Does Vape Juice cause popcorn lung?

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If you read nothing else, read this:  No known cases of “popcorn lung” or Bronchiolitis Obliterans have been attributed to vaping.

Since vapor companies are now regulated as tobacco products, we are compelled by law not to make any health claims including smoking cessation claims. Unfortunately anti-vaping groups and unscrupulous journalists are not bound by the same regulations and restrictions on health claims, even when they’re exaggerated, unfounded, or completely made up.

We can, however, provide you basic facts to make your own informed decisions as a consumer.

What is “Popcorn Lung”?

In August 2000, the National Institute for Occupational Safety and Health (NIOSH) began investigating a string of 8 popcorn factory workers who had developed Bronchiolitis Obliterans, a respiratory disorder with a number of possible causes.  The disorder was thus given the nickname “Popcorn Lung”.

NIOSH and the Center for Disease Control (CDC) found no known airborne respiratory toxins in the factory, and began to look for chemicals that may not have been previously known to cause the disorder.  In their air sample tests they found 18 parts per million (ppm) of Diacetyl in the mixing area, 1.3 ppm in the microwave packaging area, and 0.02 ppm in other areas of the factory.  Four of the eight subjects worked in the mixing room, four worked in the packaging area.  No cases had come from any other areas of the factory.  NIOSH concluded that Diacetyl was the likely cause and established strict workplace airborne exposure limits of 25 parts per billion (ppb) for short term exposure (15 minutes) and a time weighted average of 5 ppb for long term exposure (40 hour work week). Note that this falls significantly below the levels of 20 ppb found in areas of the plant where workers were unaffected.

Where does Diacetyl come from?

In the case of the popcorn factories, Diacetyl was being used as a butter flavoring. However, it Diacetyl does occur naturally, such as a byproduct of fermentation.  It is commonly found in butter, buttermilk, sour cream, as well as alcoholic beverages.  Most importantly it is also found in cigarette smoke.

The poison is in the dosage

I’d like to pause for a moment to point out this very important, but often overlooked detail. Journalists’ jobs are not to inform you. Their job is to get you to view the article on their website or in their printed newspaper, so that their employer can bring in advertising revenue. Nothing works better than shocking and scary headlines that grab your attention, like “Toxic chemicals found in so-and-so-product!”.

The first problem with this is that they turn “chemicals” into this big scary word. Everything is a chemical. Even water, the great giver of all life as we know it, is a chemical.

The second problem with this is that every chemical is toxic at the right dosage. Including water, the great giver of life. Go ahead, google “water poisoning”. I’ll give you a quick quote from wikipedia to save you the time: “Water, just like any other substance, can be considered a poison when over-consumed in a specific period of time.”

So the key here is that the poison is in the dosage. Arsenic, a chemical well known for its toxicity, has a good chance of being found in your drinking water. The key is keeping it at safe levels.

Is there diacetyl in eliquid?

Contrary to anti-vaping groups’ attempts to depict the vapor industry as a big bad wolf and tobacco industry 2.0, the Diacetyl issue was brought to light by the vapor industry itself.  There was talk of avoiding butter flavorings back in 2009 when the industry was nothing more than hobbyist vendors talking on online forums. It was Dr. Konstantinos Farsalinos, a greek cardioliogist, vaper, and vapor industry proponent who in 2014 brought this issue to the forefront. He tested a number of eliquid samples, with willing participation of the companies producing them, and found Diacetyl present in the liquids.

Dr. Farsalinos pointed out in his research that most of the liquids contained Diacetyl below the NIOSH safety limits of exposure. However even the worst offenders would expose the user to 100 times less Diacetyl that cigarette smoke, which itself has caused no known cases of popcorn lung. His opinion was that regardless of the relative level of risk, this was an avoidable risk. He suggested that the industry work with the flavoring industry to adapt flavorings for use in vape juice by eliminating Diacetyl.

Guess what happened? The industry got to work doing precisely that.  All the flavor houses that supply eliquid manufacturers spent the next two years creating new flavorings without Diacetyl.

Unfortunately “Vapor industry identifies possible but unproven health risk and works to fix it on its own” made for a bad headline, and these old news articles continue to get reposted to facebook and social media.