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Safety and Health (NIOSH)</a> </div> <div class="cdc-header-mobile__title dropdown cdc-header-mobile__title--group "> <a href="/niosh/flavoring-related-lung-disease/about/index.html">Flavorings</a> <a href="#" id="mobileDropDownButton" class="nav-link dropdown-toggle" data-mobile-toggle="open" data-bs-toggle="dropdown" data-bs-offset="0,20"> Menu <i class="cdc-fa-angle-down"></i> </a> <div class="dropdown-menu cdc-mobile-menu" role="menu" aria-labelledby="mobileDropDownButton"> <div class="cdc-mobile-menu-search"> <form action="https://search.cdc.gov/search/" method="GET" class="cdc-mobile-search" role="search"> <div class="input-group"> <button class="btn btn-outline-secondary btn--search" type="button"><i class="cdc-fa-light cdc-fa-magnifying-glass"></i><span class="visually-hidden">search</span></button> <input class="form-control cdc-mobile-search__input" data-search-input type="search" name="query" maxlength="300" placeholder="Search" required="" tabindex="-1"> </div> </form> 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href="/niosh/flavoring-related-lung-disease/site.html#gen"> View All </a> </span> </li> </ul> </div> </div> </div> </div> </div> <div class="cdc-mobile-menu-footer"> <a href="/niosh/flavoring-related-lung-disease/site.html"> <span> View All </span> <span>Flavorings</span> </a> </div> </div> </div> <div class="cdc-header-mobile__faux-title" aria-hidden="true"> </div> </div> </header> <main class="container cdc-main" role="main" aria-label="Main Content Area"> <section class="cdc-page-title-bar cdc-page-offset noindex"> <time class="cdc-page-title-bar__item cdc-page-title-bar__item--date" datetime="2024-04-23 00:00:00"> April 23, 2024 </time> </section> <div class="cdc-page-feature cdc-page-feature--ssi"></div> <div class="cdc-page-title cdc-page-offset syndicate"> <span class="page-subtitle page-subtitle__super"> <a href="/niosh/flavoring-related-lung-disease/about/index.html"> Flavoring-related Lung Disease </a> </span> <h1>About Flavoring-related Lung Disease</h1> </div> <div id="content" class="cdc-page-content cdc-page-offset syndicate container"> <div class="cdc-dfe-body "> <div class="cdc-dfe-body__top "> <div class="dfe-section dfe-section--page-summary summary-list" data-section="cdc_disease_basics_page_summary"> <div class="dfe-section__header"> <h2>Key points</h2> </div> <div class="dfe-section__content"> <ul class="nested-list"> <li class="level-1">Flavoring-related lung disease is caused by the flavoring chemical diacetyl (2,3-butanedione) and its substitute, 2,3-pentanedione (acetyl propionyl).<ul> </ul> </li> <li class="level-1">Flavoring chemicals are used in food flavoring and production industries.<ul> </ul> </li> <li class="level-1">Workers exposed to these flavoring chemicals are at risk of severe respiratory impairment.<ul> </ul> </li> </ul> </div> <div class="dfe-section__image" id="page-summary-image"> <figure class="dfe-image dfe-image__large"><div class="image-container calculated-ratio-16-9 aspect-ratio-16-9"><img src="/niosh/media/images/buttervat3.png" alt="A butter flavorings vat."></div></figure> </div> <div id="nav-buttons"> </div> </div> </div> <div class="cdc-dfe-body__center "> <div class="dfe-section" data-section="cdc_disease_basics_overview"> <a class="onThisPageAnchor" id="cdc_disease_basics_overview-overview" name="Overview" title="Overview"></a><h2>Overview</h2> <p>Diacetyl and its substitute, 2,3-pentanedione (acetyl propionyl), are flavoring chemicals used in food flavoring and production industries. These include microwave popcorn, bakery mix, and flavored <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6216a3.htm" class="">coffee</a> industries.</p> <p>Workplace exposure to diacetyl has been associated with severe respiratory impairment and a lung disease called obliterative bronchiolitis. The disease is also called constrictive bronchiolitis and bronchiolitis obliterans. This serious lung disease causes scarring and constriction in the smallest airways of the lung called bronchioles, blocking air movement. Obliterative bronchiolitis cannot be cured. The chemical 2,3-pentanedione is chemically similar and has had similar respiratory effects in animal studies.</p> <p>The U.S. Food and Drug Administration has evaluated flavoring chemicals and determined they are "generally recognized as safe" to eat. However, workers can be exposed to flavoring chemicals in different ways and quantities than the general consumer. They can be harmful for food and chemical industry workers who breath air contaminated with these chemicals.</p> <p>Much remains unknown about flavoring-related chemicals. Identifying which specific substances contribute to flavorings-related lung disease is challenging. Flavoring mixtures are complex and health data for many chemicals are unavailable. The flavorings industry has estimated over a thousand flavoring chemicals can potentially be respiratory hazards.</p> <p>Employers, safety professionals, and workers should take steps to prevent working conditions and practices that place workers at risk.</p> </div> <div class="dfe-section" data-section="cdc_disease_basics_research"> <a class="onThisPageAnchor" id="cdc_disease_basics_research-research" name="Research" title="Research"></a><h2>Research</h2> <p>NIOSH has led research on the occupational impacts of flavorings and recommendations. The first observation of obliterative bronchiolitis in a food production employee may have occurred in 1985. It was in a facility where diacetyl was listed among ingredients used in making flavorings for the baking industry.</p> <p>In August 2000, a health department requested NIOSH assistance to investigate obliterative bronchiolitis in former workers of a microwave popcorn plant. This led to further NIOSH research that found artificial butter flavorings added to the popcorn caused disease. Findings from NIOSH investigations in microwave popcorn and flavorings manufacturing industries provided a basis for the 2004 <a href="https://www.cdc.gov/niosh/docs/2004-110/default.html">NIOSH Alert: Preventing Lung Disease in Workers Who Use or Make Flavorings</a>. A <a href="https://www.cdc.gov/spanish/niosh/docs/2004-110_sp/">Summary Sheet</a> is also available in Spanish.</p> <p>In 2016, NIOSH published a <a href="https://www.cdc.gov/niosh/docs/2016-111/default.html" class="">criteria document</a> that provides critical review of scientific and technical information on:</p> <ul class="nested-list"> <li class="level-1">Prevalence or frequency of hazards<ul> </ul> </li> <li class="level-1">Existence of health risks<ul> </ul> </li> <li class="level-1">Methods to identify and control exposure<ul> </ul> </li> </ul> <p> The document also provides recommended exposure limits for diacetyl and 2,3-pentanedione.</p> </div> </div> <div class="cdc-dfe-body__right page-right-rail"> <aside class="page-right-rail__dynamic noindex" role="complementary"> <div data-related-nav></div> </aside> </div> </div> <div data-journey-next></div> <section class="container page-mobile-bar"> <time class="page-mobile-bar__item page-mobile-bar__item--date" datetime="2024-04-23 00:00:00"> April 23, 2024 </time> </section> <div class="page-content-sources noindex"> <div class="page-content-sources__header"> <a data-action="summary" class="collapsed" href="#content-sources" role="button" data-bs-toggle="collapse" aria-expanded="false" aria-controls="content-sources" data-cs-toggle="">Sources</a> <a data-action="print" href="#print" class="d-none d-md-block" aria-label="print this page" onclick="window.print()">Print</a> <a data-action="share" href="#share" data-bs-toggle="dropdown" aria-label="share this page" aria-expanded="false">Share</a> <div class="dropdown-menu page-share-bar" data-popper-placement="bottom-start"> <a href="#" class="page-share-facebook"><span class="cdc-icon-facebook"></span></a> <a href="#" class="page-share-linkedin"><span class="cdc-icon-linkedin"></span></a> <a href="#" class="page-share-twitter"><span class="cdc-icon-twitter"></span></a> <a href="#" class="page-share-syndication"><span class="cdc-icon-rss"></span></a> </div> </div> <div class="page-share-container"> <div class="page-share-popup" id="page-share-popup" role="dialog"> <a target="_blank" title="Share to Facebook" rel="noreferrer noopener" class="page-share-facebook metrics-share-facebook" href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.cdc.gov"> <span class="sr-only">Facebook</span> <span class="cdc-icon-facebook-inverse"></span> </a> <a target="_blank" title="Share to LinkedIn" rel="noreferrer noopener" class="page-share-linkedin metrics-share-linkedin" href="https://www.linkedin.com/shareArticle?url=https%3A%2F%2Fwww.cdc.gov&title=Living%20with%20High%20Blood%20Pressure"> <span class="sr-only">LinkedIn</span> <span class="cdc-icon-linkedin-inverse"></span> </a> <a target="_blank" title="Share to Twitter" rel="noreferrer noopener" class="page-share-twitter metrics-share-twitter" href="https://twitter.com/share?url=https%3A%2F%2Fwww.cdc.gov&text=Living%20with%20High%20Blood%20Pressure"> <span class="sr-only">Twitter</span> <span class="cdc-icon-twitter-inverse"></span> </a> <a target="_blank" title="Embed this Page" rel="noreferrer noopener" class="page-share-syndication metrics-share-syndicate" href="https://tools.cdc.gov/medialibrary/index.aspx#/sharecontent/https://https://www.cdc.gov/niosh/flavoring-related-lung-disease/about/index.html"> <span class="sr-only">Syndicate</span> <span class="fi cdc-icon-syndication-round"></span> </a> </div> </div> <div id="content-sources" class="page-content-sources__body accordion-collapse collapse"> <div class="callout callout-content-source" role="status"> <div class="callout-heading">Content Source:</div> <a class="cdc-block-link" href="/niosh/about/index.html">National Institute for Occupational Safety and Health</a> </div> <div class="page-content-sources__section page-content-sources__section--sources"><label for="page_sources">Sources</label><ul id="page_sources"><li>Kanwal R, Kullman G, Piacitelli C, Boylstein R, Sahakian N, Martin S, Fedan K, Kreiss K [2006]. Evaluation of flavorings-related lung disease risk at six microwave popcorn plants.J Occup Environ Med. <em>48</em>(2):149-157, <a href="https://doi.org/10.1097/01.jom.0000194152.48728.fb">https://doi.org/10.1097/01.jom.0000194152.48728.fb</a>.</li> <li>Martyny JW, Van Dyke MV, Arbuckle S, Towle M, Rose CS [2008]. Diacetyl Exposures in the flavor manufacturing industry. Journal of Occupational and Environmental Hygiene, <em>5</em>(11): 679-688, <a href="https://doi.org/10.1080/15459620802368463">https://doi.org/10.1080/15459620802368463</a>.</li> <li>Day G, LeBouf R, Grote A, Pendergrass S, Cummings K, Kreiss K, and Kullman G [2011]. Identification and measurement of diacetyl substitutes in dry bakery mix production. J Occup Environ Hyg <em>8</em>(2):93-103, <a href="https://doi.org/10.1080/15459624.2011.547148">https://doi.org/10.1080/15459624.2011.547148.</a></li> <li>LeBouf RF, Hawley B, Cummings KJ [2019]. Potential hazards not communicated in safety data sheets of flavoring formulations, including diacetyl and 2,3-pentanedione. Ann Work Expo Health <em>63</em>(1):124-130, <a href="https://doi.org/10.1093/annweh/wxy093">https://doi.org/10.1093/annweh/wxy093</a>.</li> <li>Harvey RR, Fechter-Leggett ED, Bailey RL, Edwards NT, Fedan, KB, Virji MA, Nett RJ, Cox-Ganser JM, Cummings KJ [2020]. The burden of respiratory abnormalities among workers at coffee roasting and packaging facilities. Front. Public Health, Front. 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