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Wong-Baker Pain Scale & Workers’ Compensation

Posted on October 4, 2020 by Edward Singer

Frequently Injured Workers, when attending workers’ compensation evaluations and treatment are asked to fill out a lot of questions and forms. One of these forms that they may have to fill out is the Wong-Baker FACES® Pain Rating Scale.

These Scales can impact an Injured Worker’s industrial claim.

This article will discuss the Wong-Baker FACES® Pain Rating Scale, how It is used in a Workers’ Compensation claim, and how it can impact an Injured Worker’s claim.

What is the Wong-Baker FACES® Pain Rating Scale?

The Wong-Baker Pain Rating Scale is a tool which is used to allow for patients to provide a self- assessment of their pain. It was created by Donna Wong and Connie Baker in 1983 to help children communicate about their pain. .

Part of the goal is to improve the assessment by using the scale for the purposes of assisting in pain management. The Wong-Baker Faces Foundation indicate that the Scale is self-assessment tool [that] must be understood by the patient, so [that[ they are able to choose the face that best illustrates the physical pain they are experiencing. The Foundation note that the Scale is “not a tool to be used by a third person, parents, healthcare professionals, or caregivers, to assess the patient’s pain. There are other tools for those purposes”.

What Does the Scale Look Like? How It is Scored?

The picture above is a version of the scale. This picture was taken off of the Wikipedia article. The Scale is copyrighted. The Scale is proprietary. Therefore, if you are interested in the material you should contact the Foundation.

The instructions for its usage is to “explain to the person that each face represent a person who has no pain(hurt), or some, or a lot of pain.” “Face 0 doesn’t hurt at all. Face 2 hurts just a little bit. Face 4 hurts a little bit more. Face 6 hurts even more. Face 8 hurts a whole lot. Face 10 hurts as much as you can imagine, although you don’t have to be crying to have his worst pain.”

The person is asked to choose the face that best depicts the pain they are experiencing. Supra.

Besides the Scale, the Patient may be asked to “to mark their areas of pain on a drawing of a human figure then rate each area using the faces scale.”.

What Was This Scale Designed for? What is Your Opinion Concerning It?

Originally, it was designed for children to help them communicate their pain.

In California, there are a number of Injured Workers who do not speak English. There are some Injured Workers who are illiterate. Some are illiterate even in their language of origin. This type of Pain Scale can assist these individuals express themselves with respect to their pain. It is noted by the Foundation that for children there was “considerable difficulty using any scale with unfamiliar words or scales based on numbering or ranking concepts. The use of the Numeric Rating Scale [were] growing in popularity at this time, but young children had trouble using the numbers.” Thus, this type of scale is of some value with certain Injured Workers.

With respect to other workers, the Scale is more problematic. In the world of workers’ compensation, there is a focus on activities of daily living and how an injury impacts them. This particular scale, while it may be effective with respect to ascertaining pain information for other reasons, does not provide information used for disability assessment in the workers’ compensation system.

With respect to Adults, pain is viewed must differently than with children. Adults react to pain as an irritation, a distraction, frustration, and may generate anger and upset. Adults do not necessarily cry because of their pain. Most adults, however, can understand how the scale signifies a range from no pain to extreme pain. In sum, its inquiry is superficial. Again, this is not an indictment of the Scale, it is simply the problem that occurs when it is employed for something it was not intended for.

How Can The Wong-Baker Scale Be Used For In Workers’ Compensation?

In my opinion, the Scale may have some credibility value. Also, it may document the trajectory of an Injured Worker’s condition. If this Scale is used on multiple occasions, one can look to see how consistent the reporting it. Also, it can possibly bring light to possible exaggeration. Scores at level 10 may give rise to suspicion of exaggeration.

Any Advice Concerning the Scale?

It is very important for Injured Workers to try to be accurate with respect to the score. While providing a “10” may be a “cry for help,” I would suggest that the Injured Worker actually “cry for help” and tell the evaluator or treater that they are experiencing some level of frustration with respect to their treatment and their relief from the pain. This will prevent an allegation of exaggeration.

What If I Need Advice?

If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.

ALTERED MEDICAL STATES (AMS) AND WORKERS’ COMPENSATION: INJURED WORKERS, MENTAL STATUS, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 29, 2020 by Edward Singer

Altered Medical States (AMS) is a medical condition of import within the Workers’ Compensation System. Irrespective of whether the Injured Worker’s AMS is work-related or not, the fact that an Injured Worker has such a condition which may impact their ability to communicate and their ability to understand is of concern.

Workers’ Compensation is a medical-legal system. An Injured Workers with an altered medical state raise both medical and legal concerns. The Workers’ Compensation System requires Injured Workers to provide truthful and accurate information. The System also allows for Injured Workers to enter into binding contracts and agreements. Therefore, an Injured Worker’s mental state is important.

This article will discuss Altered Medical States, how Altered Medical States can impact medical treatment and reporting, and how Altered Medical States can impact Workers’ Compensation Litigation.

What is an Altered Medical State?

Altered Medical State can range from “total loss of consciousness to extreme excitation.” Evaluation and treatment of altered mental status patients in the emergency department: Life in the fast lane Hai-yu Xiao, Yu-xuan Wang, Teng-da Xu, Hua-dong Zhu, Shu-bin Guo, Zhong Wang, and Xue-zhong Yu World J Emerg Med. 2012; 3(4): 270–277 doi: 10.5847/wjem.j.issn.1920-8642.2012.04.006 PMCID: PMC4129809 PMID: 25215076

Altered Medical States include central nervous system inhibition which can include coma, drowsiness, and confusion. It can include central nervous system stimulation including irritability and aggressiveness. It can include “abnormal behavior.” Supra.

What Are the Medical Causes of Altered Medical States?

There are many reasons as to why someone may have an Altered Medical State. Many of these AMS conditions can be work-related. Medical Causes of AMS include both Neurological and Non-Neurological Causes.

AMS causes differ based upon based upon age. Top causes of AMS for elderly patients can include cerebrovascular disease, systemic or organic failure and infection. Top causes for non-elderly are drugs and toxic factors, systemic and organic failure, and metabolic and endocrine disorders. Supra.

Various causes of AMS can include drugs and substance intoxication, infection, metabolic endocrine abnormalities, trauma, cancer, and system/organ dysfunction. This can include acute alcoholism. It can also be caused by trauma, i.e. head trauma, and infection. Supra.

What are the Workers’ Compensation Concerns with respect to Injured Workers with AMS?

With respect to the Workers’ Compensation Claim, an Injured Worker with an altered medical state can have problems with respect to the medical-legal reporting to support the claim of injury. If the work injury caused an altered medical state, then there is a likelihood that the immediate medical treatment may not have an accurate history as to how the injury/medical condition was work-related. For example, there are times when an Injured Workers are found unconscious and is then sent for medical treatment. In those circumstances, the initial medical providers may not be able to document any information that can support the work injury.

Altered Medical States can also be when an Injured Worker is attending workers’ compensation related medical appointments. Injured Workers may be taking prescription medications that impact their abilities to comprehend and answer questions posed by medical providers. This again can impact the quality of the medical-legal reporting as to both the history of injury and ongoing complaints.

An individual may be so intoxicated that evaluations may be terminated. This problem does not only relate to prescription medications. Injured Workers may consume alcohol or take street drugs that may impact their mental state.

In sum, there can be work-related and non-work related AMS issues which impact medical treatment and medical-legal reporting.

Additionally, there are some Injured Workers that suffer from severe mental health issues where they have problems being communicative. Further, these Injured Workers may have such problems where the evaluators have serious doubt as to whether they can provide accurate information.

What are the Legal Concerns of Altered Medical States?

The Workers’ Compensation System is a legal system and statements made by Injured Workers are placed under a legal microscope. False Statements can lead to allegations of Workers’ Compensation Fraud. Criminal penalties can apply.

Thus, there is a concern as to whether an Injured Worker with an altered medical state is capable to speaking the truth. For example, if the Injured Worker is having hallucinations, there may be some question as to whether they know what they are doing and saying. Additionally, an Injured Worker may be taking medications when they are having their deposition taken. The medications may impact on their ability to understand and answer questions in a truthful fashion.

Thus, if an Injured Worker has AMS issues, it is important that AMS be documented. It may be needed to address accusation so fraud. Note: there are three times in which reporting may be required: medical examinations and evaluations, the Injured Worker’s deposition, and the Injured Worker’s trial.

What Should Be Done with Respect to Injured Workers with AMS? Temporary versus Permanent AMS?

If an Injured Worker has a permanent AMS state, the use of a Guardian Ad Litem is indicated. In other words, a trusted person, i.e. parent or spouse, should be appointed by the Workers’ Compensation Appeals Board to make decisions with respect to the case.

If the Injured Worker has a temporary AMS state, the parties should all take careful consideration that the Injured Worker is understanding what is going on and is making their decisions and statements in an unaltered state. If there is some settlement, the fact that the individual is capable of entering into the agreement should be documented.

What If I Need Legal Advice?

HOSPICE WORKERS AND WORKERS’ COMPENSATION: STRESSFUL WORK ENVIRONMENTS AND PSYCHOLOGICAL WORK INJURIES: WHAT YOU NEED TO KNOW

Posted on September 23, 2020 by Edward Singer

Some Occupational or Work Environments that have unusual forms of stress. Hospices and Hospice-related duties is one. In a society with an increasing aging population, Hospice Workers perform the vital function of addressing the needs of terminally ill patients. Working in such facilities or performing such duties can have an emotional impact on the worker.

There has been a number of articles which have discussed the emotional concerns of these workers.

There are multiple issues that relate to why Hospice Workers experience stress.

This article will discuss the nature of Hospice Work, why such employment is stressful, and what a Hospice Worker can do in the event that the work-related stress becomes disabling.

What is a Hospice?

Hospices are health care facilities which provide care to those who are facing the end of their life. They provide services to ensure that the patients’ physical, emotional, and spiritual needs are met during this period.

These facilities can involve multiple disciplines, can be face-paced, and can involve transitioning caseloads.

What Are The Difficulties When Working at a Hospice?

There are a number of difficulties with Hospices. There is the difficulties of dealing with the emotional support needed for both families and the patients who are facing death. There is the difficulties with heavy caseload. There is the administrative, agency and institution, requirements in these facilities which can be a source of stress.

24-7 Care

“The hospice system provides 24-7 support and includes rapid response teams who cover nights and weekends. Even though other hospice workers have taken over providing care to that patient, the feeling of caring doesn’t stop.” Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Graveyard and Rotating Shifts have been known to cause medical problems irrespective of the fact that it involves Hospice Work.

Heavy Caseload

“Caseloads are widely different by role due to the nature of the work, with social workers and chaplains carrying larger numbers of patients than nurses and aides. Despite these differences, many of the challenges reported were remarkably similar. Workload is intense; often there is not time for lunch (unless while driving) or even to use the bathroom. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Stress from heavy caseload should not be considered as a “good faith personnel action.”

Different Roles

“Different roles reported different challenges. Many of the hospice worker roles are salaried, officially paid and expect to work 40 h per week, but often ending up putting in additional hours without additional compensation. Managers are also salaried but have less expectation of “only” working 40 h. On the other hand, aides are paid overtime when they work more than 8 h, but are discouraged from doing so. These differences led to different pressures.”. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Some of these Role Issues may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.

Communication

“Communication problems may also contribute to the chaotic nature of many workdays. Interdisciplinary teams, by definition, means different roles, responsibilities, and vocabularies, all caring for the same patients, usually in separate visits or calls. Such complexity can result in unanticipated communication problems as indicated by the following nurse’s example: Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Some of these communication difficulties may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.

What are the Consequences of The Difficulties of Working in a Hospice Environment?

The consequences of such employment is Occupational Burnout as well as Secondary Traumatic Stress.

What is Occupational Burnout?

“Job (occupational) burnout is defined as a prolonged response to job stressors, encompassing exhaustion, cynicism, and inefficacy (Maslach, Schaufeli, & Leiter, 2001); however, a more recent definition includes exhaustion and disengagement (Demerouti, Bakker, Vardakou, & Kantas, 2003; Demerouti, Mostert, & Bakker, 2010). Exhaustion, in this sense, refers to being drained of physical, cognitive and emotional energy as a result of exposure to job demands, while disengagement is interpreted as distancing oneself from work and possessing a negative attitude toward work-related objects and tasks. Job burnout is associated with depletion of energy and personal resources, which makes it an important factor in the process of health impairment (Basińska & Gruszczyńska, 2017). Burnout can cause the individual to be susceptible to other negative consequences of experienced stress, including posttraumatic stress disorder (PTSD) or secondary traumatic stress.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What is Secondary Traumatic Stress?

Secondary Traumatic Stress “is characterized primarily by symptoms of intrusion (returning thoughts, dreams related to trauma), avoidance (an effort to get rid of emotions, thoughts associated with traumatic event) and hyperarousal (increased vigilance, anxiety, and impatience; Bride, Robinson, Yegidis, & Figley, 2004 Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What is Compassion Fatigue?

In one article, it noted that “It is important to mention that the consequence of secondary exposure to trauma at work is also called compassion fatigue (Figley, 2002), which indicates that STS bears some similarity to burnout syndrome, especially to emotional exhaustion. According to Figley (1995) STS appears as a complex state of dysfunction and exhaustion in which emotional distress and suffering experienced by trauma victims is taken on by the helpers.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What are the Problems for Hospice Workers?

From the studies, as noted above, it would appear that the stress is two-fold. There is the stress from performing the job and there is the stress from dealing with the administration of the facilities. Thus, both the work, and the work-setting can be injurious to the worker on an emotional level.

If a Hospice Worker is Having Emotional Problems, What Should They Do? What Are the Concerns?

First, they should seek medical assistance. This can include utilizing an Employee Assistance Program if one is available. A workers’ compensation claim may be considered. Before doing so, an analysis should be done with respect to whether the worker will meet the threshold requirements for proving up a claim. Consultation with an attorney is recommended. Some of the threshold issues may involve the length of employment, outside stressors, and whether there has been good faith non-discriminatory personnel action.

What If I Need Legal Advice?

YOUNGER WORKERS AND WORK INJURIES: YOUTHFUL WORKERS, SPECIAL CONCERNS FOR YOUNGER WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 18, 2020 by Edward Singer

“When I was young, it seemed that life was so wonderful”

Supertramp

Does Age matter? Yes. Younger Workers get injured at different rates than Older Workers. A recent study brought light onto the issue of Age as a factor with respect to Work Injuries.

Younger Workers make up a significant number of the workforce. Adolescents and Young Adults represent approximately 13% of the U.S. workforce. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

As a result of this, like all workers, they sustain work-related injuries. Per a study, it was estimated that “3.2 million nonfatal injuries to young workers were treated in hospital emergency departments, with the highest rates among workers aged 18–19 years. Data from 2018 indicate that the leisure and hospitality industry [i.e. food service such as McDonalds hotels, and amusement parks] contributed the highest percentage of injuries to workers aged 15–17 years requiring at least 1 day away from work.” Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

This article will discuss the rates of injury for Younger Workers, the implications for Younger Workers who sustain work injuries, the special concerns a Workers’ Compensation Attorney has with respect to these claims, and how the Workers’ Compensation Systems addresses Younger Workers’ Permanent Disability.

What Was the Study?

The study that was done looked into nonfatal occupational injuries of Younger Workers within the United States during the years 2012 to 2018. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Does Age Make a Difference?

Yes. It was found that Younger Workers, aged 15-24, experienced a higher rate of job-related injury versus Adult Workers, aged 25-44. Supra.

Are There Any Interesting Facts Concerning the Injury Rates?

AGE RANGE WITH HIGHEST RATE OF INJURY: The highest injury rate (404 per 10,000 FTE) occurred among workers aged 18–19 years.

MALE VERSUS FEMALE: Within each of the four age categories, the rate of injury was 1.4 to 1.5 times higher among males than among females.

YOUNGER VERSUS MIDDLE AGED WORKERS: Annual rates of injuries among young workers aged 15–24 years were 1.2–2.3 times higher than those for workers aged 25–44 years. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Do Young People Get Hurt?

Younger Workers can get injured in a variety of ways. One of the reasons why Younger Workers get injured is that they are often learning on the job. This makes them more susceptible to injuries.

For example,

“Contact with objects and equipment was the leading cause of occupational ED-treated injuries among all age groups examined, with rates of injuries ranging from 64 per 10,000 FTE among workers aged 25–44 years to 182 per 10,000 FTE among workers aged 18–19 years.” Supra.

“Lacerations and punctures were the most common type of ED-treated injuries reported among workers aged <25 years, with injury rates ranging from 66 to 99 per 10,000 FTE, “ Supra.

To the contrary, it should be noted that

“strains and sprains were most common among workers aged 25–44 years (injury rate of 47 per 10,000 FTE).” Supra.

Why are Work Injuries to Younger Workers a Concern?

One of the big concerns with respect to Younger Workers in California is the issue of lifetime medical care. Young Workers, to some extent, are more able to recover from injuries versus Older Workers.

Some injuries that have long term implications. There are injuries which can cause arthritis. Arthritis can take decades to become a problem for the worker. Therefore, Younger Worker may need medical care decades after the injury happened. Many Young Workers do not understand or appreciate this fact. This is an issue of discussion concerning settlement of their case.

How Does the California Workers’ Compensation System View Younger Workers’ Permanent Disability?

Younger Workers’ Permanent Disability is not viewed as significant as older workers’ permanent disability. For the same injury, a Younger Worker will receive less money than an Older Worker.

How is a Younger Worker’s Age Factored into Permanent Disability?

In the SCHEDULE FOR RATING PERMANENT DISABILITIES UNDER THE PROVISIONS OF THE LABOR CODE OF THE STATE OF CALIFORNIA (2005) , there is a provision for adjusting with respect to the Injured Worker’s age.

One of the steps in the permanent disability rating formula is to make an age adjustment. Using a Table, a Younger Worker’s Permanent Disability is lowered via the rating adjustment. See Schedule at P. 1-9.

In sum, the Schedule has a specific table that is used in a permanent disability rating formula to lower the disability rating. The disability rating being lowered translates into less money for the Injured Worker.

What If I Need Legal Advice?

INDOOR SWIMMING POOLS, WATER PARKS AND WORK-RELATED ASTHMA: POOL WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 17, 2020 by Edward Singer

In California, there are many individuals who work at Water-Related Facilities. With respect to this article, the Water-Related Facilities to be discussed are swimming pools, water parks, and hydrotherapy spas.

These facilities have been implicated as a source of either “new asthma” or an “aggravation of a pre-existing asthma condition.” An “asthma-related injury” caused by work at such a facility would give rise to a workers’ compensation claim. Such a claim would allow the Injured Worker to obtain monetary compensation in the form of both temporary and permanent disability, medical care, and vocational rehabilitation benefits, if indicated.

This article will discuss the nature of Water-Related Facilities, conditions which make these facilities susceptible to “water-related asthma injuries”, and the types of workers at such facilities that are at risk.

What Has Science Found Concerning Water-Related Facilities and Asthma?

“Clinicians need to be aware of the potential adverse effect that indoor swimming pools and water parks may have on both causing the onset of new asthma and aggravating pre-existing asthma. Attention to swimming pools and water parks as potential triggers for asthma may, for selected patients, be an important factor in asthma management.

The American College of Chest Physicians has developed a consensus statement for the diagnosis and management of work-related asthma that clinicians can refer to when evaluating adult patients with asthma35 . Weisel CP, Richardson SD, Nemery B, et al. Childhood asthma and environmental exposures at swimming pools: state of the science and research recommendations. Environ Health Perspect. 2009;117(4):500-507. doi:10.1289/ehp.11513

What Types of Workers are Susceptible to these Injuries?

Lifeguards and Pool Maintenance Workers have been implicated to be at risk for these injuries.

What Is Asthma?

Per the Centers for Disease Control, “Asthma is a disease that affects your lungs…Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs.”

“Occupational asthma occurs when someone who never had asthma develops it because he or she is exposed to something at work. This can happen if you develop an allergy to something at work such as mold or if you are exposed to irritants such as wood dust or chemicals at work over and over at lower levels or all at once at higher levels.” Supra.

What is It About Pools that Can Bring on Asthma?

The term commonly used with respect to Occupational Asthma, in this setting, is Disinfection By Products (DBPs.)

“[T]traditional chemical disinfection processes result in the formation of disinfection by-products (DBPs) (Aggazzotti and Predieri 1986; Aggazzotti et al. 1998; Beech et al. 1980; Chu and Nieuwenhuijsen 2002; Fantuzzi et al. 2001; Glauner et al. 2005; Judd and Jeffrey 1995; Kim et al. 2002; Li and Blatchley 2007; Weil et al. 1980; Weisel and Shepard 1994; Zwiener et al. 2007). The specific types and levels of DBPs formed depend on numerous factors, including the type and amount of disinfectant used, characteristics of the swimming pool and pool water, and swimmer hygiene (Zwiener et al. 2007).” Weisel CP, Richardson SD, Nemery B, et al. Childhood asthma and environmental exposures at swimming pools: state of the science and research recommendations. Environ Health Perspect. 2009;117(4):500-507. doi:10.1289/ehp.11513

One study reported that it was “nitrogrogen trichloride is a cause of occupational asthma. This should be considered when choosing chlorine-based disinfectants that are likely to come into contact with a nitrogen source. It should also be considered in anyone developing occupational asthma working at a swimming pool and is also a likely cause of asthma in those who swim in these pools. To prevent further cases, much more attention should be paid to the quality of air in indoor swimming buildings, as well as t the care of the chlorine content of the water. Occupational asthma caused by chloramines in indoor swimming-pool air. K.M. Thickett, J.S. McCoach, J.M. Gerber, S. Sadhra, P.S. Burge, European Respiratory Journal 2002 19:827-832, DOR: 10.1183/09031936.02.00232802

Does the Worker Need to Go In the Water Be at Risk for Injury?

No. Workers who do not go into pools are at risk as well. Working at the swimming pool, but not going in the pool, may be a sufficient exposure. As noted above, it is an issue of air quality within the facilities that is a concern.

I Work at a Pool Facility and Am Having Lung Problems, What Should I Do?

It is recommended you seek medical attention, If you receive a diagnosis of asthma, you would consider filing a workers’ compensation claim. It is recommended you consult with an attorney as well.

What If I Need Legal Advice?