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Bronchiolitis Obliterans and Fiberglass Lung Disease

Bronchiolitis Obliterans is a form of obstructive lung disease, along with asthma, chronic obstructive pulmonary disease, and emphysema. It is a debilitating, progressive, and severe lung disease with no known cure, other than lung transplantation. In this rare disease, the walls of the smallest airways (bronchioli) thicken and become obliterated. Hence, the disease is variously called "bronchiolitis obliterans" "obliterative bronchiolitis," or "constrictive bronchiolitis."

In the last decade an epidemic of Bronchiolitis Obliterans was detected in microwave popcorn and food flavoring workers. The cause of the disease in the food flavoring industry was identified as diacetyl, an artificial butter flavoring. Because the disease occurred primarily in microwave popcorn manufacturing workers, it was called "Popcorn Lung." Many workers in the food flavoring industry were diagnosed with the disease. Several workers died while awaiting lung transplants. Some were fortunate and received lung transplants, which saved their lives.

Recently, British physicians and public health researchers published a series of 6 cases of Bronchiolitis Obliterans in workers exposed to fiberglass and styrene. Cullinan, P., et al., "Obliterative Bronchiolitis in Fiberglass Workers: A New Occupational Lung Disease?" Occup. Environ. Med. 70(5):357-359 (May 2013). Fiberglass is a form of synthetic mineral fiber.

Five of the workers were boat builders who laid up fiberglass hulls. The disease came on rapidly without any unusual acute exposures. Two of the workers received lung transplants, while another died while waiting for a lung transplant. The diagnosis of Bronchiolitis Obliterans was pathologically confirmed in 4 of the workers, either from biopsies or from their explanted lungs. The researchers concluded that this rare, fatal disease occurring in 6 workers laying up fiberglass from five different worksites was likely caused by their occupational exposure.

In addition to being exposed to synthetic fibers, the workers were exposed to styrene, a toxic chemical used as a resin in making fiberglass. Styrene is also a nasty chemical. In 2011 the U.S. Department of Health and Human Services issued its 12th Report on Carcinogens, classifying styrene as a chemical that is reasonably anticipated to be a human carcinogen.

The recent publication regarding Bronchiolitis Obliterans in boatbuilders exposed to fiberglass and styrene is important for public health. Almost 125,000 Americans are employed in the boatbuilding industry. A substantial number of these workers are involved in laying up fiberglass. Other workers who lay up fiberglass are employed making surfboards, skis, and snowboards. These workers are all at risk of developing the dreaded lung disease known as Bronchiolitis Obliterans. The disease in this occupational setting does not yet have a name. It may be called "Boat Builders Lung," "Fiberglass Workers' Lung" or "Fiberglass-Styrene Lung." Time will tell.

The association between fiberglass and lung disease is not new. On March 15, 1987 the New York Times published an article by Philip Shabecoff titled "Evidence Grows on Possible Link of Fiberglass and Lung Illnesses." This article reported: "Emerging evidence that fiberglass and other manufactured mineral fibers may cause lung cancer and other diseases is creating a sensitive, potentially far-reaching public health issue." Shabecoff reported that Dr. Richard A. Lemen, Director of Policy for the National Institute of Occupational Safety and Health stated "We are giving this a very high priority." Shabecoff remarked that Dr. David L. Dull, Acting Director of the Chemical Control Division of the EPA noted that exposure to asbestos is now limited by law and exposure to synthetic fibers if virtually uncontrolled and said: "If I had a choice of being exposed to asbestos at current exposure levels and to respirable man-made fibers, I would breathe asbestos every time because the exposure limits are so much more stringent."

It is a tragedy of occupational health and safety that the respiratory hazards of fiberglass were recognized at least 25 years ago, but workers are still exposed to synethetic fibers and styrene.

The Metzger Law Group is now accepting clients who work laying up fiberglass and have unfortunately developed obstructive lung disease as a result of their occupational exposure. If you were exposed to fiberglass and have been diagnosed with bronchiolitis obliterans, asthma, emphysema, or other obstructive lung disease, call us for a free consultation and case evaluation.

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