“I played by the rules. I worked to support my family. The unregulated industry virtually destroyed my life. These chemicals that are used on food in large-scale production must be tested, and proper instructions and labels supplied with their sale.”

Those were the words of Eric Peoples at a congressional hearing in 2007. He testified about his experience working at a food-manufacturing plant where he was exposed to flavoring chemicals including diacetyl. Those exposures led to severe lung damage. At the time of his testimony, Peoples was awaiting a lung transplant.

Eric Peoples became one of the public faces in 2007 of our nation’s ineffective systems for protecting workers, consumers and the environment from chemical hazards. For his part, Peoples brought to light several key problems with our federal public health agencies. Workers are exposed on-the-job to a smorgasbord of chemicals, for which too little information is known about their health effects. Very, very few of the chemicals in commerce—including those used as food flavoring agents—-are subject to workplace safety regulations. Many chemicals used as food additives, including the ones to which Mr. Peoples was exposed, are considered by the Food and Drug Administration (FDA) as “generally regarded as safe” (GRAS). FDA may consider them GRAS to ingest, but some of them are clearly not safe when workers (or even consumers) inhale their vapors. A new paper to be published in the American Journal of Industrial Medicine reinforces this disturbing reality.

Dr. Kay Kreiss with CDC’s National Institute for Occupational Safety and Health (NIOSH) describes an investigation at a flavoring manufacturing plant in Indiana. Kreiss and colleagues have conducted other studies (here, here, here, here) involving workers exposed to food flavorings, most notably those involved in microwave popcorn production.  In this study, the NIOSH researchers evaluated 369 spirometry results of 112 food-flavoring production workers which were performed between 2004-2009. The exams were conducted to ensure the workers were well enough to wear respirators. Workers in the plant were involved in a variety of tasks from R&D and quality control, to packaging. Workers with the highest exposure to the butter-flavoring agent diacetyl had job titles related to “dry blend, extract and distillation, liquid compounding, process flavors, and spray dry.” The researchers compared the prevalence of “abnormal restrictive pattern of spirometry” in the exposed workers to that expected in the U.S. general population, controlling for demographic traits, BMI and smoking history. Here’s some of what Kreiss reported:

• “For non-smokers (n=38), the mean decline in FEV1 was 81.3 ml/year, and the mean decline in FVC was 94.8 ml/year.” (FVC is a value applied to an individual’s maximum forced expiratory effort.)
• “Of 70 employees with two or more spirometry tests…19 precent were identified as having excessive FEV1 declines.” (FEV1 is a value applied to the volume of breathe exhaled by an individual at the end of the first second of forced expiration.)
• Of the 25 employees who had serial measurements of lung function and abnormal restrictive spirometry results, eight of the 25 had excessive declines in lung function.
• “Of production employees, 37 percent had either abnormal spirometry or abnormal declines in spirometry or both, with the predominant abnormality being a restrictive pattern. Restriction was about 3.12 times more common than expected compared to the general United States population, after adjusting for potential contributing factors such as smoking, overweight and obesity.”

Kreiss offers a litany of flavors produced at this one Indiana plant including those mimicking butter, buttermilk, cheese, coffee, fruits, beef, chicken, and fish. The trade association for these flavoring producers is the Flavor and Extract Manufacturers Association (FEMA). Kreiss notes in her paper that the group published a list of chemicals used in flavor production that are considered respiratory hazards.

Why do food manufacturers use chemicals to flavor their products knowing the compounds can cause severe lung damage to exposed workers? Because they can. None of the compounds on FEMA’s list are regulated by OSHA. They are also shielded by FDA’s GRAS designation.

When Mr. Peoples’ and other lung-damaged workers’ experiences became public it seemed like there was momentum to address the serious risk to respiratory health of food-flavoring agents. OSHA indicated in 2008 that it intended to initiate a rulemaking. The FDA indicated that a petition calling on the agency to revoke the GRAS designation of diacetyl-containing substitutes was “under active review.” FDA added:

“Although it is highly unusual for the FDA to contemplate food ingredient regulation on the basis of inhalation, we have not ruled out any regulatory option.”

OSHA has long since moved to its back burner a regulation to address the health risk to workers of food-flavoring agents. Actually, not so much the back burner, but off the stove and out the door altogether. Perhaps, however, there’s a slim chance that FDA—an organization that insists it is a public health agency—will address the issue. Clearly, a food additive that can cause irreversible lung damage when inhaled cannot in any public health context be “generally recognized as safe.”

Dr. Kay Kreiss’ paper reminds me to ask FDA for the status of their “active review.” A letter is in the mail.