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News From the Centers for Disease Control and Prevention
June 12, 2013

Lung Disease Cases Suggest Need for Regulations to Limit Diacetyl Exposure

Author Affiliations

News From the Centers for Disease Control and Prevention Section Editor: Rebecca Voelker, MSJ.

JAMA. 2013;309(22):2318. doi:10.1001/jama.2013.6386

Two cases of a rare, irreversible form of fixed obstructive lung disease in workers at a Texas coffee-processing facility highlight the need for regulations to limit occupational exposure to diacetyl, a chemical used to flavor foods.

Both patients—a 34-year-old Hispanic woman and a 39-year-old Hispanic man—worked in a room where whole roasted coffee beans were mixed with liquid flavorings, ground, and packaged. They had the same initial symptoms of cough and dyspnea on exertion, and both sought medical care within 18 months after starting work. Both were misdiagnosed, she with possible asthma and he with bronchitis, and treated unsuccessfully with steroids and bronchodilators. They weren't correctly diagnosed with obliterative bronchiolitis until they underwent lung function testing, high-resolution computed tomography of the chest, and lung biopsies. The woman is awaiting a lung transplant and the man has worsening shortness of breath and fatigue.

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