Case Report: Flavoring-Related Lung Disease in a Coffee Roasting and Packaging Facility Worker with Unique Lung Histopathology Compared with Previously Described Cases of Obliterative Bronchiolitis

Details

• Personal Author:
  Bailey, Rachel L. ; Blackley, Brie H. ; Cox-Ganser, Jean M. ; Cummings, Kristin J. ; Harvey, R. Reid ; Korbach EJ ; Rawal AX ; Roggli VL
• Description:
  Occupational exposure to diacetyl, a butter flavor chemical, can result in obliterative bronchiolitis. Obliterative bronchiolitis is characterized by exertional dyspnea, fixed airflow obstruction, and histopathologic constrictive bronchiolitis, with bronchiolar wall fibrosis leading to luminal narrowing and obliteration. We describe a case of advanced lung disease with histopathology distinct from obliterative bronchiolitis in a 37-year-old male coffee worker following prolonged exposure to high levels of diacetyl and the related compound 2,3-pentanedione, who had no other medical, avocational, or occupational history that could account for his illness. He began working at a coffee facility in the flavoring room and grinding area in 2009. Four years later he moved to the packaging area but continued to flavor and grind coffee at least 1 full day per week. He reported chest tightness and mucous membrane irritation when working in the flavoring room and grinding area in 2010. Beginning in 2014, he developed dyspnea, intermittent cough, and a reduced sense of smell without a work-related pattern. In 2016, spirometry revealed a moderate mixed pattern that did not improve with bronchodilator. Thoracoscopic lung biopsy results demonstrated focal mild cellular bronchiolitis and pleuritis, and focal peribronchiolar giant cells/granulomas, but no evidence of constrictive bronchiolitis. Full-shift personal air-samples collected in the flavoring and grinding areas during 2016 measured diacetyl concentrations up to 84-fold higher than the recommended exposure limit. Medical evaluations indicate this worker developed work-related, airway-centric lung disease, most likely attributable to inhalational exposure to flavorings, with biopsy findings not usual for obliterative bronchiolitis. Clinicians should be aware that lung pathology could vary considerably in workers with suspected flavoring-related lung disease. [Description provided by NIOSH]
• Subjects:
  Coffee Diacetyl Flavoring Agents Lung Diseases Occupational Exposure Occupational Health Respiratory System Respiratory Tract Diseases Safety Workplace
• Keywords:
  2,3-pentanedione Author Keywords: Diacetyl Bronchiolitis Case Report Case Reports Coffee Roasting And Packaging Coffee Workers Exposure Assessment Flavoring-related Lung Disease Flavorings Inhalation Lung Disease Obliterative Bronchiolitis Occupational Exposure Workplace Studies

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• ISSN:
  2296-2565
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Minnesota ; North Carolina ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  9
• NIOSHTIC Number:
  nn:20062910
• Citation:
  Front Public Health 2021 May; 9:657987
• Contact Point Address:
  R. Reid Harvey, Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, United States
• Email:
  iez1@cdc.gov
• CAS Registry Number:
  2,3-Pentanedione (CAS RN 600-14-6) ; Butanedione (CAS RN 431-03-8)
• Federal Fiscal Year:
  2021
• Peer Reviewed:
  True
• Source Full Name:
  Frontiers in Public Health
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d5c9a46fe857fe459f66a394df25113591e6c69bf24a4b2dca08ffaa11f218e9a6cd9e7ba62dd897e86f1a1f7c8e7e998a65c0ff3fa62cae395a6ba75de7b18c
• Download URL:
  https://stacks.cdc.gov/view/cdc/226080/cdc_226080_DS1.pdf
• File Type:
  [PDF - 663.88 KB ]