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From CDC's National Institute for Occupational Safety and Health (NIOSH).
Workers exposed to flavoring chemicals can develop severe lung disease. Those affected usually have a dry cough, wheezing, or shortness of breath when they exert themselves — though not everyone has symptoms.
Symptoms
The disease is obliterative bronchiolitis. Its symptoms range from mild to severe and usually do not get better when the worker is away from work.
- Onset: symptoms usually start gradually and worsen over weeks or months, but they can also get worse suddenly.
- Other signs: some workers have fever, night sweats and weight loss.
- Look-alikes: before diagnosing it, providers may wonder whether the symptoms come from asthma, chronic bronchitis or another respiratory condition.
Medical tests
Tests may show several of the following:
| Test | What it measures | Typical finding |
|---|---|---|
| Spirometry | how well air moves in and out of the airways and lungs | often abnormal |
| Lung volumes | how much air is in the lungs | may show hyperinflation — air trapped in the lungs, inflating them more than normal |
| Diffusing capacity (DLCO) | how well oxygen and carbon dioxide pass between lungs and blood, using a gas mixture containing carbon monoxide | generally normal |
| Chest x-ray | images of the lungs | usually normal, but may show hyperinflation |
| High-resolution CT scan | a detailed image of the lungs | may show a "mosaic pattern" from air trapped in some parts of the lungs, and thickened airway walls |
| Lung biopsy | tissue examined under a microscope | may show changes consistent with obliterative bronchiolitis |
When to refer
Workers should be referred promptly for further evaluation if they have:
- frequent coughing;
- worsening shortness of breath;
- abnormal lung function on spirometry;
- a noticeable decline in lung function.
Providers evaluating these workers need to know about their exposures at work.
Outlook
So far, most patients have responded little or not at all to treatment. Workers who avoid further exposure to flavoring chemicals usually find their cough slowly eases over months to years, but shortness of breath and abnormal lung-function results can be expected to persist.
Reporting
NIOSH continues to study the risks of workplace exposure to flavorings and wants to hear from:
- workers with a lung problem they think may be work-related — workers, union representatives and managers at workplaces with flavoring exposures can request a NIOSH health hazard evaluation;
- health care providers who suspect a patient has obliterative bronchiolitis or another lung disease linked to flavorings.
Contact NIOSH through CDC-INFO: 1-800-CDC-INFO (1-800-232-4636), TTY 1-888-232-6348, or the online form, in English and Spanish, 8:00 a.m. to 8:00 p.m. Eastern time, Monday to Friday except holidays. Cases can also be reported to local and state health departments.
Sources
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, "Symptoms and Medical Monitoring", Flavoring-Related Lung Disease. https://www.cdc.gov/niosh/flavoring-related-lung-disease/symptoms/index.html
- The source page's photograph, a posed stock picture, is not reproduced. Its abbreviation "HCRT" for high-resolution computed tomography is read as HRCT.
- Rewritten in hubnx's own words.
Licencia: CC0 1.0 (dominio público) · Adaptado de www.cdc.gov
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