Effect Measure

The argument about whether bloggers ever do real reporting is not very interesting to us, but suffice it to say there are numerous instances where they do the same thing as journalists, even in the tiny public health blogosphere. A case in point is my colleague. Dr. David Michaels at The Pump Handle (TPH), who has been dogging the story of flavoring workers lung (aka popcorn workers lung) from the outset, and has even broken a few stories. Today’s post at TPH may be the most significant entry yet. But first, some background.

It is now known that an ingredient in microwave popcorn with artificial butter flavoring, probably the chemical diacetyl, is causing a serious and in some case fatal chronic lung disease among workers making the product. The lung disease is bronchiolitis obliterans. Just about all you need to know about it is in it its name. Your respiratory tract has two main parts, the conducting system, essentially a series of tubes (no, not the internet) that branches into finer and finer parts until it reaches the other functional part of the lungs, the gas exchange apparatus. It’s like an upside down tree, with the trunk and branches and twigs as the conducting system and the leaves at the end as the gas exchange part. The large branches off the trunk (the trachea) are the left and right main stem bronchi and the smaller and smaller branches are called bronchioles. Something in released during the manufacture of microwave popcorn is closing off the small branches — obliterating them. Keep this picture in mind as you read the medical notes in Michaels’ post at TPH. The workers are slowly suffocating. With advanced disease the only remedy is a lung transplant. You need to replace those bronchioles. They are closed forever. Hundreds of workers have been stricken and several have already died.

But you don’t work in a microwave popcorn factory. All you do is sometimes make a bag or two or more in your home. There are people who think of popcorn as a good source of fiber and they eat a lot of it, sometimes every day. Are you or they or your children at risk?

Despite the worker safety findings — and despite scores of jury decisions and settlements awarding millions of dollars to workers who sued after having their lungs destroyed by exposure to diacetyl — neither the Food and Drug Administration nor the Consumer Product Safety Commission have investigated. The FDA years ago declared the chemical safe for consumption. Labels on almost all products containing it call it a flavoring and only rarely do the labels mention diacetyl.

The only government investigators to examine whether consumers are at risk — whether diacetyl is released when consumers pop corn in their home microwaves, and if so, how much — is the Environmental Protection Agency. But to the frustration of many public health workers, the findings of the EPA’s study — which began in 2003 and was completed last year — have been released only to the popcorn industry. (Andrew Schneider, Seattle Post Intelligencer)

The EPA’s two reasons for not releasing the information to the public or the medical profession are that they wanted to give the industry a chance to verify no confidential business information was contained in the report; and they did not want to jeopardize the ability of EPA scientists to publish in a peer reviewed journal by premature announcement of the results. The EPA had the exposure results for two years, more than enough time to allow the business information to be checked (two days is sufficient for that). The publication excuse is just that — an excuse, and a lame one at that. The industry already knows that diacetyl is released when the bag is opened after popping. It just doesn’t want consumers to know.

What should or could change this is a case of non-occupational popcorn lung in a consumer of microwave popcorn. Now David Michaels tells us about just such a case. This is will be news to you, but again, it isn’t news to the industry or federal agencies who have known about it for some time. They couldn’t be bothered.

The Michaels post at TPH gives the details of the case and also a rundown of what many of the relevant federal agencies aren’t doing and which ones aren’t doing it.

I don’t care if you want to call this journalism or not. I’ll let the jouralist guild worry about branding. It is what it is. And what it is is damn good reporting.