A new alert has been raised concerning the condition known as ‘popcorn lung,’ a lung disease that has been historically associated with vaping.
The disease, called bronchiolitis obliterans in medical terms, gets its evocative name because it is often linked to chemical exposures, such as diacetyl found in microwave popcorn. This condition leads to inflammation and scarring of the lungs, resulting in permanently narrowed airways, a persistent cough, and difficulty breathing.
Vaping and e-cigarettes have been linked to this issue due to the presence of certain chemicals, including diacetyl, within them.
But is there a direct connection between vaping and popcorn lung?
Cancer Research notes that in 2000, a group of popcorn factory workers in the United States developed symptoms of this lung condition, leading to the nickname ‘popcorn lung.’
The Centers for Disease Control and Prevention (CDC) identified eight cases of lung disease among workers at a Missouri factory from 1992 to 2000. The investigation found that those most affected had spent significant time mixing the flavoring chemical diacetyl with hot oil.
“Diacetyl was a flavouring in the popcorn, and so the workers breathed it in,” the charity explains. “It was not related to the use of e-cigarettes.”
In reality, the charity reports that there have been ‘no confirmed cases of popcorn lung linked to e-cigarettes.’ However, it is acknowledged that some vaping devices contain liquids with diacetyl.
In 2016, the UK prohibited the use of diacetyl in e-cigarettes and e-liquids under the EU Tobacco Products Directive (TPD); meanwhile, in the US, according to Vaping360.com, it remains present in some e-liquids.
“The source of diacetyl and AP in e-liquids is the flavorings used to make them,” explains the site. “The most obvious ones are e-juices with buttery flavors, like custards and other sweet desserts. But some candy- and fruit-flavored e-liquids and even tobacco flavors can also contain diketones like diacetyl.”
Research on vaping suggests it is not a primary cause of popcorn lung, with studies showing cigarette smoke contains ‘at least 100 times as much diacetyl as the highest levels in any vaping product.’ Notably, smoking cigarettes is not directly linked to popcorn lung.
There are other triggers for popcorn lung, such as certain injuries, infections, or complications from lung or stem cell transplants.
Donal O’Shea, a Professor of Chemistry at RCSI University of Medicine and Health Sciences, noted in an article in The Conversation that the disease remains serious as there is ‘no cure’ for those diagnosed.
“Once the lungs are damaged, treatment is limited to managing symptoms,” he said.
“This can include bronchodilators, steroids, and in extreme cases, lung transplantation. For this reason, prevention – not treatment – is the best and only defence.”