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Acute Respiratory Reactions to Substances with Irritating or Inflammatory Properties
99/05/28-03
THE WORKERS' COMPENSATION BOARD OF BRITISH COLUMBIA
RESOLUTION OF THE PANEL OF ADMINISTRATORS
Re: Acute Respiratory Reactions to Substances with Irritating or Inflammatory Properties
WHEREAS:
Pursuant to Section 82 of the Workers Compensation Act, RSBC 1996, Chapter 492 and amendments thereto, the Panel of Administrators ("Panel") must approve and superintend the policies and direction of the Workers' Compensation Board ("Board"), including policies respecting compensation, assessment, rehabilitation and occupational safety and health, and must review and approve the operating policies of the Board;
AND WHEREAS:
The Board's current policy on acute respiratory reactions to substances with irritating or inflammatory properties is provided in Policy Item #29.10 of the Rehabilitation Services and Claims Manual.
AND WHEREAS:
The Policy and Regulation Development Bureau ("Bureau") has identified an inconsistency in the wording of that policy which could inadvertently affect adjudication of claims for reactive airways dysfunction syndrome (RADS);
AND WHEREAS:
The Bureau has consulted with the Occupational Disease Advisory Committee ("ODAC") on the matter;
THE PANEL OF ADMINISTRATORS RESOLVES THAT:
- The Rehabilitation Services and Claims Manual is amended as shown in the attached Appendix.
- The amendments are effective on the date the resolution is signed.
DATED at Richmond, British Columbia, June 15, 1999
| By the Workers' Compensation Board |
|
| DON COTT, CHAIR, PANEL OF ADMINISTRATORS |
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Rehabilitation Services & Claims Manual
Amendments
[Deletions Strike Through, Additions in Bold Italics]
#29.10 Acute Respiratory Reactions to Substances with Irritating or Inflammatory Properties
Schedule B lists "Acute upper respiratory inflammation, acute pharyngitis, acute laryngitis, acute tracheitis, acute bronchitis, acute pneumonitis, or acute pulmonary edema (excluding any allergic reaction, reaction to environmental tobacco smoke, or effect of an infection)" as an occupational disease. The process or industry listed opposite to it is "Where there is exposure to a high concentration of fumes, vapours, gases, mists, or dust of substances that have irritating or inflammatory properties, and the respiratory symptoms occur within 48 hours of the exposure, or within 72 hours where there is exposure to nitrogen dioxide or phosgene".
There are many agents used in industry and commerce in the province which have irritating or inflammatory properties, and which in sufficient concentrations can produce respiratory symptoms if inhaled. Symptoms associated with the inhalation of such substances can vary from mild transient symptoms (such as a mild burning sensation affecting the eyes, nose and throat) to significant symptoms throughout the respiratory tract (such as dyspnea and respiratory distress). Significant exposure to some substances may result in persistent respiratory symptoms.
Onset of symptoms can occur within a few minutes or several hours of the exposure, depending on the substance. For the presumption in Section 6(3) of the Act to apply, the symptoms must appear within 48 hours of the exposure, unless the exposure is to nitrogen dioxide or phosgene, in which case the onset of symptoms must occur within 72 hours.
A claim for compensation made by a worker who has developed persistent or chronic respiratory symptoms considered to be due to exposure to a substance with irritating or inflammatory properties, must be considered on its own individual merits without the benefit of a presumption in favour of work causation (unless the claim meets the requirements of one of the other items of Schedule B). In particular, This includes claims for chronic bronchitis, emphysema, chronic obstructive pulmonary disease, obliterative bronchiolitis, reactive airways dysfunction syndrome (RADS), chronic rhinitis, and conditions considered to be due to exposure to tobacco smoke, are determined on the merits and justice of the claim without the benefit of any presumption. The same is true of a claim made by a worker with acute respiratory symptoms where the requirements of Section 6(3) of the Act are not met (see #26.22). Where a worker who develops an acute reaction to a substance with irritating or inflammatory properties subsequently develops a persistent or chronic respiratory condition, a decision will be made based on the merits and justice of that claim on whether the chronic condition is a compensable consequence of the acute reaction.
A claim made by a worker who has inhaled a vapour or gas which was at a temperature high enough to cause thermal injury (such as inhaling steam) will be treated as a claim for a personal injury and will be adjudicated in accordance with the policies set out in Chapter 3.
Use of the words "high concentration" in Schedule B is a recognition that the amount of the particular substance in the air must be significant for the presumption to apply. The manner in which an exposed individual will react will depend on the properties of the substance inhaled (e.g., acidity/alkalinity, chemical reactivity, water solubility, asphyxiating potential) and the amount inhaled. Individual judgment must be exercised in each case to determine whether there was a "high concentration" of the particular substance having regard to the medical and scientific evidence available, including evidence as to the irritating and/or inflammatory properties of that substance.