OBJECTIVE: To report the cases of four patients with bronchiolitis caused by exposure to artificial butter flavoring at a cookie factory in Brazil. METHODS: We described the clinical, tomographic, and spirometric findings in the four patients, as well as the lung biopsy findings in one of the patients. RESULTS: All four patients were young male nonsmokers and developed persistent airflow obstruction (reduced FEV1/FVC ratio and FEV1 at 25-44% of predicted) after 1-3 years of exposure to diacetyl, without the use of personal protective equipment, at a cookie factory. The HRCT findings were indicative of bronchiolitis. In one patient, the surgical lung biopsy revealed bronchiolitis obliterans accompanied by giant cells. CONCLUSIONS: Bronchiolitis resulting from exposure to artificial flavoring agents should be included in the differential diagnosis of airflow obstruction in workers in Brazil.
OBJECTIVE: To report the cases of four patients with bronchiolitis caused by exposure to artificial butter flavoring at a cookie factory in Brazil. METHODS: We described the clinical, tomographic, and spirometric findings in the four patients, as well as the lung biopsy findings in one of the patients. RESULTS: All four patients were young male nonsmokers and developed persistent airflow obstruction (reduced FEV1/FVC ratio and FEV1 at 25-44% of predicted) after 1-3 years of exposure to diacetyl, without the use of personal protective equipment, at a cookie factory. The HRCT findings were indicative of bronchiolitis. In one patient, the surgical lung biopsy revealed bronchiolitis obliterans accompanied by giant cells. CONCLUSIONS:Bronchiolitis resulting from exposure to artificial flavoring agents should be included in the differential diagnosis of airflow obstruction in workers in Brazil.
Authors: Matthew G Duling; Ryan F LeBouf; Jean M Cox-Ganser; Kathleen Kreiss; Stephen B Martin; Rachel L Bailey Journal: J Occup Environ Hyg Date: 2016-10-02 Impact factor: 2.155
Authors: Andrew J Ghio; Joleen M Soukup; Lisa A Dailey; Victor L Roggli; Alvin L Crumbliss; Scott M Palmer Journal: Inhal Toxicol Date: 2021-11-09 Impact factor: 2.724
Authors: Rachel L Bailey; Jean M Cox-Ganser; Matthew G Duling; Ryan F LeBouf; Stephen B Martin; Toni A Bledsoe; Brett J Green; Kathleen Kreiss Journal: Am J Ind Med Date: 2015-11-02 Impact factor: 2.214
Authors: Eric J Zaccone; Janet A Thompson; Dovenia S Ponnoth; Amy M Cumpston; W Travis Goldsmith; Mark C Jackson; Michael L Kashon; David G Frazer; Ann F Hubbs; Michael J Shimko; Jeffrey S Fedan Journal: J Toxicol Environ Health A Date: 2013
Authors: R Reid Harvey; Brie H Blackley; Eric J Korbach; Ajay X Rawal; Victor L Roggli; Rachel L Bailey; Jean M Cox-Ganser; Kristin J Cummings Journal: Front Public Health Date: 2021-05-20