A cross-sectional study of lung function and respiratory symptoms among chemical workers producing diacetyl for food flavourings
- 1 Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, The Netherlands
- 2 Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, The Netherlands
- 3 Department of Pulmonology, University Medical Centre Utrecht, Utrecht, The Netherlands
- 4 Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
- 5 Arbo Unie Expert Centre for Chemical Risk Management, Utrecht, The Netherlands
- F G B G J van Rooy, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, PO Box 80.178, NL-3508 TD Utrecht, The Netherlands;
- Accepted 1 August 2008
- Published Online First 19 September 2008
Objectives: Four diacetyl workers were found to have bronchiolitis obliterans syndrome. Exposures, respiratory symptoms, lung function and exposure–response relationships were investigated.
Methods: 175 workers from a plant producing diacetyl between 1960 and 2003 were investigated. Exposure data were used to model diacetyl exposure. Lung function and questionnaire data on respiratory symptoms were compared to a general population sample and respiratory symptoms to an internal reference group.
Results: Workers were potentially exposed to acetoin, diacetyl, acetaldehyde and acetic acid. Historic diacetyl exposure ranged from 1.8 to 351 mg/m3, and from 3 to 396 mg/m3 for specific tasks. Diacetyl workers reported significantly more respiratory symptoms compared to the general population sample (continuous trouble with breathing (prevalence ratio (PR) = 2.6; 95% CI 1.3 to 5.1), daily cough (PR = 1.5; 95% CI 1.1 to 2.1), asthma attack (ever) (PR = 2.0; 95% CI 1.2 to 3.4), doctor diagnosed asthma (PR = 2.2; 95% CI 1.3 to 3.8) and asthma attack in the last year (PR = 4.7; 95% CI 1.9 to 11.4)) and to a minimally exposed internal reference group (ever trouble with breathing (PR = 2.8; 95% CI 1.1 to 7.0) and work-related shortness of breath in the last year (PR = 7.5; 95% CI 1.1 to 52.9)). Lung function did not differ between groups. A positive relationship between exposure and FEV1 was found.
Conclusion: The excess of respiratory symptoms in this retrospective cohort suggests that diacetyl production poses an occupational hazard. Limited historical exposure data did not support a quantitative individual diacetyl exposure–response relationship, but our findings suggest that preventive measures are prudent.
Funding: This study was supported by a company under a contract which guaranteed the independence of the research group according to criteria set by the Dutch Royal Academy of Sciences (KNAW) in close collaboration with the occupational health service.
Competing interests: None.
Patient consent: Obtained.