e-cigarettes and Popcorn Lung

     I saw a scare headline on the Internet the other day that screamed e-cigarettes cause popcorn lung.  What was NOT made evident though was that not all do...many, but not all. For people that use e-cigarettes, extreme care must be used when purchasing these products. 
    Bronchiolitis obliterans (aka popcorn lung) is a serious and irreversible condition in which the tiny air sacs in the lungs become scarred. Popcorn lung begins with a cough, wheezing and shortness of breath and usually progresses slowly, but severe symptoms can develop without warning. Other symptoms include fever, weight loss, and night sweats. 
      In 2004, The US Centers for Disease Control and Prevention reported several cases of bronchiolitis obliterans in workers at a microwave popcorn plant in Missouri in 2000. After investigation by the National Institute of Occupation Safety and Health, it was discovered that a flavoring agent, diacetyl, was used to give the popcorn a buttery taste and that inhalation of this flavoring likely contributed to the development of the illness. The disease that results often is associated with cough and shortness of breath, similar to that seen in people with chronic obstructive pulmonary disease (COPD). This condition is irreversible.
     Industrial workers at risk for the disease include nylon-flock workers, workers who spray prints onto textiles, battery workers and workers at plants that use or manufacture flavorings. 
     Microwave popcorn is not the only thing that contains chemical flavorings using diacetyl. A study published in 2015 in the journal Environmental Health Perspectives showed that harmful chemicals associated with popcorn lung are present in many types of flavored e-cigarettes, particularly those with flavors like fruit and candy. Of the 51 flavored e-cigarettes tested diacetyl was found in 39 samples. 
     As a result of a lawsuit in 2007 a heavy consumer of microwaved popcorn was diagnosed with popcorn lung that resulted from smelling the stuff after he consumed microwave popcorn for a decade. The result was he was awarded over 7 million dollars by the jury. Because of that, several corporations removed diacetyl from their products. However, many e-cigarettes, often touted as safer than tobacco cigarettes, may still contain diacetyl.  
     Most of the health concerns about e-cigarettes have focused on nicotine, but there is still a lot of unknown factors. For example, they contain other cancer-causing chemicals such as formaldehyde.  In the e-vapor industry there are more than 500 different brands and that does not include stores that make their own in-house liquids. These vendors are not regulated or monitored for quality control. Until FDA e-cigarette regulations go into effect, anyone can make e-liquid. All you have to do is get a business license, buy liquid nicotine, propylene glycol and flavoring. Then you buy small plastic bottles and labels and just like that, you have a liquid for e-cigarettes that you can sell in your store...all totally unregulated. While there are many e-liquid brands that do not use diacetyl, who knows what other hazards may be discovered as more evidence is uncovered?

New Report Warns of the Dangers of E-Cigarettes 
American Lung Association - e-cigarettes and Lung Health 
The Hidden Dangers of e-cigarettes
What's the Harm in Vapor?