Does Diacetyl in Vaping Cause Popcorn Lung?

Have you heard of popcorn lung? Are you wondering whether as a vaper you could be at risk?

Also known as Bronchiolitis, Obliterans, this recently discovered disease causes unpleasant symptoms such as wheezing, respiratory problems and coughing.

One primary cause of this condition is diacetyl – a chemical component found in many e-juice flavourings.

So, what do you need to know about popcorn lung, and should you be worried?

What is Popcorn Lung?
Popcorn lung is a rare lung condition which has been associated with diacetyl.

The link was made when several workers in a Missouri microwave popcorn factory were found to have developed this condition back in 2004.

Popcorn lung is an irreversible, serious illness which causes the tiny air sacs in the lungs to become damaged.

After investigating the outbreak at the factory, the NIOSH found that the most likely cause was the inhalation of diacetyl, a flavouring which is was used routinely to give the popcorn a buttery flavour.

This is how the disease was given its nickname, although the true name of the disease is obliterative bronchiolitis, bronchiolitis obliterans or constrictive bronchiolitis.
In a case of popcorn lung, the bronchioles, or smallest airways in the lungs, become scarred.

This, in turn, reduces their efficiency and capacity. Inflammation and damage to the bronchioles can occur in many ways.

Bacterial, fungal or viral infections can cause this condition, however, inhaling chemical particles such as diketones (of which diacetyl is one) are most commonly associated with popcorn lung.

Some other chemicals which may cause the condition when inhaled include sulfur dioxide, ammonia and chlorine, and inhaling metal fumes during welding is also linked to the development of the disease. 

What are the Symptoms of Popcorn Lung?
When lung tissue becomes scarred, the airways become blocked and this stops the lungs from working to their full capacity.

The symptoms experienced by the sufferer are similar to those experienced in someone suffering from COPD (chronic obstructive pulmonary disease).

The primary difference is that popcorn lung symptoms appear within around 2-8 weeks and COPD symptoms develop over many years.

Some of the symptoms include: 

·Shortness of breath
·Dry cough
·Reduced tolerance to activity
·Wheezing without asthma or a cold

The initial symptoms of popcorn lung are quite similar to those of a cold.

However, over weeks and months, the symptoms get worse and eventually, severe breathing problems develop.

When allowed to progress untreated, it causes respiratory failure and death within just a few years or even months. 

At present, there isn’t a cure for popcorn lung, however, treatment may slow down its progression.

Antibiotics, corticosteroids and immunosuppressive drugs may be given as a treatment, along with oxygen or cough medications to manage the symptoms.

The most severe cases will necessitate a lung transplant. 

What is Diacetyl?
Diacetyl naturally occurs in fermented products such as cultured milk products and alcoholic drinks.

It is also found in tobacco and some types of fruit. It is also used to flavour processed foods thanks to its buttery taste and its ability to make sweet flavours even better.

Commonly, it was added to butter-flavoured microwave popcorn but after the link between diacetyl and popcorn lung was discovered, most manufacturers switched to using different flavourings without diacetyl. 

Known as 2,3-butanedione, diacetyl is a diketone, like an acetyl propionyl which is another popular flavouring.

When ingested, AP and diacetyl aren’t dangerous. Both have been designated by the FDA as GRAS (generally recognized as safe).

However, if they are inhaled in a large quantity, the lung damage caused can be irreversible.

Some e-liquids also contain diacetyl, especially dessert flavours and those with buttery tastes.

However, in the EU and UK, diacetyl has been banned for use as an ingredient in any nicotine-containing e-juice, so there should be no concerns in this respect. 

What Does the Evidence Really Say about Diacetyl and e-cigarettes?
Some studies which were published around 2015 examined whether e-juices contained diacetyl and the result showed that quite a lot of the flavours available on the market at that time did, indeed, contain some diacetyl.

This was where the idea that vaping could result in the development of popcorn lung arose.

However, it’s important to note that those studies didn’t examine whether a link had been proven between vaping and the development of popcorn lung.

Up until now, no conclusive evidence has been brought to light to prove that vaping causes popcorn lung.

Nevertheless, diacetyl has been banned in e-juices in the UK and the EU since 2016. 

Does Vaping Cause Popcorn Lung?
For anyone who is worried that vaping might cause them to develop popcorn lung, it’s important to bear in mind that until now, there have been no cases of popcorn lung in vapers.

Nevertheless, there have been many stories in the media which have implied that e-cigarettes could be a cause of this serious health problem.

This is interesting to note that cigarettes also contain diacetyl and there has never been a link reported between smoking cigarettes and popcorn lung.

Cigarette smoke as around 100 times more diacetyl than that found in vaping products and a billion smokers worldwide inhale diacetyl on a daily basis when they smoke cigarettes.

Despite this, there are absolutely no reports of any smoker having been diagnosed as suffering from popcorn lung.

In fact, the only smokers who have developed the condition were those who worked in the popcorn factory. 

Smoking is certainly associated with numerous risks and health problems including COPD and lung cancer.

However, popcorn lung isn’t considered to be a related condition. Vaping doesn’t involve any combustion, and therefore no carbon monoxide or tar is produced.

This makes vaping 95% safer than smoking tobacco cigarettes.

In the absolute worst-case scenario, e-juices only contain around 1% of the total amount of diacetyl found in cigarettes, so it’s fairly safe to say that the chances of developing popcorn lung solely from vaping are extremely slim, if not entirely non-existent.