Endemic bronchiolitis obliterans syndrome in microwave popcorn workers: a new occupational lung hazard.
Kreiss K; Gomaa A; Kullman G; Fedan K; Schleiff P; Simoes E; Enright P
Am J Respir Crit Care Med 2002 Apr; 165(8)(Suppl):A461
In followup of a cluster of severe fixed airway obstruction in former workers, we studied current employees and exposures in a microwave popcorn plant. We conducted questionnaire interviews, spirometry, lung diffusing capacity, and chest x-rays. Age- and smoking-adjusted rates were compared to National Health and Nutrition Examination III data. We evaluated exposure-response relations by comparing rates of symptoms and abnormalities by estimates of cumulative exposure to diacetyl, the predominant ketone in artificial butter flavoring and in the plant air. The I 17 current workers (87% response rate) had 26 times the rates of chronic cough and shortness of breath compared to national data; 3.3 times the rate of obstructive spirometry abnormalities; and about twice the rate of physician-diagnosed asthma and chronic bronchitis. Excess abnormalities were higher in never smokers, who had 11.8 times the national rate of airways obstruction Strong exposure-response relationships existed between quartile of estimated cumulative exposures to diacetyl and respirable dust and frequency and degree of airway obstruction. The exposure-related excess lung disease in this plant population is e best explained by work-related bronchiolitis obliterans syndrome from inhaling butter flavoring vapors. Animal studies and longitudinal surveillance will clarify the causative agent(s) and efficacy of prevention measures.
Airway-obstruction; Airway-resistance; Spirometry; Chest-X-rays; Age-groups; Smoking; Ketones; Air-sampling; Air-quality-monitoring; Chronic-exposure; Respiratory-irritants; Pulmonary-function; Pulmonary-disorders; Respirable-dust; Lung-disease; Respiratory-system-disorders; Pulmonary-system-disorders; Food-processing-workers; Food-processing-industry; Food-processing; Food-additives
Abstract; Conference/Symposia Proceedings
DRDS; DSHEFS; HELD
Disease and Injury: Asthma and Chronic Obstructive Pulmonary Disease
American Journal of Respiratory and Critical Care Medicine, 2002 International Conference, The American Thoracic Society, Atlanta Georgia, May 17-22, 2002