Highlights of Noteworthy Decisions
- Chronic obstructive lung disease
- Board Directives and Guidelines (chronic obstructive lung disease)
The worker appealed a decision of the Appeals Resolution Officer denying the worker entitlement for chronic obstructive pulmonary disease. The Board determined that the worker had cumulative exposure to respiratory particulate over his 45-year working history in the range of 22 mg/m3 to 38 mg/m3 years. The Board took the average of this range and deemed the worker's occupational exposure to respirable dust at 30 mg/m3 years. The Board uses a COPD Binder containing adjudicative advice. The Board adjudicator stated that the COPD Binder set a cumulative occupational threshold in the range of 40 mg/m3 to 50 mg/m3. The worker did not meet that exposure threshold. The Board also noted the worker's smoking history. The Panel noted that the COPD Binder is not Board policy. In fact, that is specifically acknowledged in the Binder. Further, the COPD Binder does not create a rigid threshold requirement of 40 mg/m3 to establish entitlement. Rather, it presents and explains a matrix of potential causal factors to consider. Magnitude of occupational exposure is one of six factors. The others are: age at onset and latency; possible clinical markers; type of exposure; occupations and industry groups; and influences on risk of impairment. While magnitude of exposure is undoubtedly a key factor, the COPD Binder does not suggest that all claims with respirable dust exposure below 40 mg/m3 ought to be denied. The COPD Binder also addresses non-occupational risk factors, of which smoking is the most relevant to this case. The Panel reviewed the exposure evidence in detail and concluded that it supported the high point of the range (38 mg/m3) as the best estimate of the worker's exposure, based particularly on exposure in three key areas (woodworking, construction and railway). The Panel also noted that the COPD Binder provides for rounding up or down of values for pack years of smoking and the dust years of exposure. Thus, the 38 years of exposure would be rounded up to 40 mg/m3 years. The Panel found that the worker had 30 pack years of smoking. The medical evidence supported a conclusion that the worker's smoking history was a contributing causal factor in the development of the worker's COPD. However, given the nature and magnitude of the worker's occupational exposure, the Panel found that the occupational exposure was not overwhelmed by the smoking history. The worker had entitlement for COPD. The appeal was allowed.