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Rapidly Progressive, Fixed Airway Obstructive Disease in Popcorn Workers: A New Occupational Pulmonary Illness?

Rapidly Progressive, Fixed Airway Obstructive Disease in Popcorn Workers: A New Occupational Pulmonary Illness?,10.1097/00043764-200203000-00002,Journ

Rapidly Progressive, Fixed Airway Obstructive Disease in Popcorn Workers: A New Occupational Pulmonary Illness?   (Citations: 14)
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A number of former employees at a microwave popcorn packaging facility in Missouri presented in spring 2000 with severe pulmonary symptoms characterized by fixed airway obstruction. Most had well-preserved carbon monoxide diffusing capacity of the lungs. These patients had seen numerous other practitioners but for the first time were recognized as all working in the same facility and as having been potentially exposed to the same occupational environment. The characteristics of Popcorn Packers' Lung seemed to be due to an environmental exposure to a workplace toxin that causes a unique and previously unrecognized form of rapidly progressive obstructive lung disease. We report the clinical cases here to increase awareness of the occupational medical providers in the hope that additional cases will be classified, hazardous workplaces will be identified, and primary preventive intervention will take place. The facility, located in Missouri, received raw corn and produced packaged popcorn. The process consisted of mixing salt, oil, and flavoring; combining this with the popcorn; and packing it in single-serving packages for use in microwave ovens. The flavoring consisted of various spices, and a butterlike flavor was provided by the chemical diacetyl. Depending on where the employee worked in the plant, exposure to the flavoring components could vary by more than an order of magnitude.
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    • ...( 1 , 2 , 3 ) Bronchiolitis obliterans, an irreversible obstructive lung disease, has since been identified throughout the microwave popcorn industry( 4 ) and in flavoring and diacetyl manufacturing workers...

    Gregory Dayet al. Identification and Measurement of Diacetyl Substitutes in Dry Bakery M...

    • ...( 1 3 ) The inhalation of butter flavorings containing diacetyl can cause severe shortness of breath and cough in workers exposed during microwave popcorn manufacturing...

    Randy Boylstein. Identification of Diacetyl Substitutes at a Microwave Popcorn Producti...

    • ...InMay 2000, anoccupational medicinephysiciannotified public health authorities of a cluster of cases of severe fixed airways obstruction and other findings consistent with bronchiolitis obliterans among former workers of a microwave popcorn production plant (sentinel plant) [1,2]...
    • ...HRCT scans with expiratory views have shown mosaic attenuation and air trapping, bronchial wall thickening, cylindrical bronchiectasis, and scattered ground glass opacities (Figs 1 and 2) [1,7,11,16]...
    • ...One microwave popcorn worker with mild airways obstruction did return to normal after treatment with oral corticosteroids and cessation of exposure to flavoring chemicals [1], but lung function again declined after he returned to work...

    Richard Kanwal. Bronchiolitis obliterans in workers exposed to flavoring chemicals

    • ...In addition, a case of fixed airways obstruction occurred in another microwave popcorn plant [21]...

    M. Akpinar-Elciet al. Bronchiolitis obliterans syndrome in popcorn production plant workers

    • ...[1,2] These workers had become ill during the period from 1993 to 2000, while employed at the popcorn plant, and none had reported an incident of presumed overexposure that preceded their symptoms...
    • ...[19] An additional case of fixed airway obstruction in a person who had never smoked was reported at another microwave-popcorn packaging plant; this worker had mixed butter flavorings from a different manufacturer with oil. [1]...

    Kathleen Kreisset al. Clinical Bronchiolitis Obliterans in Workers at a Microwave-Popcorn Pl...

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