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Evaluation of Methods to Determine Excessive Decline of Forced Expiratory Volume in One Second in Workers Exposed to Diacetyl-Containing Flavorings

Chaisson, Neal F. MD; Kreiss, Kathleen MD; Hnizdo, Eva PhD; Hakobyan, Artak PhD; Enright, Paul L. MD

Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e3181f84577
Original Articles

Objective: To evaluate methods for determining excessive short-term decline in forced expiratory volume in one second (FEV1) in diacetyl-exposed workers.

Methods: We evaluated five methods of determining excessive longitudinal FEV1 decline in diacetyl-exposed workers and workers from a comparative cohort: American Thoracic Society (ATS), ACOEM an 8% limit, and a relative and absolute longitudinal limit on the basis of spirometry data variability. Relative risk and incidence of excess decline were evaluated.

Results: Incidence of excessive FEV1 decline was 1% in the comparative cohort using ATS and ACOEM criteria, 4.1% using relative limit of longitudinal decline, 4.4% with absolute longitudinal limit of decline, and 5.6% by using the 8% limit. Relative risk of abnormal FEV1 decline in diacetyl-exposed workers was elevated in all evaluated methods.

Conclusion: Alternative methods for respiratory surveillance in diacetyl-exposed workers may be preferable to ATS or ACOEM.

Author Information

From The Johns Hopkins University School of Medicine (Dr Chaisson), Baltimore, Md; Division of Respiratory Disease Studies (Drs Kreiss and Hnizdo), National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention and SRA International, Inc (Dr Hakobyan), Morgantown, WVa; and College of Public Health (Dr Enright), University of Arizona, Tucson, Ariz.

Address correspondence to: Kathleen Kreiss, MD, 1095 Willowdale Rd, Mailstop-H2800, Morgantown, WV 26505;

©2010The American College of Occupational and Environmental Medicine