Longitudinal decline and spirometric restriction in microwave popcorn and flavoring manufacturing workers

Details

• Personal Author:
  Bailey, Rachel L. ; Cox-Ganser, Jean M. ; Fedan, Kathleen B. ; Kreiss, Kathleen ; White, Sandra K.
• Description:
  Introduction: Occupational exposure to artificial butter flavorings containing diacetyl is a risk for obliterative bronchiolitis and fixed airway obstruction. However, some flavoring manufacturing workers have restriction, and restriction has been found in some soldiers returning from Iraq and Afghanistan with biopsy-documented obliterative bronchiolitis. Whether spirometric restriction in flavoring-exposed workers reflects interstitial lung disease remains unanswered. Methods: We used SPIROlA software to analyze existing interpretable longitudinal lung function data collected from 2000 to 2003 by NIOSH on current and former workers from a microwave popcorn (MP) plant and collected from 2004 to 2009 by 20 companies on current California flavoring manufacturing (FM) workers as part of a medical surveillance program. We assessed excessive declines in FEV1 and in FVC using the longitudinal limit of decline calculated by SPIROLA with settings of a 30 ml/year referential decline and a 10%annual decline. HRCT scans taken in 2014 on a subset or the MP workers were analyzed in relation to restriction. Results: As of last spirometry test. 47/ S28 (9%) of MP workers had restriction. 65 (12%) had obstruction. and 28 (5%) a mixed pattern, while 67/600 (11%) of FM workers had restriction, 29 (5%) had obstruction, and 6 (1%) had a mixed pattern. In the MP workers, 35 of 268 (13%) with > 2 observations experienced excessive decline: 13 with FEV1 only; 9 with FVC only; and 13 with both FEV1 and FVC (8% total with FVC decline}. In the FM workers, 50 of 333 (15%) with > 2 observations experienced excessive decline: 12 with FEV1 only; 17 with FVC only; and 21 with both FEV1 and FVC {11% total with FVC decline). HRCT scans in 2014, for 12 MP workers with restriction at last test, and one worker normal at last test but with excessive decline in both FVC and FEV1 showed radiographic evidence of airways disease in eight workers and no evidence of interstitial lung disease in any of the 13 workers. Conclusions: In flavoring-exposed workers, spirometric restriction or an excessive decline in serial FVC should be considered as signs of possible occupational airways disease consistent with obliterative bronchiolitis and not interstitial disease. [Description provided by NIOSH]
• Subjects:
  Diacetyl Flavoring Agents Lung Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Safety Workplace
• Keywords:
  Airway Obstruction Bronchiolitis Diseases Flavorings Food Food Additives Lung Disease Soldiers Statistical Analysis Work Environment Workers

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• 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:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  193
• NIOSHTIC Number:
  nn:20048426
• Citation:
  Am J Respir Crit Care Med 2016 May; 193(Abstract Issue):A5433
• Email:
  alicia.swartz@ucsf.edu
• CAS Registry Number:
  Butanedione (CAS RN 431-03-8)
• Federal Fiscal Year:
  2016
• NORA Priority Area:
  Manufacturing
• Performing Organization:
  University of California
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Abstract Issue
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:38a3aff39154a377d83238a6c55bf75f068b71f5a5f670ac03b325208549387d5e8a14edc9d3e6df7420d74149cda786062d6e14b9113a8a3547148bed056369
• Download URL:
  https://stacks.cdc.gov/view/cdc/203182/cdc_203182_DS1.pdf
• File Type:
  [PDF - 18.08 KB ]