Health hazard evaluation report: HETA-2008-0125, 0126, 0127-3093, respiratory symptoms in workers at three commercial kitchens, Aramark, New York, New York.
In February 2008, the UNITE HERE International Union requested Health Hazard Evaluations to evaluate both respiratory health and inhalation exposures of food preparation workers at three New York City food service facilities managed by the Aramark Corporation. This request was triggered by concerns of exposure to artificial butter-flavored cooking oils, containing diacetyl. Exposure to diacetyl is associated with a severe lung disease, called bronchiolitis obliterans. At NIOSH's request, in February 2008, the New York City Department of Health and Mental Hygiene collected four bulk samples of current-use cooking oils at the 1 Chase Manhattan Plaza (CMP) Aramark facility. On March 11-12, 2008, we completed a walk-through visit of the three facilities where we performed limited air sampling, evaluated the cooking area ventilation systems, collected bulk samples of current-use cooking oils, and reviewed material safety data sheets (MSDSs) and Occupational Safety and Health Administration (OSHA) 300 logs. We visited the facilities again from March 31 to April 4, 2008 to perform a medical survey consisting of an interviewer-administered questionnaire and spirometry (lung function) testing. We detected low levels of diacetyl in bulk samples of unsalted butter at the 277 Park Avenue (Park) and 1 New York Plaza (NYP) Aramark locations and in two bulk samples of Prep ZT, a butter-flavored cooking oil, from the CMP Aramark location. We did not detect acetoin, a ketone similar to diacetyl also found in many butter-flavored products, in any bulk samples. We did not detect diacetyl or acetoin in any area or personal air samples at the three facilities and have no evidence that workers are currently exposed to diacetyl or acetoin vapors while using these products during cooking or food preparation. We did not detect oxides of nitrogen (NOx) or nitrous dioxide (NO2) at any of the locations. Carbon monoxide (CO) was not detected at the Park and NYP locations, but two separate one-minute readings of 6 and 3 parts per million (ppm) were detected at the CMP location during a cooking operation. These short-term concentrations were well below the OSHA Permissible Exposure Limit (8-hour time-weighted average of 50 ppm) and the NIOSH Recommended Exposure Limit (8-hour time-weighted average of 25 ppm) for CO. Real time monitoring for VOCs at all locations did not detect levels greater than 2 ppm, and real time particle measurements were generally below 1 mg/m3; however, there are no applicable exposure guidelines for these measurements. We observed some employees handling cleaning agents without the proper eye and skin protection recommended in the MSDSs. NIOSH staff interviewed 116 workers (82%) about their health and job histories and obtained interpretable spirometry tests from 104 of these participants. Among the 116 participants, 71 (61%) reported nasal irritation; 54 (47%) eye irritation; and 26 (22%) reported a post-hire skin rash or skin problem. Aramark workers had higher than expected prevalence of wheeze (a symptom of asthma); stuffy, itchy or runny nose; watery, itchy eyes; nasal allergies, including hay fever; and shortness of breath on exertion compared to the U.S. adult population as reported in NHANES III [CDC 1996]. Workers who reported cooking as part of their job were twice as likely to report asthma-like symptoms, shortness of breath following exercise, and cough than those who did not report cooking among their job duties. Additionally, they were three to four times more likely to report work-relatedness of their respiratory symptoms. Participants who reported cleaning as part of their duties were also more likely to report lower respiratory symptoms, specifically, asthma-like symptoms and shortness of breath while walking uphill compared to those whose job duties did not involve cleaning. Workers who reported cleaning hot surfaces were more than three times more likely to report shortness of breath following exercise than those not reporting this exposure. Aramark workers had a higher than expected prevalence of a restrictive pattern on spirometry tests (14%) compared to the U.S. adult population as reported in NHANES III; the prevalence of airways obstruction was not higher when compared to the U.S. adult population [CDC 1996]. We identified five workers (5%) with airways obstruction; of whom two had fixed obstruction which did not appear to be flavoring-related. These two workers started working at their current Aramark facility after artificial butter-flavored products were no longer in use. They, as well as the other three workers with airways obstruction, did not report any professional cooking experience in their current facility or in the food service industry outside of their current facility. Three of the workers reported cleaning experience. One worker with reversible airways obstruction reported no smoking history. The other four workers with airways obstruction reported past or current smoking. No cases of obstruction were observed at the CMP Aramark location where a diacetyl-containing butter-flavored cooking oil was used at the time of the survey. Diacetyl and acetoin were not detected in any personal or area air samples at the three facilities collected by NIOSH at the time of the survey.
Region-2; Food-additives; Food-handlers; Food-processing; Food-processing-industry; Food-processing-workers; Food-services; Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disorders; Lung-disease; Spirometry; Skin-irritants; Skin-protection; Eye-irritants; Eye-protection; Personal-protective-equipment; Allergens; Allergies;
Author Keywords: Flavoring Syrup and Concentrate Manufacturing; Food service contractors; cafeteria and caterers; flavorings; diacetyl; engineering controls; bronchiolitis obliterans; asthma; respiratory symptoms; spirometry; airways restriction; airways obstruction; cooks; cleaners