By David Michaels

In the last few days, the national media has finally focused on the failure of OSHA to protect workers from devastating lung disease caused by exposure to artificial butter flavor. (The problem goes well beyond microwave popcorn factories, to the flavor industry and other snack food plants.) Articles in the Washington Post, the New York Times and The National Journal all compare OSHA’s inaction with the activities the California Division of Occupational Safety and Health (or CalOSHA), which is moving toward a rule forcing employers to protect workers in the food industry exposed to diacetyl, the butter flavor chemical implicated in the illnesses.

OSHA may be in “Slow Motion” (the title of Jim Morris’s article in the National Journal), but CalOSHA is not only working on a new standard — the California legislature is considering banning diacetyl from that state’s workplaces.

My prediction is that a few years from now, the food industry will look back with regret that OSHA didn’t issue a standard sooner. When the feds abdicate their role in protecting the public, states are stepping in. California has insisted on greenhouse gas reductions; other states are following. Now California legislators may ban diacetyl; they wouldn’t be considering it if OSHA had not virtually ignored the problem for the last five years.

I’ve written at length (here, here and here, for example) on the compelling scientific evidence linking diacetyl with bronchiolitis obliterans, an obstructive lung disease. Today, Sonya Geis, of the Washington Post, highlights the human toll of the disease by focusing on Irma Ortiz, a California flavor worker:

She was once in constant motion; her co-workers compared her to a roadrunner because of the way she darted around the workplace. But now Irma Ortiz sits at the edge of her couch, too winded to sweep her patio or walk her son to school without resting. She is slowly suffocating.

Ortiz, 44, is among a group of California food-flavoring workers recently diagnosed with bronchiolitis obliterans, a rare and life-threatening form of fixed obstructive lung disease. Also known as popcorn workers lung, because it has turned up in workers at microwave-popcorn factories, the disease destroys the lungs. A transplant is the only cure.

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Ortiz kept working until one day in December 2005 when she felt, she said, “I put all my strength into the job and I can’t do no more.” Ortiz is petite and birdlike; her black hair shows no streaks of gray.

“Before, I used to do a lot of exercise. I ran from place to place,” she said, her sentences broken into panting phrases as if she were hiking a steep hill. Now, she does not like to be in public because long, body-shaking coughing fits could overcome her at any time. On Christmas, “I tried to dance with my brother, but not even five minutes,” she said.

The loss of her $17-an-hour job makes keeping up with house payments difficult, said Ortiz’s husband, Victor Mancia.

They are waiting for a lung transplant. “I was perfectly fine when I started,” Ortiz said. “I want to be the same. But my doctor says I’m not going to be the same.”

Jesse McKinley of the New York Times gives a group portrait of the sick workers:

The workers, by and large, have been young and healthy. None were smokers, and none had any history of lung disease. But after working at plants that produce food flavorings, they all had one thing in common: they could not breathe.

Over the last several years, California health officials have been tracking a handful of workers in flavoring factories who have been incapacitated with a rare, life-threatening lung condition — bronchiolitis obliterans — for which there is no cure or treatment. Usually found only in people who are poisoned by chemical fires or chemical warfare or in lung transplant patients, bronchiolitis obliterans renders its victims unable to exert even a little energy without becoming winded or faint.

“The airways to the lung have been eaten up,” said Barbara Materna, the chief of the occupational health branch in the California Department of Health Services. “They can’t work anymore, and they can’t walk a short distance without severe shortness of breath.”

Seven flavoring-factory workers in California are known to have the disease or similarly serious lung damage, and 22 others have had lung tests come back with abnormal results. In each case, scientists and health officials say, the common dominator is exposure to the vapors from a pungent yellow-colored flavoring called diacetyl, best known for giving microwave popcorn its buttery goodness.

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The first case of bronchiolitis obliterans in flavoring-factory workers was reported in California in August 2004. The unidentified worker, who is now in his early 30s, had worked at a plant in Southern California since 2001 as a flavor compounder, handling and mixing diacetyl with other ingredients in cauldron-like blenders. Early symptoms included wheezing, chest pain and cough. Soon, the man was unable to walk more than 15 feet without breathing heavily.

In April 2006, state authorities found another worker with similar symptoms, and officials have since confirmed five other cases of “severe fixed obstructive lung disease.” All of the victims worked in factories in California. At the time they sought medical attention, they ranged in age from 27 to 44. One of them is now on a list for a lung transplant, Ms. Materna, the California health official, said.

The tide is clearly turning. OSHA is being shamed by the national media’s attention. Once enough states issue their own standards, some perhaps banning diacetyl, the food industry will come begging OSHA for a national standard. In the meantime, the flavor industry is far ahead of OSHA. According to the New York Times:

John B. Hallagan, the general counsel for the Flavor and Extract Manufacturers Association, a trade group, said his members had provided information on worker health to state and federal authorities since 2001, shortly after the National Institute for Occupational Safety and Health issued a report linking lung problems in 16 workers at a popcorn packaging plant in Missouri to diacetyl. Mr. Hallagan added that his group was working closely with the California Division of Occupational Safety and Health to “help flavor manufacturers have the safest workplaces possible.”

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Mr. Hallagan said that data on any link between diacetyl and lung disease was inconclusive, but that his industry was not waiting for definitive proof. He said many flavor manufacturers had already embraced better ventilation, employee health testing, and new safety and educational programs.

I don’t agree with Mr. Hallagan on the data being “inconclusive”, but at least the industry isn’t ignoring the problem. The flavor manufacturers are acting rationally, acutely aware of dozens of sick workers and law suits in which their members have already have had to pay out more than $100 million. What’s disheartening is that OSHA has continues to avoid issuing a standard that would prevent more cases of this terrible disease.

David Michaels heads the Project on Scientific Knowledge and Public Policy (SKAPP) and is Professor and Associate Chairman in the Department of Environmental and Occupational Health, the George Washington University School of Public Health and Health Services.

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