- Sarcoidosis
A 45-year-old worker worked as a library technician for the school board accident employer from August 29, 2002. In August and September 2002, the worker assisted in removing and cataloging moldy books damaged by flooding in the school. Air quality testing in the school found mold above the Health Canada Standards.
The sole issue under appeal was whether the worker has entitlement for sarcoidosis as a result of occupational exposure to mold. The Vice-Chair referred this matter to a Tribunal medical assessor whose report was reviewed in this decision. The report opined that the appropriate diagnosis in this case was sarcoidosis. In regard to causation, the assessor stated that there is no objective test to determine the triggering cause of sarcoidosis though it is hypothesized that it is an immunologic response to an antigen in a person with a genetic predisposition to this response but in clinical practice the cause is unknown for an individual patient. Given the relatively short period of exposure to mold (8 days) and the delay of onset of symptoms of about 4 years, it was not likely that the mold caused sarcoidosis. The Vice-Chair noted that this opinion was consistent with that of a Board medical consultant cited in Decision No. 496/20I which also stated that it was not likely that the worker's sarcoidosis resulted from occupational exposure to mold.The other medical opinions on file supporting the claim, in the Vice-Chair's view, were not persuasive, at most supporting a finding of a possible rather than a probable cause. The worker's representative, referring to Decision No. 1386/03, submitted that an extremely high standard of virtual scientific certainty is not required to determine causation. The Vice-Chair noted however that, while scientific certainty is not required, the evidence must support causation, in that it cannot be speculative. These other medical opinions, in the Vice-Chair's view were largely speculative in nature.The Vice-Chair, on a balance of probabilities, found that the worker did not have entitlement for sarcoidosis.The appeal was denied.