Bronchiolitis obliterans or obliterative bronchiolitis, often known as popcorn lungs, is a severe but rare condition. Its name may not sound like a threat to you, but this condition may cause irreversible damage to your lungs. While not directly linked to the consumption of popcorn, it is associated with exposure to specific chemicals, particularly diacetyl, a flavouring agent found in certain food items such as microwave popcorn. Vaping or use of e-cigarettes may also be a risk factor. In this condition, scarring may occur in the lung airways, which can pose a risk for various serious diseases.

What causes popcorn lungs?

Bronchiolitis obliterans, commonly known as popcorn lung, isn’t contagious, meaning it can’t be transmitted from one person to another. It’s mainly caused by exposure to diacetyl, a chemical found in butter-flavoured products like microwave popcorn.

“Prolonged inhalation of diacetyl can inflame and scar the small airways of the lung, leading to symptoms like coughing and shortness of breath. It damages lung tissues, impairing normal function. Workers in industries using diacetyl, such as popcorn factories, face heightened risks of developing this condition,” says pulmonologist Dr Sanggita Checker.

Although diacetyl is no longer used in popcorn production to safeguard workers’ health, it remains in use in various other sectors. Despite its association with popcorn lung disease, diacetyl is included in the liquid utilised in certain flavoured e-cigarettes. Vaping involves heating a liquid and inhaling the aerosol into the lungs. In fact, researchers at Harvard found that 39 of 51 e-cigarette brands contained diacetyl.

Another prevalent factor is acetaldehyde, present in the smoke of marijuana and certain electronic cigarettes, which can harm the lining of the mouth, throat, and stomach. Additionally, various other chemicals, such as chlorine, ammonia, sulfur dioxide, nitrogen dioxide, fumes from welding, formaldehyde, phosgene, mustard gas, etc., might also contribute to popcorn lung when inhaled.

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Who is at risk for developing popcorn lung?

Certain health conditions that are linked to the increased risk of popcorn lung include:

• Respiratory illnesses such as pneumonia or bronchitis.
• Viral infections such as respiratory syncytial virus (RSV).
• Collagen vascular diseases.
• Drug reactions.
• Inflammation and scarring from a lung transplant.
• Autoimmune diseases such as rheumatoid arthritis.

Symptoms of popcorn lungs

Bronchiolitis obliterans causes the smallest airways in your lungs (called bronchioles) to become irreversibly inflamed and scarred. This can result in several symptoms, such as:

• Persistent cough: A chronic cough that doesn’t improve with regular treatments could be a sign of bronchiolitis obliterans.
• Shortness of breath: The gradual onset of breathlessness, especially during physical activity, may indicate lung issues.
• Wheezing: Unexplained wheezing or whistling sounds while breathing may be a symptom of airway narrowing.
• Fatigue: Feeling excessively tired or weak, even with adequate rest, might be associated with compromised lung function.
• Chest discomfort: Some people experience chest pain or discomfort as the lungs are affected.

How does vaping increase the risk of popcorn lung?

The American Lung Association has called popcorn lung a dangerous risk of flavoured e-cigarettes. While numerous studies have demonstrated the adverse effects of e-cigarettes, a 2015 study in the Journal Environmental Health Perspectives revealed the presence of harmful chemicals linked to popcorn lung in various flavoured e-cigarettes, especially those with fruity and candy flavours that may appeal to young smokers. This can cause severe damage to your lungs.

How is popcorn lung treated?

Popcorn lungs can’t be cured. The treatment is available to slow down its progression and ease symptoms.

• If the condition is linked to occupational exposure, avoiding harmful substances is crucial.
• Bronchodilators and corticosteroids may be prescribed by your doctor to manage symptoms and reduce inflammation.
• In advanced cases, providing additional oxygen can alleviate breathing difficulties.
• Quitting smoking and maintaining a healthy lifestyle can improve overall lung health.
• In severe cases, when conservative measures fail, a lung transplant may be considered.

Since popcorn causes long-lasting damage, early detection and prompt intervention are essential in managing the condition.