Popcorn lung, a sometimes lethal disease caused by inhaling chemical butter flavoring, has been found among candy makers.

by Andrew Schneider on April 6, 2009

A recently identified outbreak of severe cases of popcorn lung among former candy factory workers may prove what government and civilian occupational health experts have long feared – the sometimes-fatal disease can afflict those exposed to diacetyl butter flavoring regardless of where they work.

Five patients were diagnosed so far this year with bronchiolitis obliterans by two physicians – Drs. Allan Parmet and David Egilman. Both doctors are occupational medicine specialists who had, over the past ten years, diagnosed the rare disease in hundreds of workers in Midwest microwave popcorn factories.

These patients worked as candy makers at a now closed Brach’s Candy plant on Chicago’s west side, says the International Brotherhood of Teamsters. The union is concerned that workers in other plants that use diacetyl may be exposed to disabling or lethal levels of chemical flavoring agents and not know it.

“What could be gentler than being a candy maker, doing butterscotch and butter toffee and all those sweet goodies that children love?” Doris Stubbs asked me last week. When she came to the phone, it took her about three minutes to gasp in enough air to speak with me.

The mother of five said she worked for Brach Candy for 22 years and “loved about every minute of it” until she had such a hard time breathing that, in 2002, she had to use oxygen almost all the time. She has a basket of inhalers and pills to help her get through the day.

“Who ever thought that being a candy maker would make me this sick,” the 65-year-old woman said. She told me that several of her fellow workers also had become sick. Some had died “from breathing problems.

“I was never worried. We were just making candy, and they never told us the flavorings we were using were dangerous,” she said.

There is no indication that consumers are at risk from eating food, or in this case candy containing diacetyl.    Photo by A.Schneider

There is no indication that consumers are at risk from eating food, or in this case candy containing diacetyl. Photo by A.Schneider

They never told Don Stevens either.

“I’m the lucky one so far. I have problems breathing a lot but I’m not on oxygen,” he told me last week.

“Other people got a lot sicker. We didn’t know the flavoring that I used to cook up butter toffee, butterscotch and some kind of butter cinnamon mixture could harm our lungs,” Stevens said. “We were just never told.”

Over the years I’ve written about several cases of isolated workers reportedly sickened by diacetyl in mom and pop flavoring plants in California, snack makers in Tennessee and multiple employees at large flavor producers in Ohio. The Chicago candy worker cases appear to be the first – since the popcorn episodes – in which many employees were exposed at a facility where the butter flavoring was used in products being sold.

It was two years ago that health and safety officials for the nation’s largest unions and occupational medicine activists petitioned the Department of Labor to order OSHA to broaden its examination of diacetyl beyond popcorn workers. But many of those inside the agency says there is little or no interest in worrying about the thousands of other manufacturers who still use the chemical.

Last week, LaMont Byrd, director of the Teamsters Safety & Health Department, addressed the Chicago cluster of illness.

“There may be other workers in the hard candy manufacturing industry and other end users who may be at risk of experiencing adverse health effects due to exposures to chemicals used to make these products,” said Byrd.

He praised the recent steps by U.S. Secretary of Labor Hilda Solis to speed up rulemaking to address exposure to diacetyl, but says, “OSHA and NIOSH must further investigate this matter to protect workers who are currently exposed to these hazards.”

The union wants NIOSH, which is the worker health and safety research arm of the CDC, to check out the other candy plants that use the suspect flavoring.

NIOSH spokesman Fred Blosser says his agency is aware of the “case cluster ” but told me, “Since the (Brach) plant isn’t in operation any longer, we don’t have a situation where we can do a health hazards evaluation (HHE).”

An HHE is the detailed inspection in which NIOSH’s varied public health specialists are permitted into a plant to determine what is causing illness or injury among workers.

However, this morning, a teamster official said that they are having discussions with OSHA about inspecting candy plants in Tennessee.

Meanwhile, lawsuits against the suppliers of the butter flavoring to popcorn plants continue to be tried.
A trial begins today in a suit filed against Cincinnati-based Givaudan Flavors Corp. and New York-based International Flavors and Fragrances Inc. of New York.

The plaintiff is 48-year-old Kathryn Rayburn who developed bronchiolitis obliterans while working at a ConAgra plant that produced Orville Redenbacher and other popular brands of popcorn.

Egliman, who is scheduled to testify on the woman’s behalf, wrote a peer-reviewed article in the medical journal International Journal of Occupational and Environmental Health called ” Popcorn-worker Lung Caused by Corporate and Regulatory Negligence: An Avoidable Tragedy.” In the paper, Egliman, who is also an associate professor of public health at Brown University, wrote about eight workers from the Ohio plant who contracted the lung destroying disease. One, he said, had died of the disease.

The physician has long been critical of companies that conceal hazards from their workers and of government regulatory agencies that don’t do their job in protecting these employees.
“The cluster of new cases of bronchiolitis obliterans among candy makers has got to be the signal to even the most lethargic government agency that more workers – hundreds if not thousands – that use these chemical flavoring agents are in danger,” said Egilman.
“I’d use the cliché and say it was a wakeup call, but that happened years ago at the popcorn plants and OSHA has yet to do anything meaningful.”

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