• Sean Mills

Popcorn Lung


Hidden danger or sensational story?

You’ve likely seen some scary new stories about the risks of vaping and popcorn lung.” As I Google “vaping” right now, I see a story published yesterday at the top of the page connecting the two.

Charlotte Vapes commits to our customers. We want you to have all the relevant information so you can make your own decisions. I’ve added my own editorial, but I will attempt to be as unbiased as possible until that clearly marked point.

Popcorn lung, or obliterative bronchiolitis (OB), is a lung condition that obstructs the bronchioles. Bronchioles are the smallest, deepest airways in your lungs. Treatment can slow the progression, but it is not reversible. Because it is a permanent impairment, the disease is quite serious.

Why “popcorn” lung?

“Popcorn lung” first came to the public attention in 2000. Papers coined the term for sick workers at the Gilbert-Mary Lee popcorn plant. The Jackson, MI factory was the workplace of eight people that contracted the disease there.

Investigators tied their illness to a chemical called diacetyl. Workers who handled diacetyl at the factory got sick at a much higher rate than other areas. Researchers observed the same effects in a study with acetyl propionyl (2,3-pentanedione). Because diacetyl and acetyl propionyl are so similar, they’re commonly referred to as DAP.

The National Institute of Safety and Health (NIOSH) now deems DAP an environmental hazard. Because of the public attention and fear, popcorn companies reformulated butter flavors. They turned to alternatives that replaced it in the popcorn you have at home.


What does popcorn lung do?

OB causes those tiny bronchiole airways from earlier to scar and close your lungs. This prevents the lungs from filling with air efficiently. It progresses until patients need cough suppressants, medications to open airways, or oxygen.


The end treatment is a transplant, thought the disease may redevelop as a result. If left untreated, it can be fatal – as you may have heard, you need good lungs. Here are some of the symptoms a person suffering this illness would experience:


  • Dry cough

  • Shortness of breath

  • Difficulty breathing

  • Wheezing

  • Fatigue

  • Throat, eye, mouth, or nose irritation.

How do you get it?

The biggest risk factor for the disease is workplace exposure. Obliterative bronchiolitis is a rare illness found in workers in specialty fields. Industries include welding, glue and building manufacture, fossil fuels, and the military. These are results of inhaling carcinogens, acids, metal oxides, and cleaners like ammonia. It’s also found in many patients who have received lung transplants.

Despite the factory incident, FDA generally regards both chemicals as safe for consumption. In your everyday life there is no reason to worry. If you can believe it, it’s in actual butter. It’s also in cocoa-flavored products, frostings, and many other everyday products. If DAP is an occupational risk factor for you, someone was required to tell you so as part of your job.

Can you get it from vaping? More on that below.


What does this have to do with vaping?

Some crowd favorites through the years included buttery, creamy flavors. Reports showed that the liquids contained trace amounts of diacetyl and/or acetyl propionyl. News outlets picked up the story with gusto in 2015 with rumors that several bestsellers contained trace amounts. Those outdated stories still make their rounds today.

There was overwhelming pushback from consumers concerned for their health. Almost all manufacturers quickly released public statements to reassure their customers. Companies said they were testing and reformulating where necessary to remove DAP from their e-liquids. This was a similar response to that given by popcorn factories to similar protest in the 2000s.

How much risk is there?

Laboratories tested over 200 e-liquids to confirm rumors. A few dozen reported up to 200 parts per million. NIOSH recommendations for workplace air are all listed as less than one part per billion.

This sounds like even small amounts are dangerous, and it’s helpful to quantify exposure. Studies have compared inhaled amounts of diacetyl from e-cigs using tobacco cigarettes as a standard. The comparisons are staggering.

Average inhaled daily diacetyl dose associated with smoking vs. vaping

Vaping: 9 micrograms

Smoking: 6718 micrograms

Maximum inhaled daily diacetyl dose associated with smoking vs. vaping

Vaping: 239 micrograms

Smoking: 20340 micrograms (see Pierce et al., 2014)


If you do the math, you’ll find that at most, vapers inhale about 1.2% as much diacetyl as smokers. On average, it’s 0.13%. Tobacco smoke also had 750 times higher diacetyl on average than e-cigarette vapor.


Even though smokers inhale more than 700 times as much diacetyl, we have never seen a case tied to smoking. Similarly, we’ve never seen a case of vaping causing obliterative bronchiolitis.


Editorial

Told you it would be early marked. We have been presented with no cases of popcorn lung caused by vaping explicitly. Where we’ve seen hazards of popcorn lung, they’re tied to the air you breathe at work over years. This is stark contrast to the 1-2 second pulls a few dozen times a day a vaper takes.


It would be fair to urge caution on this issue if we had at least one case of a smoker contracting the illness. The exposure is similar in duration and style, and both involve heat. We have a longer data set with smokers, and they’re inhaling as much in a day as a vaper does in a year. If there were inherent risks, we should see them in smokers.


If I saw a long-time vaper that worked in a bank get popcorn lung, I would re-evaluate my reasoning. Almost no manufacturer uses ingredients that contain DAP now. Minimal amounts when inhaled don’t seem to cause it in smokers. For those reasons, I’m not asking a vendor for lab reports on each batch number.


It’s fine if you disagree with me; let’s continue the conversation! Message us on Facebook or email me at sean@charlottevapes.com. I look forward to the productive discussion and I’m always open to updating this post.


Don’t be that guy.

My boss says I must tell you, “not to take medical advice from me, a stranger on the internet. While I slept at a Holiday Inn last night, I am not in fact a doctor. Talk to one of those before doing weird stuff or you get what you deserve. My opinions are my own and do not represent the opinions of Charlotte Vapes, its employees, or your local dairy council.”

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