Were a worker’s severe respiratory issues caused by decades of exposure to automotive paint or non-occupational allergies? Can he collect workers’ compensation even if his doctors can’t decide?
The Utah Court of Appeals upheld a decision from the state’s Labor Commission finding that the worker’s debilitating respiratory symptoms were caused by 30 years of exposure to “a veritable laundry list” of chemicals at work.
Automotive resin spilled onto his face and body
Bradley West worked as an autobody technician for BASF Corporation for more than 30 years. During that time, West held several different positions. In 2015, his role was as a trainer of other autobody technicians who were learning how to use BASF’s paint system.
Throughout his time working for BASF, West was exposed to a host of chemicals and had been diagnosed with industrial asthma in 1997 along with a deviated septum, sinus cyst, bronchitis and allergic rhinitis due to allergens.
On March 12, 2015, West was moving inventory from one BASF warehouse to another as part of his regular job duties. He reached up to a top shelf for a gallon can of industrial automotive resin, which he didn’t realize had an unsecured lid. As he pulled the can down from the shelf, the lid fell off and the resin spilled onto his face and down his body.
The incident left West with:
- burning in his eyes
- plugged sinuses
- runny nose
- rashes on his face and arms, and
- significant coughing.
Most of these symptoms resolved over time, but the sinus congestion and runny nose persisted.
Continued exposure to aerosol paints, dust, chemicals
Following the incident, West continued to train other technicians on the paint system, which resulted in further exposure to chemicals and particulates. To protect his lungs, West wore an air-supplied hood respirator, a paint suit, nitrile solvent resistant gloves and safety boots anytime he anticipated that he would be exposed to chemicals and dust.
However, he would “frequently walk through auto shops without the safety apparatus when looking for a painter or manager and, as a result, was exposed to whatever was in the air while doing so.”
In October 2015, West reported to his doctors that he’d been exposed to an increased amount of aerosol paints and chemicals as part of his job duties. He continued to have a cough and sinus congestion, but he thought it was from seasonal allergies. His symptoms worsened in November 2015, leading him to seek medical treatment for what he thought was just a cold.
Over the next three months, West’s symptoms continued to get worse, leading to difficulty breathing, cough, congestion, runny nose, sinus pain and clogged ears.
In March 2016, during a product demonstration at work, West had a two-hour coughing fit that caused him to lose consciousness twice.
Diagnosed with rare respiratory disorder
Further medical testing led to a diagnosis of interstitial lung disease with an unclear cause. In April 2016, a biopsy indicated West was suffering from chronic eosinophilic pneumonia. This is a rare disorder that involves a “massive accumulation” of a certain type of white blood cell in the lungs, according to the National Organization for Rare Disorders.
The doctor who diagnosed West with interstitial lung disease reported that his condition was likely the result of “occupational exposure in the auto industry.” In August 2016, the director of the Interstitial Lung Disease Program at the University of Utah reported that West’s condition was due to his decades of chemical exposures, especially isocyanates. These chemicals are “powerful irritants to the mucous membranes of the eyes and gastrointestinal and respiratory tracts,” according to the National Institute for Occupational Safety and Health.
By December 2016, West’s health was still declining, leading him to file for workers’ compensation benefits for the March 2015 resin incident and for occupational lung disease.
Conflicting opinions lead to medical panel review
From May 2017 through January 2018, multiple doctors for both West and BASF produced conflicting reports as to the cause of West’s respiratory problems. Some doctors blamed West’s years of chemical exposure at work while others felt there was insufficient evidence connecting the lung disease to his occupation.
In August 2018, an administrative law judge overseeing the workers’ compensation claim referred the case to a medical panel for review. The panel consisted of doctors who were experts in respiratory illnesses.
The medical panel explained that “there is no scientific consensus concerning whether isocyanate exposure” could cause chronic eosinophilic pneumonia. Despite that fact, the panel found occupational “causation in this case to be strongly possible.”
The judge adopted the medical panel’s conclusions in July 2020 and ordered BASF to provide compensation for past and future medical expenses associated with West’s condition along with total disability compensation.
Company demands review by second medical panel
BASF requested that the Utah Labor Commission review the judge’s order, arguing that the judge erred because the medical panel didn’t reach a conclusion of medical probability regarding cause. On review, the commission explained that the circumstances of the case left it “with the unusual scenario of having to make a determination on medical causation for an uncommon condition that even the medical panel did not fully comprehend.”
The commission ordered the judge to remand the case to a second medical panel. This panel, which consisted of a different set of medical experts who specialized in respiratory health, found that West’s “occupational disease is largely … attributable to industrial causes.” Further, the panel found that “occupational exposure permanently worsened West’s chronic sinopulmonary disease.” It explained that West had “low personal risk factors for developing non-industrially related” lung disease, such as no exposure to animal allergens, no exotic travel history and no history of smoking.
BASF objected to the second panel’s report, but the judge found that the evidence supported the determination that West’s disease was occupational in nature. The judge again ordered BASF to compensate West for medical expenses and provide total disability benefits.
Court: Prior decisions supported by ‘clear, reasoned explanations’
On review with the Utah Court of Appeals, BASF argued that both the judge and the commission erred in concluding that the second medical panel’s opinion provided the proper level of medical probability as to the cause of West’s condition.
The appeals court disagreed, finding that the judge and the commission “provided detailed explanation as to why their review of the record with the support of the medical panel reports left them convinced that West’s repeated exposure to isocyanates through his regular course of employment was the cause of his condition.”
While both medical panels acknowledged a lack of medical agreement about whether isocyanates can be the medical cause of chronic eosinophilic pneumonia, the second panel didn’t rely solely on scientific consensus. Causation was supported “by the second panel’s review of the facts in West’s case coupled with its expertise in the fields of pulmonary and occupational diseases,” according to the court.
The court found that the judge and the commission referenced West’s work history, his 2015 resin incident, working conditions and medical reports in their decisions. “From their review, they drew clear, reasoned and supported inferences and provided detailed explanations for their conclusions,” the appeals court stated.