Dr. Egilman highlights the need for testing of chemicals prior to their use by workers and consumption by the public [Egilman, 2014]. We agree that the demonstrated toxicity of diacetyl illustrates the need for testing and great vigilance regarding diacetyl substitutes, other flavoring chemicals, and chemicals involved in flavor manufacture, and that such an approach would better ensure the safety of workers and the public. Nonetheless, we currently know little about the toxicity of flavoring chemicals other than diacetyl and 2,3-pentanedione. Thus, the workforce studied had been exposed to diacetyl, which is a recognized cause of obliterative bronchiolitis, along with hundreds of chemicals with unknown effects on the respiratory system. This epidemiologic study found a 3.7-fold excess of restrictive abnormalities overall and an association between higher potential for chemical exposures and excessive decline in the forced expiratory volume in one second (FEV1) [Kreiss, 2014]. This pattern differed from the predominant obstructive pattern found in microwave popcorn manufacturing workers with a more limited number of chemical exposures in which diacetyl predominated.
Kathleen Kreiss, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV 26505
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