NIOSH eNews

From the Director’s Desk

John Howard, M.D.
Director, NIOSH

What Do Coffee Processing Facilities Have To Do With Lung Disease?

Obliterative bronchiolitis sounds daunting, and it is. It is a severe, irreversible lung disease that occurs when the smallest airways (called bronchioles) in the lungs become scarred and constricted, blocking air movement. This can result in cough, shortness of breath during daily activities, and sometimes wheezing. Work-related obliterative bronchiolitis has been identified in employees in flavoring manufacturing facilities and microwave popcorn facilities where the flavoring chemical diacetyl (2,3-butanedione) or butter flavorings containing diacetyl were used. The chemical 2,3-pentanedione is  similar to diacetyl, and it is sometimes used in place of diacetyl in the manufacture of flavorings.

Diacetyl and 2,3-pentanedione are volatile organic compounds (carbon-based chemicals that can evaporate at room temperature) known as alpha-diketones. Both diacetyl and 2,3-pentanedione have been shown to cause airway damage in laboratory animals. These two chemicals are produced commercially by chemical manufacturers as ingredients in flavorings that are added to some food products, such as microwave popcorn, bakery mixes, or flavored coffee.

Diacetyl and 2,3-pentanedione are also naturally produced when coffee beans are roasted. Grinding roasted coffee beans produces greater surface area for the off-gassing of these and other chemicals than do the whole beans. Coffee roasting facilities package newly roasted coffee in bags fitted with one-way valves or permeable paper bags to allow for off-gassing. Alternatively, newly roasted coffee beans are placed in tubs or containers and allowed to off-gas, which can contribute to worker exposures.

Physicians at a university medical center diagnosed obliterative bronchiolitis in five people who had worked at a coffee processing facility. In 2013, NIOSH and the physicians from the university medical system summarized two of the cases of obliterative bronchiolitis in a Morbidity and Mortality Weekly Report (MMWR), published by the U.S. Centers for Disease Control and Prevention. 

NIOSH conducted a health hazard evaluation at the same facility, and in November 2015, NIOSH investigators published an article in the American Journal of Industrial Medicine about their evaluation. Investigators found that current workers had excessive shortness of breath and reductions in lung function as measured by a test called spirometry, which showed obstructed air flow (air was exhaled from the lungs more slowly than normal).  Both indicators are  consistent with undiagnosed lung disease. They also found elevated levels of diacetyl and 2,3-pentanedione in the air at the facility and identified three sources:

1. Flavoring chemicals added to roasted coffee beans in the flavoring area.
2. Grinding and packaging unflavored roasted coffee in a distinct area of the facility.
3. Storing roasted coffee in hoppers to off-gas.

In 2015, NIOSH published a best practices document that recommends exposure monitoring and work interventions (such as engineering controls and work practices) to decrease occupational exposures to diacetyl and 2,3-pentanedione.

Currently, NIOSH has ongoing health hazard evaluations at a number of coffee processing facilities and has developed a coffee processing webpage with interim recommendations that include air sampling to detect and measure potential concentrations of the chemicals. Additionally, a medical surveillance program that includes health questionnaires and breathing tests, such as spirometry, may be indicated to screen for respiratory symptoms or abnormalities in employees. These recommendations may change to reflect additional knowledge as we learn more.

Physicians who find progressive shortness of breath in current or former workers in food production industries should be alert to the possibility that this may be a symptom of obliterative bronchiolitis associated with occupational exposure to flavoring chemicals. If obliterative bronchiolitis is suspected, immediate steps should be taken to stop further exposure to prevent further deterioration of lung function.

If exposure to diacetyl and 2,3-pentanedione are a concern, I invite you to contact NIOSH through the Health Hazard Evaluation Program. Site visits are often conducted that may include exposure and/or health evaluations to better understand potential hazards.  No one should have a shorter or sicker life because of what they had to do to earn a living.

Bill Reauthorizes WTC Health Program

On December 18, 2015, President Obama signed into law a bill reauthorizing the James Zadroga 9/11 Health and Compensation Act of 2010. This includes reauthorization of the World Trade Center Health Program for 75 years, ending in 2090. Read a statement from the World Trade Center Health Program administrator, John Howard, M.D.

NIOSH Ladder Safety App Now Includes Step Ladders

Climbing for work? NIOSH’s award-winning Ladder Safety app, first released in 2013 to provide user-friendly guides and interactive tools for extension ladder selection and safe use, now includes step ladder safety resources and other enhancements based on user input. Download the free app, available in English and Spanish (adaptive to which language is set on your device), for iPhone/iPad or Android. Visit the NIOSH Ladder Safety Mobile Application website to learn more.

NIOSH Announces New Leadership for Spokane Mining Research Division

NIOSH has appointed Dr. Eric A. Lutz as director of its new Spokane Mining Research Division, part of the NIOSH Office of Mine Safety and Health Research (OMSHR). In his new role, Dr. Lutz will provide oversight, guidance, and direction to research personnel, and he will support NIOSH’s cutting-edge health and safety research that focuses on the mining community. He will help guide the translation of research results into practice to ultimately protect the health and improve the lives of miners and mining communities.

NIOSH Announces New Leadership for Western States Division

NIOSH recently announced the leadership team for the new Western States Division:

• Max Kiefer will serve as the interim director of the new Western States Division until a permanent director can be named.
• CAPT Jennifer Lincoln has been selected as the Western States Division’s associate director for science.
• Kara Perritt will serve as the interim deputy director until the Western States Division deputy director position can be posted and permanent deputy director selected.

First CCER Approved under New Standard

On January 4, NIOSH and the Mine Safety and Health Administration (MSHA) approved the first large-capacity closed-circuit escape respirator (CCER) under new standards published in 42 CFR Part 84, Subpart O. Additional information, including the status of CCERs approved under Subpart H, is available on the NIOSH NPPTL website.

NIOSH Hosts Earl Dotter Exhibit

NIOSH’s Morgantown, West Virginia, facility and Cincinnati, Ohio, Alice Hamilton Laboratory were honored to host a recent photography exhibit for employees. The occupational health photography exhibit was created by the influential American photographer Earl Dotter. “Badges: A Memorial Tribute to Asbestos Workers,” included personal remarks by Mr. Dotter. The exhibit, which was sponsored by the Asbestos Disease Awareness Organization, illustrates the history and lasting impacts of asbestos exposure among American workers. Mr. Dotter explained the exhibit. “My goal in creating this exhibit is not to just touch viewers who are already sympathetic to the overwhelming number of tragedies faced by asbestos victims and their families, but to command the attention of newer generations, who might forget them today,” he said. Mr. Dotter is pleased to announce that next on the agenda is a showing at the 12th Annual Asbestos Disease Awareness Organization Conference (ADAO), April 8–10, Washington, DC, and then at the American Industrial Hygiene Conference and Exposition (AIHce) annual meeting on May 21–26 in Baltimore, MD. 

NIOSH Congratulates

NIOSH Nano Researcher Recognized as One of World’s Most Influential Scientific Minds    

Congratulations to Dr. Anna Shvedova for her recognition as one of most influential scientific minds of 2015 by Thomson Reuters. The international publisher has named Dr. Shvedova a “Highly Cited Researcher,” recognizing her significant contributions in the field of pharmacology and toxicology. Dr. Shvedova is one of only 128 worldwide who were recognized in the area of pharmacology and toxicology. Dr. Shvedova will be listed in Thomson Reuters’ publication, The World’s Most Influential Scientific Minds 2015. Thomson Reuters analyzed citation data over an 11-year period to determine which researchers were cited the most by their scientific peers.

HHS 2016 Federal Engineer of the Year                                                                    

Congratulations to Dr. John Sammarco for being named as the U.S. Department of Health and Human Services (HHS) agency winner for 2016 Federal Engineer of the Year. Each year the National Society for Professional Engineers honors those who have made significant contributions to their organizations through cutting-edge engineering achievements. Dr. Sammarco’s insights and vision have led to new research, methods, and interventions that are revolutionizing mine illumination. More importantly, his research reduces the likelihood of fatalities and injuries caused by poor illumination that reduces the ability of miners to see hazards. He designed a machine-mounted visual warning system that reduces the risks of striking/pinning accidents. It alerts miners of impending machine movements and conveys the type and direction of movement. His work has directly influenced the Mine Safety and Health Administration’s certification and regulatory procedures for field inspection of mine lighting, the International Electrotechnical Commission (IEC) standard for cap lamps, and two commercial cap lamp designs.                                                                                    

NORA

Sudden Deaths of Oil and Gas Extraction Workers               

The NIOSH Oil and Gas Extraction Program worked with partners to identify and investigate nine deaths under similar circumstances. This article revealed a previously unrecognized hazard of worker deaths resulting from exposure to hydrocarbon gases and vapors during manual tank gauging, sampling, and fluid transfer activities. Health-care professionals need to be aware of these risks to oil and gas extraction workers, and medical examiners and coroners investigating oil and gas fatalities need to be aware that hydrocarbon gases and vapors can cause fatal heart attacks. Appropriate toxicology analyses should be included in investigations of deaths involving oil and gas extraction.

News from Our Partners

Integrating Occupational Health Data: Occupational Health Indicators

New York State has been compiling occupational health indicators with the Council of State and Territorial Epidemiologists. The occupational health indicators are a set of surveillance measures that allow states and territories to define, collect, and report occupational illness, injury, and risk data. Since 2012, the New York State Department of Health’s Bureau of Occupational Health and Injury Prevention has been integrating select occupational health indicators into the state’s county health assessments, which consist of a series of tables, maps, and graphs containing health statistics organized by county of residence. The occupational health indicators are also being analyzed in detail on the state and regional level for 2000–2010 data, and the indicators are being made available on a chapter-by-chapter basis.

Iowa Occupational Safety Outreach to a High-risk Population 

Iowa preliminary 2014 Census of Fatal Occupational Injuries data show that 31% of 90 Iowa worker deaths occurred in the agriculture industry. The Iowa Fatality Assessment and Control Evaluation (FACE) program contributes articles to Iowa Farmer Today for a monthly Safety Watch column. The publication is distributed to 70,000 farm owners and operators in and around Iowa each week. Iowa FACE articles are based on FACE case studies and first person interviews. Links to recent columns can be found in the Ag Safety Resource list.

Louisiana Occupational Health and Injury Surveillance

The Louisiana Occupational Health and Injury Surveillance program promotes the health, safety, and quality of life of people working in Louisiana. Among the program’s primary activities are surveillance of workplace injuries, illnesses, and hazards. These findings are published in an annual report. Highlights from the recent surveillance report include findings that Louisiana’s work-related fatality rate remains consistently higher than the U.S. rate, the rate of work-related burn hospitalizations in Louisiana has steadily increased during the past 6 years, and about 20% of Louisiana workers are employed in an industry where they face a high risk of being killed on the job. 

OSHA Quarterly Update on New Compliance Assistance Resources

The new OSHA quarterly report on new compliance assistance resources is now available. The report is available on the OSHA website. This report covers products issued in the first quarter of FY2016 (Oct. 1 to Dec. 31, 2015) and includes the following:

• OSHA compliance assistance products. 
• Materials developed by grantees under the Harwood Grant Program.
• Products developed by OSHA’s Alliance Program participants.
• NIOSH resources, including Fatality Assessment and Control Evaluation (FACE) Program reports and Workplace Solutions.

OSHA Schedules Public Hearing on Proposed Rule on Occupational Exposure to Beryllium

OSHA has scheduled a public hearing on the agency’s proposed rule to amend its existing exposure limits for occupational exposure in general industry to beryllium and beryllium compounds. The hearing will be held at 2 p.m., Feb. 29, 2016, in Room N-4437 A-D; U.S. Department of Labor; 200 Constitution Ave., N.W.; Washington, DC. If necessary, the hearing will continue from 9:30 a.m. to 5 p.m. ET on subsequent days.   

Story Highlights NIOSH-funded Program on Building Better Health in Construction

The Washington University School of Medicine in St. Louis featured a story, Building Better Health, on an occupational safety research project sponsored by NIOSH. The story focuses on a campus building project and the necessary approaches and attitudes required to keep construction workers safe on the job.

AOHP Celebrates 35^th Anniversary, Extends Invitation to Conference

The Association of Occupational Health Professionals in Healthcare (AOHP), which has been serving occupational/employee health professionals since 1981, is commemorating its 35th anniversary in 2016. AOHP is extending an open invitation for others to join the celebration during the 35th Annual AOHP National Conference, scheduled September 7–10 at the Sheraton Myrtle Beach Convention Center Hotel in South Carolina. For more information about AOHP or how to register for the national conference, call 800-362-4347, e-mail info@aohp.org, or go to the conference website.                                                                          

FACE Reports

Hispanic Scrap Yard Worker Dies When Struck by Material Handler at Metal Recycling Facility—South Carolina

A Hispanic worker died from crushing injuries when he was struck by a material handler. It is believed that after directing a truck to the loading area, the worker paused in front of the track of the parked material handler. The material handler operator put the equipment in forward gear, and the worker was caught in the track, knocked to the ground, and run over by the track. The worker died from multiple crushing injuries.

Fire Fighter Fatality Investigation and Prevention Program Reports

Firefighter Suffers Fatal Heart Attack at Commercial Fire—New Jersey

A volunteer fire fighter responded to a commercial fire and performed interior fire suppression activities. After entering the building twice, he exited and collapsed in the front of the building. The fire fighter received resuscitation and was transported to an emergency department. The fire fighter died and NIOSH investigators concluded that the physical exertion associated with fire suppression activities triggered the fire fighter’s heart attack and cardiac death.

Lieutenant Suffers Heart Attack During Fire Suppression Operations at Residential Fire and Dies Ten Days Later—Georgia
A career lieutenant responded to a residential structure fire and performed exterior fire suppression before his crewmembers advanced a hoseline to the rear of the structure. As he returned to the front of the structure, he collapsed. He received life support and was transported to an emergency department and then to an advanced hospital for care. After 10 days, he remained unconscious, tests revealed brain damage, and he was taken off life support and died. 

Health Hazard Evaluation (HHE) Program Update

Ergonomics Recommendations for an Airline Catering Company

HHE Program investigators found work-related risk factors that could explain employees’ musculoskeletal symptoms, injuries, and disorders. Investigators also found problems related to cold exposure, dry ice, job stress, and communication. Investigators recommended redesigning workstations, employee rotation, training, and addressing job stressors. For more information click here.            

What’s New on the NIOSH Science Blog? Join the Discussion Today!

• New NIOSH Study Supports the OSHA Annual Fit Testing Requirements for Filtering Facepiece Respirators
• Coffee Workers at Risk for Lung Disease

Federal Register Notices of Public Meetings and Public Comment

A Vapor Containment Performance Protocol for Closed System Transfer Devices Used during Pharmacy Compounding and Administration of Hazardous Drugs— Extension of Comment Period                                                                                                         

The notice was posted on November 9. Electronic and written comments must be received by March 8. 

Ingress/Egress and Work Boot Outsole Wear Investigation at Surface Mines—New  

The notice was posted on December 14.  Written comments must be received by February 12.

Mining Industry Surveillance System—New

The notice was posted on December 17.  Written comments must be received by February 16.

Employer Perspective of an Insurer-Sponsored Wellness Grant—New

The notice was posted on January 12.  Written comments should be received within 30 days.

Assessing the Impact of Organizational and Personal Antecedents on Proactive Health/Safety Decision Making—New

The notice was posted on January 14. Written comments should be received within 30 days.

Request for Information on Development of a Performance Test Protocol for Closed System Transfer Devices that Incorporate Air-Cleaning Technology to Provide Worker Protection During Pharmacy Compounding and Administration of Hazardous Drugs

The notice was posted on January 19.  Electronic or written comments should be received on or before March 8.

Request for Information on NIOSH Center for Direct Reading and Sensor Technologies: Sensors for Emergency Response Activities

The notice was posted on January 19.  Electronic or written comments should be received on or before March 21.

Measuring Perceived Self-Escape Competencies among Underground Mineworkers—New

The notice was posted on January 21. Written comments must be received on or before March 21.

Monitoring and Coordinating Personal Protective Equipment (PPE) in Healthcare to Enhance Domestic Preparedness for Ebola Response—New

The notice was posted on January 21. Written comments must be received on or before March 21.

Draft Current Intelligence Bulletin: Health Effects of Occupational Exposure to Silver Nanomaterials; Notice of Public Meeting and Comment

The notice was posted on January 21. Comments must be received on or before March 21.

Call for Abstracts

American Public Health Association
Call for abstracts. Abstracts must be submitted February 22–26.

Alliance for Hazardous Materials Professionals
Call for abstracts: Abstracts must be submitted by February 29, 2016.

Upcoming Conferences and Workshops

International Conference on Occupational Health and Safety 2016
March 1–2, 2016, Miami, FL

2016 National Safety Council Texas Safety Conference & Expo
March 20–22, 2016, San Antonio, TX

American Association of Occupational Health Nurses
April 11–16, 2016, Jacksonville, FL

American Industrial Hygiene Conference
May 21–26, 2016, Baltimore, MD

2016 International Hazardous Materials Response Teams Conference
June 16–19, 2016, Baltimore, MD

ASSE Professional Development Conference & Exposition Safety 2016
June 26–29, 2016, Atlanta, GA

Alliance for Hazardous Materials Professionals
August 28–31, Washington, DC

Association of Occupational Health Professionals in Healthcare (AOHP)
September 7–10, Myrtle Beach, SC

American Public Health Association
October 29–November 2, Denver, CO

The NIOSH web page, Conferences and Events, offers a list of upcoming conferences.

“This Month in History”

A NIOSH bulletin from February 5, 1979, recommended that certain workplaces curb smoking because of “increasing evidence of adverse health effects due to the combined actions of tobacco use and exposure to chemical and physical agents in the workplace.” Cigarette smoking could harm workers in six different ways, the bulletin stated:

1. Certain toxic agents in tobacco products and/or smoke may also occur in the workplace, thus increasing exposure to the agent.
2. Workplace chemicals may be transformed into more harmful agents by smoking.
3. Tobacco products may serve as vectors by becoming contaminated with toxic agents found in the workplace, thus facilitating entry of the agent into the body by inhalation, ingestion, and/or skin absorption.
4. Smoking may contribute to an effect comparable to that which can result from exposure to toxic agents found in the workplace, thus causing an additive biological effect.
5. Smoking may act synergistically with toxic agents found in the workplace to cause a much more profound effect than that anticipated simply from the separate influences of the occupational exposure and smoking.
6. Smoking may contribute to accidents in the workplace.

For more information about preventing exposure to tobacco smoke at work, visit Tobacco Smoke in the Workplace.