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Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation

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Flavoring-related bronchiolitis obliterans.

Kathleen Kreiss¹

¹Field Studies Branch, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, USA. kkreiss@cdc.gov

Current Opinion in Allergy and Clinical Immunology

|March 14, 2007

Summary

Workers in microwave popcorn and flavoring industries may develop irreversible obstructive lung disease from inhaling butter flavoring vapors, primarily diacetyl. Prevention requires exposure reduction and medical surveillance until safe levels are established.

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Area of Science:

Occupational Health
Toxicology
Pulmonary Medicine

Background:

Inhalation of butter flavoring vapors, particularly diacetyl, has been linked to bronchiolitis obliterans in microwave popcorn production workers since 2000.
Subsequent toxicologic and epidemiologic studies have highlighted significant intervention and research implications.

Purpose of the Study:

To review the toxicologic and epidemiologic findings related to butter flavoring exposure and bronchiolitis obliterans.
To discuss the implications for worker health, safety, and regulatory standards.

Main Methods:

Review of toxicologic studies, including rodent experiments demonstrating respiratory epithelial necrosis.
Analysis of epidemiologic data from workers in microwave popcorn production, flavoring manufacture, and chemical synthesis.
Measurement of diacetyl exposure levels in work environments.

Main Results:

Irreversible obstructive lung disease is prevalent in workers across the microwave popcorn and flavoring industries.
Diacetyl is a predominant chemical in butter flavoring implicated in causing bronchiolitis obliterans.
Significant diacetyl exposures, as low as 0.02 ppm, were measured in areas with worker disease.

Conclusions:

Prevention necessitates reducing exposure through substitution, engineering controls, improved work practices, and personal protective equipment.
Medical surveillance is crucial for early detection of pulmonary function decline.
Further research combining epidemiologic surveillance and toxicology studies is needed to establish health-protective exposure limits for flavoring chemicals.