Bronchiolitis obliterans, a rare inflammatory disorder of the small airways, has been associated with various infections, aspiration, toxic fume inhalation, drugs, transplants, and collagen vascular disorders. In May 2000, this condition was described in eight workers in a microwave popcorn plant in Missouri. Subsequent studies reported its association with exposure to volatile organic compounds used in butter flavoring. Diacetyl was found to be the most predominant of these compounds. We report a case of this rare but serious disease in a 41-year-old flavor industry worker who was initially diagnosed with occupational asthma.
Key Points
* Bronchiolitis obliterans is a rare inflammatory disorder of the small airways that causes severe irreversible damage to the lungs.
* Diacetyl used in popcorn butter flavoring and other flavorings used in the food industry are associated with the development of bronchiolitis obliterans.
* It is imperative to increase awareness about this entity among health care professionals, industry officials, and industry workers to limit exposures to such potentially lethal flavors.