There's an Epidemic in Jasper County: Popcorn Workers' Lung- The History, Biology and Occupational Medicine Occupational Heath Issues of Flavoring-Induced Bronchiolitis Obliterans (FIBO) • Prevent occupational illness and injury • Treat occupational illness and injury • Dedicated to promoting the health of Allen J. Parmet, MD, MPH workers through preventive medicine, 816-931-2501 clinical care, research, and education
[email protected] Kansas City, MO History of a new illness Jasper, Missouri • Jasper, Missouri popcorn facility Small facility located in SW Missouri, packs • Biology of the lung popcorn. • Initial Clinical Cases Initially in 1980s, packed for home popping in • Epidemiology jars. • NIOSH Investigation In early 1990s, began packaging microwave packets. •Chemistry • Brochiolitis Obliterans Syndrome Popcorn Packaging Facility Facility Layout Popcorn Mixing Area Salt (Mezzanine) Packaging Final Product Boxing Area Oil Office Lines (Below) Seasoning 1 The airways decrease in individual BUT FIRST… size, increase in total cross section • A quick review of human/mammalian respiratory physiology • Out goes the bad air, in comes the good… Upper Airway Trachea Bronchus Bronchiole Alveolus bone structure cartilage rings muscular tubes sacs 2 cm2 100m2 Pulmonary Functions Pulmonary Functions Forced Expiratory Flow from the 25th to 75th Percentile FEF25-75) in Litres per second Forced Expiratory Forced Vital Volume in One VOLUME Tidal Volume VOLUME Capacity (FVC) in Second (FEV1) in Litres Litres 1s And Diffusing TIME TIME Capacity (DLCO) O2 (40) CO2(40) Initial Cases • Early 1990s, workers AIR O2 O2 + began noting difficulty CO2 Glucose breathing, particularly N O2 (100) 2 with certain product lines. CO2 CO2 + O2 Water + • Several became too ill to work and ENERGY developed asthma, respiratory illnesses of various sorts.