Public Health Hardball: More Lessons from California

By David Michaels

Labor health advocates in California are supporting legislation banning diacetyl, the flavoring chemical implicated in numerous cases of bronchiolitis obliterans, a debilitating lung disease, among workers in the food industry. The ban may never occur, but by demanding it we are getting closer to protecting workers and the public from this very toxic material.

The threat of a ban has forced the food industry into an unusual position - industry representatives are now praising the California OSHA program, which is also moving to issue regulations limiting exposure to the deadly chemical but has no plans to ban it (to industryâs relief.)

Meanwhile, federal OSHA continues to do NOTHING. Perhaps the public health advocates here in the nation's capital should follow California's lead, and lobby for Congressional legislation banning diacetyl nationally. The food industry would immediately demand an OSHA standard, and we might finally see some movement at OSHA .

Here's where things stand in California. The bill to ban diacetyl from state workplaces by 2010 has been making itâs way through committees in the California Assembly (see our earlier post here), and a similar one has moved from the Senateâs Environmental Quality committee to its Appropriations committee.

The industry will do their best to stop a legislated ban â meaning that they will support (at least publicly) Cal-OSHAâs regulatory process. Without the fear of legislation, theyâd simply tell Cal-OSHA to back off.

An excerpt from an article in the Cal-OSHA Reporter (sub only) gives a flavor of the debate that took place at a March 28th hearing of the Assembly Labor and Employment committee:

Division of Occupational Safety and Health (DOSH) Acting Chief Len Welsh told the committee that guidance from the National Institute for Occupational Safety and Health "indicates that occupational exposure to flavorings can be controlled to safe levels," and DOSH's draft proposal "reflects that assumption."

But George Landers of the United Food and Commercial Workers' Western States Council said, "We are greatly concerned about the impact of even minimal exposure to diacetyl can have," as well as misdiagnoses by physicians. One of the most frightening aspects of the hazard is the lack of information, he said. The best defense, Landers said, "is to eliminate exposure altogether."

Attorney Fran Schreiberg, a volunteer for the WORKSAFE! worker advocacy group, said she had never encountered a chemical that posed such an acute hazard to workers. "It's so toxic that it's hard to imagine something worse," she told the committee.

Dr. Leslie Israel, associate clinical professor for UC-Irvine's Division of Occupational Medicine, commented, "What we're seeing is just the tip of the iceberg." Controlling exposures can reduce risks, and medical surveillance is critical. "There is no good medication to treat these patients," she added.

But Broyles, representing the Grocery Manufacturers Association for California Advocates, said diacetyl is used "in almost everything." Food processors add it in a diluted form. "Everyone needs to understand where the exposures are occurring," she said. "We are at the table," she added, working with DOSH to identify exposures and how the substance is being used. There have been no confirmed cases of Bronchiolitis obliterans in food processing, Broyles added.

She called a ban an "extreme" response. Once controls have been put place, there have been no further cases, she argued. "Let's concentrate where the problem is," Broyles said.

One committee member asked about the Cal/OSHA draft standard, when it could be adopted and if the legislature should let that process run its course. Broyles said DOSH's process has been "very effective" and "extraordinarily fast" for a rulemaking effort.

Marti Fisher of the California Chamber of Commerce agreed that the Cal/OSHA process is "the way to go." Banning diacetyl could lead to use of substances that could be just as bad.

At the same time, a draft of a Cal/OSHA standard has been circulating for public discussion, and âfast trackâ rulemaking on it could begin in three months, according to another piece in the Cal-OSHA Reporter. The regulation will apply to processes that use not only diacetyl, but also acetaldehyde and benzaldehyde, two other flavoring chemicals thought to cause lung disease.

The current draft of the standard would require engineering and work practice controls to prevent employee exposures to harmful flavoring substances, and exposure assessment to monitor the effectiveness of these controls. If air sampling detects exposure after the controls have been implemented, employers would be required to supply respiratory protection. Annual training for employees on flavorings exposure and control methods and ongoing medical surveillance for employees working in or near areas where flavorings are handled would also be required.

There is going to be strong push-back, against this proposed regulation. We can expect strong pressure from the food industry to limit the types of workplaces covered by the standard and the level of exposure that would trigger implementing controls.

Part of the argument that the food industry uses is that (they assert) there have been no cases of bronchiolitis obliterans in food processing.

But this is not true. The number of workers diagnosed with bronchiolitis obliterans and similar fixed obstructive lung disease continues to grow, and the workersâ exposures to diacetyl and other flavorings have occurred in a variety of workplaces, including manufactures of microwave popcorns, flavorings, and potato chips. (See this review, from NIOSH's Dr. Kathleen Kreiss, for citations for these and other cases.)

David Michaels heads the Project on Scientific Knowledge and Public Policy (SKAPP) and is Professor and Associate Chairman in the Department of Environmental and Occupational Health, the George Washington University School of Public Health and Health Services.