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Bronchiolitis obliterans syndrome in popcorn production plant workers.

Authors
Akpinar-Elci-M; Travis-WD; Lynch-DA; Kreiss-K
Source
Eur Respir J 2004 Aug; 24(2):298-302
NIOSHTIC No.
20025308
Abstract
Following sentinel case recognition, an excess of fixed airways obstruction was found among current workers in a microwave popcorn plant associated with butter flavouring exposures. In order to characterise the clinical presentation of sentinel cases, the medical records of sentinel cases were reviewed, interviews conducted and serial spirometric testing performed. Cases worked in microwave popcorn production, and five of the nine cases had mixed flavourings. Most had never smoked or smoked minimally. Cases showed onset of cough, shortness of breath and wheezing 5 months to 9 yrs after starting work at the popcorn plant. Initial forced expiratory volume in one second ranged 14.0-66.8% of the predicted value. Eight high-resolution computed tomography scans showed marked bronchial wall thickening and mosaic attenuation with air trapping. Open lung biopsy results were consistent with, or diagnostic of, constrictive bronchiolitis in two of three cases. Five cases are on lung transplantation waiting lists. After leaving employment, nearly all cases experienced stabilisation of their lung function within 2 yrs. Astute clinicians can help identify new causes of airways obstruction by alerting public health authorities to unexplained disease cases occurring in groups of workers.
Keywords
Airway-obstruction; Lung-disease; Spirometry; Chest-X-rays; Respiratory-irritants; Airway-resistance; Smoking; Chronic-exposure; Pulmonary-function; Pulmonary-disorders; Respirable-dust; Respiratory-system-disorders; Pulmonary-system-disorders; Food-processing-workers; Lung-function; Medical-care; Medical-monitoring; Food-additives; Clinical-diagnosis; Age-groups; Author Keywords: Airways obstruction; flavouring; food industry; occupation
Contact
National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies, MS H-2800, 1095 Willowdale Road, Morgantown, WV 26505
CODEN
ERJOEI
CAS No.
431-03-8
Publication Date
20040801
Document Type
Journal Article
Email Address
melci@cdc.gov
Fiscal Year
2004
NTIS Accession No.
NTIS Price
Issue of Publication
2
ISSN
0903-1936
NIOSH Division
DRDS
Priority Area
Disease and Injury: Asthma and Chronic Obstructive Pulmonary Disease
Source Name
European Respiratory Journal
State
WV; CO; MD
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