MID-ATLANTIC ADAACCOMMODATING EMPLOYEES WITH ALLERGIES

SITUATIONS AND SOLUTIONS

MARCH 2, 20161:00 P.M. CST

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Slide 1>> MARIAN VESSELS: Good morning and afternoon to everyone. Welcome to

Accommodating Employees with Allergies, presented by the Mid-Atlantic ADA Center. My name is Marian Vessels, and I'm the director of the Mid-Atlantic region. I will be serving as your moderator for this session. We are privileged to be joined by our presenter, Teresa Goddard, from the Job Accommodation Network. I'm going to give you instructions for listening to the webinar, if you are new to our platform.

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to the Mid-Atlantic ADA Center, you can E-mail us at ADAtraining@TransCen.org, or you can call 301-217-0124.

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you received about this session for the instructions on obtaining a Certificate of Participation. You will need to listen for the continuing education code which will be announced at the conclusion of this session. Requests for continuing education credits must be received by 12:00 p.m. EDT, March 3, 2016.

Slide 11It is now my pleasure to introduce our speaker for today, Teresa Goddard, who is the

lead consultant, at the Job Accommodation Network, otherwise known as JAN. She holds a Master's degree in speech pathology from West Virginia University and has completed the training program for ADA coordinators. She joined the JAN staff as a program assistant in March, 2008 and joined the motor team as a consultant in August, 2008.

Teresa has now transitioned to JAN sensory team. She fields questions from employees and employers regarding their rights and responsibilities under the Americans with Disabilities Act, and assists in identifying accommodation solutions for employees with sensory area of impairments. Before joining JAN, she worked as a speech language pathologist and teacher. She has presented at educational workshops in Japan and at assistive technology conferences including ATIA, C-Sun, and MSAT.

It is my pleasure to turn the program over to Teresa.

>> TERESA GODDARD: Thank you, Marian, for that great introduction. I'm excited to be here today to talk with you about how to accommodate employees with allergies. We are

going to be talking about a number of situations and solutions that I hope you can apply in your own work.

Slide 12Today's objectives, at the end of the session, I'd like you to be able to understand three

common job related issues for employees with allergies, identify three accommodation approaches for employees with allergies, learn to use JAN's searchable on-line accommodation resource, which is on our website, and also be able to apply information in JAN's sample interactive process publication and other resources to sample accommodation request situations.

This is my second slide, but it's slide 12 for those who are following along. We are going to advance to slide 13 now.

Slide 13This is an overview of what we are going to cover today. First I'll tell you about the Job

Accommodation Network and issues related to allergies in the workplace, we will have questions, talk about the interactive process, have questions again, and then go through situations and solutions, talk about JAN's searchable on-line accommodation resource, talk about additional resources, and then we will have time for questions at the end. If you miss the first two question spots, don't worry, there will be another chance. Moving to slide 14.

Slide 14In case you didn't know, JAN has been around longer than the ADA. We were

established in 1983 as a national free service. We remain a national free service today. We are funded by ODEP, Office of Disability Employment Policy of the Department of Labor. We specialize in providing technical assistance and consultation on job accommodations, and on the employment provisions of the ADA, and also the Rehab Act, and what we do is give technical assistance. It's not legal advice. It is technical assistance. All of our calls are totally confidential. We will not reveal to anybody else if you have contacted us. You can reach us in a number of ways, phone, chat, even by texting, TTY, relay services, E-mail and social networks.

We also offer live and archived training opportunities, and we will work as your partner to help you figure out the ADA.

Slide 15Moving to slide 15, a big part of what JAN does is consultation on the topics of job

accommodations and employment legislations. We don't care what industry you are calling about, what job category, what impairment it is involved. If you can think of an employment scenario, we have probably heard it here before.

Of course we specialize in Title I of the ADA and in 501 of the Rehabilitation Act. Now if you have detailed questions about 503, we encourage you to consult OFCCP for those.

Slide 16Moving to slide 16, we are going to talk about workplace issues next.

Slide 17Slide 17, what are challenges that employees with allergies experience on the job? We

have a list for you that is based on information we have gotten from our callers here at JAN. Some typical issues include interacting with customers, supervisors and coworkers who wear products or eat foods that trigger allergy symptoms. Some people may be allergic to certain colognes and perfumes. If they come in contact with someone who is wearing those things, it can cause an allergic reaction. It could be something severe, or it could be something that just makes their day a lot more difficult, like a bad headache. Sometimes people who are allergic to certain foods may have an allergy that is so sensitive and severe that they could experience something like anaphylaxis, which is a serious medical condition, even when they encounter someone who has recently eaten the food to which they are allergic. It can be difficult to interact with someone who is wearing or has recently used or recently eaten something to which an employee is allergic.

Another typical issue is that the employee might need to access their own work station or common area like a cafeteria, a path of travel like a hallway or a meeting room. When those places contain allergens, it can be a challenge for people to get where they need to go, in order to do their job, and to have equal access to common areas like breakrooms.

Sometimes employees may have reactions to their personal protective equipment, that they need to wear to do their job. Typically this would happen with something like a glove. Someone with a latex allergy may be restricted in the types of gloves they can wear. Occasionally it will also come up with something else like hearing protection, especially in-the-ear hearing protection, sometimes those have latex. We did get a call once about a law enforcement officer who was allergic to Kevlar. And we had to try to help that employer come up with some alternate vest ideas. It could be any type of PPE, but gloves are the most common. Cleaning product could be an issue.

Some employees report that they don't feel safe during events where food is served, especially if they have a very severe food allergy.

It can also be a challenge to plan for a reaction, because despite your best efforts, someone may have a reaction during the course of their workday. Sometimes it can be hard to manage medication side effects. Some of the medications related to allergies can cause problems concentrating, especially just after a dosage is taken. Sometimes it might interfere with a person's sleep schedule, make them sleepy in the morning. Managing medication's side effects can be a real challenge.

Slide 18Moving on to slide 18, let's talk about some of the challenges that employers of people

with allergies face. Sometimes an employer may have employees with conflicting accommodation needs. For instance, one employee may need to bring their service dog to work, so that they can find their way to their work station safely. Another employee might be allergic to that dog. What is an employer to do? We are going to talk about that.

Sometimes employers may have limited ability to change the air quality in a workplace. It could be because of the nature of the work environment, maybe the job is outdoors, and you can fix inside air, but you may be limited what you can do to the pollen outside.

Sometimes it might be because they are renting a space and they are limited in the types of renovations that can actually be done. There could be a variety of reasons why air quality could be a challenge. Sometimes there is limited availability of private work spaces. Many people with allergies, who need to avoid coworkers who are wearing things to which they are allergic, find they do better if they can go into a more private space where they can control the environment more completely.

It's great when there is an office available. Sometimes there is not. Sometimes there may be a situation where the employer is moving to a new building, and they just don't have a number of offices that they used to have. I talked to a guy last week, his office is moving from a place with 40, 40 private offices, in the new building there are plans to have 15. That is going to displace a lot of unhappy people.

Sometimes an employee may want to do their work from home, but they have a task that absolutely must be done on site. The same problems can arise if that person maybe hasn't had the best productivity, the employer may feel a little bit of concern about how they are going to be able to monitor and assist that person from off-site. Sometimes there could be a security issue. For example, I would like to work from home, but because of the high privacy standards that we have here at JAN, that is simply not possible for me to take your calls and do consultations from home.

Sometimes, an employee may be in a workplace where there are a lot of clients and customers coming in from outside the workplace, and the employer really doesn't have a lot of control over what they wear or what type of food they may bring with them.

Sometimes an employer may try to have a policy related to personal care products or related to banning of food from the workplace, but the coworkers aren't cooperating. Maybe they even harass the employee who has disclosed allergies to them.

Of course, the employer shouldn't be disclosing, but we all talk to our coworkers, and sometimes an employee might disclose their allergy and experience harassment from coworkers because of it.

And of course, there may be some safety concerns.

Slide 19Next I'm going to go to slide 19. We are going to talk about ideas for accommodations

to prevent reactions.When I think about accommodations for allergies, I really think of three basic

approaches. You may have other ideas, but this is how I frame it up in my mind. The first thing I think about trying to do is remove the allergen from the work environment. Let's say an employee with MCS is reacting to an air freshener that's recently been installed in the company bathroom. Can we just remove that air freshener? Would that fix the problem? Let's say someone has a severe allergy to a cleaning product, so for a person who is allergic let's say to citrus, some of the all-natural cleaning products that are great for people who may have MCS or other conditions, contain orange oil, and that could cause a real problem for a person with a citrus allergy. If one is reacting to a cleaning product, can we pick a different product? Can we dispose of the old one, and change to something new?

Can we change the soap? If there is mold in the workplace, can we get rid of it? If someone is not feeling safe, because of catered food at events, can we choose a caterer who can provide food that is safe? Food maybe that is peanut-free, or for someone with severe celiac disease, can we provide food that is gluten free, can the caterer guarantee that. Basically, what we like employers to think about is whether those things that are causing a reaction at work that are within the employer's control, and employers, let's control those things that are within your control, and remove things from the environment to the extent possible.

Slide 20Moving to slide 20, what are some other accommodations to prevent a reaction? Could

we remove the employee from the area where the allergen is located? Can we move their

work station maybe to a different room? Can we put them in an office in a different building that is not going to cause the same problem? Let's say the person does some of their work out of doors. Could they trade tasks with another employee, so that they are inside more during pollen season and not outside where the pollen to which they are reacting is located. Could we restructure the job in another way to prevent exposure, so if someone has to do a task let's say near the cafeteria where people are eating different kinds of food, could the job be restructured, could they trade the task with someone else who could be near the cafeteria safely?

What about telework? Could they work in a different location? What about flexiplace, where they are working at the employer's site, but from a different spot part of the time or all of the time? Could we just give telework during renovation, if someone is having reactions to building materials? Remember, leave is less effective than other accommodations. If there is a way to keep the person working, like letting them do telework, that may be something to consider.

Do we need to reassign the person to a different position, where they are not going to be exposed to the allergen? Remember, reassignment is accommodation of last resort, but sometimes it is the only thing that really helps.

Let's move to slide 21.

Slide 21Let's talk about a third approach to prevent a reaction, reducing the employee's

exposure to the allergen. Sometimes we can't totally get rid of the allergen. And we can't keep the person out of the place where the allergen is located all the time or enough of the time.

What can we do to mitigate the effect of that allergen on the employee? What can we do to reduce their exposure?

When it comes to employees who react to personal care products, something that they will sometimes tell us helps is to change their work schedule, so that they are coming and going at a different time of day from everyone else.

That way, they are not sharing an elevator or going up a stairwell with a lot of people who are just out of the shower, still really smell strongly of their shampoo and soap.

Sometimes we might need to modify the schedule in another way to allow the person to take breaks away from their work station, maybe out of doors where they can get some fresh air.

Another thing by the way that some people say is helpful is to be located near a window. If they can't get all the way outside, sometimes they would like to be able to open a window if they are having a problem with a fragrance or chemical in the workplace. I know some buildings you can't do that. But if you have the option, it's something to consider.

Another thing that you can try is to provide an air purification system, one that is designed specifically for the irritant in question. For example, you wouldn't use one that is rated for removing cigarette smoke if cologne is the problem. It can be challenging to pin down what kind of air purifier might work. We usually suggest contacting the manufacturers to get the most detailed information. But we do have some products in our database that might be worth exploring depending on your needs. If you are looking for an air purifier, you may want to contact manufacturers for details about their system, but we would be happy to speak with you as well.

Another thing you can think about is modifying communication methods. Is there a

meeting that takes place between the person who is allergic and someone who wears something that causes them to have a headache or even something more serious like an anaphylactic response? Does that meeting have to be face-to-face? Could it be on-line? Could it be by telephone? Do they have to meet at all? Could they deal with more of their communication by instant messaging and E-mail? Maybe, it's worth thinking about.

An employer could consider implementing a food ban or fragrance policy, depending on what is causing allergic reactions at work. I didn't include this under removing the allergen from the workplace, because the truth is, it is almost impossible to get total compliance. There is always going to be someone who forgets. You may also have times when you are bringing someone in to apply for a job and be interviewed and maybe no one told them about the ban.

I wouldn't count on policies as being a perfect way to protect someone. But they can be a way to reduce the exposure. Let's move on to slide 22.

Slide 22We talked earlier about situations where someone has a service animal and someone

else is allergic. What is the responsibility of the employer to provide reasonable accommodations when something like that happens? Well, the employer doesn't choose who is going to get an accommodation and who isn't if they both need accommodations. But there are some things they can do to try to meet both people's needs. The key things to keep in mind are, reducing or if possible eliminating in-person contact between those two employees, and the idea is to keep the two employees separate, have separate paths of travel, just to make it so that those people can get where they need to go to do their job and have access to the things they need to access, without having to come face-to-face or face to doggy nose. Hopefully it will work. We are going to talk about examples where it was a little challenging. But it is something to keep in mind. There is a way to fix those types of problems, or at least to address them.

Slide 23Let's look at slide 23. We have an example for you. A newly hired federal employee

requested to bring her service dog into the workplace. After starting, after she was already on the job, a coworker told the employer that they had a severe allergy to animals. The employer moved one employee's work station. They provided an air purifier for the employee with the allergy. They helped the employees develop separate routes of travel through the buildings. They maintained a regular cleaning schedule to make sure that there was as little animal dander as possible, and let the employees communicate in a different way instead of having to have face-to-face communications.

Let's go to slide 24.

Slide 24Here are a few more ideas for managing a condition. One thing an employer might

consider is offering an employee with an allergy a chance to voluntarily develop a plan of action, a plan for what is going to happen if I have an allergic reaction in the workplace. Where is my medication stored? Who do I want to be called, under what circumstance would an ambulance need to be called? Under what circumstances can I treat my reaction at work and continue working? Because it's going to be different for every person. By planning ahead, both the employee and the employer can have some peace of mind that if they happen to experience a reaction at work, there is a plan. People know what to do. It is not going to be

quite the same moment of panic that you would have if you have had no plan.On the JAN website, AskJAN.org/media/epplan.doc, if you forget that, call in, we will tell

you where to find it, we have a sample plan of action. The sample plan of action on the website is geared towards a different type of medical condition. The example in it is geared towards someone with epilepsy. But you can use the same framework to plan for emergencies related to many types of conditions, including allergies.

If you want more information about that, like I say, you can call in. If you forget the link, call in. It is no problem. We will E-mail it to you. Again these need to be voluntary. You are offering the employee the chance to plan ahead.

Sometimes an employee might need some time off to treat an allergic reaction or to recover from a severe one that required medical treatment. An employee might need a safe storage space for the medication that they use to treat their allergy, or an employee with a food allergy might need a safe place to store their food. They might need a safe place to eat as well.

Sometimes an employee might need to manage a side effect or a symptom. Some ways to do that might be a modified schedule. If their medication interferes with their sleep, if they are very fatigued, maybe some ergonomic changes to the work station could help them get through their day.

For a person who gets migraines as part of their allergic reaction, they may have a lot of pain, but they may still want to continue working to minimize their use of leave. Pain can make it hard to concentrate, and other types of reaction that people experience when they are exposed to an allergen can cause difficulty concentrating. Some of the medications people take may cause difficulty concentrating.

What we do is think, what limitation is this person experiencing? And how can we accommodate that? A cookie cutter approach is never going to work for an allergy.

Let's go to slide 25.

Slide 25Some accommodation ideas for fragrance and chemical sensitivity, maintaining the air

quality, get rid of fragrance products, if you can. Try to use unscented cleaning products. Provide scent-free meeting rooms and restrooms. Maybe move a work station. Maybe allow a modified schedule. Let a person take fresh air breaks. Provide an air purification system that is designed for the irritant that is causing the problem. Modify communication methods. Not everything has to be face-to-face. Maybe consider a fragrance-free policy. If you have one, maybe modify it, so that it works a little better. Maybe offer telework. We are not saying that every employee with fragrance or chemical sensitivity needs all these things. But these are things that employers may want to consider. They are part of your accommodation toolbox.

You can read more about this on the JAN website, in our fragrance hub.

Slide 26Moving to slide 26, let's talk about food bans. Sometimes an employer will consider

banning or restricting a food to assist an employee with a food allergy.It's not a fail-safe, because people are going to forget. Sometimes people won't realize

what is in the food they are bringing from home. But it can be a way to reduce exposure. What are things you can do when you are implementing a food restriction policy? You might want to post signs at the entrance to the building, waiting rooms, hallways, restrooms,

classrooms and cafeterias that certain foods are restricted due to a severe food allergy. You might send a memo to employees so that precautions can be taken. Sometimes an allergic reaction can occur just from coming in contact with someone who has previously eaten an offending food. Send occasional memos encouraging compliance with policy. This is a good idea around certain holidays like Valentine's Day, where people may have received a gift of chocolate or other food and they want to bring it to work to celebrate. That is a good time to remind people to be careful what they bring.

And also, if you are going to have a policy, you may want to consider how you are going to enforce the policy and what type of consequences there will be for violations. This will really be part of your overall performance and conduct policy for your workplace, if it's going to be effective.

You can read more about that in our document on food allergies. Let's go to the next slide.

Slide 27We have a lot to get through today. Before we get into the interactive process really

deeply, I want to take a minute to talk about the word, reasonable accommodation. A lot of people call us asking is this reasonable?

Here is what the EEOC says. A reasonable accommodation is any change in the work environment or in the way things are usually done that results in an equal employment opportunity for an individual with a disability.

Any change. That leaves a lot of room for different things to be reasonable accommodation. They do give us some examples of categories of things that the EEOC says can be reasonable accommodation. Those would include making existing facilities accessible, like adding a ramp, to make a place that didn't previously have one accessible for a person who uses a wheelchair. Job restructuring. Job restructuring means maybe taking a marginal job function, something that is not central to the job, and trading it with another employee, or letting someone else do that job, reallocating it; not reallocating the whole job, just those marginal functions. But it could also include changing the way the central function is, under the location where it's done, which is how we get telework. It might include modifying schedules, reassignment, modifying equipment or devices, adjusting or modifying policies, and providing qualified readers or interpreters. This is what the EEOC has said in the Title I technical assistance manual. We have a link on this slide to the Title I technical assistance manual if you want to dig in deep on that.

Let's go to slide 28.

Slide 28It's time for questions. Do we have any questions?

>> MARIAN VESSELS: Thank you so much. If you have a question, please do put it in the chat box or send us an E-mail at adatraining@transcen.org. We do have a question.

When employers do not prevent folks from doing things that an employee has asked, when she has an allergy, should the employee need to take her own sick time due to the allergy reaction? This person has a severe food and perfume allergy. She's identified it to the employer. But she is allergic to cinnamon, coffee, sage, ginger, old bay, orange, chili pepper and garlic. She gets severe allergy reaction and sometimes needs to use an epi pen. She has

had instances where people walk down the hallway in front of her office with the freshly made cinnamon Pop-Tart. The employer uses cinnamon air freshener. The employer says that she could use a single person bathroom in the building to eliminate some of the risk of people contaminating the bathroom with perfumes. But she still finds that there are perfumes smells in the bathroom, and has now been given permission to go to a nearby convenience store which has less chance of the bathroom having a scent. She would like your guidance on her situation.

>> TERESA GODDARD: I would encourage a person with a situation this complex to give us a call later in the day or in the week, so that we can do an in-depth consultation. Something like this could take an hour to talk through. But just to give the basics, when somebody does need time off from work due to disability, the EEOC does say that an employer should allow that person to use accrued PTO, accrued paid time off, first, if the person has it, and then after that, provide unpaid leave. For those times when time off from work is exactly what is needed, it is appropriate in many instances for the employer to charge that against sick time, to avoid the person being off unpaid, which nobody wants. Well, some people do. But the EEOC says we should first allow use of paid time off and then offer unpaid leave later.

However, the EEOC also wrote an informal guidance letter from which we derive, or from which we understand the EEOC to feel that leave is less effective than accommodations that allow a person to continue working. This is why, for instance, it's better for a person to work from home than to take time off for a long period, in many cases, because if they are working from home, they are still working, and they are not using up all of their sick time or vacation time or even on unpaid leave. Is it more effective according to the EEOC if that person is working. What we often will encourage employers to do is to develop accommodations that are effective, and allowing the individual to be at work as much as they can.

Also, sometimes to minimize the need for use of sick leave or use of annual leave, or unpaid leave, an employer and employee might work together to allow an employee to make up some of that time, so that they are not losing so much of their sick leave when they are needing temporary removal of themselves from the workplace. But for something like this it's very complex. I would really encourage a phone call or an E-mail to JAN, so that we can really discuss it in a great amount of depth.

A person who is experiencing an accommodation that is not effective, I'll just tell you this much, may want to put that in writing, put something in writing to HR and/or their supervisor letting them know that the accommodations that are currently in place are not effective, what the problem is with those accommodations, and asking that the employer revisit the accommodation with them, go back to the drawing table, in other words, and try to come up with some accommodations that will work better, and let them be at work more consistently.

That is my quick in a nutshell answer. But I would encourage someone who is experiencing a complex situation like that to call in and have an in-depth consultation free of charge and confidentially. Does that help?

>> MARIAN VESSELS: Great, thank you. We have no more questions at this time.>> TERESA GODDARD: Fantastic. Let's move to slide 29.

Slide 29We are going to talk next about the interactive process. This is the process of figuring

out what accommodation to provide and how to provide it. Let's move on to slide 30.

Slide 30Why do we want to have a process for choosing an accommodation? It can help with

consistency. Having a process can help us get to a place where we are implementing successful accommodations. It can be a good way to show good faith effort.

The interactive process is not something that is absolutely set in stone required by the Equal Employment Opportunity Commission, but it is recommended.

And it can be a way to show good faith effort. And we all know sometimes it's not possible to provide the really effective reasonable accommodation, but an employer needs to go through the steps to show, whether it's steps of the interactive process or the steps of how they have put together their own process, just so that they can show that they have made a good faith effort. What is really important for an employer is to show that they have made a good faith effort to accommodate, even in those situations where ultimately accommodation could not be provided. Good faith effort can be important in situations where we wind up providing an accommodation, because you never know when something may come up, and an employer may have to show what they have done.

Let's move to slide 31.

Slide 31 I wanted to give a list of people that might be helping an individual with accommodation.

This isn't specific to allergies, but there are a lot of people that might be part of a person's circle of support and part of the team that is helping a person document their disability, come up with accommodation ideas, figure out if things are effective. It could be a doctor, could be a speech language pathologist, if somebody's voice is causing them an issue, could be an assistive tech professional, social worker, could be any of a variety of allied health professionals, rehabilitation counselor. Those are all people that might be part of the team.

Also with some allergy medications, people have reported that some of their medications may cause side effects that impact their emotions, so a mental health counselor would not be totally out of the realm of possibility in the cases of an allergy or something like that, but this list again is not specific to allergies.

Slide 32Slide 32. Let's move on. JAN has come up with a 6-step process. We call it the JAN

interactive process. It's not official, because remember the EEOC doesn't technically require the interactive process. They just recommend it.

The steps of the JAN interactive process are step one, making or recognizing an accommodation request; providing information; exploring accommodation options; choosing an accommodation; implementing an accommodation; monitoring the accommodation; and then hopefully by following those six steps, you will get to a successful accommodation. That is what we all want.

I'm going to go through the steps one by one. Let's move to 33.

Slide 33The first step of the JAN interactive process is to make an accommodation request, if

you are the employee. If you are a service provider, you might make one on someone's behalf. If you are the employer, you want to recognize when an accommodation request is

made. Here are some tips. If you are a assisting a person with a disability, make sure your client is aware of the

rights under the ADA. Employers may also have some responsibility to let employees know through use of signage a little about their rights. When there is a request, the employer wants to document the request. We think it's a good idea for employees to document the request too. Technically requests don't have to be in writing, but it's a good idea that something be put in writing to document that a request is being made. Good to be clear and specific when making a request. But as we are going to discuss in upcoming slides, sometimes that first step is not as clear as we would hope.

Let's go to slide 34.

Slide 34Let's look at an example. An employee has been out of work for six months. They had

a reaction to some materials used in remodeling. The doctor sent the employer a letter saying that the employee is released to return to work, but with certain work restrictions. Did we make an accommodation request? Has this employee made an accommodation request? Think about that.

Slide 35Let's look at slide 35. I'm going to say yes, because there was an indication that

workplace accommodations are needed. No, we don't know exactly what they are yet. But we do know that something needs to change. When this person comes back to work, they are released to return to work with accommodations. It's because of a medical condition, the medical condition that caused their reaction. Do we have all of the info? No. Don't worry, we are not stopping here.

Step 1 is just to make a request or to recognize that a request is made. The bare minimum is that either the employee or their representative let the employer know that a change or adjustment in the workplace is needed for a medical reason.

Let's move on to 36.

Slide 36I said we weren't done. We are only on step 2 now. This is the step where the

employee provides information, maybe the medical provider provides information for the employee. They are going to be gathering information at this stage. It's helpful for the employee to describe the limitation that they are experiencing and the problem that they are experiencing in the workplace.

How can employers address the problem if they don't know exactly what it is?When possible, an employer should work with the individual with the disability, and

speak with them to try to figure out exactly what is going wrong and what the employee's ideas are for what might be done to help.

Technically, for the initial request, the employee doesn't have to use the words, “ADA,” or “reasonable accommodation.” But when we are gathering information, this is the stage where the employer might be gathering information to figure out, does this person have an ADA-covered condition? Do they have an impairment that substantially limits a major life activity? If so, what impairment? What major life activity? This is a stage where ADA language, or vocabulary, if you will, might be introduced.

Let's go to 37.

Slide 37Here we have a screen shot of the cover of one of JAN's very popular publications,

“Practical Guidance for Medical Professionals: Helping Write Effective Accommodation Letters.” What we suggest people do is the person write accommodation request letter on their own behalf if they can, and then their medical provider provides additional documentation, which might include a letter to accompany a form or something of that nature. This document actually has a sample letter for medical providers that they can use when they are trying to figure out exactly what they want to write.

Slide 38Slide 38, this is a picture of interactive process, “The Interactive Process and Service

Providers,” another publication that is designed to help service providers like rehabilitation counselors and allied health providers understand their role in the interactive process and how the interactive process unfolds. These are good resources that you can find on the JAN website.

Slide 39Let's look at an example on slide 39. In response to a poor performance evaluation, a

teacher provided a doctor's note claiming her allergies are contributing to her performance problems, and says she may benefit from an accommodation.

Do we have all the information we need to make a decision at this point? Did she provide all of the information to us?

Slide 40Let's look at slide 40. I'm going to say no. We don't really know what limitations she is

experiencing. We don't even know what she is allergic to. We don't know if maybe she is experiencing some fatigue or some confusion and brain fog as a result of her allergy medication.

We don't know how she is being affected. Is she having trouble with some particular workplace tasks like maintaining her grade book? Is she having difficulty maintaining good classroom control? We don't know what is going on. We understand there is a problem. We don't have all the information. We need the limitation and we need to understand what problems this person is experiencing.

Slide 41Let's look at 41.Okay. So once we know a little bit more, we can start exploring accommodation

options. At this stage, it's important to keep an open mind. The individual may come up with some ideas that seem a little bit out there to the employer. But at this stage, we are just exploring our options, not pinning ourselves down on anything. This is the chance for the individual to suggest accommodation ideas. This is the time when an employer might consult with other service providers. This is when we often get a call. Often when an employer is at the stage when they are ready to start figuring out what accommodations they are going to consider, that is when they call JAN to get some ideas that they might consider.

Slide 42Let's look at 42. We got another example for you. A social worker with an allergy to

cigarette smoke requested to be excused from meeting with clients who smoke.I gotta tell you, here in Morgantown if all of the social workers decided they weren't

going to meet with clients who smoked, they would have very little work to do.It's probably not practical in a lot of settings for an employer to restrict the clients that

someone will meet with to that degree. How can we figure out what else might work? How can we figure that out?

Slide 43Slide 43. One thing you might do is call JAN and talk it over. And any of the

consultants here would be happy to speak with you. If you are calling about allergies, there is a good chance you will get to talk to me. But there are a couple other people on the allergy team. You can reach us at 1-800-526-7234. That is our voice number. 877-781-9403 is our TTY. We have an E-mail address, JAN@askJAN.org. And you can get us by Skype at JANconsultants, or chat with us on-line through our website, www.askJAN.org.

Slide 44You also might look at the website in the searchable on-line accommodation resource.

That is the part of the website where you can go through a list and select the impairment that you are dealing with and the limitation that you are dealing with. Let's move to slide 45.

Slide 45After that, you would select the job function that the person is having an issue with.

Maybe it's organization. Then you can choose from some accommodation ideas. You can find this on-line at ask JAN.org/soar. But we are going to show a few slides later on that will really take you through the process of looking through SOAR. Again, you also want to talk to the individual, get their ideas, look at the medical documentation that you have on hand. JAN is just one tool in your toolbox as you are going through this process.

Let's go to slide 46.

Slide 46 In step 4, we will be choosing the accommodation. It is good if the employer can

explain their decision-making process to the employee, so that everybody is on the same page.

An employer really ought to be able to justify their preferences. The EEOC does say that an employer should give primary consideration to an employee's first choice, but that doesn't mean that the employer always picks what the employee wants. We know from the EEOC publication, reasonable accommodation and undue hardship, under the ADA, that employers get to choose among the range of effective accommodations. Employees might not know that. That is why it's good for the employer to explain the decision-making process, and justify what they are choosing.

Let's look at 47.

Slide 47Here is an example. A customer service representative could not tolerate personal

fragrances worn by coworkers. No private office space was available. His employer was

considering putting up cubicle walls and an air purifier in his work area. His work could be done from home, but the employer was concerned about isolating the employee, didn't want them to work from home so they wouldn't feel isolated. But how can we help this employer decide which accommodation to choose?

Let's look at 48.

Slide 48One thing they want to do is talk with the employee. In this particular case, this is from

a real example, the employee preferred to work at home. It wasn't forced isolation. The employee was actually more concerned that the cubicle and the air purifier was going to draw a lot of attention that he didn't really want.

The employee expressed that preference and those concerns to the employer. Let's look at 49.

Slide 49Once we know what accommodation we are going with, it's time to implement the

accommodation. A service provider might be helpful by providing assistance during the implementation of the accommodation. An IT professional might be helpful at this stage especially if the accommodation involves a computer or telephone. An employer would want to make sure to involve the individual who brought the implementation or accommodation throughout the process of actually putting it in place.

Let's look at slide 50.

Slide 50Here is an example. A secretary with a voice disorder had difficulty speaking on the

phone for long periods of time during allergy flare-ups. Her employer purchased a text-to-speech communication device with phone connectivity. How can service providers help with implementation?

Slide 51Let's look at 51. Somebody might need customized equipment, like this speech

generating device, in order to meet individual preferences.An employee might need to know how to use the equipment, might need some

instruction. Someone from the IT department might need to work with the employee and the equipment to get the equipment set up and integrated with the employer's overall system.

Let's look at 52.

Slide 52Step 6, monitoring the accommodation. An employer would want to check on the

effectiveness of the accommodation, make sure it's still working. You want to leave the individual in good hands, make sure they have a point of contact, someone that they can reach consistently in case they have a problem with their equipment or another part of their accommodation.

You want to encourage ongoing communication. The employee needs to know who to contact and how to contact, if there is a problem.

Let's look at 53.

Slide 53All right. This is a brand-new example, never seen before. A park worker with

fragrance sensitivity related to perfumes and colognes had been accommodated through an informal fragrance policy and cooperation by her coworkers. Recently the employer purchased fragranced air fresheners for all of the restrooms in the worker's area including those that weren't even open to the public.

She started bringing in surgical masks from home to wear into the restrooms, so she could not have symptoms in the restrooms, but she was still having problems every time she entered a restroom. Incidentally, this is one of the first things that people try. You need to remember, surgical masks are designed to keep the surgeon from sneezing on you, not designed to keep smells out. There are other types of masks that are designed to do that.

On her own she contacted the vendor of the air fresheners and learned that they actually had a fragrance-free option that the employer could have explored from the get-go. Could the employer have avoided this problem?

Let's look at slide 54.

Slide 54I think they probably could have. Whenever you are purchasing new products and

equipment, it is important for an employer to think about accessibility and how that is going to affect employees that they already have, and employees and customers that they may get down the road.

Employees also might need to be proactive in communicating their accommodation needs. There are two sides, but I think the employer could have thought ahead, hey, we have got someone with some fragrance issues, maybe we should think twice before putting something that is fragranced in every single bathroom.

Let's look at 55.

Slide 55Okay, we are going to pause briefly for some questions.

>> MARIAN VESSELS: Hi, yes, we do have some questions. We have an employee that has been evaluated by medical doctor that has a history of immune sensitivity, making him more sensitive to irritants, and other individuals, he says his work area is causing issues for him, we had an IH test done in the area and reports said it meets standards. We did the interactive process with him. He wants to be moved. How do we know that the new area will be suitable since we haven't had it tested? What do we do from here?

>> TERESA GODDARD: If there is a way to test the new area, that might be helpful. But the truth is, sometimes there is no way to know for sure if an accommodation will work without trying it. In some cases, you just have to do the best you can to find the most suitable space that you can, and take it from there. But if the previous area was tested, I'm curious as to why the new area cannot be or has not been.

I see that there was a question about telework. I know, and what if there are some productivity concerns, when employers talk to me about their concerns that a person may not be as productive from home, I usually have a conversation with them about why they think that is true, if there is something in this employee's work history that makes them think they are not productive in the office now? And I also talk with them about how they monitor employees who

are in the office, because the truth is most of us don't have a supervisor standing over our shoulder every minute of every day. Employers evaluate on productivity, by whether or not the work is actually getting done.

It's usually possible to do something similar for someone who is working from home. Now, a person who is working from home might also need to check in with their supervisor, maybe by phone or by Skype or by E-mail, because they can't check in on a face-to-face basis. But that is something that needs to be worked out between the individual who is seeking telework and their employer. But I don't think it's automatic that someone working from home is not working as hard. We know from some studies that often a person who is working from home will be less distracted and therefore might be more productive.

I don't know. But think about how you assess productivity for those employees that are in the workplace, and how could you apply that same framework to someone who is out of the office. That is where I usually start. Any more questions right now?

>> MARIAN VESSELS: Yes. We have one more. We have an employee that says they feel sick when they come into our building. What is the best way to approach that? I don't want to immediately go to the landlord because I don't know what the issue is. About 50 percent of her job requires her to be in the building.

>> TERESA GODDARD: I think this is a good chance to apply the interactive process, to gather some more information about where exactly in the building she is feeling sick, whether that feeling means she needs to leave work, or whether she is okay if she can rest and retreat to another area of the building. There is just not enough information here to know what accommodation might work.

It's a good chance to start applying the interactive process. If an employer in this situation has accommodation request forms that they customarily have an employee fill out, then they might want to think, do I have an accommodation request on my hands? Has this person asked for a change in the workplace for a medical reason? Do I need to start the interactive process, so that I can get more information and start identifying a solution that will work.

Another thing that some employers find helpful as they go through the process is consider telework on a trial basis or a temporary basis while they are researching the accommodation. A trial period can be nice because you can gather some data that will help you decide whether telework can work long term, and putting an end date when the employee and employer will come back together to evaluate how well the telework is working can give you a little bit of an end point, so that an employer doesn't feel completely locked in at this early stage. It can be a way to show good faith effort as well.

If someone is in that situation, it sounds a little complex and might want to call in. Any more right now?

>> MARIAN VESSELS: No, I think we're good.

Slide 56>> TERESA GODDARD: Great. Let's go to slide 56. We are getting to the fun part of

the presentation, situations and solutions. These are examples from real JAN calls.

Slide 57Slide 57. A nurse at a hospital had experienced anaphylaxis when exposed to chlorine

fumes even at very low concentrations. The hospital had already made a number of accommodations including providing safe paths of travel from the parking lot to the work area,

from the work area to the cafeteria, alternative cleaning products at the work station, developing an emergency plan of action, removing the function of patient transport, providing a parking space on the same level as her work area so she could avoid elevators, why? Her most recent reaction took place when she was exposed to air coming from an elevator door that opened right in front of her.

They also tried to eliminate chlorine in the cafeteria area. That was a huge challenge because even if the employer controls their cleaning products, you don't know what some member of the public might bring in.

Slide 58Slide 58. What did they do? They worked together, the nurse and hospital, to develop

paths of travel to let her avoid the elevators. The employer and employee explored the use of face masks and respirators to limit exposure, but the employee's medical team provided information that caused them to determine that neither of these were going to reduce the chlorine to an acceptable level.

Masks and respirators are some of the first things that employers and employees want to try because it's easy to purchase something, right? But they don't always work. It is important to get input from the treating medical provider, when you are thinking about a mask. Also really things that are worn and visible need to be voluntary. That is an aside for you.

Let's look at slide 59.

Slide 59The employer in this particular situation did not report a cost to us. We don't know how

much it cost to provide all of these things. Paths of travel are usually free. But changing cleaning products could have triggered a cost. At the stage that we were following up with this individual, it was too soon to tell if there were going to be a lot of benefit from the accommodation because they were still working on a way for the employee to access the cafeteria.

Slide 60Let's look at another one, slide 60. A federal employer contacted JAN about an

employee who experienced extreme allergies when working in the buildings. Previously the employer had cleaned the building, including carpets, and provided an air cleaner. When she continued to have symptoms, they granted temporary telework while the accommodation was reviewed. The employee's doctor gave approval for the employee to return to the building, but when she attempted to do so she became ill again. She went out on leave and requested reassignment and an allergen-free environment.

I have to tell you, allergen-free environments are pretty hard to guarantee. Let's see what happens.

Slide 61In this particular case, the employer reported back to us that they provided a higher

level work space. They didn't tell us that this was altitude or gave her a high level position in different part of the building. But they did move her work space to a place that they thought was going to be more suitable.

Let's look at 62.

Slide 62We know that accommodation was made. We don't know the cost. The employer did

not do what the employee requested. But ultimately, we know from the EEOC, from reasonable accommodation and undue hardship under the ADA, that ultimately the employer has the role and responsibility of choosing the reasonable accommodation as long as it's effective, and of course absent undue hardship to the employer.

Okay not to do what the employee asks, as long as something effective happens. Let's look at 63.

(There is a period of silence from 1:06 to 1:07 on the webinar recording, and the section in quotes was not captured.)

“A worker responsible for licensing child care settings for a local government had an office in a very old building. She said that the air in the building had irritants that triggered allergy symptoms including a change in her voice. This and other symptoms flared up during forest fires, volcanic ash plumes, and other times when outdoor pollution was high. I don't know where she was located, but I'm wondering if it was the northwest. She was considering requesting telework or working in a different building, and she needed information on how to request accommodation and also information to figure out if she was covered. She didn't know much about the definition of disability.

Half of JAN calls come from employees, half come from employers, and there are rehab counselors and professionals that make up the sliver in between.”

Slide 63Can you hear me now? I'm going to reread slide 63. A worker responsible for licensing

child care settings for a local government had an office in an old building. The air in the building had irritants that triggered her allergy symptoms, caused problems with her voice. This and other symptoms flared up when there was forest fires, volcanic ash plumes and other times when outdoor pollution was high. She was considering requesting telework, to work in a different building, needed information on how to request accommodation, and information about the definition of disability.

Slide 64Let's go again to slide 64. In this case, the pending accommodation solutions at the

time of follow-up included buying a product or piece of equipment, changes to her work schedule, working from home or telework, and a private office for on-site work.

She couldn't totally eliminate on-site work, but with a private office and air purifier, that is probably what they did, hopefully helped her to better tolerate the work environment. Also telework, looks like they were looking at telework as an option for her, at those times when she didn't absolutely have to be in the office.

Let's go to 65.

Slide 65At the time of follow-up we did not yet know the cost or benefits for this accommodation. Let's go to 66.

Slide 66In this example a police officer for a school district disclosed wool and leather allergies.

The required uniform contained wool and the holster was made of leather.

Slide 67 The employee found alternatives to wear and made an accommodation request, but in

this particular case no accommodation was made. The employer thought that the employee should pay, and that it wasn't the employer's responsibility. If I had talked to this employer, I might have gone back and forth on that with them a little bit. But that is what happened in this real call.

Slide 68Look at 68. No accommodation was made, so there was no cost and no benefit.Let's look at 69.

Slide 69An employee at a junior college was experiencing symptoms due to mold/mildew allergy

and chronic fatigue syndrome. The employee was told that testing had shown mold in the building, but that it was at safe and legal limits. The employee felt that the air quality in the building had become poor. She contacted JAN for information about the ADA and her rights.

Let's look at slide 70.

Slide 70In this particular case the college agreed to allow the employee to change work spaces.

Slide 71Slide 71. They did not report a cost. According to the employee at the time of benefit it

was too soon to tell if the accommodation would work or not, because they still hadn't actually moved her, just said that she could move.

Let's look at 72.

Slide 72A local government employer contacted JAN following a request from an engineer who

had asthma, sinusitis and allergic rhinitis. The engineer asked for a sealed space and also applied for FMLA. The employer was not able to provide this since they were temporarily renting a space while the office's permanent space was undergoing renovation. According to the employer, "all employees must be in one cube." Actually I took this call and tried to find out what he meant, but I never could understand what he meant by that.

But the employer there, their main thing was they wanted the employee to stop smoking, because they thought if he stopped smoking, it would improve his condition, and maybe he wouldn't need the accommodation.

Let's see what happened. Slide 73.

Slide 73After we talked, the employer provided a modified work schedule using flex time. The

employer was not able to grant the employee's request for his own space. But the employer did not attempt to get the employee to stop smoking. Instead, they focused on what accommodations they could and could not offer.

Let's look at 74.

Slide 74There was not a cost reported. But the company benefited by keeping an employee

happy, as the employer stated, he knows his job so well.And we know from EEOC guidance, you can read more in “The Employer’s Practical

Guide to Reasonable Accommodation Under the ADA” on the JAN website, employers shouldn't be compelling an employee to treat or mitigate an impairment; for example, to stop smoking or to purchase personal need items needed to mitigate a disabling condition.

Let's look at 75.

Slide 75Here is another example. A supply technician for the federal government has been

working in a warehouse for ten years. She developed allergies to dust and mold and could no longer work in the warehouse. She asked to give her warehouse duties to another employee, leaving her to do office tasks. The employer countered and said that it would require moving an essential function of her job, which they were not required to do. They also said there was no one else available who could take on the duties in the warehouse.

Let's look at 76 to see what happened.

Slide 76In the end the employee was assigned to a new position better suited to her health

needs. Let's look at 77.

Slide 77No cost was reported, but an accommodation was made, and that's a good thing.We don't know for sure if it was effective or not. We would have to wait and see how

she did in the new position. Let's look at 78.

Slide 78Here is another example. A surgical technologist experienced hot, itchy and painful

rashes when exposed to gloves and surgical gowns. The rashes became so severe that they sometimes caused bleeding. The employee had missed a lot of work. She was concerned about running out of leave. A representative of her employer had even said that she might want to consider finding another line of work.

She was pretty upset when she finally reached JAN. Let's look at 79.

Slide 79After she made a formal accommodation request, the employer ordered a different

brand of neoprene gloves that didn't have the same accelerators that were found in other nonlatex products. According to the employee, her dermatologist thought that the accelerators were actually the substance to which she was allergic. It was very important that she gathered that information from her dermatologist and shared it with the employer.

Let's look at 80.

Slide 80We don't know the cost of the accommodation. At the time of follow-up it was too soon

to tell if it was going to work or not. This was actually the third brand of gloves that the employee had tried. Sometimes you might have to go through multiple steps.

Let's look at 81.

Slide 81A clerical employee at a college had a history of cancer and suppressed immune

system. She was undergoing allergy treatments to help improve her immunity. She wanted to modify the work schedule so she could get to her allergy shots once a week, and asked to leave work one hour early one day each week, but the supervisor didn't want to do that, saying he might need her during that one hour. They wanted her to get her shots in the morning instead. But this would actually require her to be out for a longer period of time, three whole hours instead of just one. The employer contacted JAN for more about schedule modifications in the ADA.

Let's look at 82.

Slide 82Following a meeting involving the college's ADA/EEO department, the department's

ADA coordinators, the employer made the decision to accommodate. They provided a modified work schedule, letting the employee leave work to receive treatment. We don't know the exact schedule. But the accommodation was reported to be extremely effective, “because it allows her to receive treatment in order to live.”

Let's look at 83.

Slide 83There wasn't a cost for this accommodation, but the employer did say there were a lot of

direct benefits which included doing the right thing, and improving morale, keeping a qualified employee, they didn't have to train someone new, saved on worker's comp, productivity and attendance were improved. They estimate the value of those direct benefits was more than a hundred, less than $500. But a lot of things worked out for the employer because they chose to provide this accommodation. They thought it was a valuable step for them.

Let's look at 84.

Slide 84A social service worker with allergies and asthma had difficulty meeting with clients in

their homes, especially those clients who smoked.Let's look at 85.

Slide 85The employee was allowed to meet some of her clients in a neutral place, without

smoke. Let's look at 86.

Slide 86It didn't cost the employer anything. They were able to keep an experienced employee. Let's look at 87.

Slide 87An employee with severe peanut and tree nut allergies asked her employer to restrict

these foods from her workplace. Let's look at 88.

Slide 88The employer agreed to accommodate, but then left it up to her to put up signs, send

memos, and talk to people who have products on, rather than doing this at the management level.

Unsurprisingly, her coworkers did not follow the signs consistently. As a result, she had an anaphylactic reaction at work. Of course, that is very serious. She stated that the employer then wrote her up for having the reaction.

Again this is a real scenario from a real JAN call. But I would encourage you not to be like this employer.

Let's look at 89.

Slide 89There was no cost to the accommodation, no real benefit, either, from what we can tell

in the follow-up.Let's look at 90.

Slide 90An educational career counselor with asthma and allergies typically did her charting in

an office in the basement of one of the buildings where she worked. Something about the building gave her breathing problems and headaches.

Slide 91Looking at 91, she asked for an air purifier. Initially the employer declined. They

thought it was a personal use item. They talked more and gave her permission to buy an air purifier and reimbursed her. It is sometimes difficult to know whether an air purifier is a personal use item or not. If you are confused, call in. We have resources to help figure it out.

Let's look at 92.

Slide 92We don't know the cost of the accommodation. But according to the employee, it was

fine for her office, but didn't address other places at the work site. Let's look at 93.

Slide 93This is a screen shot of the JAN website. If you click on accommodation search on the

JAN website you will come to this page, the searchable on-line accommodation resource. Once you are on this page, click on the graphic on the magnifying glass.

Let's look at 94.

Slide 94Once you clicked on the icon of the magnifying glass, you will be able to select an

impairment from a long list of impairments.

For the purposes of this example, let's choose MCS (multiple chemical sensitivity.) Let's go to the next slide, slide 95.

Slide 95Next, we want to select the limitation. So for the purposes of this example, we are going

to select working with, or around, irritants. Let's go to 96.

Slide 96We are going to select, “the individual has difficulty working with cleaning chemicals in

the workplace.” On this page, we look at all of the job functions on the list and pick the one that comes closest.

Slide 97Here we are on slide 97. We can see some information on respiratory difficulties due to

cleaning chemicals, and how you might use alternate cleaning products and practices. It's hard to tell from the slide, but the term, alternative cleaning products is clickable. Click on that.

Slide 98Slide 98. And here we have a screen shot from a page that gives us a list of vendors

that carry alternative cleaning products, and a little explanation about what that is all about.

Slide 99Let's move on to slide 99. Say at Step 4, we wanted to choose something different. If

someone was having respiratory problems due to fragrances, one option might be to provide an air purification or personal air supply system that is suited to the space and irritants that need to be addressed. Say we clicked on that.

Slide 100Go to slide 100, and we get information on air cleaners and purifiers, and places that

sell that kind of thing. Again, you want to check with the manufacturers to make sure that the one you are considering has the features you want.

Let’s go to 101.

Slide 101The slide has information on resources that can be helpful to you as you go through this

process. One, the person is a wonderful resource. An individual can tell you lots about their own condition and how they experience it, and how it impacts them in the workplace. They are probably going to have ideas for things that work for them, because they know it worked in another work setting or it's what they do at home. Your person with a disability who is seeking an accommodation is a wonderful resource for accommodation ideas.

You can call JAN at 1-800-526-7234 or go on our website. You may also want to contact your state vocational rehabilitation agency. Sometimes the state AT project may be able to lend something that is useful for federal employers. CAP is a wonderful resource for many types of accommodations. I'm not sure if they are going to be able to help a lot with allergy related accommodations, but they are a good referral for many other types. Where they might be able to help is if you are looking for something like a good conference phone,

because it's telephone related, maybe a person is having problems with their voice.Another resource that you may want to check out is EWG.org. They have resources to

help people choose between different personal care products, and they have an app called skindeep. And if you go on the JAN website under the A to Z list you can find organizations related to MCS, respiratory impairments and other impairments as well.

Let’s move to 102.

Slide 102And again, the JAN phone number is 800-526-7234, TTY, 877-781-9403. You can find

us on-line at askJAN.org, and you can E-mail us at JAN@askJAN.org. If you still have questions after today that we don't get to during the follow-up, I would encourage you to contact us, and I'd be happy to speak with you or respond to E-mails.

Thank you for having me here today. It has been a pleasure. Do we have some questions? I see one in the question box. What kind of accommodations can be made in an industrial or factory setting for

airborne allergies since the area can be so big?That is a great question that unfortunately does not have a great solution. The larger a

room is, the harder it is going to be to really cleanse the air.For someone who is on a production line, typical accommodations might be looking into

PPE, personal protective equipment, like a mask, or like a respirator. In industrial settings, sometimes a more industrial quality respirator might be suitable. But particularly when it comes to respirators, really when it comes to any mask, it's important that the person's medical provider give input on whether or not it is safe, because if a person has allergies as well as something like asthma, there is a chance that a mask or respirator might be medically contraindicated.

Sometimes you can do a little bit with job restructuring to move a person farther away from an irritant. But to clear an irritant completely from a very large area is extremely challenging.

Do we have other questions? I can tell you, if you are looking into a mask or some type or a respirator, if you go on to

the JAN website, through the searchable on-line accommodation resource like we discussed, or if you call in and get a link from a JAN consultant, we can show you examples of different types, and it sometimes helps to show the individual with the disability the range of things that may be possible, and get their input. Maybe see if they would be willing to go back to their healthcare provider and see if the healthcare provider can help you choose something that would be appropriate.

Again, masks because they are visible need to be voluntary. The reason for that is that we do not want to force someone to reveal that they are receiving an accommodation, by making them wear something that makes that obvious. I can't stress this enough. When it comes to a mask, or a respirator, it's very important to know that it's safe for the person to use.

I would say that is also true when considering an air purification system that releases any amount of ozone. Some people are sensitive to ozone. Some people who have asthma may have ozone as an asthma trigger. If you are going through the list of options and discover that you are considering something that releases a minute amount of ozone, or a significant amount, I don't know, there may be a few like that, just check and make sure that it's okay, and that it's going to be safe for the individual to use.

I see another question. My physician recommended a surgical mask with an oil scent that I can tolerate to protect me from smells. Earlier I saw that surgical masks don't help. Is the oil recommendation what makes the difference?

It was a recommendation from your doctor, and I would never go against an M.D.'s opinion. But I would say it may be the oil, if it was an essential oil. Sometimes people find that exposing themselves to an essential oil that is safe for them and that is perhaps present for them can help them to tune out some of the other scents that are coming toward them. So if there is a psychological component to the exposure, having a masking fragrance may help.

Some essential oils people find may be helpful in altering the way they perceive information that comes to them through the nose. It may even alter how their nasal passages function. I'm not sure what oil was involved or what the doctor's hope was in suggesting it, but I would say in this case the doctor was suggesting a surgical mask not only for protection but as a delivery method for this oil treatment. Obviously, if a doctor says try a surgical mask, that might be a good thing to consider.

But the reason I said what I said is that surgical masks aren't designed to keep smells out. They are designed to keep sneezes and coughs and secretions in. They are designed for a different purpose. Can you use them in a fragrance sensitivity situation? Sure. A lot of people do and are successful. But it's not what they were initially designed for.

A lot of people will use other types of methods to expose themselves to essential oils. There are essential oil diffuser necklaces. These are often made of clay, and you drip an essential oil on to them. Sometimes they are more like a locket that has air holes, and people will put a felt pad with a drop or two essential oil in the pocket. We talked to an individual with autism who needed essential oils to regulate her mood, but she was in a fragrance-free work setting, they had a fragrance-free policy. We talked about storing cotton balls with essential oil on the ball inside of just a regular medication container like pill bottles, maybe storing those inside another airtight container like a zip lock bag, so that if she needed to use essential oils, she could retreat to a safe location where she would be allowed to use that, and then retrieve the cotton ball with the scent that she needed in order to manage her mood.

These are great questions, by the way. Keep them coming.

Slide 103>> MARIAN VESSELS: Teresa, I think we have come to the end of the session. I want

to thank you so much for your wonderful information, and people have the information for contacting you at JAN. They can also reach us through the ADA national network at 1-800-949-4232. Or, calling us about this presentation, they can reach the Mid-Atlantic ADA Center at 301-217-0124, or adainfo.org.

Slide 104For those of you that need a Certificate of Participation, the continuing education code

for this session is “breathe.” B-R-E-A-T-H-E. Please consult your webinar reminder E-mail for further information on receiving continuing education credits.

Thank you for joining us today. We hope you have a wonderful rest of the afternoon.