HEARING LOSS AND WORKERS’ COMPENSATION: NOISE EXPOSURE AND INDUSTRIAL INJURY: WHAT YOU NEED TO KNOW

Hearing Loss, if there is industrial contribution, can be grounds for a workers’ compensation claim.  A workers’ compensation claim, if successful, would allow the Injured Worker to claim monetary benefits, medical care, and vocational rehabilitation benefits.   For Hearing Loss cases, if medically indicated, the Injured Worker would be entitled to be supplied Hearing Aids as long as they are deemed medically necessary pursuant to Labor Code Section 4600.

Hearing Loss can be caused for a variety of reasons.  One of the sources is noise.  Definitionally, it is called “Noise Induced Hearing Loss.” (NIHL)

This article will discuss “Noise Induced Hearing Loss”, how “Noise Induced Hearing Loss” can be work-related, what Occupations are susceptible to hearing loss, and other possible causes for industrial hearing loss.

Is there a Historical Legal Basis for Work-Related Hearing Loss?

Caselaw has supported work-related hearing loss.   In Messner vs. IAC, (1962) 27 Cal. Comp. Cases 226 (writ denied) it is quoted “[w]hile the distinction between the etiological mechanics of continuous trauma and disease may be elusive in its application to a particular set of facts, there is a considerable difference in the legal consequences flowing therefrom. The Commission has long taken the position that hearing loss is an occupational disease. We do not believe that we can alter the theory to fit the facts.” [emphasis added]

How is Noise Induced Hearing Loss (NIHL) Caused?

Noise-induced hearing loss (NIHL) occurs when loud noise causes an irreversible damage of the cochlear hair cells of the inner ear. This can occur by exposure to either intermittent or continuous hazardous sounds.  Hazardous noise sound levels can occur when they exceed 85 decibels.

What Type of Doctor Addresses Hearing Loss?

The field of medicine that addresses hearing loss is Otolaryngology.  Doctors within the specialty focus on the ears, nose and throat.  There are referred to as Otolaryngologists or also known as ENT (Ear, Nose, and Throat) Doctors.

Are There Controversies with Respect to Work-Related Hearing Loss?

Yes. There are controversies with respect to hearing loss claims.   They include causation and disability.

CAUSATION

An excellent example of an analysis of causation comes from the case of Kaiser Cement vs. WCAB (1986) 51 Cal. Comp. Cases 232 (Opinion Not Published.) The doctor opining non-industrial causation went through the following analysis. Bear in mind that this is a long analysis. While the WCAB did not side with this doctor, it clearly shows the depth and the analysis that will be done when a doctor evaluates a NIHL claim.

“The audiology report submitted by Dr. Billings noted noise exposure consisting  of use of rifles and 22-millimeter guns without hearing protection while applicant was in the Navy from 1942 to 1945, as well as noise exposure on the job at Kaiser Cement. Dr. Billings described the occupational noise exposure at Kaiser Cement as “Mill noise about 20% of the time while employed as a laborer by Kaiser Cement from 1966 to 1968 and about 50% of the time while employed as an electrician/oiler by Kaiser Cement from 1973 to 1979. [Applicant] was also exposed to conveyor belt noise, motor noise and fan noise while employed as a cooler tender by Kaiser Cement from 1968 to 1973 and he was exposed to noise from dozers, graders, scrapers and loaders while employed as a heavy equipment operator by Kaiser Cement from 1979 to 1984. [Applicant] did not wear ear protection from 1966 to 1973 but he did wear ear plugs whenever exposed to intense noise from 1973 on. Cement mill noise, conveyor belts, motors, fans and heavy equipment such as dozers, graders, scrapers and loaders can generate noise levels that are hazardous to hearing without the use of ear protection.”

Dr. Billings further reported nonoccupational noise exposure consisting of applicant’s recreational use of shotguns, rifles and pistols approximately 15 times between 1946 and 1984. Dr. Billings further noted that presbycusis (hearing loss due to normal aging) usually begins at about 45 years of age in males. Because the applicant was 58 years of age at the time of evaluation, Dr. Billings reported presbycusis as a causative factor related to his hearing loss. Dr Billings concluded, “It is most probable that at least a portion of [applicant’s] present hearing loss was caused by all of the above factors and that his noise exposure at Kaiser Cement was the major causative factor of the noise causative factors. It is also most probable that some other unknown medical factor caused a significant portion of [applicant’s] present hearing loss. This opinion is based on the fact that [applicant’s] present hearing loss is considerably more severe than would be expected from his noise exposure and presbycusis …. [M]ost employees who are exposed to intense occupational noise all day every day during a working lifetime of 21 years without wearing ear protection will not incure a hearing loss at 1,000 Hz and lower frequencies. In addition, it is generally accepted that a noise-induced hearing loss will reach a maximum level of about 70 dB HL, regardless of the number of years of exposure. Since [applicant’s] hearing loss in both ears exceed these criteria considerably, it must be concluded that some other medical causative factor is responsible for a significant portion of [applicant’s] present hearing loss in addition to his noise exposure and presbycusis. It is recommended that [applicant’s] hearing loss due to noise exposure be calculated as being 0 dB HL at 500 and 1,000 Hz and as being the maximum noise-induced hearing loss of 70 dB HL at 2,000 and 3,000 Hz in both ears. Using these levels in the AAO method for calculating percent hearing handicap …, [applicant] would have a 15% hearing impairment of the right ear, a 15% hearing impairment of the left ear and a 15% binaural hearing handicap. Using these levels for calculation gives [applicant] the benefit of the doubt since these levels are based on 21 years of full-time exposure to intense occupational noise without wearing ear protection while [applicant] was only exposed to noise about 20% of the time from 1966 to 1968 without wearing ear protection, he was exposed to noise all of the time (including many 12 to 18 hour days) from 1968 to 1973 without wearing ear protection and although he was exposed to noise from 1973 on (including many 16 hour days from 1979 to 1984), he wore earplugs during all of his noise exposure from 1973 on and he reported that the earplugs were effective in reducing the background noise levels.””

PERMANENT DISABILITY

Hearing Loss becomes a Permanent Disability when the testing reaches a certain level. Currently, the AMA Guides for Rating Permanent Impairment, 5th Edition apply.

The following is an analysis of hearing loss that was made under the old non-AMA Permanent Disability Schedule.  This case provides insight as to how a doctor will make a no Permanent Disability assessment.  In Fleming vs. WCAB (1975) 40 C.C.C. 642, “Dr. Charles Lebo in his reports dated August 17, 1973 and September 24, 1974 indicated that Fleming had a minor bilateral high frequency hearing loss and that noise induced hearing losses are permanent, non-progressive, untreatable and non-disabling. Dr. Lebo also stated that the “regular use of approved ear protectors” would let Fleming continue to work in his regular occupation “without the risk of further noise-induced ear damage.””

What Types of Industries/Occupations are Subject to Hearing Loss?

There are various industries that can be subject to hearing loss claims.  They include industries such as agriculture, airline, construction, law enforcement, mining, oil railroad, refining, safety, textile, and trucking. See Occupational Noise-induced Hearing Loss MH Azizi Int J Occup Environ Med Vol 1, No 3 (2010)

Further, there are occupations like Dentists, Professionals, and Trucking that are at risk of NIHL.

Besides NIHL, Are There Other Occupational Sources of Hearing Loss?

Yes. There are other Occupational Sources of Hearing Loss.  Hearing Loss can be caused by ototoxicity. “Ototoxicity is, quite simply, ear poisoning (oto = ear, toxicity = poisoning), which results from exposure to drugs or chemicals that damage the inner ear or the vestibulo-cochlear nerve.” Vestibular Disorders Organization. “Many chemicals have ototoxic potential, including over-the-counter drugs, prescription medications, and environmental chemicals.” Supra.

What If I Need Legal 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. Click Here.

BREAST CANCER, JOB CATEGORY, OCCUPATIONAL ACTIVITY AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

In the workplace, there are certain activities that makes one susceptible to work injury or illness.

A recent study examined Breast Cancer in relation to Job Category and Occupational Activity. Information from this study may assist an Worker on whether they should consider filing a claim for Breast Cancer.

This article will discuss Breast Cancer and the association it has with respect to Job Category and Occupational Activity and Workers’ Compensation.

What Is Breast Cancer?

Per the CDC, Breast Cancer is “a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.”

There are different kinds of Breast Cancers.   Some are more common than others.  The more common Breast Cancers are invasive ductal carcinoma and invasive lobular carcinoma.   Also, there are less common Breast Cancers that include Paget’s Disease and Inflammatory Breast Cancer.  Further, there is Ductal Carcinoma in Situ which is a breast disease which may lead to breast cancer.  CDC.

What Was Studied with Respect to Breast Cancer?

A recent study addressed whether job category or occupational activity were a risk factor with respect to Breast Cancer.  Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study Gita Nirmala Sari, Ehab Salah Eshak, Kokoro Shirai, Yoshihisa Fujino, Akiko Tamakoshi & Hiroyasu Iso  BMC Public Health volume 20, Article number: 1106 (2020)

The study did the following analysis and found that “[t]here were 138 incident cases of breast cancer during 13.3 years median follow-up period. Office workers compared with manual workers were at a higher risk of breast cancer after adjusting for reproductive health factors and physical activity indicators; the multivariable HR (95% CI) was 1.65 (1.07–2.55). Also, women who had mainly a sitting position during work compared with those moving during work had the higher risk: the multivariable HR (95%CI) of 1.45 (1.01–2.12). The excess risk of breast cancer was observed for office workers when time spent in walking was < 30 min/ day; HR (95% CI) was 1.11 (1.01–1.23), and for women mainly at a sitting position during work when time spent in walking was 30–59 min or < 30 min/day; HRs (95% CIs) were 1.87 (1.07–3.27) and 1.74 (1.07–2.83), respectively.”

What Did the Study Find?

The study found that certain work activities can be associated with breast cancer.   The study did an analysis as to the there is an association with respect to physical activities and Breast Cancer.   It found that “Office workers compared with manual workers were at a higher risk of breast cancer.” Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study Gita Nirmala Sari, Ehab Salah Eshak, Kokoro Shirai, Yoshihisa Fujino, Akiko Tamakoshi & Hiroyasu Iso  BMC Public Health volume 20, Article number: 1106 (2020)

What was a Manual Worker for the Study? What was an Office Worker?

In the study, there was a focus on Manual (Active) Workers vs. Office (Inactive) Workers.

The study used a “self-administered questionnaire, participants were further asked to classify their job category into office, manual and others. Based on the Japan Standard Industry Classification (JSIC) published by the Ministry of Internal Affairs and Communication of Japan which included a wide range of specific jobs coded from 1 to 99 [22], the participants who answered the job category as others were allocated to manual (for examples; sales, restaurant, forestry, fisheries workers, etc.), office (for examples; clerk, postal, management staff, etc.), professional (for examples; health worker, judges, accountant, musician, etc.) and unclassified job categories. For the current research, we reclassified job categories into four categories namely manual, office, professional and unclassified. The occupational activity was classified according to the position during work as moving, mainly standing and mainly sitting. Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study Gita Nirmala Sari, Ehab Salah Eshak, Kokoro Shirai, Yoshihisa Fujino, Akiko Tamakoshi & Hiroyasu Iso  BMC Public Health volume 20, Article number: 1106 (2020) [emphasis added]

What Was the Level of Physical Activity Used Within the Study?

The associations of the breast cancer risk with the job category and occupational activity were tested after the stratification by walking time (< 30 min/day, 30–59 min/day, or ≥ 1 h/day). [Note: walking time was the physical activity used to differentiate.]

What Does this Study Mean for Injured Workers Who Have Breast Cancer?

If you are a Worker who is succumbed with Breast Cancer, you should look to see if you fit within the framework of the study.  Please note that this study is not an exclusive of the proposed industrial causes of breast cancer.   This article is limited to the issue of activity and occupation.

Are There Other Studies Which Support the Theory of Decreased Physical Activity and Increased Risk of Breast Cancer?

There was a previous study which also supported the theory of increased activity and the reduction of the risk of breast cancer.  Physical Activity and the Risk of Breast Cancer Inger Thune, M.D., Tormod Brenn, M.Sc.,  Eiliv Lund, M.D., Ph.D., and Maria Gaard, M.D. May 1, 1997 N Engl J Med 1997; 336:1269-1275 DOI: 10.1056/NEJM199705013361801. The conclusion of the report was “Physical activity during leisure time and at work is associated with a reduced risk of breast cancer.”

What If I Need Legal 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. Click Here.

CLEANING PRODUCTS AND WORK-RELATED ASTHMA: HOUSEKEEPERS, PROFESSIONAL CLEANERS, JANITORS, AND HEALTHCARE WORKERS: WHAT YOU NEED TO KNOW

Cleaning Products can be a source of Industrial Asthma also known as Occupational Asthma.   There are certain occupations that account for a large percentage of these claims.  This article will discuss Industrial Asthma, the occupations that are at risk for Industrial Asthma.  It will also discuss caselaw on the issue as well.

What is Industrial Asthma?

Per the American Academy of Allergy, Asthma, and Immunology, “Occupational asthma has become the most common work-related lung disease in developed countries. However, the exact number of newly diagnosed cases of asthma in adults due to occupational exposure is unknown. Up to 15% of asthma cases in the United States may be job-related. Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while “on the job.”  Often, …symptoms are worse during the days or nights…work[ed], [and] improve[d] when…[there is]time off and start again when…[there is a return] to work.”

What Occupations Are Impacted by Industrial Asthma?

The highest percentages worked in healthcare (41.1%), and were building cleaners (20.3%), or registered nurses (14.1%.) Cleaning Products and Work-Related Asthma 10 Year Update DOR 10.1097 JOM.0000000000001771

It has been found that Cleaners are at risk of some asthma‐associated symptoms and reduced lung function. Respiratory health in professional cleaners: Symptoms, lung function, and risk factors https://doi.org/10.1111/cea.13597

A “study found that professional cleaners have an increased risk of current asthma and reduced lung function. Cleaners identified as having asthma were more likely to be non‐atopic, less likely to have a doctor diagnosis of asthma ever, and had airway obstruction that was less responsive to bronchodilator administration. Amongst cleaners, working in cafes/restaurants/kitchens and/or use of multi‐use cleaner and upholstery sprays was associated with a significantly increased asthma risk, whilst exposure to glass cleaning sprays was associated with reduced (pre‐bronchodilator) lung function.” Respiratory health in professional cleaners: Symptoms, lung function, and risk factors    https://doi.org/10.1111/cea.13597

Further, concerns of Industrial Asthma relate to domestic cleaners as well.  See Job hazards and respiratory symptoms in Hispanic female domestic cleaners Kristina W. Whitworth,Brenda Berumen-Flucker,George L. Delclos,Sonia Fragoso,Claudia Mata & David Gimeno Ruiz de Porras,Pages 70-74 | Published online: 29 Apr 2019 https://doi.org/10.1080/19338244.2019.1606774 (“In conclusion, this vulnerable population has high prevalence of physician-diagnosis asthma and BHR(bronchial hyperresponsiveness) symptoms and is potentially exposed to myriad occupational hazards.”)

What Types of Agents Do Cleaners Use that May be Involved with Industrial Asthma? 

“Cleaners are frequently exposed to a range of agents including chlorine/bleach, ammonia, ethanolamines, chloramine‐T, aldehydes, and quaternary ammonium compounds (QACs),7 which may contribute to both new‐onset asthma through sensitization (in a minority) or irritation, and exacerbation of pre‐existing asthma.8 Importantly, as many people worldwide, other than cleaners, are exposed to cleaning products, asthma due to, or exacerbated by cleaning products is a considerable public health concern.”  Respiratory health in professional cleaners: Symptoms, lung function, and risk factors,  https://doi.org/10.1111/cea.13597

Is There Any Caselaw Concerning Cleaners and Asthma? 

In LAUSD vs. WCAB (2007) 72 C.C.C. 1719 (writ denied), a Health Care Assistant was found to have sustained an injury to her lungs and in the form of asthma when Applicant was exposed to toxic fumes during daily cleaning duties from chlorine gas that evaporated from hypochlorite found in the cleanser, “Dispatch.”

Is there anything Important that an Injured Worker can do if They believe that They have Industrial Asthma?

There are three things that are recommended.   First, the Injured Worker should seek medical attention to diagnose and treat their condition.   Second, the Injured Worker should documents the chemicals and cleaning material that they use on the job.   Third, the Injured Worker should seek a consultation whether an industrial injury claim should be pursued.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

The California Public Employees’ Retirement System (CALPERS) and Your Workers’ Compensation Case: What You Need to Know

The California Public Employees’ Retirement System (CALPERS) is a California State Agency which is responsible for managing the pension and health benefits for California Public Employees, Retirees and their families. If you are an employee with the State of California or have an agency which contracts with CALPERS, you most likely are eligible to receive a CALPERS retirement.

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Workers’ Compensation Back Injuries: What You Need to Know

How can Industrial Back Injuries occur?

In California, Workers’ Compensation Back Injuries can occur in many ways. Injuries can be the result of a specific incident, a cumulative trauma, a presumptive injury, or a compensable consequence arising out of an injury to other body parts or systems. A Back Injury can also be an aggravation of a pre-existing back condition. This article discusses the types of industrial back injuries, the testings that are available, an the treatments that are available.

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