Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
Department of Pathology, University of Utah, Salt Lake City, Utah, USA.
Occup Environ Med. 2018 Oct;75(10):709-715. doi: 10.1136/oemed-2018-105150. Epub 2018 Jul 25.
Diacetyl, a butter flavour compound used in food and flavouring production, is a respiratory toxin. We characterised the burden of respiratory abnormalities in workers at popcorn and flavouring manufacturing facilities that used diacetyl as evaluated through US National Institute for Occupational Safety and Health (NIOSH) health hazard evaluations.
We performed analyses describing the number and percentage of current and former workers from popcorn and flavouring manufacturing facilities where NIOSH administered a respiratory health questionnaire and spirometry testing who met case definitions of suspected flavouring-related lung disease. Case definitions were pathologist reported: lung biopsy pathology report stating supportive of/consistent with constrictive bronchiolitis or bronchiolitis obliterans; probable: obstructive/mixed spirometric pattern with forced expiratory volume in 1 s (FEV) <60% predicted; possible: obstructive/mixed spirometric pattern with FEV ≥60% or any spirometric restriction; symptoms only: normal spirometry plus exertional dyspnoea or usual cough.
During 2000-2012, NIOSH collected questionnaire and spirometry data on 1407 workers (87.0% current, 13.0% former) at nine facilities in eight states. After applying case definitions, 4 (0.3%) were classified as pathologist reported, 48 (3.4%) as probable, 234 (16.6%) as possible and 404 (28.7%) as symptoms only. The remaining 717 (51.0%) workers had normal spirometry without exertional dyspnoea or usual cough. Seven of 11 workers with biopsies did not meet the pathologist-reported case definition, although four met probable and three met possible.
This approach demonstrates the substantial burden of respiratory abnormalities in these workers. A similar approach could quantify the burden of respiratory abnormalities in other industries that use diacetyl.
二乙酰是一种用于食品和调味生产的奶油味化合物，是一种呼吸道毒素。我们通过美国职业安全与健康研究所（NIOSH）的健康危害评估，对使用二乙酰的爆米花和调味制品生产设施的工人的呼吸异常负担进行了特征描述。
我们对从爆米花和调味制品生产设施中抽取的当前和以前的工人进行了分析，这些工人接受了 NIOSH 管理的呼吸健康问卷和肺活量测定检查，并符合疑似与调味剂相关的肺部疾病的病例定义。病例定义是由病理学家报告的：肺活检病理学报告表明支持/符合缩窄性细支气管炎或细支气管闭塞；可能：阻塞性/混合性肺活量测定模式，用力呼气量 1 秒（FEV1）<60%预测值；可能：阻塞性/混合性肺活量测定模式，FEV1≥60%或任何肺活量测定限制；仅有症状：正常肺活量测定加上运动性呼吸困难或通常咳嗽。
在 2000-2012 年期间，NIOSH 在八个州的九个设施中收集了 1407 名工人（87.0%为当前工人，13.0%为以前工人）的问卷和肺活量测定数据。在应用病例定义后，4 名（0.3%）被归类为病理学家报告，48 名（3.4%）为可能，234 名（16.6%）为可能，404 名（28.7%）为仅有症状。其余 717 名（51.0%）工人的肺活量测定正常，没有运动性呼吸困难或通常咳嗽。11 名接受活检的工人中，有 7 名不符合病理学家报告的病例定义，尽管有 4 名符合可能病例，3 名符合可能病例。
这种方法表明这些工人的呼吸异常负担很大。类似的方法可以量化其他使用二乙酰的行业中呼吸异常的负担。
