Occupational airway diseases such as occupational asthma, bronchitis, reactive airways dysfunction syndrome and byssinosis are common workplace diseases. The involvement of the small airways, such as the bronchioles are infrequently reported in occupational airway disease, but these may lead to serious chronic lung injury.
One such disease of the bronchioles is bronchiolitis obliterans. This disease is initiated by damage to the epithelium of the small conducting airways and progresses to inflammation of the airways, frequently to the adjacent alveolar tissue as well. The clinical consequence of this injury and inflammation is irreversible airway obstruction.
Exposure to an agent during diacetyl production appears to be responsible for causing bronchiolitis obliterans syndrome in chemical process operators, consistent with the suspected role of diacetyl in downstream food production.
This first came to public attention when eight former employees of the Gilster-Mary Lee popcorn plant in Jasper, Missouri, developed bronchiolitis obliterans. In 2000, the Missouri Department of Health called in NIOSH to make a determination of the cause, and to recommend safety measures. After surveying the plant and each patient's medical history, NIOSH recommended respiratory protection for all workers in microwave popcorn production. Due to this event, bronchiolitis obliterans began to be referred to in the popular media as "Popcorn Lung" or "Popcorn Workers Lung".