The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

IV.c

Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx)

Notably diacetyl, a butter flavoring agent used in the food industry

Publications

Cavalcanti Zdo R, Albuquerque Filho AP, Pereira CA, Coletta EN

Bronchiolitis associated with exposure to artificial butter flavoring in workers at a cookie factory in Brazil.

Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia. 2012;38(3):395-9

Kreiss K, Hubbs A

Letter to the editor: RE: Galbraith D and Weill D (2009), popcorn lung and bronchiolitis obliterans: a critical appraisal 82:407-416.

International archives of occupational and environmental health. 2010;83(4):467-9

Kreiss K

Occupational bronchiolitis obliterans masquerading as COPD.

American journal of respiratory and critical care medicine. 2007;176(5):427-9

van Rooy FG, Rooyackers JM, Prokop M, Houba R, Smit LA, Heederik DJ

Bronchiolitis obliterans syndrome in chemical workers producing diacetyl for food flavorings.

American journal of respiratory and critical care medicine. 2007;176(5):498-504

Kreiss K, Gomaa A, Kullman G, Fedan K, Simoes EJ, Enright PL

Clinical bronchiolitis obliterans in workers at a microwave-popcorn plant.

The New England journal of medicine. 2002;347(5):330-8