Since the initial report of bronchiolitis obliterans in microwave popcorn workers, exposures to flavouring substances have been identified in a variety of food and flavour manufacturing facilities and in the consumer market. Attempts to decrease the risk of lung disease have included the use of flavouring substitutes; however, these chemicals may cause similar injury. This study reviews recent flavouring exposures and data on the pathogenesis, clinical characteristics, and surveillance of flavouring-induced lung disease. Diacetyl and 2,3-pentanedione exposures have occurred in food production facilities that make cookies, cereal, chocolate, and coffee. Airborne levels often exceed proposed occupational exposure limits. Cases of biopsy-proven bronchiolitis obliterans in heavy popcorn consumers have also been reported. New data demonstrate the presence of diacetyl and 2,3-pentanedione in flavoured nicotine liquids used in electronic nicotine delivery systems. Diacetyl substitutes cause similar peri-bronchiolar fibrotic lesions in animal studies. Their use may continue to place workers at risk for flavouring-induced lung disease, which may present in forms beyond that of fixed airflow obstruction, contributing to delays in identifying and treating patients with flavouring-induced lung disease. Engineering controls, medical surveillance and personal protective equipment can limit flavourings exposure and risk for lung disease.
Authors: Holden VK, Hines SE. ;Full Source: Current Opinion in Pulmonary Medicine. 2016 Jan 12. [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][Epub ahead of print] ;[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]