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Spirometry monitoring in the detection of bronchiolitis obliterans in flavor manufacturing workers.

Authors
Bailey-R; Sahakian-N; Kanwal-R; Israel-L; Kreiss-K
Source
Am J Respir Crit Care Med 2008 Apr; 177(Meeting Abstracts):A164
NIOSHTIC No.
20034644
Abstract
Background: Bronchiolitis obliterans (BO) associated with diacetyl, in artificial butter and other flavorings, occurs in workplaces without effective exposure controls. Methods: The National Institute for Occupational Safety and Health initiated a spirometry monitoring program for a flavor manufacturing company. We used a volume spirometer interfaced to a personal computer and administered a bronchodilator to assess reversibility of airways obstruction. Surveys occurred in October 2006 and March 2007. Results: Among 14 workers with current or past flavor manufacturing experience, initial spirometry revealed severe fixed airways obstruction, later confirmed as BO, in a 37-year-old never-smoker. He developed shortness of breath and cough 1 and 4 years, respectively, after beginning work in powder production. He added diacetyl and other ingredients to powder flavorings, monitored blending operations, and packaged finished products. His work tenure included 6 years in powder production, then approximately 5.5 years in liquid production, followed by less than 1 year in the warehouse due to debilitating respiratory symptoms. Spirometry tests 4.5 months later revealed that a 25-year-old asymptomatic worker had progressed from borderline to mild fixed airways obstruction after a 1 liter drop in FEV1. He had a 2 pack-year smoking history. He worked approximately 3 months in powder production and 21 months in liquid production. High-resolution computed tomography showed expiratory air trapping. With exposure cessation, both workers had stable FEV1 on follow-up. Conclusions: Serial spirometry identified a prevalent and an incident case of flavor-related BO. Exposure controls, respiratory protection, and serial spirometry, with removal of those with large decrements or abnormalities, are necessary to protect flavoring workers from permanent, severe disability
Keywords
Respiratory-system-disorders; Pulmonary-system-disorders; Pulmonary-system; Pulmonary-function; Pulmonary-disorders; Food-additives; Food-processing-workers; Food-processing; Pulmonary-function; Pulmonary-function-tests; Humans
CODEN
AJCMED
CAS No.
431-03-8
Publication Date
20080401
Document Type
Abstract
Fiscal Year
2008
NTIS Accession No.
NTIS Price
ISSN
1073-449X
NIOSH Division
DRDS
Source Name
American Journal of Respiratory and Critical Care Medicine
State
WV; CA
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