APPEALS RESOLUTION OFFICER DECISION

DECISION NUMBER:

20250055

OBJECTING PARTY:

WORKER

REPRESENTED by:

WORKER REPRESENTATIVE

RESPONDENT PARTY:

EMPLOYER (NOT PARTICIPATING)

HEARING:

HEARING IN WRITING

HEARD by:

DATED:

S. CRISOSTOMO, APPEALS RESOLUTION OFFICER

AUGUST 8, 2025

ISSUE

The worker objects to the Adjudicator’s decision dated October 8, 2019, which denied initial entitlement to Workplace Safety and Insurance Board (WSIB) benefits for a 2019 work-related allergic reaction.

BACKGROUND

The employer completed the Employer’s Report of Injury/Disease (Form 7) dated April 10, 2019 and indicated the hospital changed the gloves they used from vinyl to nitrile in early February of 2019 and that on February 20, 2019, following the worker’s return to work from vacation, the worker reported an allergic reaction to the gloves. Following the worker’s reported reaction, the employer converted back to vinyl gloves; however, the worker continued to report difficulties due to nitrile glove fumes in the air.

The worker completed a Worker’s Report of Injury/Disease (Form 6) dated April 30, 2019 and indicated upon their return from vacation on February 19, 2019, the dissemination of nitrile gloves began and that they knew they had some sensitivity to nitrile after using nitrile gloves one year earlier. Some of their co- workers were using nitrile gloves and as the gloves were used hospital wide, their symptoms of headaches, and eye, nose and throat irritation worsened. As a result, they sought medical attention.

Dr. Bozek’s Health Professional’s Report dated April 8, 2019 noted the worker was seen on April 8, 2019 related to an allergic reaction to the smell of nitrile gloves.

Following the establishment of the claim, the Adjudicator referred the worker for an assessment at Hospital A Occupational Disease Specialty Program, where the worker underwent patch testing and was seen by Dr. Betschel, Occupational Allergist.

Following the worker’s assessment at the Hospital A Occupational Disease Specialty Program, the Adjudicator reviewed the file in October of 2019. Based on the review, the Adjudicator denied entitlement for a 2019 work-related allergic reaction after determining the worker’s employment exposures did not significantly contribute to the development of their reported symptoms. This decision was communicated on October 8, 2019.

The worker objected to the October 8, 2019 decision; however, it remained unchanged and as a result, the matter was referred to the Appeals Services Division for further consideration.

Worker Representative’s Position

The worker’s representative submits:

• There is evidence to suggest that the worker’s symptoms were a reaction triggered by exposure to a component in the dye used in nitrile gloves.

• The worker’s affidavit supports that it was their prolonged and escalated airborne exposure to the components in the gloves that caused them to experience excessive symptoms.

• The worker’s assessing medical professionals all identified the nitrile gloves as being a barrier to their employment.

• Benefit of doubt should be given to the worker.

• Entitlement should be allowed for the worker’s 2019 allergic reaction.

Employer’s Position

The employer is not participating in the appeal and did not provide a submission related to the issue before me.

AUTHORITY

Sections 2(1) and 15 and Schedule 3 and 4 of the Workplace Safety and Insurance Act, 1997 (the Act)

Operational Policy Manual:

Published

11-01-01 Adjudicative Process 11-01-13 Benefit of Doubt

11-01-02 Decision-Making

November 3, 2008

October 12, 2004

October 12, 2004

ANALYSIS

I have carefully considered all of the available information, the applicable legislation, and the relevant operational policies in reaching this decision.

I find no evidence that the worker’s exposure to gloves (including nitrile) and/or rubber products at work significantly contributed to their reaction and development of symptoms in 2019. Therefore, initial entitlement to WSIB benefits for the worker’s reaction and symptoms in 2019 is denied. The reasons for my decision follow.

Operational Policy 11-01-01 related to the adjudicative process states in part: Five-point check system

All decision-makers use the same criteria for ruling on initial entitlement to Workplace Safety and Insurance Board (WSIB) benefits. This system is known as the "five-point check system.”

An allowable claim must have the following five points:

• an employer

• a worker

• personal work-related injury

• proof of accident, and

• compatibility of diagnosis to accident or disablement history.

Occupational disease cases are adjudicated under Section 2 (1) and s. 15 of the Act and by Regulation in Schedules 3 & 4 of the Act. If the disease is not listed in the Schedules, entitlement to benefits and services, is determined based on the merits and justice of the case. It must be established that it is more probable than not that the circumstances of the worker’s employment and exposure history significantly contributed to the development of the medical condition being claimed. In this case, the worker claims that they developed a reaction and symptoms in 2019, as a result of their exposure to nitrile gloves at work in early-2019.

There is no WSIB policy that applies specifically to the worker’s claim. Therefore, entitlement must be determined based upon the available evidence and the individual merits of the case.

A review of the file reveals:

• Dr. Bozek initially assessed the worker on April 8, 2019 and diagnosed them with an allergic reaction to the smell (my emphasis added) of nitrite gloves.

• Dr. Fischer, Allergist, saw the worker on April 16, 2019 and April 18, 2019, and noted that he was unaware of any patients having anaphylactic reactions to nitrite and that none of the tests performed on the worker for chemicals found in gloves caused the worker to have an allergic reaction. Based on the assessment, Dr. Fischer opined the worker’s symptoms of shortness of breath could be more of an over response to the smell of the gloves as opposed to something truly anaphylactic.

• Dr. De Koven, Dermatologist, assessed the worker May 22, 2019 and diagnosed them with a possible type 1 Immunoglobulin E reaction to nitrile gloves and/or latex and a possible anxiety reaction.

• The worker was seen by Dr. Betchel in July of 2019 at the Hospital A Occupational Disease Specialty Program-Allergy/Asthma Stream who performed a patch test with gloves. It was noted that after 30 minutes of patch testing different gloves the worker started to experience cold sweats, palpitations, and felt clammy; however, objectively there was nothing to see at the sites where the patches were applied. The worker was observed for approximately 60 minutes and reassessed with no objective changes including evidence of any rash; however, the worker stated that they felt generally unwell. Based on the assessment, Dr. Betchel opined that they were unable explain the worker’s symptoms based on cutaneous exposure to the gloves with nothing objective and that the worker’s symptoms were not compatible with typical allergic reactions to gloves or rubber products.

• Dr. Kerr assessed the worker using telecommunication tools on January 3, 2022, and diagnosed the worker with multiple chemical sensitivity syndrome, reaction to influenza immunization and allergic reaction to dye from patch testing.

For entitlement to be established for the worker’s 2019 reaction and development of symptoms due to exposures at work, it must be established that it is more probable than not that the circumstances of the worker’s employment and exposure history significantly contributed to the development of the reaction/symptoms and/or condition.

In assessing the medical evidence in the file, I place significant weight on Dr. Betchel July 2019 medical opinion for the following reasons:

• Dr. Betchel is an Occupational Allergist with extensive education and training in diagnosing allergies, asthma, and other immune system-related conditions.

• Dr. Betchel obtained a complete “picture” of the worker’s employment exposures and conditions prior to providing his opinion.

• Dr. Betchel’s opinion is well explained and supported through the available objective evidence (patch testing results).

• There is no specific medical evidence and/or opinion in the file from a physician who specializes in allergies that refutes Dr. Betchel’s opinion.

As such, I accept Dr. Betchel’s medical opinion that the worker’s reported symptoms were not compatible with typical allergic reactions to gloves or rubber products.

In the absence of any evidence that supports the worker was exposed to a toxic substance/exposure at work between February 19, 2019 and April 2019, that may have caused and/or contributed to their reported reaction and development of symptoms in 2019, I find the weight of the evidence noted above and contained within the record does not establish the worker’s reported reaction and symptoms in early 2019 was causally related to an employment exposure to gloves (including nitrile) or rubber products.

Therefore, I am satisfied on a balance of probabilities that the worker’s workplace exposures to gloves (including nitrile) or rubber products in early 2019 did not significantly contribute to their reaction and development of symptoms from February 2019 to April 2019. Thus, the criteria in Policy 11-01-01 for ruling on initial entitlement to WSIB benefits have not been met. Therefore, initial entitlement for the worker’s reaction and symptoms in 2019, due to their workplace exposure to gloves and/or rubber products is denied.

Benefit of Doubt

I recognize the worker’s representative submits that benefit of doubt should be given to the worker. Operational Policy 11-01-13 states in part:

Where it is not practicable to determine an issue because the evidence for or against the issue is approximately equal in weight, the issue shall be resolved in favour of the person claiming benefits.

Based on my assessment of the evidence, I find the evidence for or against the issue before me is not approximately equal in weight. Thus, the application of Operational Policy 11-01-13 would not be considered in this claim.

CONCLUSION

Based on the evidence outlined in this decision, I conclude entitlement for the worker’s reaction and symptoms in 2019 due their workplace exposure to gloves (including nitrile) and/or rubber products is denied.

The worker’s objection is denied.

DATED AUGUST 8, 2025

S. Crisostomo

Appeals Resolution Officer Appeals Services Division