Image: Dr. Allen Parmet
Charlie Riedel  /  ASSOCIATED PRESS
Dr. Allen Parmet examines a chest scan of one of his patients who contracted a lung disease as a result of exposure to buttery microwave popcorn flavoring, as the public health physician works in his office in Kansas City, Mo.
updated 10/29/2007 12:52:27 PM ET 2007-10-29T16:52:27

Each morning, Eric Peoples sits up in bed and starts his day with a cough. A deep, long, hacking cough.

He plants his feet on the bedroom floor and immediately feels as if someone is standing on his chest. That’s a good day. When it gets really bad, it seems as though a giant creature is crushing his lungs, squeezing the breath out of him.

Eric Peoples has lived this way for eight years. He got sick while mixing butter flavoring at a Missouri microwave popcorn plant, developing a ravaging lung disease that has tormented a small but alarming number of food workers across the nation.

Peoples sued. He won millions of dollars. Money isn’t a worry now. His health is.

At 35, he walks slowly. Stairs are murder; sometimes he stops to rest on each one. He has lost three-fourths of his lung capacity and depends on oxygen when it’s humid. One day, he may need a double lung transplant.

Peoples says no amount of money can make up for all that he has missed out on in life: the chance to play ball with his son, teach his daughter to ride a bike, do whatever he wants. He isn’t as angry as he once was, he says, and was thrilled when some microwave popcorn makers said they’ll stop using the chemical tied to his illness.

But even now, it’s confounding to him that a pungent-smelling flavoring that he poured in giant vats, a bright yellow pudding-like substance used to improve the taste of a common snack — popcorn — did this to him.

“When I first started getting sick, I was trying to figure out what it was,” he says. “It never dawned on me that it was the butter flavoring. It’s food. You eat it. I kept telling my family, surely it can’t be. Why would something like that be harmful? How could it be bad?”

Hidden threat
In a world filled with hazards, some workers obviously face perilous conditions: miners burrowing hundreds of feet in the earth, farmers spraying pesticides, meatpackers wielding long knives to carve up huge carcasses moving quickly down a line.

By that yardstick, mixing an additive that’s used to flavor popcorn, candy, baked goods and other foods — it’s also found naturally in small amounts in staples such as milk and butter — almost seems innocuous.

But to many, it’s not.

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For several years, diacetyl, a chemical that gives foods a buttery taste, has been linked to a rare, irreversible lung disease. The result has been a public health debate that has stretched from Congress to courtrooms across the nation, leading to tens of millions of dollars in judgments.

Scientists, doctors, politicians, food companies, labor unions, lawyers and others have weighed in — some pointing angry fingers at the government — as hundreds of workers have claimed they have severe lung disease or other respiratory illnesses from inhaling diacetyl vapors.

And it may go beyond workers.

In recent months, it was disclosed that a man who ate at least two bags of buttery microwave popcorn daily for 10 years may have the same disease found in workers. His lung problems were linked to breathing the vapors. His kitchen had diacetyl levels comparable to those in popcorn plants.

Now some major microwave popcorn companies have eliminated or plan to drop the ingredient, while Congress — with the support of the flavoring industry — is looking to reduce the danger in the workplace. But the Bush administration, some business groups (including the U.S. Chamber of Commerce) and others say there isn’t enough scientific evidence to warrant immediate government limits.

Edwin Foulke Jr., a top federal official, testified this spring at a congressional hearing that Diacetyl is a “substance of suspicion,” but there’s no clear evidence it’s the one chemical that causes this disease.

The doctor who made an early link between the disease and the flavoring disagrees. “It is absolute baloney,” says Dr. Allen Parmet, a Kansas City public health physician. “The science is solid. ... For him to say that is a willful disregard of reality.”

Parmet thinks popcorn makers are “doing the right thing” by dropping diacetyl. “I just wish this had been done earlier,” he says. “There are hundreds of people who are sick and who are hurt and it never should have happened.”

'Pretty strange lung problems'
Seven years ago, an attorney approached Parmet with a mystery. He told Parmet he was representing several workers with “some pretty strange lung problems” and asked the doctor to review their medical records.

Image: Eric Peoples
Charlie Riedel  /  ASSOCIATED PRESS
Eric Peoples stands in front of the popcorn plant where he contracted a lung disease from exposure to butter flavoringin Jasper, Mo.
Within 20 minutes, Parmet says, he knew the problem was bronchiolitis obliterans, a devastating disease that destroys the small airways of the lungs, leaving victims coughing and gasping for air. The illness has been associated with jet fuel, strong acids, some viruses and rejections of lung transplants.

Parmet had seen it only three times in 25 years. Now he was poring over documents indicating several people had the disease — all employees of the Gilster-Mary Lee microwave popcorn plant in Jasper, Mo.

“It was ‘holy smokes!”’ he says. “I’ve got eight or nine cases here in a group of 200 people in a town of 1,000. Mentally, I’ve made this leap — that’s an epidemic.”

The National Institute for Occupational Safety and Health dispatched investigators to the plant. By 2001, it had reported a link between butter flavorings and the disease, which became known as popcorn lung.

Three years later, the agency sent an alert to 4,000 companies with about 150,000 workers explaining steps both sides should take as safety precautions. Among them: respirators, ventilation systems that prevent vapors from escaping and regular lung function tests for employees.

By then, Keith Campbell was already sick.

He says he was diagnosed with bronchiolitis obliterans in 2002, after working two years at a ConAgra microwave popcorn plant in Ohio.

Why, he wonders, did it take so long to do something about this?

“They’ve known for five years that something is wrong,” he says. “I don’t understand it. Once something is found out something is bad for you, instead of trying to control it, I think it should be banned. I don’t care if it’s butter flavoring or a nuclear power plant. Why mess around? ... Take responsibility.”

Campbell, who lost about 60 percent of his lung capacity, doesn’t blame the plant. He sued the flavor companies, winning an undisclosed settlement. But it’s a hollow victory.

“I got a new truck and new home, but I paid a high price for it,” he says.

“I can’t go deer hunting. I don’t get to play basketball. I can’t go out and run and play catch with my grandkids. If I dwelled on it, I’d be mad.”

So he putters around his house in Caledonia, Ohio, forcibly retired, trying not to wear himself out, even though sweeping a bedroom or changing a light bulb can do just that. And every time he drives by the popcorn plant, the powerful smell makes his chest ache.

“They tell me I’ve got the lungs of an 80-year-old,” he says. “If I was 80, I’d be pretty perky. But when you’re 50, it stinks.”

Mistaken for something else
Campbell, like others, wasn’t immediately diagnosed with the lung disease.

It’s often mistaken for asthma or emphysema, and though doctors have become more aware, they might not necessarily think exposure to a food additive is risky or ask many questions about a patient’s job, says Dr. Richard Kanwal, a NIOSH medical officer who has investigated the illness since 2001.

Once someone becomes sick, the disease can progress quickly.

“In months you can go from being a healthy person to hardly being able to breathe, coughing all the time, not being able to do your job,” Kanwal says. “It’s terrifying.”

Over the years, NIOSH investigators have identified or reviewed medical records of dozens of cases in microwave popcorn plants in Illinois, Iowa, Missouri, Nebraska and Ohio and flavor-making plants in California, Indiana, New Jersey, Maryland and Ohio.

There have been three reports of deaths among workers.

How many people are ill is unclear.

Kanwal says some cases may have gone undetected many years ago — a few go back to the 1980s — and he has heard reports of sick workers at candy and potato chip plants but has not yet been able to investigate them.

“There could be dozens or hundreds more that we’re not aware of,” he says. “It’s certainly possible.”

There are, however, hundreds of claims filling the court dockets.

Awaiting a trial
Missouri attorney Ken McClain has more than 500 lawsuits pending against the companies that produce or use the butter flavoring. About $50 million has been awarded in verdicts that were later settled for confidential amounts. Another 100 cases have been settled that reportedly involve tens of millions of dollars.

Gerardo Solis is among those waiting for a trial.

He says he was diagnosed last summer with the lung disease, 16 years after he started getting sick. In the past two decades, he worked at three Chicago-area flavor plants — one of which also handled microwave popcorn.

His illness progressed from wheezing to severe shortness of breath to coughing so hard, he’d pass out. Now 42, he’s trying to figure out how to pay for a lung transplant, meet his mortgage payments while living on Social Security disability and stay healthy enough to see his 4-year-old daughter grow up.

He tries to stay positive, he says, but sometimes even good intentions upset him, like when relatives paid for him to travel to Mexico to see family. “They treat me like I’ll be dying soon,” he says. “Every morning when I get up, I think I’ve got to do something so I can forget about how sick I am.”

“I should have looked for another job that wouldn’t have cost me my lungs,” he adds. “I feel so bad, sometimes I don’t know what to do, to tell the truth.”

As the civil lawsuits have increased, so, too, has the pressure on federal agencies by scientists, unions and some in Congress to do more to protect workers.

The Occupational Safety and Health Administration has been criticized by some researchers, unions and doctors who claim the agency has been lax, not ordering safety standards or increasing inspections at the many plants using diacetyl.

“OSHA has abdicated its responsibility,” says David Michaels, a professor of occupational and environmental health at the George Washington University School of Public Health who writes about diacetyl on his blog. “Their performance has been miserable.”

This spring, Foulke, assistant secretary of labor for OSHA, defended his agency, saying that after the 2001 report about the Missouri cases, it alerted its regional offices and ordered them to look into the issue. He also said the OSHA region that included many popcorn plants produced a brochure.

“Sending out a brochure is not enough when you’ve got a disease that’s destroying people’s lungs,” Michaels says.

OSHA has stepped up its activity on diacetyl since April. It says it will inspect all popcorn plants by end of 2007; it has issued a safety bulletin on how to protect workers and an advisory on how to communicate the hazards of diacetyl to those who buy it.

For Michaels, it’s too little, too late.

Why, he says, weren’t these plants inspected earlier, and why hasn’t there been more attention on workers who produce flavorings who’ve become ill?

“It would have been better,” he says, “to be safe than sorry.”

Popcorn lung debate
After years of studies, lobbying and lawsuits, the popcorn lung debate reached the floor of Congress this fall.

In September, the U.S. House of Representatives ordered federal safety regulators to compel microwave popcorn factories and other plants to limit exposure to diacetyl. The bill is supported by the Flavor and Extract Manufacturers Association.

Whether that measure will become law is unclear. Opponents — including the White House — say this step is premature and misguided. They also believe that focusing on diacetyl alone ignores the possibility other flavorings are involved in the lung disease.

Foulke, the OSHA official, recently denied a labor petition asking for an emergency workplace limit on the chemical, saying there isn’t conclusive proof it causes the illness or that exposures “constitute a grave danger.”

He also noted that four major companies are changing their recipes to eliminate diacetyl. ConAgra — the largest microwave popcorn maker in the nation — said it wanted to “provide the safest possible environment for workers.”

All this won’t help Eric Peoples.

He starts each day with 12 pills, then it’s 30 minutes on the treadmill — walking slowly. He tries not to become too frustrated by his limitations. He tries not to worry about the future.

“I played by the rules and I did what I was supposed to do,” he says. “It darned nearly cost me my life.”

“This is a pain to live the way I am,” he adds. “But there’s always somebody worse than I am. And every morning, I keep telling myself, it’s one more day this thing hasn’t beaten me.”

© 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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