Popcorn Lung Disease — what it is, symptoms, and treatment

"Popcorn lung disease" or bronchiolitis obliterans is a serious disease that can lead to respiratory failure, early disability, and even death. One of the most common causes of its occurrence is the inhalation of toxic substances, such as diacetyl, which is part of vaping liquids. Izvestia talks about the symptoms and consequences of this pathology.

"Popcorn lung disease" — what is it, the symptoms

Bronchiolitis obliterans is an obstructive disease of the small respiratory tract, in which bronchioles (branching bronchi with a diameter of less than 3 mm) primarily suffer. Inflammation occurs in them, which limits the ability of the affected areas to absorb oxygen.

There are several types of bronchiolitis obliterans, depending on its origin:

• Post—infectious - develops against the background of other infectious diseases such as adenovirus, cytomegalovirus, parainfluenza, herpes, klebsiella, HIV, etc.;
• Inhalation — occurs due to inhalation of toxic gases (sulfur dioxide, nitrogen dioxide, chlorine, ammonia), acid vapors, organic and inorganic dust, nicotine;
• Idiopathic — it can develop against the background of diffuse connective tissue diseases (rheumatoid arthritis), aspiration pneumonia, inflammatory processes of the gastrointestinal tract, lymphoma and other diseases.

The initial symptoms of bronchiolitis obliterans may be similar to acute respiratory viral infections and other respiratory diseases: weakness, general malaise, high fever, and an obsessive dry cough. Subsequently, the patient develops shortness of breath during any physical activity, chest pain, wheezing, and pulmonary hypertension may develop.

As Alexander Umnov, a lecturer at the Department of Surgery at the Medical Faculty of the State University of Education, explained in a conversation with Izvestia, the further course of the disease can have serious consequences.

"Due to the inflammation, which turns into a scarring process, part of the lung tissue is no longer involved in gas exchange, which can lead to respiratory failure. The lungs are so damaged that they may need to be transplanted," the expert said.

"Popcorn lung disease" and vapes — what is the connection

Obliterating bronchiolitis received the name "popcorn disease" in the early 2000s, when the American media drew attention to the frequent cases of the disease among employees of microwave popcorn factories. Diacetyl was used as a flavoring agent in the products, a substance that is harmless when eaten, but dangerous if inhaled. Similar incidents were recorded in the production of roasted ground coffee, where diacetyl was also used.

In 2019, doctors for the first time a link has been established between the occurrence of "popcorn disease" and vaping. The disease was found in a 17-year-old Canadian resident. The young man, who had never worked in harmful industries, developed symptoms of bronchiolitis obliterans. It turned out that over the past five months, he had been actively using electronic cigarettes, regularly adding the active ingredient of marijuana to them.

The patient was in serious condition and needed mechanical ventilation. X-rays and computed tomography showed extensive tissue damage to both lungs with characteristic frosted-glass darkening. However, all microbiological studies turned out to be negative, which allowed doctors to conclude about the inhalation nature of the disease and its connection with the smoking mixtures that the patient consumed.

Research shows that one of the main causative agents of the "popcorn disease", diacetyl, is found in many e-cigarette liquids. The flavoring agent is used to create flavors such as butter, cheese, ice cream, caramel, vanilla coffee, chocolate, as well as in various "nutty", "berry", "fruit", "meat" and "alcoholic" vaping mixes.

In this case, the danger is not only diacetyl, but also other substances contained in liquids for electronic cigarettes. They can cause allergic reactions, irritation of the mucous membranes and respiratory tract, nausea, headache, diarrhea, weakness. In addition, vaping has a negative effect on the functioning of the central nervous system, and nicotine in mixtures is a powerful carcinogen.

"How quickly the "popcorn disease" develops when smoking vapes depends on the stability of the lung tissue. After about three years, the first symptoms may begin. The only way to protect yourself is not to smoke vapes!", — said Alexander Umnov.

"Popcorn disease" — treatment and prevention

The diagnosis of bronchiolitis obliterans is often complicated by its similarity to other respiratory diseases, and the rapid progression and irreversibility of changes in lung tissue complicate its treatment. Most often, therapy is reduced to containing the inflammatory process in the patient's respiratory tract. Patients can be prescribed various inhalations, antiviral and anti-inflammatory drugs, oxygen therapy and vitamins. However, even with timely medical treatment, complete restoration of respiratory tract functions is impossible.

To reduce the risk of "popcorn disease", it is recommended to completely eliminate smoking of conventional and electronic cigarettes (including passive), not to use narcotic substances, observe safety precautions when working with toxic substances, undergo regular medical examinations, observe sleep patterns and devote time to physical activity.

Earlier, Elena Polikanova, a physiotherapist at JSC "Medicine" (Academician Roitberg Clinic), PhD, told Izvestia about href="https://iz.ru/1826357/2025-01-23/vrac-rasskazala-o-negativnom-vozdeistvii-veipov-na-serdecno-sosudistuu-sistemu " target="_blank">the negative effects of vaping on the cardiovascular system.