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Hubbs AF, Kreiss K, Cummings KJ, Fluharty KL, O'Connell R, Cole A, Dodd TM, Clingerman SM, Flesher JR, Lee R, Pagel S, Battelli LA, Cumpston A, Jackson M, Kashon M, Orandle MS, Fedan JS, Sriram K. Flavorings-Related Lung Disease: A Brief Review and New Mechanistic Data. Toxicol Pathol 2019; 47:1012-1026. [PMID: 31645208 DOI: 10.1177/0192623319879906] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Flavorings-related lung disease is a potentially disabling and sometimes fatal lung disease of workers making or using flavorings. First identified almost 20 years ago in microwave popcorn workers exposed to butter-flavoring vapors, flavorings-related lung disease remains a concern today. In some cases, workers develop bronchiolitis obliterans, a severe form of fixed airways disease. Affected workers have been reported in microwave popcorn, flavorings, and coffee production workplaces. Volatile α-dicarbonyl compounds, particularly diacetyl (2,3-butanedione) and 2,3-pentanedione, are implicated in the etiology. Published studies on diacetyl and 2,3-pentanedione document their ability to cause airway epithelial necrosis, damage biological molecules, and perturb protein homeostasis. With chronic exposure in rats, they produce airway fibrosis resembling bronchiolitis obliterans. To add to this knowledge, we recently evaluated airway toxicity of the 3-carbon α-dicarbonyl compound, methylglyoxal. Methylglyoxal inhalation causes epithelial necrosis at even lower concentrations than diacetyl. In addition, we investigated airway toxicity of mixtures of diacetyl, acetoin, and acetic acid, common volatiles in butter flavoring. At ratios comparable to workplace scenarios, the mixtures or diacetyl alone, but not acetic acid or acetoin, cause airway epithelial necrosis. These new findings add to existing data to implicate α-dicarbonyl compounds in airway injury and flavorings-related lung disease.
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Affiliation(s)
- Ann F Hubbs
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Kathleen Kreiss
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Kristin J Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Kara L Fluharty
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ryan O'Connell
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.,West Virginia University, Morgantown, WV, USA. Cummings is now with California Department of Public Health, Richmond, CA, USA. O'Connell is now with Department of Biochemistry, West Virginia, University, Morgantown, WV, USA. Flesher is now with Department of Biology, West Virginia University, Morgantown, WV, USA. Cole is now with Department of Pediatrics-Hematology/Oncology, University of Colorado School of Medicine, Aurora, CO, USA. Kreiss (retired) is in Sitka, AK, USA
| | - Allison Cole
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.,Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Tiana M Dodd
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Sidney M Clingerman
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.,West Virginia University, Morgantown, WV, USA. Cummings is now with California Department of Public Health, Richmond, CA, USA. O'Connell is now with Department of Biochemistry, West Virginia, University, Morgantown, WV, USA. Flesher is now with Department of Biology, West Virginia University, Morgantown, WV, USA. Cole is now with Department of Pediatrics-Hematology/Oncology, University of Colorado School of Medicine, Aurora, CO, USA. Kreiss (retired) is in Sitka, AK, USA
| | - Jordan R Flesher
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.,West Virginia University, Morgantown, WV, USA. Cummings is now with California Department of Public Health, Richmond, CA, USA. O'Connell is now with Department of Biochemistry, West Virginia, University, Morgantown, WV, USA. Flesher is now with Department of Biology, West Virginia University, Morgantown, WV, USA. Cole is now with Department of Pediatrics-Hematology/Oncology, University of Colorado School of Medicine, Aurora, CO, USA. Kreiss (retired) is in Sitka, AK, USA
| | - Rebecca Lee
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.,West Virginia University, Morgantown, WV, USA. Cummings is now with California Department of Public Health, Richmond, CA, USA. O'Connell is now with Department of Biochemistry, West Virginia, University, Morgantown, WV, USA. Flesher is now with Department of Biology, West Virginia University, Morgantown, WV, USA. Cole is now with Department of Pediatrics-Hematology/Oncology, University of Colorado School of Medicine, Aurora, CO, USA. Kreiss (retired) is in Sitka, AK, USA
| | - Samantha Pagel
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.,West Virginia University, Morgantown, WV, USA. Cummings is now with California Department of Public Health, Richmond, CA, USA. O'Connell is now with Department of Biochemistry, West Virginia, University, Morgantown, WV, USA. Flesher is now with Department of Biology, West Virginia University, Morgantown, WV, USA. Cole is now with Department of Pediatrics-Hematology/Oncology, University of Colorado School of Medicine, Aurora, CO, USA. Kreiss (retired) is in Sitka, AK, USA
| | - Lori A Battelli
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Amy Cumpston
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Mark Jackson
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Michael Kashon
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Marlene S Orandle
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Jeffrey S Fedan
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Krishnan Sriram
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
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