Popcorn Lung (a.k.a. Bronchiolitis Obliterans) reportedly causes coughing and wheezing, shortness of breath, and in some extreme cases, may even require the patient getting a lung transplant. Researchers detected that the chemical components of 39 out of the 51 flavoring fluids used for vaping contained diacetyl– one of the causes of Popcorn Lung. So what does this mean for vapers? Read on to find out.
What Is Popcorn Lung And Its Causes?
In a microwave popcorn factory in Missouri, many cases of bronchiolitis obliterans were reported in the year 2004 by the US Center for Disease Control and Prevention (CDC). Bronchiolitis Obliterans is a severe and irreversible disease in which tiny air sacs present in lungs, become damaged. After further investigation, the National Institute of Occupation Safety and Health- NIOSH, discovered that Diacetyl, a flavoring agent, was being commonly used to give popcorn its buttery taste. While consumption of this flavoring agent was not harmful, inhaling it was claimed to be a likely contributing factor towards the development of Popcorn lungs.
More recently, a study carried out by researchers at the Harvard School of Public Health discovered that a lot of juices used in e-cigarettes for vaping contain Diacetyl. This lead to the theory that inhalation of vapor that contains this chemical agent is dangerous for health. It is usually associated with symptoms like shortness of breath, coughing, which are the exact ailments of people diagnosed with Chronic Obstructive Pulmonary Disease (COPD). Currently, this disease is irreversible.
Why is this Condition Called Popcorn Lung?
Between 1992 and 2000, CDC found at least eight cases of an irreversible lung disease in workers of Gilster-Mary Lee Corp., a southwest Missouri based popcorn factory. Diacetyl, a buttery flavor food chemical used in popcorn was found to be the culprit for causing Bronchiolitis Obliterans. The disease has the slang name of popcorn lung because of its association with the popcorn factory. The company ended up paying millions in lawsuits, and the of use diacetyl has been removed from food since.
What is Diacetyl?
Diacetyl is a chemical compound with formula (CH3CO)2. We find this food chemical in beans, butter, honey, dairy, coffee, fruits, apples, vinegar, and artichokes. In concentrated form, it becomes a yellow/green liquid and has rich buttery flavor. It is also called diketone, used as a flavoring agent, and classified safe to ingest. However, many health professionals claim it is not safe to inhale. When it is heated under high pressure – for instance as in the case of Gilster-Mary Lee Corp., where workers would heat it up in microwave – it is believed to cause respiratory illnesses like shortness of breath.
Smoking and Popcorn Lung
As cigarettes contain diacetyl, it makes sense to be concerned if you’re a smoker. A study named “Determination of toxic carbonyl compounds in cigarette smoke” was published in 2006 that claimed that one cigarette could contain more than 400 micrograms of diacetyl, that is equivalent of 30 cartridges of e-liquid. Popcorn lung has never been diagnosed in smokers – or at least not because of smoking. People who work in the factories and inhale it directly are the only ones diagnosed with it.
That means diacetyl present in cigarettes does not cause popcorn lung, right? May be, but we are not completely certain about it as more research is required.
What is Batch Testing of E-Liquids?
Batch testing of e-liquids detected quantities of potentially risky chemicals like nicotine, diacetyl and acetyl propionyl in different batches of e-liquid bottles. These tests performed by accredited laboratories use scientifically verified procedures and analytical detection limits to test the presence of harmful chemicals. As different flavors are formulated having varying ingredients, detection and quantification complications arise. Furthermore, they use state of the art instruments for testing, which are expensive themselves.
Another problem with batch testing is that the standards of safe vaping of diacetyl have not been determined yet. We do not know what the dangerous amount to inhale is or how the results of the test can be related to inhaling. If you are a concerned vapor looking for an e-liquid that is diacetyl free, then it is easy to find one. There are even brands today that have displayed the testing results on their websites.
COPD and its Similarities to Popcorn Lung
COPD or Chronic Obstructive Pulmonary Disease has similar symptoms as popcorn lung. COPD is a disease that makes breathing difficult, but it develops over time. To understand the similarities we first have to know what causes the diseases.
Let’s talk about COPD first. The air goes through the windpipe into the lungs via two large tubes. Then the tubes are divided further into tree-like branches of smaller tubes ending in clusters of tiny air sacs. These air sacs contain thin walls having tiny blood vessels. As you inhale, it passes oxygen into the blood vessels, and it enters the bloodstream. As we all know, we then exhale carbon dioxide as a result. The human lungs rely on the elasticity of the tubes and air sacs for forcing out air from the body. If you have COPD, they lose their elasticity and over-expand. Because of this, some air is left trapped in the lungs even while you exhale.
Now let’s see how it develops into popcorn lung. When a person inhales diacetyl, the tiny air sacs in their lungs become scarred, and they then thicken and narrow the airways. Although popcorn lung (also known as it causes bronchiolitis obliterans) does not sound dangerous, it is. It causes shortness of breath, wheezing and coughing.
Common symptoms of COPD include increased breathlessness even when you wake up at night, persistent cough, chest infection and wheezing. These symptoms are so similar to popcorn lung that often patients who have popcorn lung are misdiagnosed with COPD. The diagnosis for popcorn lungs and COPD both requires a risky invasive procedure called lung biopsy. The procedure involves opening the chest of the patient to learn about the medical condition which caused the symptoms. As accurate diagnosis is difficult, there is no real benefit of performing this procedure.
Does Vaping Cause Popcorn Lungs?
So as it turned out, it is not only microwave popcorn that uses diacetyl as a dangerous chemical flavoring. In 2015, the Environmental Health Perspectives published a journal that studied harmful chemicals linked to “Popcorn Lung”. This study also listed different types of e-cigarettes as items that contain Diacetyl, especially those that are flavored like candy and fruit, targeting young smokers.
An article on this study was published in The Independent, detailing the sampling and testing processes. 51 flavored e-cigarettes were tested, out of which 47 contained flavoring chemicals including diacetyl, more specifically in large amounts in 30 samples. It only makes sense that exposure to such dangerous chemicals through e-cigarettes or vaporizers can potentially lead to severe lung damage.
There are several vaping liquid brands and manufacturers that still use the chemical Diacetyl in their products, while others have either realized that it is hurting business, or turned it into a marketing strategy by branding their items as diacetyl-free. Some companies go to the extent of paying for chemical analysis of the products they offer, and in turn use the results for promotion and advertising purposes to health conscious people.
Of course, sometimes it is just a gimmick. We must warn you that it was reported in the news that two manufacturers were selling their products by labeling them as diacetyl-free, were using the chemical after an analysis of their products. Either way, despite the potential health hazards linked to vaping, many cigarette smokers still perceive vaping as a healthier alternative, believing it to be the lesser evil among the two.
To debunk all these reports and researches, some people- which include some prominent reputable figures, claim that the fact that e-cigarettes contain diacetyl was well-known even before the study was published. They also state that e-cigarettes don’t have any more diacetyl than normal cigarettes, and so far, research had failed to deem cigarettes as a cause of Popcorn Lung disease.
The main counter-argument remains that the presence of diacetyl in certain levels was hardly a secret, even before the 2015 research study.
Side arguments say that the research from Harvard excluded comparison to a larger and more influential group of smokers when formulating these concerns about popcorn lung, e-cigarettes, and diacetyl.
The final argument is that a research conducted on tobacco cigarettes determined that it is not a cause or risk factor for popcorn lung, despite containing higher traces of diacetyl. Seeing as how e-cigarettes contain a tiny concentration of diacetyl, their juice cannot possibly be linked as a cause of popcorn lung.
The Bottom Line
The Public Health England said in August that e-cigarettes are estimated 95 percent healthier than tobacco cigarettes, and help smokers quit smoking tobacco as well. A Government agency also noted that there is no hard evidence to support the fact that vaping specifically leads to popcorn lung disease. However, long-term effects of e-cigarettes are still under research.
For now, an easy solution that can be implemented is to common-sense and moderate legislation to stop the use of diacetyl and other similar harmful chemicals in vape juices. Another suggestion is time-consuming; conduct more research on vaping and create a standardized way to test it for any dangerous chemical agents. This alternative is robust, but some vaping companies such as the Five Pawns have been advocating for this and implementing it by paying for studies to be conducted on their products.
Till then, until the vaping industry has more transparency and evidence, activists, advocates and bloggers are constantly reminding the smoker community that vaping is overall, a much healthier option than cigarettes.