title: Respiratory symptoms and lung function abnormalities related to work at a flavouring manufacturing facility.
abstract: OBJECTIVE
  To better understand respiratory symptoms and lung function in flavouring manufacturing workers.
  
  
  METHODS
  We offered a questionnaire and lung function testing to the current workforce of a flavouring manufacturing facility that had transitioned away from diacetyl and towards substitutes in recent years. We examined symptoms, spirometric parameters and diffusing capacity measurements by exposure variables, including facility tenure and time spent daily in production areas. We used linear and logistic regression to develop final models adjusted for age and smoking status.
  
  
  RESULTS
  A total of 367 (93%) current workers participated. Shortness of breath was twice as common in those with tenure ≥ 7 years (OR 2.0, 95% CI 1.1 to 3.6). Other chest symptoms were associated with time spent daily in production. Participants who spent ≥ 1 h daily in production areas had twice the odds of any spirometric abnormality (OR 2.3; 95% CI 1.1 to 5.3) and three times the odds of low diffusing capacity (OR 2.8; 95% CI 0.9 to 9.4) than other participants. Mean spirometric parameters were significantly lower in those with tenure ≥ 7 years and those who spent ≥ 1 h daily in production. Mean diffusing capacity parameters were significantly lower in those with tenure ≥ 7 years. Differences in symptoms and lung function could not be explained by age, smoking status or employment at another flavouring plant.
  
  
  CONCLUSIONS
  Symptoms and lung function findings were consistent with undiagnosed or subclinical obliterative bronchiolitis and associated with workplace exposures. Further efforts to lower exposures to flavouring chemicals, including diacetyl substitutes, are warranted.
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: Cummings
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Boylstein
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stanton
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Piacitelli
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: Nicole T
authors.initials: NT
authors.lastname: Edwards
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: Ryan F
authors.initials: RF
authors.lastname: LeBouf
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kreiss
mesh_terms: D000328:Adult; D000368:Aged; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D001989:Bronchiolitis Obliterans / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003931:Diacetyl / Q000009:adverse effects*; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005421:Flavoring Agents / Q000009:adverse effects*; D005541:Forced Expiratory Volume; D006801:Humans; D007221:Industry; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D012129:Respiratory Function Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D014797:Vital Capacity; D014937:Work; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational; D005421:Flavoring Agents; D003931:Diacetyl
keywords: exposure; flavorings