An eight-case cluster of seven fixed airway obstruction (four on transplant lists) among former workers of a microwave popcorn plant suggested an outbreak of unrecognized occupational lung disease. We reviewed medical records of sentinel cases, conducted interviews, and performed serial spirometry testing. Cases worked in microwave popcorn production, rather than in kernel popcorn packaging or warehouse areas. Exposures included soybean oil, salt, butter flavorings for four male oil mixers and four female microwave packager flavorings and kernel popcorn. Ages ranged from 29-53 years (median age 43.3), three had never smoked. Cases had onset of cough, shortness of breath and wheezing, between 1992-2000, after 5 months -6 years employment. FEYI % predicted ran from 14-68%; FEYIIFYC % predicted from 22.6-75%, and all had high residual volume. Six of eight workers had normal single breath carbon monoxide diffusing capacity. Chest x-rays showed hyperinflation in three cases. Two cases had pathology consistent with alliterative bronchiolitis, one of whom had granulomas. This worker cluster of fixed airway obstruction is best explained endemic bronchiolitis obliterans syndrome likely caused by a previously unsuspected inhalation hazard from occupational exposure.
Disease and Injury: Asthma and Chronic Obstructive Pulmonary Disease
Source Name
American Journal of Respiratory and Critical Care Medicine, 2002 International Conference, The American Thoracic Society, Atlanta Georgia, May 17-22, 2002
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