Response to Galbraith and Weill

Details

• Personal Author:
  Gelb A ; Harber P ; Harrison, Robert
• Description:
  To the Editor: The article of Galbraith and Weill (2009, https://doi.org/10.1007/s00420-008-0337-x), which seriously questions whether diacetyl-induced bronchiolitis obliterans exists, also expressed doubt about the validity of the diagnoses of the two cases reported by the California Department of Health Services (Harrison 2006). We agree that the CAT scan results alone do not establish the diagnosis of bronchiolitis obliterans; however, bronchiolitis obliterans is by far the most likely diagnosis when considering the other clinical findings and pulmonary function testing showing severe nonreversible obstructive spirometric abnormalities, lung volume hyperinflation and air trapping, and maintained diffusing capacity. Similar comments apply to the biopsy of the second case, which was actually interpreted as highly consistent with bronchiolitis obliterans by an expert pathologist. While the authors severely criticize individual components of much of the published literature, the overall weight of the scientific evidence supports an association between flavoring exposure and bronchiolitis obliterans. We concur, however, that the link to diacetyl per se is not 100% established, although the data are strongly supportive of such a causal association. [Description provided by NIOSH]
• Subjects:
  Diacetyl Flavoring Agents Lung Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Flavorings Health Effects Lung Disease Lung Function Respiratory Diseases Respiratory Function Tests
• ISSN:
  0340-0131
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  83
• Issue:
  1
• NIOSHTIC Number:
  nn:20058489
• Citation:
  Int Arch Occup Environ Health 2010 Jan; 83(1):111
• CAS Registry Number:
  Butanedione (CAS RN 431-03-8)
• Federal Fiscal Year:
  2010
• Performing Organization:
  University of California Los Angeles
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  International Archives of Occupational and Environmental Health
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e6bcd359d18bfd8318b2eecbe2eb3fe6693a7283a15389447d0865907f7a5c4b30fe49c4b94b6443eff05011e09b0624b319600f16888433695ef0b24f63c571
• Download URL:
  https://stacks.cdc.gov/view/cdc/221576/cdc_221576_DS1.pdf
• File Type:
  [PDF - 104.64 KB ]