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Shootie
Artificial Butter Suspected in Lung Disease
By PHILIP J. HILTS [NYT]
Workers in two states have come down with a severe lung disease that is apparently linked to their work with vats of artificial
butter flavoring, doctors have reported.
The National Institute for Occupational Safety and Health issued a report in August that described the cases of nine workers in a
small Missouri factory who developed a rare and disabling lung disorder, bronchiolitis obliterans, and an additional seven workers
who had other lung problems after being exposed to artificial flavoring while mixing and packaging microwave popcorn.
The lung damage from bronchiolitis obliterans appears to be permanent, and four of the workers are so ill that they are on the
waiting list for lung transplants.
Today, in a telephone interview, a doctor in Nebraska described a similar case of the lung disorder in another patient, who is also a
worker handling artificial butter flavoring for popcorn.
Doctors who investigated for the federal agency said that the problem appeared to be limited to workers who inhaled large amounts
of the liquid flavoring and that there was no danger to anyone eating the flavoring on popcorn or in other foods.
Dr. Talmadge E. King, chief of medicine at the San Francisco General Hospital and an expert on bronchiolitis obliterans, said these
cases were the first time he had heard of an outbreak of the disease, which usually occurs in individual patients. He said it sometime
occurred in transplant patients whose immune systems are compromised and historically has been seen in people who had heavy
exposure to chemicals in accidents like the explosion of chlorine tanks, or when farmers have opened corn silos and inhaled large
amounts of nitrogen oxides at once.
Dr. Kathleen Kreiss, who led the investigation, said that the finding was a surprise and that two important questions are now being
pursued by government scientists: are there cases that have not been reported, and what ingredient in the flavoring may have
triggered the disease?
The cases were first reported in The Wall Street Journal on Wednesday.
The illnesses occurred in workers at a Gilster-Mary Lee Corporation plant in Jasper, Mo., where microwave popcorn was mixed
with salt, oil and flavoring, then packaged.
Government investigators and the doctor in Nebraska, Dr. Susanna Von Essen at the University of Nebraska Medical Center, who
treated a worker at a Nebraska company, declined to identify that company. But the government has begun to work with the
Nebraska company to investigate the case, and investigators said the worker contracted the disease after working with vats of a
different brand of butter flavoring from the one used in Missouri.
In Missouri, 16 current and former employees have filed a workers' compensation claim against the Gilster-Mary Lee Corporation,
and a class-action lawsuit against International Flavors and Fragrances, based in New York and New Jersey, which makes the
flavoring. Seven plaintiffs are still employed at the Gilster-Mary Lee factory, though some are on disability leave.
The plaintiffs are seeking an undefined amount in damages to cover medical costs.
"Some of these people can't even help out with household chores like mowing the lawn because they're so out of breath, and things
like playing with their kids are hard for them," said Amy Powell, a lawyer with Humphrey, Farrington, McClain & Edgar, a firm in
Independence, Mo., that is representing the plaintiffs.
Gilster-Mary Lee has denied liability and until recently also denied benefits, Ms. Powell said. She said International Flavors and
Fragrances had not yet responded to the class-action lawsuit filing
Calls to Gilster-Mary Lee and to International Flavors and Fragrances were not returned.
The workers in Missouri were young, averaging 36 years old, and that "is part of the reason this is so alarming," Ms. Powell said.
One of the Gilster workers was Angela Nally, 48, who began working on the production line in October 1993. Until then, she had
been a homemaker, and she decided to take her first job outside the home only because her husband had lost his.
Mrs. Nally drove 11 miles from her home in Carthage to the factory on the outskirts of Jasper. She worked the late shift, from
midafternoon until midnight, making $5.50 an hour.
About four months after Mrs. Nally started working at the factory, she developed a persistent cough. She did not think anything of it
at first. "It was kind of like a cold or a flu-type thing," she said in an interview. "I'd get to feeling better after the doctors gave me
something for the cough, but it gradually kept getting worse and worse. I thought I was going to get over it, but I didn't."
Breathing became more difficult and she started coughing so hard that she broke a rib. She consulted doctors in Carthage, Joplin,
Springfield and St. Louis, and soon was so weak and short of breath that her doctors advised her to quit working. So in June 1994,
she did.
In October 1994, Mrs. Nally went to a hospital in Denver for a lung biopsy. Her lungs were so inflamed and damaged that doctors
warned she might have only a year to live, and she was put on a waiting list for a double-lung transplant.
Her condition has now stabilized, and she said she has been moved to the "inactive" waiting list. Mrs. Nally said she suspected her
illness was linked to her job because she had been active and healthy before starting at the plant, and she soon noticed that other
workers shared her symptoms. But no one in the company or on the production line ever talked about it, she said.
The investigation of the outbreak began more than a year ago when a doctor in Kansas City, Mo., Allen Parmet, who handles
occupational health problems, noticed that several patients had the rare, disabling lung problem. Late last year, he saw six patients at
the same time with the disorder, all from one small area of Missouri. That was four more than he had seen in his entire career.
He reported the cases to the Missouri Department of Health, where an investigation was begun.
Dr. Eduardo Simoes, the state epidemiologist for Missouri, said his group calculated that the odds of having that number of cases in
a town as small as Jasper were less than one in 10,000. Federal investigators were asked to aid the investigation in August 2000.
The investigators have done a test on rats, and have found that when they inhale substantial amounts of butter flavoring like that used
in the Missouri plant, many develop similar lung disease.
The chief ingredient in the flavoring is a chemical called diacetyl, said Dr. Greg Kullman of the federal agency, and it may be the
agent that triggers the problem. Tests of the effects of diacetyl on rodents have begun, Dr. Kullman said. |
