Case Name: PAULINE C. HANSEL, Employee-Plaintiff v. SHERMAN TEXTILES, Employer; TRAVELERS INSURANCE COMPANY, Carrier-Defendants
Court: North Carolina Court of Appeals
Jurisdiction: North Carolina
Decision Date: 1980-10-07
Citations: 49 N.C. App. 1
Docket Number: No. 8010IC207
Parties: PAULINE C. HANSEL, Employee-Plaintiff v. SHERMAN TEXTILES, Employer; TRAVELERS INSURANCE COMPANY, Carrier-Defendants
Judges: Judge Hedrick concurs.
Reporter: North Carolina Court of Appeals Reports
Volume: 49
Pages: 1–14

Head Matter:
PAULINE C. HANSEL, Employee-Plaintiff v. SHERMAN TEXTILES, Employer; TRAVELERS INSURANCE COMPANY, Carrier-Defendants
No. 8010IC207
(Filed 7 October 1980)
Master and Servant § 68- worker’s compensation - byssinosis caused by employment - insufficient evidence
The evidence was insufficient to support a determination by the Industrial Commission that plaintiff contracted byssinosis as a result of her exposure to cotton dust in her employment as a weaver with defendant where plaintiffs medical expert testified that he was unable to make a definitive diagnosis of byssinosis because he had no information about the extent of plaintiffs exposure to cotton dust and because plaintiff suffered from asthma and chronic bronchitis, and where there was no finding with respect to the amount of cotton dust ordinarily present in the area where plaintiff worked.
Judge Wells dissenting.
Appeal by defendants from Opinion and Award of the North Carolina Industrial Commission filed 17 December 1979. Heard in the Court of Appeals 28 August 1980.
Plaintiff seeks recovery on the grounds that she contracted byssinosis as a result of exposure to cotton dust in the course of her employment as a textile worker in defendant’s plant. At the hearing before the deputy commissioner, the plaintiffs evidence consisted of her own testimony, the testimony of Dr. T. Reginald Harris, a pulmonary specialist who had examined plaintiff, and a medical report made by Dr. Harris following his examination of plaintiff.
Plaintiff is 51 years old and has worked some 31 years in various textile plants in the Gastonia-Bessemer City area. Most of her work assignments have been in the weave room area of the plants in which she has been employed. Plaintiff has a history of respiratory problems which dates from her early childhood. At the age of nine years, she suffered from an inability to breathe properly through her nose while lying in a prone position. When she first started to work in the textile mills, she complained of a dry, hacking cough which bothered her both at home and at work, but was more severe while at work. In 1948, plaintiff was advised by her doctor that she had chronic bronchitis. In 1964 and again in 1974, plaintiff had surgery performed on her vocal cords. Plaintiff began her employment with defendant in 1967. About 1970, plaintiff was advised by a doctor that she had asthma and that she had been suffering from the condition for some period of time theretofore. Plaintiff has smoked cigarettes since age 16 and for the last 25 years, has averaged a pack a day. Sometime during 1971, plaintiff developed a mucous producing cough which was accompanied by tightness in the chest and swelling of the throat. These'symptoms became more severe when the plaintiff returned to work at the plant following a weekend or vacation absence. On eight different occasions, these symptoms culminated in blackout spells. In 1975, plaintiff learned that she had emphysema and signs of byssinosis. In 1977, she was hospitalized for three weeks in Black Mountain and was told that she suffered from chronic obstructive lung disease. Plaintiff was advised that she could continue to work only if she did so in a dust-free environment. Upon her return to work, plaintiff was reassigned to the cloth-inspection room of defendant’s plant. Her symptoms did not abate, however, and she terminated her employment on 5 May 1977.
On 10 August 1978, plaintiff was examined by Dr. Harris who testified as a medical expert. Dr. Harris noted that there exist three distinct syndromes which probably contribute to the plaintiffs current impairment. These he identified as asthma, chronic bronchitis, and possibly byssinosis. He went on to state, however, that he was unable to make a definitive diagnosis of byssinosis in this case. Here, he noted two distinct reasons as the source of his difficulty.
First, the preexisting chronic bronchitis and asthmatic conditions make a byssinosis diagnosis more difficult because of the tendency of the three syndromes to manifest identical symptoms. In this regard, Dr. Harris noted his inability “to separate out any specific symptoms related to byssinosis that this lady has that cannot be explained by the other two conditions that are present.”
The second factor which makes a conclusive diagnosis more difficult is the absence of sufficiently specific information about the density of cotton dust in plaintiffs work environment. Dr. Harris testified that ordinarily the weave room in a textile plant is an area of minimal cotton-dust exposure, and that he had no information as to what plaintiffs history of cotton-dust exposure had been. He noted further that such information “is one factor that would tend to add weight or less weight to consider the diagnosis” and that the less the amount of cotton dust in plaintiffs work environment, the greater the improbability that plaintiffs current impairment is a result of byssi-nosis.
Defendant’s evidence consisted of the testimony of William Michael Jackson, the plant manager at the facility where plaintiff worked. He testified, in pertinent part, that most of the material handled by Sherman Textiles is sixty percent cotton and forty percent rayon, that the weave room where plaintiff worked was ventilated by seven, five-foot by five-foot fans, and that while the operations conducted in the weave room are productive of some dust, the amount of dust produced is very small, particularly in comparison to other plant operations.
Deputy Commissioner Denson concluded that plaintiff had contracted byssinosis as a result of her exposure to cotton dust in her employment with defendant and that plaintiff was due compensation for permanent partial disability. On appeal, the full Commission, with one member dissenting, affirmed and adopted the Opinion and Award of the deputy commissioner. From the adverse ruling of the full Commission, defendant appealed.
Frederick R. Stann, for plaintiff appellee.
Hollowell, Stott & Hollowell, by Grady B. Stott, for defendant appellants.
The weave room is that area of a textile plant where the processed yarn is woven into fabric. Before the material reaches this phase of processing, it has been treated with water and a special sizing formula to cut down on flying lint and to make it easier to handle during the weaving process. The weave room is the final phase of processing performed at defendant’s textile plant.

Opinion:
ERWIN, Judge.
Defendants raise assignments of error to the findings of fact by the full Commission. For the reasons which follow, we conclude that the Commission's findings are not supported by sufficient competent evidence to support the award and, therefore, vacate the award of the full Commission.
For purposes of our review, the pertinent facts as found by the deputy commissioner and adopted by the Commission follow:
"FINDINGS OF FACT

In 1967 plaintiff began working for defendant-employer as a weaver. Except for a six month's absence in 1971, plaintiff worked continuously until May 5, 1977. The air was very dusty from the cotton that was processed.
Plaintiff in about 1972, began to notice that when she began the work week on Sunday night, she would have chest tightness and some coughing after being there two or three hours. In about 1974 or 1975, plaintiff felt that way all the time at work with no particular time being worse.
EXCEPTION NO. 1
3. Because of shortness of breath and other respiratory problems and some blackout spells, plaintiff moved to the cloth room during the last six months of her employment by defendant. This took her out of dust but her respiratory problems had reached the irreversible stage, and she could hardly exert herself. She quit on May 5, 1977 because of respiratory problems.
EXCEPTION NO. 2
4. Plaintiff has both asthma and byssinosis which are causing her respiratory impairment. Her impairment is severe and irreversible.
EXCEPTION NO. 3
5. Plaintiff has byssinosis as a result of her exposure to cotton dust in her employment with defendant-employer and this is partly responsible for her disability.
EXCEPTION NO. 4
6. Plaintiff has not worked since May 5, 1977."
On the basis of the foregoing findings of fact, the deputy commissioner made the following conclusions of law which were adopted by the Commission:
"1. Plaintiff has contracted the disease byssinosis as a result of exposure to cotton dust in her employment with defendant-employer. This disease is compensable under the provisions of G.S. 97-53 (13).
EXCEPTION NO. 5
2. Defendants owe plaintiff compensation for permanent, partial disability from May 5, 1977 for her period of disability not to exceed 300 weeks. G.S. 97-30.
EXCEPTION NO. 6."
It is well settled in this jurisdiction that the findings of fact of the Industrial Commission are conclusive on appeal when they are supported by any competent evidence, even though there is evidence that would support a contrary finding. Willis v. Drapery Plant, 29 N.C. App. 386, 224 S.E. 2d 287 (1976); Russell v. Yarns, Inc., 18 N.C. App. 249, 196 S.E. 2d 571 (1973); 8 Strong's N.C. Index 3d, Master and Servant, § 96. Therefore, while a review in this Court of actions taken by the full Commission does not contemplate a retrial of the facts of the case here, we do have the duty of reviewing questions of law and of legal inference as decided by the full Commission. For this purpose, questions of law include: "(1) Whether or not there was any competent evidence before the Commission to support its findings of fact; and (2) whether or not the findings of fact of the Commission justify its legal conclusions and decision." Inscoe v. Industries, Inc., 292 N.C. 211, 216, 232 S.E. 2d 449, 452 (1977).
As noted above, the deputy commissioner concluded, inter alia, the "[pjlaintiff has contracted the disease byssinosis as a result of exposure to cotton dust in her employment with defend ant-employer" and that "[t]his disease is compensable under the provisions of G.S. 97-53 (13)." The statutory scheme for occupational diseases set forth in G.S. 97-53 provides in part as follows:
"§ 97-53. Occupational diseases enumerated; when due to exposure to chemicals. — The following diseases and conditions only shall be deemed to be occupational diseases within the meaning of this Article:

(13) Any disease, other than hearing loss covered in another subdivision of this section, which is proven to be due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation or employment, but excluding all ordinary diseases of life to which the general public is equally exposed outside of the employment."
The clear import of this language is that in order for an illness to be compensable under the Act, it must be fairly traced to the employment as a contributing proximate cause. That there must be established a causal relation between the disabling condition and the performance of some duty of the employment is well settled in the law of this State. In Booker v. Medical Center, 297 N.C. 458, 256 S.E. 2d 189 (1979), our Supreme Court expressly held that proof of a causal connection between the disease and the employee's occupation is an essential element in proving the existence of a compensable "occupational disease" within the meaning of G.S. 97-53. There, the Court noted that in addition to the statutory limitations that the disease be "characteristic" of a trade or occupation and that it not be an ordinary disease of life to which the general public is equally exposed outside of the employment, "[t]he final requirement in establishing a compensable claim under subsection (13) is proof of causation. It is this limitation which protects our Workmen's Compensation Act from being converted into a general health and insurance benefit act." 297 N.C. at 475, 256 S.E. 2d at 200. As a guide in determining what evidence would suffice for purposes of proving causation, the Court went on to state as follows:
"Among the circumstances which may be considered are the following: (1) the extent of exposure to the disease or disease-causing agents during employment, (2) the extent of exposure outside employment, and (3) absence of the disease prior to the work-related exposure as shown by the employee's medical history." (Emphasis added.)
297 N.C. at 476, 256 S.E. 2d at 200.
It is apparent upon review of the evidence in the case sub judice that the Commission's conclusion that plaintiff had contracted byssinosis during her employment with defendant is based in large part upon the expert medical testimony of Dr. Harris. We are of the view that such evidence, when considered in connection with the other evidence adduced at the hearing, fails to establish the requisite causal relation between plaintiff's disability and her employment and does not support the Commission's findings.
A diagnosis of byssinosis represents a medical conclusion that one's respiratory problems stem from prolonged exposure to high levels of cotton dust. For purposes of our review, the testimony of Dr. Harris is particularly noteworthy because of the conspicuous absence of any such conclusion. Indeed, the doctor admitted that he was unable to repose much confidence in a diagnosis of byssinosis in Mrs. Hansel's case, because he had no information about the extent of her exposure to cotton dust and because of the presence of the asthma and chronic bronchitis conditions, which could account for the symptoms which plaintiff experienced. In response to a hypothetical question propounded by plaintiff as to whether her condition could or might be byssinosis, Dr. Harris gave the following response:
"Cotton, you said. If she did not work in cotton, I would not have any diagnosis of byssinosis. In her particular case, I don't really have any reliable information as to what the particular fiber was and the extent of exposure to various fibers and exposure, and to what was in the weave room. It is more difficult to answer that question."
When plaintiff repeated her hypothetical question asking the witness to assume the additional fact that plaintiff had been exposed to a significant amount of cotton dust, the witness responded, "There is a possibility that she has byssinosis and she certainly could have." Dr. Harris went on to explain, however:
"I have difficulty in this patient for several reasons, to answer so specific a question. One of the difficulties, Pm not really aware of how much cotton dust exposure this lady was involved. Your hypothetical question assumed considerable amounts of cotton dust exposure . If there was a lot of other fibers in the cotton in that department, there would be less exposure."
On cross-examination, Dr. Harris noted: "Because asthmatics react to all manners of dust. I said the symptoms of coughing, tightness of the chest could result or could be caused by the asthmatic condition rather than the breathing of dust." The above excerpts are representative of the tenor of the entire testimony offered by Dr. Harris.
Our review of the record reveals that the absence of specific findings with respect to the amount of cotton dust ordinarily present in the area where plaintiff worked leads us to conclude that the Commission's finding that the plaintiff contracted bys-sinosis as a result of her exposure to cotton dust in her employment with defendant is unsupported by sufficient competent evidence.
The award of the full Commission is
Vacated.
Judge Hedrick concurs.
Judge Wells dissents.