Date: 17 Jun 2009

Letter to the Editor

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Dear Editors,

We are concerned that readers may be mislead by David Galbraith and David Weill’s criticisms of several recent studies that have shown risk to workers from exposures to butter flavoring chemicals (Galbraith and Weill 2009). Some of their criticisms are largely semantic. As previously noted, “The terminology of bronchiolitis obliterans has been a source of confusion which has not yet been completely resolved” (Cordier 2007). This semantic confusion regarding bronchiolitis obliterans terminology does not affect the science of recent research on workers. More disturbing are the misconceptions, inaccuracies, and omissions in their review. We appreciate the opportunity to clarify the peer-reviewed literature on diacetyl and flavorings-related lung disease.

In epidemiologic study of an emerging health issue, invasive evaluation with biopsy is unnecessary to establish excess of disease and work-related risk factors. In two microwave popcorn plants, 27% of worker-participants had a ...