Popcorn lung disease: what is it?

Popcorn lung disease is a recently described condition. It is the common way of referring to obliterative bronchiolitis. Actually, this disorder is rare, but its incidence increases progressively.

Popcorn lung disease has this name because the first cases described appeared in people exposed to a compound with which this food was made. The problem is that it significantly alters the capacity of the lungs. Therefore, in this article we explain why it occurs and how to avoid it.

What is popcorn lung disease?

Popcorn lung disease, as we have noted, is also called obliterative bronchiolitis. This is how the American Lung Association. This term refers to inflammation of the bronchioles. They are the branches of the bronchi, that is, part of the lower airway.

When the bronchioles become inflamed, edema occurs at this level of the airways. In addition, the process leads to the appearance of fibrosis. All these events make, each time, the bronchioles are narrower and the air cannot get through correctly.

Popcorn lung disease was first described in people who worked in popcorn factories. This is because they were exposed to something called diacetyl. It is a substance that occurs naturally in some fermentation processes and is used frequently in the food industry. It is used to give food a butter flavor.

In most cases this flavoring is combined with other ingredients to obtain the artificial flavor. The problem is that when inhaled, the vapor containing diacetyl can lead to popcorn lung disease.

Although popcorn was associated with this pathology, there are other compounds that cause a similar picture.

Why is it produced?

One of the main causes is inhalation of diacetyl, which is toxic to the lungs. However, other origins have been described. The use of electronic cigarettes, for example, seems to be one of them. This is the main reason that the incidence of obliterative bronchiolitis increases.

Many think that they are a good option to give up tobacco. Until recently, the possible harmfulness of this type of cigarette was unknown. In fact, many of its side effects are still being investigated today.

A study published in Environmental Health Perspectives showed that almost 75% of people who smoked e-cigarettes or vapers had diacetyl in their lungs. That is to say, were exposed to the same chemical as workers in certain food factories.

Additionally, popcorn lung disease can be secondary to other conditions. For example, it can appear after a lung transplant. In this case, it is due to chronic rejection of said organ.

Other causes

A study published in Science and Health explains that obliterative bronchiolitis in the case of children it usually appears after a respiratory infection. It is usually caused by adenovirus. However, there have also been cases of influenza, measles, or Legionella.

Another possible cause of popcorn lung disease is autoimmune pathologies. For example, certain vasculitis, which are disorders in which inflammation of the walls of blood vessels occurs. It can even appear in rheumatoid arthritis.

In the same way, there are cases secondary to the ingestion of certain drugs. Any inhaled substance, such as cocaine, causes severe damage to the lungs, as they are toxic to the tissue.

Symptoms of popcorn lung disease

Popcorn lung disease does not immediately cause symptoms. In fact, it is estimated that symptoms appear between two and eight weeks later of the exhibition to the chemical in question.

When the cause is an autoimmune disorder or a lung transplant, it can take years for symptoms to appear. The lesion that occurs is obstruction of the bronchioles, which is irreversible.

This leads to a decrease in lung capacity. Expiratory power, which is the action of expelling air from the lungs, decreases. Popcorn lung disease clinically resembles chronic obstructive pulmonary disease. The latter is very common in smokers.

According to specialists from the Centers for Disease Control and Prevention, the most common symptoms include non-productive cough and shortness of breath. In addition, wheezing, sounds similar to a hiss, may appear.

Some people experience constant tiredness and general malaise. In the same way, there may be fever, weight loss, or night sweats. When the cause is exposure to a chemical, it is common to find irritation to the eyes or skin.

How is it treated?

As explained by the National Center for Advicing Translational Science, a specific and optimal treatment for this pathology has not yet been established. What is known is that measures should be used to reduce the symptoms and related complications.

First, if the disease is advanced and the patient has hypoxemia administering oxygen is essential. In the same way, it is recommended to vaccinate these people against certain viruses, such as influenza. In this way the possibility of acquiring a concomitant pathology is reduced.

Another of the pillars of treatment is respiratory physiotherapy. People with popcorn lung disease should stay away from contaminants or irritants. That is why it is essential that they stop smoking and avoid places where there is smoke.

The most useful drugs in the treatment of this pathology are corticosteroids. They reduce airway inflammation and can be administered orally or intravenously.

Inhaled corticosteroids can be helpful in these cases, always in combination with physical therapy and measures to reduce exposure to irritants.

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Popcorn lung disease prevention

Popcorn lung disease can be preventable. Especially it is important to stop using e-cigarettes. Also, as we have seen, many of the cases occur in factory workers. That is why it is key that all employees have access to good safety equipment.

What we must bear in mind is that this pathology is irreversible. It produces serious consequences at the lung level that can greatly reduce the quality of life.