title: Popcorn-worker lung caused by corporate and regulatory negligence: an avoidable tragedy.
abstract: Diacetyl-containing butter flavor was identified as the cause of an outbreak of bronchiolitis obliterans (BO) and other lung diseases in popcorn-plant workers. Litigation documents show that the outbreak was both predictable and preventable. The industry trade organization was aware of BO cases in workers at butter-flavoring and popcorn-manufacturing plants but often failed to implement industrial hygiene improvements and actively hid pertinent warning information. Due to weaknesses in the organization and mandates of regulatory bodies, organizations such as NIOSH, OSHA, the FDA, particularly the "generally recognized as safe" (GRAS) system, and the EPA failed to detect and prevent the outbreak, which highlights the need for systemic changes in food-product regulation, including the need for corporations to act responsibly, for stronger regulations with active enforcement, for a restructuring of the GRAS system, and for criminal penalties against corporations and professionals who knowingly hide information relevant to worker protection.
authors.affiliation: Brown University, Attleboro, MA 02703, USA. degilman@egilman.com
authors.forename: David
authors.initials: D
authors.lastname: Egilman
authors.forename: Caroline
authors.initials: C
authors.lastname: Mailloux
authors.forename: Claire
authors.initials: C
authors.lastname: Valentin
mesh_terms: D001989:Bronchiolitis Obliterans / Q000139:chemically induced* / Q000453:epidemiology; D002079:Butter; D003931:Diacetyl / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D005421:Flavoring Agents / Q000633:toxicity*; D005525:Food-Processing Industry / Q000331:legislation & jurisprudence*; D019570:Inhalation Exposure; D008168:Lung / Q000187:drug effects*; D009314:National Institute for Occupational Safety and Health, U.S.; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology; D016273:Occupational Exposure; D014481:United States / Q000453:epidemiology; D014486:United States Food and Drug Administration; D014489:United States Occupational Safety and Health Administration; D014835:Volatilization
chemical_list: D005421:Flavoring Agents; D002079:Butter; D003931:Diacetyl