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Vaping Side Effects: Popcorn Lung

What is popcorn lung? You’ve probably heard or seen this term a lot recently, usually connected with vaping or e-cigarette use. No, your lungs don’t turn into popcorn if that’s what you’re thinking. It’s a nickname for bronchiolitis obliterans, a rare condition in which the lungs’ air passages become inflamed and narrow 1 Barrington-Trimis, J. L., Samet, J. M., & McConnell, R. (2014). Flavorings in electronic cigarettes: an unrecognized respiratory health hazard? JAMA, 312(23), 2493–2494. . The nickname has spouted from popcorn factory workers who suffered from this condition more than most people. Doctors eventually realized that diacetyl, a popular food flavoring that companies added to popcorn, might cause bronchiolitis obliterans. Unfortunately, there is no cure for popcorn lung once you have it, though treatments can help make the symptoms easier to manage.

Evie Alexander
Published October 9, 2020

What is Popcorn Lung?

Your lungs consist of thousands of tiny, branched tubes called bronchioles, that eventually lead to air sacs called alveoli. These structures play an essential role in oxygen transport and gas exchange. Oxygen goes into your bloodstream in the alveoli and carbon dioxide comes out. These delicate structures are sensitive to many things in the environment, including chemicals, temperatures, and humidity.

Contracting and expanding smooth muscles make up the bronchioles. And different environmental conditions can cause narrowing or widening of lung tissue. For example, suddenly breathing in cold air can cause the tubes to contract, and breathing in warm, moist air causes them to expand. People with allergic reactions or asthma often start wheezing when they’re exposed to allergens. That wheezing sound is the air whistling through narrowing bronchioles.

When people continually breathe in chemicals that irritate the lungs or develop an infection, the tubes first become inflamed. Inflammation causes swelling, narrowing of the tubes, and eventually, scarring. Less air travels through the lungs and people end up having a tough time breathing 2 2. Krishna, R. (2020, May 30). Bronchiolitis Obliterans (Obliterative Bronchiolitis, Constrictive Bronchiolitis). Retrieved August 16, 2020 .

What Causes Popcorn Lung?

Many chemicals can cause popcorn lung, though it’s important to remember that people generally need to be inhaling them for long periods. These chemicals irritate the lung tissue, causing inflammation and swelling, which leads to the narrowing of the bronchioles and breathing difficulties. Repeated exposure increases the risk.

Some lung-irritating substances are already in the air, such as sulfur dioxide and nitrogen oxides. Things like car exhausts and cigarette smoke produce these pollutants. Other chemicals include cleaning and industrial chemicals in the workplace, such as:

  • Diacetyl
  • Metal oxides
  • Ammonia
  • Formaldehyde
  • Chlorine
  • Hydrochloric acid
  • Sulfur mustard
  • Acetaldehyde

Sometimes, an infection or an immune reaction can cause popcorn lung. Pneumonia, bronchitis, and even rheumatoid arthritis are common causes. If this inflammation or swelling isn’t controlled, the smooth muscle around the bronchioles can scar. People with lung transplants that experience organ rejection may end up with popcorn lung. Their immune system attacks the lung tissue, resulting in scarring 2 2. Krishna, R. (2020, May 30). Bronchiolitis Obliterans (Obliterative Bronchiolitis, Constrictive Bronchiolitis). Retrieved August 16, 2020 .

Finally, lifestyle choices can also lead to popcorn lung. Diacetyl is a food flavoring chemical found in, you guessed it, microwave popcorn and sometimes in vape oil. However, thanks to popcorn lung, the FDA have banned all flavored e-cigarettes except mint, menthol, and tobacco flavors 3 3. Products, C. (n.d.). Flavored Tobacco. Retrieved August 16, 2020 . Even in the EU, companies are not allowed to put diacetyl in vaping oils and juices.

What are the Symptoms of Popcorn Lung?

Popcorn lung symptoms usually start showing up 2-8 weeks after exposure. The most common symptoms are a dry cough and shortness of breath. You may notice these symptoms when you are exercising, but they get progressively worse without intervention. There are also less common symptoms, such as:

  • Flu-like symptoms
  • Fever
  • Tiredness
  • Weight loss
  • Wheezing
  • Eyes and nose irritation

If you experience any of these popcorn lung symptoms, it’s essential to see a healthcare provider. There are several tests they can run to determine if your symptoms are due to asthma, bronchitis, or popcorn lung 2 2. Krishna, R. (2020, May 30). Bronchiolitis Obliterans (Obliterative Bronchiolitis, Constrictive Bronchiolitis). Retrieved August 16, 2020 .

Woman holding her throat from symptoms caused by popcorn lung

What is the Treatment for Popcorn Lung?

The first intervention for popcorn lung is to take away whichever chemical is causing the problem. This could mean quitting smoking, finding alternatives to chemicals like ammonia and chlorine, or in extreme cases, leaving your job or moving house.

Medications such as immune suppressants and steroids are useful for calming down the immune system and lung inflammation. This helps to reduce bronchiole narrowing and scarring. If you’re having trouble breathing, your doctor may give you oxygen or a cough suppressant to open up your airways. Sometimes, if there is inflammation due to an infection, your doctor will prescribe you antibiotics.

In severe cases of popcorn lung, patients may need a lung transplant. And because popcorn lung is an irreversible lung disease, severe cases where people are unable to breathe can lead to death 4 4. Hakim, A., Cooke, K., Pavletic, S., Khalid, M., Williams, K., & Hashmi, S. (2018, July 23). Diagnosis and treatment of bronchiolitis obliterans syndrome accessible universally. Retrieved August 16, 2020 .

FAQs

What is popcorn lung from vaping?

Popcorn lung from vaping was a series of lung injuries and deaths caused by certain flavorings and additives in e-cigarettes and THC vapes [5]. In response to these injuries and deaths, the FDA tightened its regulations on vape products and fined or warned online retailers for misleading product labels [6].

Can popcorn lung go away?

No, popcorn lung is irreversible. However, treatment can help slow down the progression of the disease and alleviate symptoms.

How do you know if you have popcorn lung?

If you suspect you have popcorn lung, the first thing to do is to let your doctor know that you’ve been exposed to toxic chemicals. A chest scan (usually a CT scan), lung-function tests, and sometimes a lung biopsy will confirm if you have the condition [7].

Do Juuls cause popcorn lung?

While inhaling any drug can cause lung irritation or damage, there has not been any conclusive evidence that Juuls directly cause popcorn lung [8]. While there are lots of popcorn lung vaping myths out there, it’s always good to get your lung health information from a trusted medical professional, and familiarize yourself with the effects of vaping.

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Evie Alexander

Evie is the queen of reinventing herself. She got her undergraduate degree at Cornell University and worked in microbiology labs for 6 years. When she outgrew research, she earned a Master’s degree and became a teacher. After a decade in the classroom, she started over as a remote science writer. She enjoys reading up on the newest cannabis research and any other topic that the NIH pushes to the top of their website. Evie also enjoys paddle boarding, playing the guitar, learning languages, observing pond microorganisms, and brewing beer.

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References
  1. Barrington-Trimis, J. L., Samet, J. M., & McConnell, R. (2014). Flavorings in electronic cigarettes: an unrecognized respiratory health hazard? JAMA, 312(23), 2493–2494.
  2. 2. Krishna, R. (2020, May 30). Bronchiolitis Obliterans (Obliterative Bronchiolitis, Constrictive Bronchiolitis). Retrieved August 16, 2020
  3. 3. Products, C. (n.d.). Flavored Tobacco. Retrieved August 16, 2020
  4. 4. Hakim, A., Cooke, K., Pavletic, S., Khalid, M., Williams, K., & Hashmi, S. (2018, July 23). Diagnosis and treatment of bronchiolitis obliterans syndrome accessible universally. Retrieved August 16, 2020
  5. 5. Stanbrook M. B. (2019). Vaping-associated lung illnesses highlight risks to all users of electronic cigarettes. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 191(48), E1319–E1320
  6. 6. Commissioner, O. (n.d.). FDA takes new steps to address epidemic of youth e-cigarette use, including a historic action against more than 1,300 retailers and 5 major manufacturers for their roles perpetuating youth access. Retrieved August 16, 2020
  7. 7. Bronchiolitis obliterans. (n.d.). Retrieved August 16, 2020,
  8. 8. Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults. (2020, July 28). Retrieved August 16, 2020
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