Work-related spirometric restriction in flavoring manufacturing workers


  • Kathleen Kreiss MD

    Corresponding author
    1. Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia
    • Correspondence to: Kathleen Kreiss, MD, 1095 Willowdale Road, Morgantown, WV 26505. E-mail:

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  • Disclosure Statement: The authors report no conflicts of interests.



Flavoring-exposed workers are at risk for occupational lung disease.


We examined serial spirometries from corporate medical surveillance of flavoring production workers to assess abnormality compared to the U.S. population; mean decline in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC); and excessive declines in FEV1.


Of 106 workers, 30 had spirometric restriction, 3 had obstruction, 1 had both, and 13 (of 70, 19%) had excessive declines in FEV1. The adjusted prevalence of restriction was 3.7 times expected. Employees with higher potential for flavorings exposure had 3.0 times and 2.4 times greater average annual declines in FEV1 and FVC respectively, and had 5.8 times higher odds of having excessive FEV1 declines than employees with lower potential for exposure.


Exposure-related spirometric abnormalities consistent with a restrictive process evolved during employment, suggesting that exposures in flavoring production are associated with a range of pathophysiology. Am. J. Ind. Med. 57:129–137, 2014. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.