When we put it in all caps and bold the words, popcorn lung seems extra scary, but you might be wondering if a condition called popcorn lung is a real worry or just a bunch of fearmongering hype. Like most answers in life, it isn’t one or the other, but something in-between; a real disease such as lung cancer with very scary implications like lung transplants, that could possibly be a hazard for people who vape.
Could possibly be?
I know, not very definitive, but that is the answer, as in based on science yes it is possible, but right now we don’t have any documented cases of a vaping and popcorn lung link. Also, it can be hard to even document cases because the disease acts like other much more common diseases of the lung and it is hard to test for.
What is popcorn lung?
In simple terms it is a disease where the tiny air sacs in the lungs that fill with air and oxygenate the blood get damaged. This means people with popcorn lung have shortness of breath, blue tinged fingers, wheezing, crackling, and fatigue. It sounds a lot like our last battle with a really bad flu, minus the fever, but these symptoms never get better. The official name of the disease is Bronchiolitis Obliterans, but the first cases of the disease were traced back to popcorn factories earning it the much more popular and memorable name of Popcorn Lung.
I know we bolded the words again, but it is like the slimy green thing from the swamp depths and seems to deserve the scary treatment, and it is a scary disease. Currently the damage caused by Bronchiolitis Obliterans cannot be reversed, only managed and one of the better treatment options is a lung transplant.
Currently popcorn lung can only be detected with a biopsy of the lung tissues as chest x-rays are not sufficient. I know we are all waiting for the day when machines will be able instantly give us diagnoses, but our technology hasn’t caught up with Star Trek yet, which means there could be a lot of cases of Bronchiolitis Obliterans that go undiagnosed. The one okay thing about a misdiagnosis is the treatment for chronic obstructive pulmonary disease (COPD) seems to work for Bronchiolitis Obliterans. So even if a patient really has Bronchiolitis Obliterans, but has been diagnosed as having COPD, they will still respond to the treatment and will still get the best outcome current medicine can give them.
Right now a doctor would probably only suspect popcorn lung when presented with someone who worked in a factory that made flavorings using one of two chemicals; diacetyl or acetyl propionyl. Another factor in the possible low profile of Bronchiolitis Obliterans is that it is a fairly new when it comes to disease diagnosis and treatment, which means that many doctors aren’t familiar with and therefore can’t give medical advice. The first cases came to light as occupational safety investigations in 2002 with 8 cases in a popcorn plant in Missouri.
This makes it a low profile disease and with expensive biopsy procedures or autopsies as the only way to diagnose, we will probably never know if Bronchiolitis Obliterans is a more widespread problem or a rare disease left to the musings of researchers in the form of hypothesis.
What is Diacetyl?
Diacetyl is the flavoring agent that used to make popcorn taste buttery. I say ‘used to’ be because popcorn manufactures don’t use it anymore. For a more scientific explanation, diacetyl or 2,3-butanedione is a, okay never mind, if you want the whole science thing, check out Wikipedia because it spells it all out in a Bill Nye the science guy way that we can’t. The big thing to know is this nonharmful chemical and a few cousins are used to flavor food and are perfectly safe to eat, but not to breathe in. We had that same sinking feeling you just had when we put it together too, inhaling it is bad, and this is an article on a Vaping website, so does that mean that this flavoring is used in vaping liquids. The short answer is yes, but that doesn’t mean those e-liquids have given anyone popcorn lung.
Does Vaping Cause Popcorn Lung?
The best answer we could find from all of the journals and scientific reports we read is probably not. That’s not very comforting, so let’s break it down. In order to get popcorn lung you have to breathe in a lot of the chemicals that cause it and those quantities are more than people get exposed to when vaping. To put in context, Cigarettes have a lot of the popcorn lung chemicals, but doctors don’t check for Bronchiolitis Obliterans.
Even in the factories where diacetyl was used and there were confirmed Bronchiolitis Obliterans cases, the CDC ruled out smoking as the cause. Cigarettes contain significantly more diacetyl than vaping liquids, to like the power of 100 times more. Even with all of the cigarette research and lawsuits, there has been no link between smoking and the disease. In theory there could be some cases in smokers that were misdiagnosed as COPD, which is very common in long term smokers, but the science just doesn’t support a link between smoking tobacco cigarettes and popcorn lung. Vaping is considered safer than smoking and has fewer of these harmful chemicals so most likely there isn’t a link between popcorn lung and vaping either.
Another fact that makes us breathe easier when we vape is that for those exposed to the high levels of inhaled diacetyl in factories, the symptoms showed up fairly quickly, in about two years. With more than a decade of vaping and no surge in mystery lung diseases, it seems a safe bet to say it is unlikely that people who vape are developing this lung disease from exposures to diacetyl.
Just to be safe can I avoid the bad chemicals in my vaping liquid?
When the vaping industry was small and young, there weren’t a lot of flavoring options available and most of the ones on the market for manufactures were designed for food. The creators of these flavoring chemicals didn’t expect people to be inhaling them so they never put any warnings or caveats on the products that contained diacetyl or one of its cousins. That has changed and every day new products are being developed for the vaping industry. These new products are designed to be safe for inhalation.
You will still find products on the market with the popcorn lung chemical flavorings, unfortunately it is both difficult and expensive to test for these chemicals so even if a manufacturer is using chemicals they believe to be free of the bad stuff, it is prohibitively expensive to double check. There are manufacturers that are checking and publishing the results for their products, but even when they do that, they usually are not batch testing e-liquids, so a formula that was safe could become unsafe.
Manufacturers constantly reformulate products and there is a problem with cross contamination at factories that make multiple flavoring products, so a product intended to be diacetyl free could end up with some small amounts of the substance. Because of all the moving parts even industry insiders expect some of these chemicals are making their way into vape juice products even when the manufacturer is making an effort to keep them out.
Just don’t get any vaping liquids with buttery flavors, problem solved right?
We would be doing a happy dance if it were that easy, but since these chemicals are also great for enhancing sweet and savory flavors; we can’t just eliminate a flavor and be done with it. It isn’t like Red Dye 40 where if you avoid all foods that use any red dye you know you are safe from it. We would love it to be that simple, but it isn’t at least not today. The industry hasn’t given up and keeps working to make products that are safer for vapers.
Woot! The industry is solving the problem. I can go back to my regularly scheduled life and never think about this again, right?
You know we are going to tell you wrong, and we also know you want to know why. No industry is perfect. With the vaping industry, because vaping is so much safer than smoking, some people feel they can take shortcuts. We now have doctors advising smokers to switch to e-cigarettes and vaping not just as a smoking cessation tool, but because it has been shown to be so much safer than smoking, so if people are going to have a vice, doctors prefer vaping over smoking.
That has made some manufacturers think they have the green light because safer is good enough. This is a capitalistic society, so there are going to be those companies who take the easy, profitable route even if there is a safer route because they are safe enough. That said vaping has a unique community that tends to be more grassroots and more willing to take their dollars away from companies that show they don’t care about people.
What this involvement in the products vapers use by the consumers is pushing more companies to actively eliminate chemicals known to be harmful and work on making a product that is has a higher level of safety than “safer than cigarettes.”
So what can I do?
You have already done the first big thing by reading this article and getting educated. The next thing to do is be a conscientious customer and ask for products from companies that are actively avoiding the ingredients known to cause Bronchiolitis Obliterans. In fact look for companies that are actively making all vaping products as safe as they can be. Remember, we are not the tobacco industry that denied the possibility of having cancer-causing ingredients long after multiple studies made the deadly link with lung cancer.
Instead, we are an industry with a vaping community that is talking about these concerns when they are just maybe possibilities, and that is a huge difference. With the vaping industry being so young, consumers have the ability to play a big role in how the industry treats consumer safety. We expect that the impact consumers have on the industry will be positive and make it, so these products set the standard for safety and responsibility in the marketplace.