Obliterative bronchiolitis in fibreglass workers: a new occupational disease?: Table 1

Cullinan, Paul; McGavin, C R; Kreiss, Kathleen; Nicholson, Andrew G.; Maher, Toby M.; Howell, Timothy; Banks, John; Taylor, A J Newman; Chen, Chi‐Hsien; Tsai, Perng Jy; Shih, Tiffany Ting-Fang; Burge, P. S.

doi:10.1136/oemed-2012-101060

Cited by 31 publications

(32 citation statements)

References 9 publications

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“…There were no strong associations between cumulative potential styrene exposure and a priori or elevated causes of death and none of the excess mortality was for causes of death considered likely a priori. The COPD excess points to a need for an in-depth investigation of respiratory disease and occupational styrene exposure, particularly in light of recent reports associating styrene reinforced plastic manufacturing with the lung disease bronchiolitis obliterans 36 37. Our study of cancer incidence in this cohort may clarify some of the cancer mortality results.…”

Section: Discussionmentioning

confidence: 76%

Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

2015

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COPD was more pronounced among those with potential high-styrene exposure. However, no outcome was related to estimated cumulative styrene exposure, and there was no change when latency was taken into account. We found no excess leukaemia or lymphoma mortality. As in most occupational cohort studies, lack of information on lifestyle factors or other employment was a substantial limitation although we excluded from the analyses those (n=3525) who worked <1 year. Unanticipated excess ovarian cancer mortality could be a chance finding. Comparing subcohorts with potential high-styrene and low-styrene exposure, COPD mortality SRR was elevated while lung cancer SRR was not, suggesting that smoking was not the only cause for excess COPD mortality.

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Section: Discussionmentioning

confidence: 76%

Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

2015

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“…Cullinan et al 1 reported six obliterative bronchiolitis (OB) cases with plausible correlation with fiberglass-reinforced plastics (FRP) fabrication. Five of them were boat builders and one worked for a cooling-tower manufacturer.…”

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confidence: 99%

Obliterative bronchiolitis in workers laying up fiberglass-reinforced plastics with polyester resin and methylethyl ketone peroxide catalyst

et al. 2013

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“…Biomarkers for transplant-related obliterative bronchiolitis are being evaluated in occupational cohorts at risk for occupational lung disease. Within the occupational lung disease community, the occurrence of obliterative bronchiolitis without recognized accidental over-exposure is a paradigm that contributed to recognition of deployment hazards for U.S. soldiers (King et al, 2011) and reporting of obliterative bronchiolitis cases in boat builders and others using plastic-reinforced fiberglass (Cullinan et al, 2013; Chen et al, 2013; Kreiss, 2013). The need to improve the quality of commercial spirometry for medical surveillance of excessive decline in lung function led to development of longitudinal decline freeware, retraining requirements for technicians performing occupational spirometric surveillance, and improved NIOSH-certified training courses.…”

Section: Toxicologic and Public Health Outcomesmentioning

confidence: 99%

Recognizing occupational effects of diacetyl: What can we learn from this history?

Kreiss

2017

Toxicology

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For half of the 30-odd years that diacetyl-exposed workers have developed disabling lung disease, obliterative bronchiolitis was unrecognized as an occupational risk. Delays in its recognition as an occupational lung disease are attributable to the absence of a work-related temporal pattern of symptoms; failure to recognize clusters of cases; complexity of exposure environments; and absence of epidemiologic characterization of workforces giving rise to case clusters. Few physicians are familiar with this rare disease, and motivation to investigate the unknown requires familiarity with what is known and what is anomalous. In pursuit of the previously undescribed risk, investigators benefited greatly from multi-disciplinary collaboration, in this case including physicians, epidemiologists, environmental scientists, toxicologists, industry representatives, and worker advocates. In the 15 years since obliterative bronchiolitis was described in microwave popcorn workers, α-dicarbonyl-related lung disease has been found in flavoring manufacturing workers, other food production workers, diacetyl manufacturing workers, and coffee production workers, alongside case reports in other industries. Within the field of occupational health, impacts include new ventures in public health surveillance, attention to spirometry quality for serial measurements, identifying other indolent causes of obliterative bronchiolitis apart from accidental over-exposures, and broadening the spectrum of diagnostic abnormalities in the disease. Within toxicology, impacts include new attention to appropriate animal models of obliterative bronchiolitis, pertinence of computational fluid dynamic-physiologically based pharmacokinetic modeling, and contributions to mechanistic understanding of respiratory epithelial necrosis, airway fibrosis, and central nervous system effects. In these continuing efforts, collaboration between laboratory scientists, clinicians, occupational public health practitioners in government and industry, and employers remains critical for improving the health of workers inhaling volatile α-dicarbonyl compounds.

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Obliterative bronchiolitis in fibreglass workers: a new occupational disease?: Table 1

Abstract: A rare, potentially fatal disease occurring in six workers laying up fibreglass with styrene resins from five different worksites suggests that work exposures were the cause of their OB. The precise agent responsible awaits identification.

Cited by 31 publications

References 9 publications

Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

Obliterative bronchiolitis in workers laying up fiberglass-reinforced plastics with polyester resin and methylethyl ketone peroxide catalyst

Recognizing occupational effects of diacetyl: What can we learn from this history?

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