Popcorn Lung – Will Diacetyl in Vaping Lead to This Disease

Popcorn Lung
Have you ever heard of Popcorn Lung? While it comes off as rather tasty, it is, unfortunately, an incurable lung condition. Frequently known as BO, this condition is scientifically known as bronchiolitis obliterans.

The most common noteworthy case of this condition dates back more than a decade back where microwave popcorn factory employees feel ill due to continued inhalation of a then-popular ”buttery flavor’ component Diacetyl.

In consequence, major popcorn makers excluded diacetyl from their main products, although various individuals are still under exposure to this kind of chemical, in more ways than just a typical worksite occurrence such as through inhaling poisonous other fumes. On the inhalation, this compound results in the condition referred to as Popcorn Lung.  

What Is Popcorn Lung?

Popcorn lung represents a rather rare condition which is primarily marked by the smallest lung airways getting damaged. It is a result of bronchioles getting scarred, effectively reducing their efficiency and capacity as well. Unfortunately, its only cure is getting a lung transplant.

Several environmental and medical provisions can also cause this condition. Typically, fungal, viral, and bacterial infections can lead to the damage and inflammation of the bronchioles. Also, it can result from inhaling other chemical particles.

What Is Popcorn Lung

Does Vaping Lead to Popcorn Lung?

With vaping gadgets (either vape mods or even vape pens), these gadgets heat volatile liquid content inside a cartridge that a user subsequently inhales from the gadget. In essence, as opposed to burning tobacco, vapes merely turns a clear liquid into vapor form hence the name vaping.

Referring to a report by the AMA (American Lung Association), vaping, or the use of electronic cigarettes, especially the various flavored brands, can stimulate popcorn lung condition. 

After discoveries were made concerning the potentially harmful effects of diacetyl back in the 2000s, many of the significant popcorn manufacturers abolished the use of this chemical. Nonetheless, it is a known fact that vapor form e-cigars contains a small diacetyl content.

Later in 2016, research on e-cigarettes identified that a majority of tested e-cigarette brands (39/51 to be precise) contained the chemical substance diacetyl. In addition, this research also outlined that many of these brands contained other toxic chemicals, such as 2,3 pentanedione and acetoin. 

Usually, the manufacturers add the chemical to the “e-juice”, and in particular the strongly-flavored brands. In essence, diacetyl is found in multiple flavored e-cigarettes items that range from caramel, coconut, and vanilla. 

Does vaping cause popcorn lung

But Is It Real That Vaping Will Lead to Popcorn Lung?

Interestingly, it is only in 2018 that e-cigarettes made their way under the FDA (Food and Drug Administration). Ultimately, there is a need to alter the regulations over the coming years with more and more researches being carried out.

While popcorn lung is commonly associated with vaping, no actual research has confirmed that until today. Typically, although vaping products MIGHT contain diacetyl (which is linked to popcorn lung), vaping has not been proved to cause popcorn lung. 

Cigarettes have a significantly high content of diacetyl compared to vaping products. Nevertheless, there is yet a report indicating that cigarette smoking results in popcorn lung.

The only smokers reported having contracted the ailment were all employees in a popcorn factory. That is to say; there’s simply no evidence that vaping causes popcorn lung. 

What Is Diacetyl?

Diacetyl, commonly used as an additive in microwave popcorn, is the compound most associated with a popcorn lung condition. Typically, it is a naturally-occurring organic compound mainly in fermented products such as the cultured-milk products and alcoholic drinks. Also, it is present in various fruits as well as in tobacco.

This compound usually finds use in flavoring processed foods primarily due to its sweetening capacity and buttery taste. 

Surprisingly, when ingested, diacetyl is not harmful. This is evidenced by the various research studies carried out by the FDA, which identifies it as ”safe” for human consumption. However, when inhaled (in high quantities), it can result in irreversible damage to the lungs. 

Presence of Diacetyl in Vapes

In essence, e-liquid can contain diacetyl. However, it is not a sure thing, although various products in the market have been proven to have considerable amounts of it. Usually, the diacetyl can come from the flavorings utilized in their production. This is generally common in e-juices that have a buttery flavor such as sweet desserts and the custards. Diacetyl is also present in the tobacco flavors.

Several pieces of research that were published in 2015 sought to identify whether the available e-liquids contained any diacetyl. The results outlined that a significant portion of the tested e-liquid flavors had small diacetyl content. The little notion that vaping could result in popcorn cancer emanated from these distinct research studies. 

Nonetheless, this research study, unfortunately, did not evaluate or assess whether there is an association between the occurrence of popcorn lung condition and vaping. However, until now, there is no conclusive evidence pinpointing that e-cigarettes can result in popcorn lung disease. 

In some countries such as the UK, the regulation bodies banned the use of diacetyl in e-cigarettes in 2016 courtesy of distinct Tobacco Products Directive (TPD) as provided for by the EU. As such, every e-liquid that is available on the UK market should not contain any traces of diacetyl.

The latest studies outline that compared to standard cigarette smoking, vaping is relatively less harmful and there is even increased evidence citing that they may actually assist some individuals ultimately quit. 

Presence of Diacetyl in Vapes

Symptoms of Popcorn Lung

Despite being an incredibly rare condition, popcorn lung has similar symptoms as those associated with the common cold. Additionally, these symptoms also resemble those associated with COPD (Chronic Obtrusive Pulmonary Disease).

Typically, the symptoms of this condition may subsequently develop over a period ranging from weeks to a few months and may often occur habitually. Unlike asthma, these symptoms are not episodic. And they include:  

  • Breath shortness
  • Fatigue
  • Dry cough
  • Wheezing especially when an individual has no asthma or cold
  • Limited activity tolerance

 Many of these symptoms don’t usually come immediately once the popcorn lung condition develops. Often, these symptoms take between two weeks or even two months before popcorn cancer begins to manifest after being exposed to toxic gas and fumes.

Adverse popcorn lung cases can lead to significant mucosal surface inflammation inclusive of the nose, throat, as well as eyes not to mention skin inflammation. 

Causes of Popcorn Lung

In essence, some various factors and compounds can lead to a popcorn lung condition. Usually, the primary cause known is the inhalation of chemical compounds. Some of the popular cases are caused by fumes produced in the production of various products such as potato chips, candies, and different dairy products.

In addition, chemical damage to lung tissues and hereditary conditions also make up this list. 

Although diacetyl is most associated with popcorn lung, inhaling other chemicals can also result in the condition. Some of the other compounds include:

  • Chlorine and ammonia from cleaning agents and industrial chemicals
  • Nitrous oxide/laughing gas
  • Welding fumes

Finally, during transplant surgeries, the body can reject the transplantation, a condition known as a graft-verse-host condition. Typically, this occurrence can also result in popcorn lung. 

Diagnoses of Popcorn Lung

Diagnosis of Popcorn Lung
Essentially, while standard pulmonary function and CT scan tests can indicate its presence, popcorn lung is best diagnosed through a process called surgical lung biopsy. This procedure known as the lung tissue biopsy that usually mandates for an open lung procedure (surgical) is essential in confirming a diagnosis of the condition bronchiolitis obliterans.

Typically, popcorn lung may be randomly located in distinct lung tissue rendering it challenging to perform an accurate diagnosis. 

With this form of biopsy, general anesthesia might usually be necessary. The surgeon will often create an incision directly on the chest, to extract lung tissue piece. 

On suspecting the condition, doctors perform a full medical test and review the patient’s medical history to identify possible causes. In consequence, they perform various diagnostic tests, including:

  • Bronchoscopy: the process of looking inside the person’s airways
  • Pulmonary function tests (PFT): these are breathing tests to monitor and assess symptom progress
  • Computer tomography (CT): chest scans for comprehensive airway and lung images 
  • Biopsy: extracting a small portion of the lung tissue affected for further evaluation
  • Chest X-rays: supplementary test

Treatment of Popcorn Lung

As aforementioned, popcorn lung has no cure, although treatment is used to inhibit the condition from progressing. If CDC reports are anything to go by, most persons exhibit little or virtually no response to standard medication and treatment designed to alleviate popcorn lung condition.

Nonetheless, if an individual is ultimately diagnosed early and the subsequent exposure to various toxic chemicals are halted, it is expected that the individual will experience discontinuation or reduction of the symptoms like a typical chronic cough. 

Usually, antibiotics, corticosteroids, and immunosuppressants are used to treat the condition, although the efficiency depends on the initial cause. What’s more, oxygen or use of cough syrups can help further manage its symptoms; although if the condition is severe, a lung transplant is the only option. Another option is steroid prescriptions. 

Available popcorn lung treatment options include: 

  • Steroids/corticosteroids: reduce inflammation
  • Singulair (montelukast): medication to inhibit inflammation
  • Macrolide antibiotics: treat bacterial infections 
  • Immuno-suppressants: minimize inflammation and immune system activity
  • Lung transplant

If this condition is left unattended to or untreated, it can usually be lethal in several instances. With this in mind, you must consult with your physician if you are subsequently exhibiting symptoms associated with the condition or you have had exposure to toxic chemicals. This way, not only can you get the necessary and proper medication or subsequently refer you to specialists for the best treatment plan.

How to Prevent Popcorn Lung Disease

Although popcorn lung is incurable, it is, however, well preventable. The most effective way to ensure this is altogether avoiding any lung damage, as well as any components known to result in the condition or stimulate it. Nonetheless, besides this, there are several other approaches and precautions you can apply, including:

  • Abstaining from the use of any tobacco-related, e-cigar, and vaping products (especially flavored brands)
  • Refraining from settings that expose the body to inhalation of toxins or chemicals like welding sites
  • Proper monitoring of subsequent organ transplant symptoms, particularly bone marrow, stem cell, or lung transplants. 
  • Use of proper gear such as face masks when one is visiting areas that are exposed to harmful toxins or chemicals. 

How to Prevent Popcorn Lung Disease

Bottom Line

Typically, the long-term stance with numerous reported cases of popcorn lung patients is that the severity, cause, and progression of the condition are dependent on the distinct type of popcorn lung disease in question. Owing to the complexity of diagnosis, and the diversity of the forms of popcorn lung condition, it is essential to consult a physician to ensure the proper diagnosis and treatment administration.

Luckily, despite being irreversible, the symptoms of this condition are quite effectively manageable with the correct kind of treatment. Nonetheless, as they say, prevention is better than cure, and what a better way to do this is reducing or even utterly avoiding exposure to the various harmful chemicals and toxins or better yet, quit smoking. 

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