Flavor Workersâ Lung Disease: What Do We Know and What Should Be Done?

By David Michaels

All of a sudden, America has become acutely aware of the terrible lung disease caused by workplace exposure to artificial butter flavor. Last week, the failure of OSHA to do anything in response to the outbreak of cases across the country was the subject of several powerful newspaper articles (including a front page story and editorial in the New York Times) and hearings in the House and Senate. In addition, the obstructive lung disease cases in the flavor industry were discussed in an alarming article in CDCâs Morbidity and Mortality Weekly Report. The article reported that

Bronchiolitis obliterans has been identified in microwave-popcorn workers in several states, including Missouri, Iowa, Ohio, New Jersey, and Illinois; bronchiolitis obliterans in flavor-manufacturing workers has been identified in Ohio, California, Maryland, and New Jersey.

No doubt prompted by all the unwanted publicity, OSHA has announced a National Emphasis Program, finally promising to inspect microwave popcorn plants. To me, this is little more than a half-hearted attempt to make OSHA look busy, since NIOSH has been focused on the hazards in microwave popcorn production for the last six years. If OSHA really wanted to inspect factories with dangerous exposures and sick workers, they would start at the factories where flavors are manufactured and mixed, then visit the plants where diacetyl-containing snack foods like Twinkies are made.

A colleague who has been following the developments in the artificial butter flavor debacle sent me a note, underscoring just why OSHAâs emphasis program misses the boat:

• diacetyl and related food flavoring chemicals are among the most acutely toxic chemicals to the lungs;
• damage to the lungs occurs at very low levels (lowest observed exposure level associated with disease is 0.02 ppm or 20 parts per billion);
• exposed workers don't suspect they are getting sick because it smells like butter;
• there is no warning that the damage to the lungs is happening;
• young workers start getting sick even after a short time, as short as several months after exposure began;
• companies don't warn workers about the dangers of diacetyl (little or no information on Material Safety Data Sheets or training on how to prevent exposure);
• many workers continue working even after their doctors find something wrong with their lungs, since the connection to workplace chemical exposure is often missed; and
• early medical testing can make a difference, but that requires employer recognition of the problem.

There needs to be a national emergency program to be sure all workers are no longer exposed to this toxic chemical. The earliest warning we had about diacetyl was 1985, and then more cases were found in Ohio in the 1990s. The company hired experts who told them they had a problem, and the company didn't ever tell anyone and kept the cases under wraps. NIOSH finally studied this and found the definitive link in 2002. [See our case study at DefendingScience.org for more details.]

Twenty years is far too long to wait. All companies that use this toxic chemical need to be inspected by OSHA immediately. Companies need to test their workers for lung problems and get them examined and then removed from exposure immediately.

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.