Bronchiolitis obliterans syndrome in popcorn production plant workers
Bronchiolitis obliterans syndrome in popcorn production plant workers
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DOI：
10.1183/09031936.04.00013903
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发表时间：
2004-08-01
影响因子：
24.3
通讯作者：
Kreiss, K
中科院分区：
文献类型：
--
作者：
Akpinar-Elci, M;Travis, WD;Kreiss, K
哨点病例识别后，在微波爆米花工厂的现有工人中发现与黄油调味剂暴露相关的固定气道阻塞过多。为了描述哨点病例的临床表现，我们对哨点病例的医疗记录进行了审查，进行了访谈并进行了系列肺活量测试。这些病例从事微波爆米花生产，九个病例中有五个使用了混合调味料。大多数人从不吸烟或很少吸烟。病例在5个月至9岁时出现咳嗽、气短和喘息；在爆米花厂开始工作后。一秒内初始用力呼气量为预测值的 14.0-66.8%。八次高分辨率计算机断层扫描显示明显的支气管壁增厚和马赛克衰减并伴有空气滞留。三分之二的开放肺活检结果与缩窄性细支气管炎一致或诊断为缩窄性细支气管炎。肺移植等待名单上有五例。离职后，几乎所有病例的肺功能都在两年内稳定下来。精明的临床医生可以通过提醒公共卫生当局注意工人群体中发生的不明原因疾病病例，帮助确定气道阻塞的新原因。
Following sentinel case recognition, an excess of fixed airways obstruction was found among current workers in a microwave popcorn plant associated with butter flavouring exposures.In order to characterise the clinical presentation of sentinel cases, the medical records of sentinel cases were reviewed, interviews conducted and serial spirometric testing performed.Cases worked in microwave popcorn production, and five of the nine cases had mixed flavourings. Most had never smoked or smoked minimally. Cases showed onset of cough, shortness of breath and wheezing 5 months to 9 yrs; after starting work at the popcorn plant. Initial forced expiratory volume in one second ranged 14.0-66.8% of the predicted value. Eight high-resolution computed tomography scans showed marked bronchial wall thickening and mosaic attenuation with air trapping. Open lung biopsy results were consistent with, or diagnostic of, constrictive bronchiolitis in two of three cases. Five cases are on lung transplantation waiting lists. After leaving employment, nearly all cases experienced stabilisation of their lung function within 2 yrs.Astute clinicians can help identify new causes of airways obstruction by alerting public health authorities to unexplained disease cases occurring in groups of workers.