Lungs of the Living Dead

"The only thing this group of people ever did wrong was go to work."

In a rational, responsible society, a company that invented a new chemical to add buttery flavor to popcorn (called diacetyl) would test it for health effects on humans. And if this is what you found....

After breathing diacetyl vapors for just four hours, some rats gagged and gasped for breath. Half the rats in the study died within a day.

All rats exposed to diacetyl rapidly showed signs of distress. Those exposed to medium and high levels died within seven days, according to the industry data. Of the 10 rats with highest exposure, nine died the first day.

Examination of their tissues after death showed that parts of their lungs had collapsed and filled with blood and fluid. Tissue swelled in the liver and cells in the kidney died.

Oops. Hmm. What would you do then?

a) Trash the new chemical and go back to the drawing board?

b) Put it into commerce, but with strict warnings to downstream users, NIOSH and OSHA that the most protective measures should be taken so that workers can’t inhale it.

c) Send information to the Flavor and Extract Manufacturers Association, a trade group based in Washington, and hope they take care of the problem.

Well, if you're BASF and the year is 1993, looks like you chose c), which (predictably) didn't work out so well because a few years later, here we are:

Former workers at a Missouri microwave popcorn plant are slowly suffocating from breathing a chemical that was known to be toxic long before most of them got sick, according to documents obtained by the Post-Dispatch.

At least 31 people who worked at a popcorn factory in Jasper County have been diagnosed with severe lung disease linked to breathing vapors from a butter flavoring. Eight are on waiting lists for lung transplants.

One of the problems with writing Confined Space is that sometimes you feel like a broken record. How many times can you write the same story about workers getting sick or dying because they are not provided with lifesaving information or well-recognized precautions? If you published this same article, but changed the dates back 50 or 75 years, most people would have been shocked, then shaken their heads about the way things used to be, smugly thinking "Thank God, we're not doing THAT to workers any more. That was back in the old, unenlightened, uncompassionate days when we needed unions and regulatory agencies like OSHA.”

Well, wake up, it's the 21st century. We’re sending robots to explore Mars, we’re fighting wars on video screens, we have computers in our kids’ bedrooms that are thousands of times more powerful than the computers that sent men to the moon. Yet when it comes to protecting workers, we seem to be back in the smoky dawn of the industrial revolution.

Linda Redman started working as a packer at the Jasper popcorn plant in 1995, two years after the original study. Within two years, her breathing was so bad that she had to quit.

Redman used to work 12 hours a day and then come home to garden, cook dinner, and do her family's laundry. Now, she lives alone in Joplin, relying on home health nurses four days a week to help with basic chores around the house.

Redman, 55, doesn't have the stamina to change her bedsheets or cook herself dinner, unless it's something out of a can.

Only 15 percent of her lung capacity remains. Redman bides her time while waiting for a lung transplant by taking breathing treatments every four hours. She is constantly tethered to an oxygen tank, but she still gets exhausted walking from the bedroom to the couch.

"There's no amount of money that can ever buy back what we've lost - our health," Redman said of herself and the other sick workers. "There's a couple of us I don't think can make it much longer."

Eric Peoples, 31, and the father of two small children, will be the first plaintiff to have his case heard. He started work at the plant in 1995 and now is on the waiting list for a double lung transplant.

Angela Nally, 51, started working at the plant in 1993 and quit eight months later. She has 20 percent of her lung capacity left.

Dustin Smith, 24, started at the plant in 1999 and didn't quit until NIOSH told him he had lost half his lung capacity.

Thirty workers affected with “popcorn workers lung” are suing two manufacturers of the butter flavoring. A judge separated the suits into separate trials and Eric Peoples, the most seriously ill, comes up first, this week.

The health and safety information developed by BASF was passed on to the Flavor and Extract Manufacturers Association (FEMA), although it is unclear when it was placed on FEMA's database and when members had access to it. According to FEMA's webpage, the association's "Critical Objectives" are:

To maintain a credible, globally recognized scientific program.

• Achieve and maintain a consistent, scientifically valid approach to safety evaluation of flavor ingredients.
  
  
• Continue to support the ongoing role of the FEMA Expert Panel for independent evaluation of the safety-in-use of flavor ingredients.
  
  
• Identify and address emerging issues.

well, this one apparently "emerged" when no one was looking. While most of FEMA's website is closed to non-members, its "General Information" page notes that it has approved the safety of hundreds of flavoring agents over the past ten years. The names of the agents are not listed. FEMA, which is not named in the lawsuit, had previously issued statements saying that "flavors are safe when handled properly." A January 2001 entry on their database stated that "diacetyl carries a risk of serious damage to eyes, is harmful by inhalation, and is irritating to skin."

The sad thing is, it all could have been prevented.

Dr. David Egilman, an expert on occupational lung disease at Brown University, said that all of this misery could have been avoided if the chemical and flavoring industries responsibly followed up on the 1993 rat study.

The BASF study proved that the chemical was lethal to rats at a level similar to that which could be experienced by plant workers, Egilman said.

"That's why it's so sad," said Egilman, who is scheduled to testify as an expert witness for the plaintiffs. "It wasn't hard for (the flavor manufacturer) to prevent people from dying. They had enough information to prevent people from getting sick."

Instead of warning its customers appropriately, Egilman said, International Flavors & Fragrances led its customers to believe that the product wasn't dangerous.

The company distributed a safety sheet with its butter flavoring that read, "Respiratory protection: none generally required. If desired, use NIOSH-approved respirator." The Material Safety Data Sheet is dated 1992.

A safety sheet written in 1994 by flavoring manufacturer Bush Boake Allen, another defendant in the lawsuit, said that respirators were not normally required for its butter flavoring, unless vapor concentrations were "high." The company is now a subsidiary of International Flavors & Fragrances.

Egilman is no shrinking violet. Last July, the Journal of Occupational and Environmental Medicine refused to publish a letter from him about a corporate cover-up of adverse toxicologic study results. Not to be silenced, he placed the material in a two- page advertisement in the back of the journal along with a poll coupon that sought to survey the readership on the interest that they have in this topic.

The issues we raised at that time are just as relevant now:

Most chemical testing in this country is done by the companies that manufacture the chemicals.... In an ideal world, this information will be peer-reviewed and then publicized. The regulatory authorities could then use the information to decide whether or not exposure to the substance needs to be controlled or eliminated. Even without regulation, workers and consumers could use the information to take some kind of action.

But none of this works – the regulatory process or (mythical) worker choice – if scientific information about the health effects of chemicals is covered up.

Again, I sound like a broken record, but until we have a mandatory system in this country where companies are required to test all new chemicals, and release all results to relevant government agencies and the public; until we make easier for government agencies to regulate these chemicals, and until workers have the clear right to refuse to work with chemicals unless they have been tested and the information made available, tragedies like this will keep happening.

Every couple of weeks, I publish “The Weekly Toll,” a compilation of all of the articles I run across about workers being killed on the job. But workers like Linda Redman, Eric Peoples, Angela Nally and Dustin Smith will never show up on that list. Their lungs have been shredded by the chemicals they work with and they will likely die years or even decades earlier than they should have, but they won’t even get the short article in the paper that a trench collapse victim gets. While they’re not easy to count or to see, and the exact origin is difficult to prove (as we have seen I in the recent IBM trial) experts estimate that between 50,000 and 60,000 people silently die every year from occupational illnesses, most from exposures suffered years or decades before.

Many of these cases are never recognized by knowledgable medical authorities as job-related, and even the, workers compensation is often refused unless a definite link can be made to their on-the-job exposures. Third-party lawsuits are often all workers have to fall back on to cover their medical and living expenses adquate, but even this course is often unsuccessful, despite the right-wing frenzy over runaway lawsuits.The bottom line was summed up by Ken McClain, an attorney representing the plaintiffs:

"The only thing this group of people ever did wrong," he said of the plaintiffs, "was go to work."

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More here.

NIOSH has a webpage and documents on "Preventing Lung Disease in Workers Who Use or Make Flavorings"