the gastrointestinal cancers and occupational asbestos exposure
  • summary of evidence for non-occupational sources of asbestos exposure (e.g., drinking water, environmental etc.), including summary of findings of previous reviews for each of the gastrointestinal cancers and non-occupational asbestos exposure
  • a discussion on biological plausibility
  • overall objectives of systematic review

d)    Methods;

  • search strategy for sources of evidence, including keywords, databases, and resources used
  • inclusion and exclusion criteria with rationale (e.g., study design, year of publication, human studies, studies with overlapping populations, grey literature, etc.)
  • approach used for data extraction (e.g., incidence and/or mortality outcomes, exposure assessment, health outcome and corresponding ICD codes, effect measures, risk estimates, and confidence intervals or p-values)
  • approach used for assessment of study findings of risk of developing gastrointestinal cancers (as described under research request) in asbestos-exposed workers, including how issues such as bias, confounding and study quality will be considered/addressed in analysis
  • description of how subgroup analysis will be conducted (e.g., those involved in particular tasks, were employed during specific time periods, were exposed to specific forms of asbestos, had different routes of exposure, or have comorbidities that may predispose to certain adverse health effects with asbestos exposure).
  • examination of exposure-response relationships, by cumulative exposure, duration, frequency and/or intensity of exposure, or whether there is a minimum threshold of exposure below which no gastrointestinal cancers were reported 
  • description of statistical analyses used, including any statistical software, and approach for quantitative assessment of study findings, if appropriate, such as meta-analysis (fixed effects versus random effects model) or other weight of evidence approach; should include assessment of bias in meta-analysis, such as publication bias
  • assessment of any interdependent causes or synergistic relationships with other risk factors (e.g. smoking or other occupational exposures, like X- and gamma-radiation) with occupational exposure to asbestos in the development of gastro-intestinal cancer
  • approach used for determination of a causal relationship, using accepted principles for assessing causation
  • appropriate and validated quality appraisal approach, including quality assessment tool/checklist used for grading quality of individual studies

e)    Results and analysis;

  • results of the literature search
  • results of the quality appraisal, including examination of methodological issues of individual studies (i.e., bias, confounding and study quality)
    • specifically examining how issues of latency and exposure misclassification were addressed
  • presentation of the systematic review findings of risk of developing gastrointestinal cancers (for all gastrointestinal cancers combined and individually for cancers of the esophagus, stomach, small bowel, colon and rectum) in asbestos-exposed workers (synthesize the results quantitatively, i.e. evidence table, and qualitatively)
    • by study characteristics such as study design, geographic region, years of follow-up, study population, reference population, type or route of asbestos exposure, and health outcome
    • consideration of findings for all studies in comparison with those studies deemed to have higher methodological quality 
    • graphical representation of systematic review findings, such as funnel plots, forest plots, etc.
  • identification of subgroups of workers (by industry or occupation) with increased risk of developing the gastrointestinal cancers with occupational asbestos exposure, as described under methods above
  • presentation of significant exposure-response trends, as described under methods above
  • evidence for a minimum interval (latency) between the first exposure to asbestos and the diagnosis of gastrointestinal cancer
  • statistical analysis, including test of heterogeneity and quantitative assessment of study findings, if appropriate, such as meta-analysis; if possible, additional meta-analyses by study design (cohort, case-control), industry or occupation, and subgroup
  • assessment of any interdependent causes or synergistic relationships of other risk factors (e.g. smoking or other occupational exposures, like X- and gamma-radiation) with occupational exposure to asbestos in the development of gastro-intestinal cancer

f)    Discussion;

  • overall findings of systematic review of risk of developing gastrointestinal cancer (for gastro-intestinal cancers together and individually for cancers of the esophagus, stomach, small bowel, colon and rectum) in asbestos-exposed workers 
    • identification of any subgroups of asbestos-exposed workers who have an increased risk of developing adverse health conditions
    • identification of any exposure-response trends of increasing risk with increasing duration, frequency or intensity of exposure 
    • any interdependent causes or synergistic relationships with other risk factors
    • a minimal interval (latency) between the first exposure to asbestos and the diagnosis of gastrointestinal cancer
    • evaluation of sources of error, bias, confounding factors (e.g. tobacco smoking, alcohol consumption), and limitations of the included studies and how these may have impacted systematic review conclusions
    • how the results of the quality assessment, sensitivity analysis and overall weight of evidence factored into assessment of causality
    • strengths and limitations of systematic review
  • determination of whether a causal relationship can be established for any of the identified health conditions based on the available scientific evidence, using accepted principles for assessing causation
  • appraisal of systematic review findings in relation to past reviews of adverse health conditions and occupational asbestos exposure
  • appraisal of systematic review findings in relation to reviews of adverse health conditions with non-occupational asbestos exposure (e.g., asbestos exposure through drinking water, environmental, etc.) 
  • presentation of the strengths and limitations of this review and their potential impact on the findings

g)    Conclusions;

  • Statements about the overall level of evidence for all gastro-intestinal cancers combined and for each individual cancer under investigation 
  • Explanation of levels of evidence framework/scale for levels of evidence and a description of each level and an explanation of how the level of evidence was reached in each analysis 

h)    Appendices - Supplementary tables of the individual study results

  • If study provided more than one risk estimate for health condition, indicate which risk estimate was used in analysis

i)    Citations