- Environmental hypersensitivity
- Exposure (chemicals)
- Multiple Chemical Sensitivity
The worker sought entitlement to Multiple Chemical Sensitivity (MCS), or in the alternative, entitlement to benefits for mold exposure. Occupational diseases are adjudicated under Section 2(1) and Section 15 of the WSIA and by Regulations 3 and 4 of the WSIA. As mold exposure and/or MCS are not included, entitlement was determined on the basis of the merits and justice of the claim. The worker testified that while sorting mail, she was exposed to various chemicals at work, including scented cleaning products and ink on flyers.
The Panel allowed the appeal.In the Tribunal Medical Discussion Paper entitled "Idiopathic Environmental Intolerance," Dr. Weinberg explained that MCS (also known as Idiopathic Environmental Intolerance) is not a recognized disease with demonstrable pathology, but instead it is a state of ill health characterized by a multiplicity of symptoms (e.g. headache, breathlessness, fatigue, impaired concentration and anxiety) attributed to environmental toxins. The Panel noted that it was not its role to determine whether or not MCS is a valid diagnosis nor to determine the diagnostic criteria to follow in determining whether a worker has such a condition. In the absence of a Board policy on MCS, the Panel was required to assess whether the worker had genuine symptoms, and if so, whether it was more likely than not that occupational exposure made a significant contribution to the development of the worker's constellation of symptoms. The Panel also considered the diagnostic criteria for MCS provided by Dr. House (Environmental Physician) in Decision No. 977/05. The Panel stated that three physicians who examined the worker each independently diagnosed the worker with MCS due to workplace exposures. The Panel placed significant weight on these physicians who each had considerable experience examining and treating workers with occupational and/or respiratory conditions. The three physicians determined that exposure to fragrances and ink at work was a significant contributing factor in causing the worker's symptoms. It was noted that the worker's symptoms increased within a very short time of entering the workplace and dissipated upon leaving the workplace. The Panel placed significant weight on this temporal relationship as did the other physicians. The medical reporting did not identify any non-work-related chemical exposures or any other medical condition that may have significantly contributed to the development of MCS or that overwhelmed the significance of the work-related exposures identified during the worker's testimony.The ARO decision advised that significant weight was placed on Dr. Tarlo's report in denying entitlement because it was noted that there is no objective test for MCS. The Panel considered the opinion of the Panel in Decision No. 82/19 who had considered the same issue. The Panel found that the rejection of MCS as an entity based on the lack of objective testing for MCS was inconsistent with Tribunal jurisprudence which considers entitlement based on medical evidence of an identifiable injuring process that significantly contributed to specific symptoms. The Panel noted that Dr. Gibson, in his January 31, 2018 report, concluded that the worker's symptoms involved multiple organ systems, she reacted to different classes of chemicals, her reactions were reproducible at low environmental concentrations, and her condition improved when she was away from work. These findings mirrored the diagnostic criteria of Dr. House as described in Decision No. 977/05, and this further supported the allowance of entitlement to MCS in this appeal.