Popcorn Lung: Information on Causes, Diagnosis & Treatments

Bronchiolitis obliterans, also called “popcorn lung,” is a severe, chronic lung disease that worsens over time. Popcorn lung damages the smallest airways of the lung called bronchioles. It is mainly caused by breathing in toxins over time. 

Many different chemicals have been found to cause popcorn lung. Harvard researchers found that 75% of e-cigarettes contain diacetyl, a chemical linked to popcorn lung. 

Causes of Popcorn Lung

When doctors first discovered popcorn lung in 2000, the disease was found in eight patients who formerly worked at a microwave popcorn factory. They had all inhaled diacetyl, a chemical used as a flavoring. Once researchers linked diacetyl to popcorn lung, most manufacturers stopped using diacetyl as a flavoring.

Diacetyl is not the only flavoring that has been linked to bronchiolitis obliterans. The CDC publishes warnings about more than a thousand flavorings that can lead to popcorn lung if they are inhaled. Chemicals linked to popcorn lung if inhaled include, but are not limited to: 

  • Metal oxide fumes (a byproduct of welding)
  • Formaldehyde (used in glues and building materials)
  • Ammonia; and 
  • Chlorine.

Many less common chemicals can cause bronchiolitis obliterans if inhaled. 

Bronchiolitis obliterans can also be caused by severe respiratory infections like pneumonia, bronchitis, or RSV. Populations at risk for developing bronchiolitis obliterans include rheumatic patients and lung transplant patients. 

Diagnosing Popcorn Lung

Doctors use symptoms, medical history, exposure history, and testing to diagnose bronchiolitis obliterans. It is important to share your symptoms and history candidly with your doctor. 

Symptoms of bronchiolitis obliterans are similar to other respiratory conditions. For this reason, the doctor must be made aware of any potential exposure to chemicals or toxins that may have been inhaled at work or in other environments. 

Symptoms of Popcorn Lung

Symptoms of popcorn lung include shortness of breath, dry cough, and wheezing if you don’t have asthma or a cold. Feeling tired or fatigued without any reason can be a symptom of bronchiolitis obliterans. Symptoms develop over weeks or months. 

Popcorn lung symptoms can worsen during exercise or strenuous work. Other symptoms include irritation like a skin rash, depending on whether the patient was exposed to a chemical and the level of the exposure. The symptoms of bronchiolitis obliterans worsen over time. 

Lung Testing

The doctor will probably start by listening to your lungs and breath sounds. Your doctor may also order a chest X-ray or computerized tomography (CT) scan. Several X-rays from different angles create a more complete picture and if the doctor notices something abnormal on the X-ray, they may order the CT scan. Images from CT scans are two-dimensional, cross-sectional images that provide even more information. 

Doctors may also test how well your lungs are working with lung function tests. One common lung function test is spirometry. Spirometry tests measure how much air the lungs can hold and how forcefully the air can be exhaled from the lungs. Other lung function tests include: 

  • Lung volume testing; 
  • Diffusing capacity testing; and
  • Exercise testing.

The tests may be conducted repeatedly to ensure accurate results. If none of these non-invasive tests lead to a clear diagnosis, a lung biopsy may be required. 

Treating Popcorn Lung

There is no cure for popcorn lung. Bronchiolitis obliterans is irreversible and causes permanent damage. However, if caught early, some treatments can slow the disease and reduce the symptoms. 

If the disease was caused by inhaling toxic chemicals, the first line of defense is to reduce exposure. If you cannot change jobs or work in a different environment, your next best option is to use robust personal protective equipment. 

Doctors may prescribe medications to help ease the symptoms. Patients may be prescribed cough suppressants to ease a persistent cough. 

Antibiotics or steroids may lessen inflammation that might scar the lungs. Corticosteroids fight inflammation but they also weaken the immune system. By weakening the immune system, steroids help prevent further scarring damage. 

Medications that open the lungs, called bronchodilators, can help ease labored breathing. They are often administered through an inhaler. You might also use supplemental oxygen to increase blood oxygen levels to combat shortness of breath. 

Lung transplant is sometimes, but rarely, indicated for the treatment of popcorn lung. It is only recommended for life-threatening conditions and patients who do not respond to other treatments. Unfortunately, popcorn lung may reoccur as a complication of the lung transplant.

If left untreated, popcorn lung can be fatal. You should seek medical treatment if you think you may have been exposed to harmful chemicals. 

Treatment for chronic conditions like popcorn lung can be costly. You may be able to seek recovery for the costs of medical treatment if you have popcorn lung due to exposure to chemicals at work. Contact a worker’s compensation attorney to learn more about your rights.