Case 3: Steamfitter, construction industry

• Worked as a steamfitter at various companies throughout the construction industry, for approximately 30 years.
• Was diagnosed with Parkinson’s disease.
• Advocate was examining whether his Parkinson’s disease was caused by numerous chemical exposures throughout his working career.

Exposure History

• Based on exposures reported by the client, documented in the literature and based on his work as a steamfitter in close proximity to welders, he was most notably exposed to the following:
  • Manganese (from welding rods)
  • Iron
  • Carbon monoxide
  • Ozone
  • Copper
  • Mercury
  • Chlorine
• The worker also reported working indoors in mainly poorly ventilated areas.
• Prior to 1986, he reported not wearing any personal protective equipment.

Symptoms and Risk Factors

• Parkinson’s disease is a progressive neurological disorder with symptoms including resting tremor, muscular rigidity, bradykinesia and postural instability. Depression and/or dementia are also developments of the disease¹.
• The cause of Parkinson’s disease is still unknown, however many causative factors have been identified in the literature, including genetic factors, atherosclerosis, viral infections, head trauma, certain medications, environmental exposures² and smoking³.
• Occupational risk factors for the development of Parkinson’s disease include exposure to various metals such as manganese and iron (and the combination of the two) and copper. Carbon monoxide exposure has also been associated with its development.
• Exposures encountered in welding, most notably manganese, iron and copper have been associated with the development of Parkinson’s disease.

Opinion and Conclusion

• Based on information provided by the client and in review of the literature, the client was exposed to chemicals which have a potential association with the development of Parkinson’s disease, mainly manganese, copper and iron, and perhaps high levels of carbon monoxide.

WSIB Decision

• This case was won. The decision letter concluded that "it has been established that it is more probable than not that your employment did significantly contribute to the development of your medical condition of manganese related Parkinsonism or manganese toxicity."

i1. Aminoff MJ. 1998. Parkinson’s disease and other extrapyramidal disorders. In Fauci, Braunwald, Isselbacher,
     Wilson, Martin, Kasper et al. (14th edition.) harrison’s principles of internal medicine. New York: McGraw-Hill;
     pp. 2356-57.

2.  Smeltzer SC and Bare BG. 2000. Medical-surgical nursing. (9th Edition). New York: Lippincott.

3.  Gorell JM et al. 2004. Multiple risk factors for Parkinson’s disease. Journal of Neurological Sciences;
     217(2): 169- 174.