Employee worked as a hairdresser for 47 years. (Cl. Ex. 3 at 14/3). He graduated from beauty school in 1967 and worked at a number of salons including Stix, Baer \& Fuller, Famous Barr, Cut-Zaven, ${ }^{1}$ and Papillon. Id. at 14/6-9, 15/3-4, 15/22-24, 16/9-11. He was employed by Cut-Zaven between 1976 and 1979. Id. at 16/3-5. He was employed by Papillon between 1979
[^0]
[^0]: ${ }^{1}$ Although Employee refers to Cut Le Coupe and not Cut-Zaven in his deposition testimony, I will refer to Cut Le Coupe as CutZaven in this Award due to the fact that Cut-Zaven and Cut Le Coupe are the same entity. See Employee's Ex. 3 at 51/22-25.
and 1982. Id. at 16/9-11. He was a self-employed hairdresser from 1983 until the fall of 2014. Id. at $36 / 18-25,37 / 1-10$. Employee believed he was exposed to asbestos from using hairdryers throughout his employment as a hairdresser until they were taken off the market. Id. at 19/15-21, $53 / 20-22$.
Employee used hand-held hairdryers, which he believed contained asbestos, when he worked at Famous Barr in 1971. (Cl. Ex. 3 at 27/4-13). Employee testified he used the following hand-held hairdryers while employed at Famous Barr: Clairol (Employee was unable to recall the name of the specific Clairol hairdryer he used but testified it was a big, yellow hairdryer. He testified the Clairol "Son of a Gun" sounded familiar to him. He also recalled using some General Electric brand hand-held hairdryers at Famous Barr but did not name any specific model numbers. He testified he believed he used some General Electric "Power Turbo" model hairdryers, but indicated it had been many years ago. (Cl. Ex. 3 at 27/11-25, 28/1-12.)
While working at Cut-Zaven, between 1976 and 1979, Employee testified he used Conair "Pro Style" hand-held hairdryers, Clairol "Son of a Gun" hairdryers, and General Electric "Power Turbo" hairdryers. Id. at 28/13-25, 29/1-6. Employee believed the hand-held hairdryers he used at Cut-Zaven exposed him to asbestos. Id. at 29/7-10.
While working at Papillon from 1979 to 1982, Employee testified he used Conair "Pro Style", General Electric "Power Turbo", and Clairol "Son of a Gun" hairdryers. Id. at 29/15-25, Id. at 30/1-4. He testified he believed asbestos was used around the hairdryer coils as a heatreduction mechanism. Id. at 30/16-22. Until 1979 or so, Employee opened the hairdryers and cleaned the filters if they became dirty. Id. at 31/7-11, 72/15-25, 73/1-3. Employee could not remember which models of hairdryers he cleaned. Id. at 74/13-17.
Between 1971 and 1982, Employee owned two or three hairdryers at a time and replaced the set at least twice a year. (Cl. Ex. 3 at 32/11-25, 34/18-25, 35/1-23). He kept a hairdryer at home that would last longer than the set at the salon. Id. at 3-4. He was responsible for providing all of his own equipment, including hairdryers, while working at Cut-Zaven and Papillon. Id. at 33/1-5. Employee estimated he replaced at least two sets of hairdryers between 1979 and when he became self-employed. Id. at 39/1-4. Employee could not recall which hand-held dryers he used at Papillon. Id. at 85/2-14.
In 2013, Employee suffered a heart attack and began experiencing issues with his lungs filling with fluid. (Cl. Ex. 3, 44/2-17). When the fluid was drained, physicians found shadows on his lungs and a biopsy was later performed. Id. at 39/10-25. Employee was diagnosed with mesothelioma on June 26, 2014, and underwent chemotherapy. Id. at 45/1-7. No physician advised Employee his diagnosis was related to his exposure to hairdryers. Id. at 54/7-9. Employee passed away on April 26, 2016, of mesothelioma and coronary artery disease. (Cl. Ex. 2).
Renate Ebbinghaus testified by deposition on behalf of Papillon, Hartford, and Argonaut. (Cut-aven Ex. B1). Ms. Ebbinghaus and her husband owned Papillon from 1979 to 2004 and she knew Employee from her work at the salon. Id. at 9/10-14, 11/14-22. When Papillon opened in the fall of 1979, all of the hooded hairdryers were new. Id. at 23/11-25. She recalled seeing Employee use hand-held hairdryers between 1979 and 1982 but could not recall
In August 1980, the U.S. Consumer Product Safety Commission ("CPSC") published a release documenting asbestos in hairdryers using information it had gathered in 1979. (Cl. Ex. 9). The release provided that Clairol "Son of Gun" Style Nos. TD-1 and TD-2 previously contained asbestos-based paper as a decorative element in the intake airstream. Id. Clairol stopped distributing the "Son-of Gun" Nos. TD-1 and TD-2 in September of 1978. Id. Clairol stated its tests indicated there were no asbestos emissions from its hair dryers. Id.
The Conair "Pro Style" 065 with serial numbers 1277, 0178, 0278, 0378, 0478, and 0578 were listed as containing asbestos. Id. Other "Pro Style" 065 serial numbers did not include asbestos. Id. As of 1979, when the CPSC gathered its information, Conair had discontinued the manufacturing of hairdryers containing asbestos heat shields. Id.
General Electric's Pro 10/5115-013 "Power Turbo" was listed as containing asbestos. Id. General Electric had discontinued shipping hairdryers containing asbestos insulation at the time it was contacted by the CPSC in 1979. Id.
On May 8, 2015, Employee's counsel contacted Dr. Thomas Hyers, who is board certified in Internal Medicine and Pulmonology, requesting a medical opinion and report. (Papillon, Hartford, Argonaut Ex. CD 2). In his correspondence, he provided Dr. Hyers with Employee's "Exposure History" which advised Employee "was directly exposed to asbestos during his full-time employment as a hairstylist from 1967 to 1979 from working with several models of hair dryers which contained asbestos linings......[s]tudies demonstrate that asbestos fibers become airborne from regular use of such hairdryers....[m]ost, if not all, models of hairdryers ceased the use of asbestos lining and were replaced with asbestos-free models in approximately 1979." Id.
At the request of Employee, Dr. Hyers prepared a report on May 14, 2015. (Cl. Ex. 10). He diagnosed Employee with malignant mesothelioma of the right pleura as a result of his use of asbestos-containing hairdryers at his workplace between 1967 and 1979. Id. He opined that the inhalation of airborne asbestos fibers from the hairdryers he used at his worksite was the prevailing factor in causing the malignant mesothelioma and that Employee was completely and permanently disabled because of the malignancy. Id.
After being provided with Employee's death certificate, Dr. Hyers provided a second report on December 19, 2016. (Cl. Ex. 11). Dr. Hyers opined Employee's medical care was appropriate for treatment of mesothelioma. Id. He also advised a standard notice period of thirty days from the date of diagnosis of mesothelioma would not have afforded the employer any additional opportunity to investigate how the exposure occurred. Id.
Dr. Hyers testified on behalf of Employee on April 4, 2017, that exposure to asbestos is the predominant cause of mesothelioma. (Cl. Ex. 14 at 12/16-18). Dr. Hyers explained he believed Employee was exposed to asbestos through his work as a hairdresser between 1967 and
Issued by DIVISION OF WORKERS' COMPENSATION
Injury No. 14-103077
- Id. at 14/22-25, 15/1-4. He testified he accepted the assertions made in Employee's counsel's May 8, 2015, correspondence as fact. Id. at 22/6-15. He testified at the time he wrote his May 14, 2015 and December 19, 2016 reports, he did not have Employee's deposition testimony. Id. at 23/11-15. Dr. Hyers testified in his practice he has not seen any hairstylists. He testified there are probably cases of mesothelioma that are caused by things other than asbestos exposure, and there are spontaneous cases of mesothelioma.
Dr. Hyers' third IME report dated April 24, 2017, advised that Employee's medical bills of $462,699.24 were fair, reasonable, usual, and customary. (Cl. Ex. 12).
At the request of Cut-Zaven and Travelers, Dr. Harold Barkman, who is board certified in pulmonology and internal medicine, provided an IME report on January 10, 2017. (Cl. Ex. 16). He explained that in 2014, Employee was evaluated for respiratory symptoms and ultimately diagnosed with right-sided pleural mesothelioma. Id. After reviewing the death certificate, he indicated the cause of death was mesothelioma but noted no comment was made regarding whether the disease was asbestos related. Id. He discussed his review of Employee's deposition testimony and reported Employee believed he was exposed to asbestos in hairdryers until 1982. Id.
Although Dr. Barkman indicated the great majority of mesotheliomas were related to asbestos exposure, he denied the prevailing factor in Employee's development of mesothelioma was his employment as a hairdresser. Dr. Barkman explained that although studies showed handheld devices emitted asbestos-containing compounds at varying levels, he did not know the amount or fiber type of various asbestos-containing compounds in the specific hairdryers. He stated given the number of hairdressers who used these devices over the years, and the lack of significant publication establishing association with the mesothelioma, he did not believe a direct correlation could be made. He stated: "In summary, historically he had exposure to asbestos-containing compounds; however, the intensity is poorly characterized. There is little scientific evidence pointing to an increased risk of mesothelioma in hairdressers. In addition, pathology report does not comment on presence of asbestos fibers. Therefore, I do not believe the prevailing factor causing his mesothelioma was his employment as a hair stylist."
Dr. Barkman testified on March 29, 2017, and clarified his opinions. (Cl. Ex. 17). He explained when determining the cause of mesothelioma, he generally relied on either epidemiological studies or scientific evidence such as tissue samples. Id. at 10/3-20. He stated in Employee's case, there were no studies linking employment as a hairdresser to an increase of development of mesothelioma and, additionally, no scientific evidence supporting asbestos exposure. Id. at 10-20. He specifically advised it would be improper to simply conclude "well, he was a hairdresser, he used a hairdryer and therefore the meso is related." Id. Dr. Barkman also testified it is not true all "mesos are associated with asbestos exposure." Id. at 33/2-11, 22/14-25.
Dr. Barkman testified if a product was recalled and no longer contained asbestos, it could not emit asbestos fibers, and could not cause mesothelioma. (Cl. Ex. 17 at 25/14-18). He conceded Employee testified he was only exposed to asbestos until the hairdryers were recalled and the hairdryers Employee claimed contained asbestos were no longer produced after
2 This number is inconsistent with the figure stipulated to by the parties. Because no benefits are awarded the discrepancy is not addressed.
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September of 1978 and 1979. Id. at 31/3-13. He also testified Employee's hairdryers could have been asbestos-free because only certain versions and serial numbers of the hairdryers contained asbestos. Id. 33/16-24.
Employee's counsel provided a settlement demand to Cut-Zaven, Travelers, Hartford, and Argonaut on January 27, 2017. (Papillon, Hartford, Argonaut Ex. CD4). In this correspondence, Employee's counsel advised, "the only reasonable inference which may be drawn is that his last exposure occurred sometime during the 1976 through spring 1979 time period while he worked at Cut-Zaven." Id. at 2. The letter further indicated Employee's social security records show he worked at Papillon from 1979 to 1983. The letter went on to note that it would be "speculative to assume Mr. Hayden may have been exposed after the hairdryer recall in Spring, 1979, but we have kept Papillon, Ltd. in the case should Cut-Zaven argue that the last exposure occurred during the time period Mr. Hayden worked there."
FINDINGS OF FACT AND RULINGS OF LAW
Based upon a comprehensive review of the evidence, and the application of Missouri law, I find:
Occupational disease is defined in §287.067³ as "an identifiable disease arising with or without human fault out of and in the course of employment." §287.067.2 provides:
An injury or death by occupational disease is compensable only if the occupational exposure was the prevailing factor in causing both the resulting medical condition and disability. The "prevailing factor" is defined to be the primary factor, in relation to any other factor, causing both the resulting medical condition and disability.
§287.067.6 states "disease of the lungs or respiratory tract...including carcinoma, may be recognized as occupational diseases for the purposes of this chapter and are defined to be disability due to exposure to smoke, gases, [and] carcinogens," amongst other hazards.
"In order to support a finding of occupational disease, employee must provide substantial and competent evidence that he has contracted an occupationally induced disease rather than an ordinary disease of life." Kelley v. Banta and Stude Const. Co. Inc., 1 S.W.3d 43 (Mo. App. E.D. 1999). Two considerations are required by this inquiry: "(1) whether there was an exposure to the disease which was greater than or different from that which affects the public generally, and (2) whether there was a recognizable link between the disease and some distinctive feature of the employee's job which is common to all jobs of that sort." Id.
The Employee has the burden to prove causation of an occupational disease. Townser v. First Data Corp., 215 S.W.3d 237, 241 (Mo. App. E.D. 2007). Questions of causation are issues of fact to be decided by the Commission. Sanderson v. Porta-Fab Corp., 989 S.W.2d 599 (Mo. App. 1999). "Where the opinions of medical experts are in conflict, the fact finding body determines whose opinion is most credible. Where there are conflicting medical opinions, the fact finder may reject all or part of one party's expert opinion which it does not consider credible
³ Language of §287.067 in effect as of January 26, 2014.
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and accept as true the contrary testimony given by the other litigant's expert." Kelley, 1. S.W.3d at 48 .
Both of the experts in this case agree Employee had mesothelioma and died from the disease. Mesothelioma is an identifiable disease, which is not an ordinary disease of life to which the general public is exposed outside of employment. With regard to the requirement that there be "a recognizable link between the disease and some distinctive feature of employee's job which is common to all jobs of that sort," Employee presented Employee's deposition testimony, a CPSC Bulletin List of Recalled Hairdryer Brands, and the expert medical opinion of Dr. Hyers. Cut-Zaven, Travelers, Papillon, Hartford, and Argonaut rely on the testimony of Renate Ebbinghaus and the expert opinion of Dr. Harold Barkman to support their position that Employee was not exposed to asbestos throughout his employment as a hairdresser.
Having thoroughly reviewed and considered all the evidence in this matter, for the reasons described in more detail below, I find Employee failed to meet his burden of proof regarding medical causation and, therefore, the Claim must be denied. I find Employee was not employed in an occupation or process in which the hazards of an occupational disease due to toxic exposure existed.
Employee testified he used Conair "Pro Style", Clairol "Son of a Gun", and General Electric "Power Turbo" hairdryers throughout his employment. However, he couldn't specifically recall the name of the Conair hairdryer he used and seemed unsure whether he had used General Electric Power Turbo hairdryers at it was "so long ago." Employee failed to provide any style numbers or serial numbers for the hairdryers he used. He testified he believed asbestos was used around the hairdryer coils as a heat reduction mechanism. He explained he would sporadically have to open the hairdryers and clean the filters but was unsure which brands of hairdryers he actually had to clean.
Despite Employee's testimony regarding the asbestos contaminated hairdryers, the CPSC Bulletin List of Recalled Hairdryer Brands provides that as of early 1979, only a small subsection of the hairdryers Employee identified contained asbestos. The Clairol "Son of Gun" Style Nos. TD-1 and TD contained asbestos-based paper as a decorative element in the intake airstream until September 1978, but not around the coils as suggested by Employee. Clairol maintained that prior to September 1978 none of its models emitted asbestos as it was not used for heat reduction, and was instead, decorative. With respect to the Conair "Pro Style" 065, only six serial numbers contained asbestos prior to 1979, all other "Pro Style" serial numbers were asbestosfree. The General Electric Pro 10/5115 "Power Turbo" was the only "Power Turbo" model to contain asbestos prior to 1979. General Electric specifically advised that the model number (5115) was "key in identifying the suspect model."
Employee depends on Dr. Hyers' conclusion that Employee suffered malignant mesothelioma of the right pleura as a result of his use of asbestos containing hairdryers due to his work as a hairdresser until 1979 and that the inhalation of asbestos fibers was the prevailing factor in Employee's malignant mesothelioma. At the time of his initial IME report and his addendum report, Dr. Hyers had not been provided Employee's deposition testimony and conceded he accepted the "Exposure History he received from Employee's counsel on May 8, 2015, as fact.
After reviewing the vocational history, relevant medical history, Employee's deposition testimony, and the CPSC Bulletin List of Recalled Hairdryer Brands, Dr. Barkman provided clear and consistent testimony that Employee's employment as a hairdresser was not the prevailing factor in the diagnosis of mesothelioma. He explained no studies supported Employee's contention that he was exposed to asbestos during his work as a hairdresser and Employee provided no scientific evidence of asbestos exposure. He further advised asbestos was not the only cause of mesothelioma and clarified it would be incorrect to assume all "mesos are associated with asbestos exposure." Dr. Barkman specifically noted it would be improper to simply conclude Employee "was a hairdresser, used a hairdryer, and therefore then meso is rclated." Importantly, he concluded there was good probability Employee was never subject to the risk of asbestos exposure because only certain models and serial numbers of the hairdryers he recalled using contained asbestos. Dr. Barkman testified there were no studies linking employment as a hairdresser to an increase in developing mesothelioma.
I find Dr. Barkman's opinion more persuasive than Dr. Hyers' opinion. Dr. Hyers' opinion fails because it is based upon the assumption that Employee was exposed to asbestos throughout his career as a hairdresser, and those assertions were not proved.
Here, Employee has simply presented a version of events he believes could have happened. Employee could have owned the specific serial numbers and models containing asbestos. It is also possible he could have used one of the serial numbers that did not contain asbestos. However, what "could" have happened is not competent and substantial evidence of what did happen. There is no testimony confirming Employee was ever exposed to any of the specific models of asbestos containing hairdryers during any particular time period with any of the named employers. Employee's testimony lacked the specificity required to prove his claim. In addition there was no scientific evidence presented that hairdressers are at an increased risk of developing mesothelioma.
Based on the vocational history, relevant medical history, and testimony, I find Employee's employment was not the prevailing factor in his development of mesothelioma. Employee's Claim is denied.
I decline using my discretionary power of assessing cost and fees in favor of Papillon, Ltd. and Argonaut. Employee's counsel's letter indicated Employee had a good faith and reasonable argument to not dismiss Papillon, Ltd.
The remaining issues are moot.
