Popcorn lung and bronchiolitis obliterans: a critical appraisal
- David GalbraithAffiliated withChemRisk, IncPalo Alto Medical Foundation Email author
- , David WeillAffiliated withDivision of Pulmonary and Critical Care Medicine, Stanford University Medical Center
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To perform a critical review of a series of journal articles and Health Hazard Evaluation Reports (HHER) by the National Institute for Occupational Safety and Health (NIOSH), where they have described the incidence of fixed obstructive pulmonary disease in a population of workers exposed to butter flavorings.
The clinical presentations, diagnostic modalities frequently employed and a review of the pertinent clinical literature are discussed for constrictive bronchiolitis and bronchiolitis obliterans with intraluminal polyps; two distinct forms of bronchiolitis obliterans (BO). An analysis of the NIOSH reports and scientific articles is provided, followed by suggestions for evaluating this public and occupational health concern moving forward.
Cases of lung disease in the food flavorings industry discussed in the literature have not been sufficiently documented to allow the conclusion that BO has been caused by diacetyl or butter flavoring. Further research is required to establish the causative agent(s).
The diagnosis of bronchiolitis obliterans should be reserved for those individuals who have diagnostic lung biopsy findings, obtained and interpreted by clinicians who are experienced with this complex disorder.
KeywordsBronchiolitis obliterans Butter flavoring Diacetyl Lung biopsy Popcorn lung
- Popcorn lung and bronchiolitis obliterans: a critical appraisal
International Archives of Occupational and Environmental Health
Volume 82, Issue 3 , pp 407-416
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Bronchiolitis obliterans
- Butter flavoring
- Lung biopsy
- Popcorn lung
- Industry Sectors
- Author Affiliations
- 1. ChemRisk, Inc, 25 Jessie Street at Ecker Square, Suite 1800, San Francisco, CA, 94105, USA
- 2. Palo Alto Medical Foundation, Palo Alto, CA, USA
- 3. Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, 300 Pasteur Drive, Room H3143, Stanford, CA, 94305-5236, USA