Popcorn Lung: Causes, Diagnosis, and Treatments

Popcorn lung is the nickname for the condition known as bronchiolitis obliterans. It is damage to your lungs’ smallest and most vulnerable airways. The main cause of the condition is exposure to a chemical vapor that is found in things like microwavable popcorn, fruit drinks, caramel, and some dairy products. It is generally safe to eat but has serious side effects when inhaled.

The chemical that causes popcorn lung has also been recently linked to e-cigarette flavoring and associate health issues from inhaling those vapors. One study found that over 75 percent of e-cigarette flavorings tested positive for the chemical.

The Basics of Popcorn Lung

Lungs play an important role in keeping you healthy. Every breath you take brings air and oxygen into your lungs through your windpipe. The windpipe is connected to two tubes called the bronchi. These go to either your left or right lung. Once the air gets to the lungs, they process it and provide oxygen to your blood which then carries it to the cells all over the rest of your body.

Inside of your lungs are even smaller tubes that look somewhat like the branches of a tree. The tiniest of these are called the bronchioles. These tubes end with air sacs where the blood picks up the oxygen. These are called alveoli. Popcorn lung leads to inflammation and scarring of these small air sacs and branches. In serious cases, this can lead to making it hard for you to breathe and distribute oxygen through your lungs and the rest of your body.

What causes Popcorn Lung?

The nickname popcorn lung came from the first reported cases of the condition. In 2000, a doctor reported an outbreak of the condition among eight former workers who had worked in a microwave-popcorn factory. All of them developed bronchiolitis obliterans after working in the factory and four of the workers were so ill that they were placed on a lung transplant list.

Researchers of the outbreak concluded that the condition was caused by the workers inhaling vapor from a particular butter flavoring that had been added to the popcorn. Diacetyl is the name of the chemical that was responsible for the harmful vapors. Additional animal studies of the vapors from the chemical found that the cells lining airways can be easily damaged by even one exposure to it.  

While the main culprit of popcorn lung is the vapors from the Diacetyl chemical, other sources have also been identified. A flavoring substitute named acetyl propionyl is similar enough that it can also cause popcorn lung. In addition to this, a 2004 alert published by the National Institute for Occupational Safety and Health (NIOSH) stated that there is the possibility that more than a thousand flavoring ingredients could be respiratory hazards.

Some specific other chemicals have been found to cause popcorn lung. These include ammonia, hydrochloric acid, byproducts of welding, formaldehyde, chlorine, nitrous oxide, and mustard gas. In rare cases, bronchiolitis obliterans can happen without inhaling a chemical. This is usually after you have had a severe lung infection like bronchitis or pneumonia. It can also happen as a side effect of rheumatoid arthritis or after a stem cell or lung transplant.

Diagnosis and Treatments of Popcorn Lung

The most common symptoms of popcorn lung are shortness of breath and coughing. It can have even more serious and severe effects. Other symptoms include fevers, weight loss, night sweats, fatigue, and a flu-like sickness. Severe and prolonged exposure to the chemicals can also include inflammation of the lungs, skin, ears, nose, and throat.

 A doctor is needed to diagnose popcorn lung. First, they would look at your history and possible connections with the chemicals that cause the condition. Next, you would need to have further testing such as chest X-rays and CT scans. These can help rule out other possible causes. Finally, you would more than likely need to undergo a lung tissue biopsy through a lung operation to identify inflamed and contaminated tissue.

Currently, there is no cure for popcorn lung. Treatment is for the symptoms and not the overall condition. It can also slow down, but not stop, the progression of the disease. Your doctor may prescribe prescription corticosteroids or immunosuppressive therapy. You may also have strong cough suppressants, oxygen therapy, or inhalers helpful. 

If you do not treat the condition, it can prove fatal over time. Severe cases of the disease are often put on lung transplant lists but this is not a cure. Recurrence of the condition after a transplant with new and healthy lungs has been known to occur. 

While treatment for popcorn lung can be expensive, you might not have to shoulder the costs alone. If you have popcorn lung because of your job– for example, at a factory– you should consult a workers’ compensation attorney to see if you qualify for financial assistance.

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