COPD and ADA

hrpagersd

We have an employee who was diagnosed with COPD (chronic obstructive pulmonary disease). This employee works in a transitional residence for people with mental illnesses and works the overnight shift. In November, the employee stated she would need to use oxygen during work hours once in a while. We then asked for a letter from the doctor stating this was necessary and we asked her to review the safety conditions that having an oxygen tank at work would bring to the workplace, and after reviewing with her doctor there wasn't any real issues. (At this time we did have her fill out FMLA paperwork and we did get the certification back.) The employee then asked to park in the handicapped parking spot so she didn't have to haul her oxygen tanks so far. We then asked for another letter from the doctor stating that employee was asking for this accomodation and this parking spot was necessary and we received that.

Two weeks ago, we received an email from the employee stating the cleaning products were affecting her COPD and she could no longer use most of the cleaning products. We told her this request was too vague and we needed a detailed list from her doctor of what items affect her medical condition. The Physician Assistant responded back with a letter that states, "I have been in contact with the patient and she has a list of products that seem to cause more breathing difficulties for her." They go on to list a series of cleaning products, candles, insect repellent, oil smells, gas and diesel fuel, hairspray, perfume, bleach, ammonia, smoke, air freshners, lysol, comet, ajax, WD-40, glass cleaners, exhaust fumes.

I don't feel that this letter medically states what products affect her COPD, it states the employee's opinion. We want to know what exactly affects her condition so we can find replacement products for cleaning as it is an essential function of the job to clean and assist the people in cleaning. Any suggestions on how I proceed from here?

Thanks in advance!

davids

[font size="1" color="#FF0000"]LAST EDITED ON 01-26-09 AT 12:34PM (CST)[/font][br][br]I have dealt with employees with environmental allergies and they almost all were messy situations. It is difficult to pinpoint the exact cause of some allergies. She could be allergic to a specific product or an ingredient in several products; or a combination of ingredients. Doctors will rely on the patient to to tell them what products cause a reaction.

I think you are on the right track by trying to find replacement products as far as meeting your obligations under ADA. However, with such a wide range of potential allergens, you will probably not be able to make the work environment allergen-free. You will probably get to a point at which you decide you have done all you can and the employee needs to make decisions on continuing to work. You will want to consult with an attorney before you get to that point.

cnghr

Since COPD is an actual lung disease, not an environmental allergy, this can make it even more difficult to pinpoint what the employee is reacting to in the products she's reacting to. COPD is a progressive disease that causes narrowing of the airways, and this narrowing is in reaction to ongoing exposure to certain things (like smoking or prolonged exposure to asbestos dust or certain kinds of dust in some mining operations) and there may be a whole range of things, as the employee apparently listed, that may make it more difficult for her to breathe. It may not necessarily be particular ingredients in any of the products she uses, it may just be that anything like that in the air causes irritation to her already narrowed airways, causing her further breathing difficulty. Certain camps feel that the effects of COPD may be mitigated and slow down progression of the disease if it is caught early enough, but if she has already been put on oxygen for it, the odds are pretty good that it is full blown and will only get worse.

I agree with David, except to say that you will probably not be able to make the work environment "irritant free" as opposed to "allergy free", since she is not suffering from an allergy.

jennifer jo

Have you considered sending her to a Dr. of your choice at your cost? I work in mental health too and we have staff overnight in our group homes. Does this ee stay awake or sleep? I have found our very own medical staff to be very helpful to me in these situations. On the few occasions that I have referred ees out for a second opinion, I have selected the Dr. based on our own medical director's professional opinion. It's worked out well. Good luck. Keep us posted.