Clinical bronchiolitis obliterans in workers at a microwave-popcorn plant
Clinical bronchiolitis obliterans in workers at a microwave-popcorn plant
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DOI：
10.1056/nejmoa020300
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发表时间：
2002-08-01
影响因子：
158.5
通讯作者：
Enright, PL
中科院分区：
文献类型：
--
作者：
Kreiss, K;Gomaa, A;Enright, PL
背景2000年5月，据报道，8名曾在微波爆米花生产厂工作的人患有严重的闭塞性细支气管炎。在工厂中没有发现公认的原因。因此，我们在医学上评估目前的员工，并评估他们的职业exposs.Methods问卷调查结果和肺功能测定结果在参与工人进行了比较，从第三次全国健康与营养检查调查的数据，调整后的年龄和吸烟状况。我们通过分析症状和异常率的暴露和健康相关的结果之间的关系，根据当前和累积暴露于双乙酰，主要酮在人造黄油调味剂和空气中在plant.Results的135目前的工人在工厂，117（87%）完成了问卷调查。根据与国家数据的比较，这117名工人的慢性咳嗽和呼吸急促的预期比率是2.6倍，医生诊断的哮喘和慢性支气管炎的预期比率是2倍。总的来说，工人的气道阻塞率是预期的3.3倍;那些从不吸烟的人的气道阻塞率是预期的10.8倍。与工厂其他部门的工人相比，直接参与微波爆米花生产的工人在工作时呼吸急促和皮肤问题的发生率更高。估计累积暴露双乙酰的四分位数和频率和程度的airway obligation.Conclusions之间有很强的相关性的肺病和肺功能异常和暴露和结果之间的关系，在这个工作人群的过量率表明，他们可能有职业闭塞性细支气管炎引起的吸入挥发性黄油调味成分。
Background In May 2000, eight persons who had formerly worked at a microwave-popcorn production plant were reported to have severe bronchiolitis obliterans. No recognized cause was identified in the plant. Therefore, we medically evaluated current employees and assessed their occupational exposures.Methods Questionnaire responses and spirometric findings in participating workers were compared with data from the third National Health and Nutrition Examination Survey, after adjustment for age and smoking status. We evaluated the relation between exposures and health-related outcomes by analyzing the rates of symptoms and abnormalities according to current and cumulative exposure to diacetyl, the predominant ketone in artificial butter flavoring and in the air at the plant.Results Of the 135 current workers at the plant, 117 (87 percent) completed the questionnaire. These 117 workers had 2.6 times the expected rates of chronic cough and shortness of breath, according to comparisons with the national data, and twice the expected rates of physician-diagnosed asthma and chronic bronchitis. Overall, the workers had 3.3 times the expected rate of airway obstruction; those who had never smoked had 10.8 times the expected rate. Workers directly involved in the production of microwave popcorn had higher rates of shortness of breath on exertion and skin problems that had developed since they started work than workers in other parts of the plant. There was a strong relation between the quartile of estimated cumulative exposure to diacetyl and the frequency and extent of airway obstruction.Conclusions The excess rates of lung disease and lung-function abnormalities and the relation between exposure and outcomes in this working population indicate that they probably had occupational bronchiolitis obliterans caused by the inhalation of volatile butter-flavoring ingredients.