Canadian Safety Reporter

5 Canadian HR Reporter, a Thomson Reuters business 2018 News | October 2018 | CSR Mask requirement not reasonable modified duties for nurse Bleach caused respiratory problems for nurse, but she refused modified duties that required her to wear a mask all the time BY JEFFREY R. SMITH AN ONTARIO nurse is entitled to loss of earnings benefits after she refused a return-to-work plan that included modified du- ties that weren't suitable for her to work with, the Ontario Work- place Safety and Insurance Tri- bunal has ruled. The worker was a registered nurse in the intensive care unit (ICU) at a Stratford, Ont., hos- pital starting in 2004. In Octo- ber 2011, the worker visited her family doctor about respiratory problems she was experiencing. She claimed the problems were related to repeated exposure to bleach since May — when the hospital responded to an out- break of antibiotic-resistant bacteria with a "terminal clean" of bleach and water. The worker had never experienced any re- spiratory problems previously. The doctor noted that the worker had a "possible sensitiv- ity to bleach fumes" and pre- scribed an inhaler and medica- tion. He referred her to an allergy clinic, which identified "airway hyper responsiveness and possi- ble asthma" and medical reports linking bleach to such problems. The clinic recommended the worker avoid bleach and sug- gested the ICU not use bleach the day before her shifts and during her shifts, pointing out a couple of non-bleach products that could be effective for infec- tion control. The hospital arranged for the worker to be assessed by an oc- cupational disease specialty pro- gram to clarify the diagnosis and determine its compatibility with the worker's exposure to bleach at work. The assessment recom- mended using "an alternative to bleach-based cleaning… if there is an alternative that would be acceptable to the hospital's in- fection control policy." The assessment also noted that if it wasn't feasible for the hospital to replace bleach as a cleaning agent, then the worker should avoid all exposure to bleach and the hospital should inform her when bleach was to be used so she could remove her- self from the area. The Ontario Workplace Safe- ty and Insurance Board (WSIB) found there was proof of expo- sures to bleach in the workplace that caused the worker "irritant induced asthma" and granted her loss of earnings benefits for time she missed due to her con- dition in June 2012. At the same time, the WSIB also granted her entitlement for a rib muscle strain she suffered in a coughing episode she had on Dec. 6, 2011, after being exposed to bleach. The worker returned to work on accommodated duties on June 9, 2012. However, she con- tinued to experience respirato- ry problems due to bleach expo- sure and missed work because of them. The WSIB arranged a return-to-work meeting in No- vember with a specialist, who recommended the worker wear a respirator throughout her shift. As part of the accommo- dation, the hospital wouldn't re- quire her to treat patients using N95 respirators, who were kept in negative pressure rooms. When necessary, the worker could wear a surgical mask over top of her respirator for a full face shield. Disagreement over return-to-work plan The return-to-work meeting was unsuccessful, so another was scheduled one month later. The hospital agreed the worker could return on Dec. 15 and they would follow a policy that in- cluded the following: • All bleach products would be stored in a locked storage cabinet in a housekeeping closet. • All instances of bleach use were to be recorded. • Housekeeping staff were to inform the worker of upcoming bleach cleaning. • The worker would keep the key to the bleach cabinet with her while on shift so no one could use bleach without her knowledge. • No bleach was to be brought from other areas of the hospital. • The written policy was to be posted above the storage cabinet. • The worker would wear the respirator at all times in the hospital, unless bleach hadn't No guarantee > pg. 8 Credit: Shutterstock/Africa Studio A specialist recommended the worker wear a respirator throughout her shift

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