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Case Report: Flavoring-Related Lung Disease in a Coffee Roasting and Packaging Facility Worker With Unique Lung Histopathology Compared With Previously Described Cases of Obliterative Bronchiolitis.

Publication ,  Journal Article
Harvey, RR; Blackley, BH; Korbach, EJ; Rawal, AX; Roggli, VL; Bailey, RL; Cox-Ganser, JM; Cummings, KJ
Published in: Front Public Health
2021

Occupational exposure to diacetyl, a butter flavor chemical, can result in obliterative bronchiolitis. Obliterative bronchiolitis is characterized by exertional dyspnea, fixed airflow obstruction, and histopathologic constrictive bronchiolitis, with bronchiolar wall fibrosis leading to luminal narrowing and obliteration. We describe a case of advanced lung disease with histopathology distinct from obliterative bronchiolitis in a 37-year-old male coffee worker following prolonged exposure to high levels of diacetyl and the related compound 2,3-pentanedione, who had no other medical, avocational, or occupational history that could account for his illness. He began working at a coffee facility in the flavoring room and grinding area in 2009. Four years later he moved to the packaging area but continued to flavor and grind coffee at least 1 full day per week. He reported chest tightness and mucous membrane irritation when working in the flavoring room and grinding area in 2010. Beginning in 2014, he developed dyspnea, intermittent cough, and a reduced sense of smell without a work-related pattern. In 2016, spirometry revealed a moderate mixed pattern that did not improve with bronchodilator. Thoracoscopic lung biopsy results demonstrated focal mild cellular bronchiolitis and pleuritis, and focal peribronchiolar giant cells/granulomas, but no evidence of constrictive bronchiolitis. Full-shift personal air-samples collected in the flavoring and grinding areas during 2016 measured diacetyl concentrations up to 84-fold higher than the recommended exposure limit. Medical evaluations indicate this worker developed work-related, airway-centric lung disease, most likely attributable to inhalational exposure to flavorings, with biopsy findings not usual for obliterative bronchiolitis. Clinicians should be aware that lung pathology could vary considerably in workers with suspected flavoring-related lung disease.

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Published In

Front Public Health

DOI

EISSN

2296-2565

Publication Date

2021

Volume

9

Start / End Page

657987

Location

Switzerland

Related Subject Headings

  • Male
  • Lung Diseases
  • Lung
  • Humans
  • Diacetyl
  • Coffee
  • Bronchiolitis Obliterans
  • Adult
  • 4206 Public health
  • 4203 Health services and systems
 

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MLA
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Harvey, R. R., Blackley, B. H., Korbach, E. J., Rawal, A. X., Roggli, V. L., Bailey, R. L., … Cummings, K. J. (2021). Case Report: Flavoring-Related Lung Disease in a Coffee Roasting and Packaging Facility Worker With Unique Lung Histopathology Compared With Previously Described Cases of Obliterative Bronchiolitis. Front Public Health, 9, 657987. https://doi.org/10.3389/fpubh.2021.657987
Harvey, R Reid, Brie H. Blackley, Eric J. Korbach, Ajay X. Rawal, Victor L. Roggli, Rachel L. Bailey, Jean M. Cox-Ganser, and Kristin J. Cummings. “Case Report: Flavoring-Related Lung Disease in a Coffee Roasting and Packaging Facility Worker With Unique Lung Histopathology Compared With Previously Described Cases of Obliterative Bronchiolitis.Front Public Health 9 (2021): 657987. https://doi.org/10.3389/fpubh.2021.657987.
Harvey RR, Blackley BH, Korbach EJ, Rawal AX, Roggli VL, Bailey RL, Cox-Ganser JM, Cummings KJ. Case Report: Flavoring-Related Lung Disease in a Coffee Roasting and Packaging Facility Worker With Unique Lung Histopathology Compared With Previously Described Cases of Obliterative Bronchiolitis. Front Public Health. 2021;9:657987.

Published In

Front Public Health

DOI

EISSN

2296-2565

Publication Date

2021

Volume

9

Start / End Page

657987

Location

Switzerland

Related Subject Headings

  • Male
  • Lung Diseases
  • Lung
  • Humans
  • Diacetyl
  • Coffee
  • Bronchiolitis Obliterans
  • Adult
  • 4206 Public health
  • 4203 Health services and systems