Spirometry Monitoring in the Detection of Bronchiolitis Obliterans in Flavor Manufacturing Workers

Details

• Personal Author:
  Bailey R ; Israel L ; Kanwal, Richard ; Kreiss, Kathleen ; Sahakian, Nancy
• Description:
  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 Description provided by NIOSH
• Subjects:
  • Food Additives
  • Food Handling
  • Food Industry
  • Food-Processing Industry
  • Lung
  • Lung Diseases
  • Occupational Health
  • Respiratory Function Tests
  • Respiratory System
  • Respiratory Tract Diseases
  More +
• 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
  More +
• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Abstract or Summary
• Place as Subject:
  California ; OSHA Region 3 ; OSHA Region 9 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  177
• NIOSHTIC Number:
  nn:20034644
• Citation:
  Am J Respir Crit Care Med 2008 Apr; 177(Meeting Abstracts):A164
• CAS Registry Number:
  • Butanedione (CAS RN 431-03-8)
• Federal Fiscal Year:
  2008
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• Download URL:
  https://stacks.cdc.gov/view/cdc/186780/cdc_186780_DS1.pdf
• File Type:
  [PDF - 75.40 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7ff79ff8d842f7de2d41cc0c386ed79f0b2f55645774c4e2a866ddcc0174b1a43507f8dfafcedaab974d2338bd1bb7dd26170bd33931f25ace4ac09ac86371a4