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-Processing Industry Food Additives Food Handling Food Industry Lung Lung Diseases Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety

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• Keywords:
  Food-additives Food-processing Food-processing-workers Humans Pulmonary-disorders Pulmonary-function Pulmonary-function-tests Pulmonary-system Pulmonary-system-disorders Respiratory-system-disorders
• 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
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7ff79ff8d842f7de2d41cc0c386ed79f0b2f55645774c4e2a866ddcc0174b1a43507f8dfafcedaab974d2338bd1bb7dd26170bd33931f25ace4ac09ac86371a4
• Download URL:
  https://stacks.cdc.gov/view/cdc/186780/cdc_186780_DS1.pdf
• File Type:
  [PDF - 75.40 KB ]