Popcorn lung symptoms

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Popcorn Lung Symptoms: An Overview

Introduction to Popcorn Lung (Bronchiolitis Obliterans)

Popcorn lung, medically known as bronchiolitis obliterans, is a severe and irreversible lung disease characterized by the obstruction of the smallest airways of the lungs due to inflammation and scarring. This condition has been notably observed in workers exposed to diacetyl, a chemical used in artificial butter flavoring in microwave popcorn production.

Key Symptoms of Popcorn Lung

Chronic Cough and Shortness of Breath

One of the primary symptoms of popcorn lung is a persistent cough that does not go away. Workers exposed to diacetyl in microwave popcorn plants have reported chronic coughs that are often accompanied by shortness of breath, especially during physical exertion 126. These symptoms can develop months to years after initial exposure to the harmful chemicals.

Wheezing and Respiratory Distress

Wheezing, a high-pitched whistling sound made while breathing, is another common symptom. This is due to the narrowing and obstruction of the airways, which makes it difficult for air to flow in and out of the lungs 12. In severe cases, individuals may experience significant respiratory distress, requiring medical intervention.

Decreased Lung Function

Spirometric testing of affected workers has shown a marked decrease in lung function, with forced expiratory volume in one second (FEV1) significantly lower than predicted values 124. This reduction in lung capacity is indicative of the fixed airway obstruction characteristic of bronchiolitis obliterans.

Radiographic and Biopsy Findings

High-resolution computed tomography (HRCT) scans of individuals with popcorn lung often reveal bronchial wall thickening and mosaic attenuation with air trapping . Lung biopsies in some cases have confirmed the presence of constrictive bronchiolitis, further validating the diagnosis 14.

Occupational Exposure and Risk Factors

Diacetyl Exposure

The primary risk factor for developing popcorn lung is occupational exposure to diacetyl, a volatile ketone used in artificial butter flavoring. Studies have shown a strong correlation between the level of diacetyl exposure and the prevalence of respiratory symptoms and lung function abnormalities 235. Workers in areas with higher concentrations of diacetyl, such as oil and flavorings mixers, are at greater risk .

Duration of Exposure

The duration of exposure to diacetyl also plays a critical role in the development of symptoms. Workers with longer work histories in environments with high diacetyl levels are more likely to exhibit severe symptoms and greater lung function decline 35.

Conclusion

Popcorn lung is a serious occupational hazard for workers in the microwave popcorn production industry, primarily due to exposure to diacetyl. The key symptoms include chronic cough, shortness of breath, wheezing, and decreased lung function. Preventative measures, such as improved ventilation and respiratory protection, are essential to mitigate the risk of developing this debilitating condition. Regular monitoring and early detection through spirometry can help manage and potentially stabilize lung function in affected individuals.

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Most relevant research papers on this topic

Bronchiolitis obliterans syndrome in popcorn production plant workers

Butter flavoring exposure in microwave popcorn plants can cause airway obstruction, with most cases stabilizing their lung function within 2 years after leaving employment.

Case ReportHighly Cited

2004·

163citations

·M. Akpinar-Elci et al.

Clinical bronchiolitis obliterans in workers at a microwave-popcorn plant.

Occupational bronchiolitis obliterans may be caused by inhalation of volatile butter-flavoring ingredients in microwave popcorn production plants.

Observational StudyHighly Cited

2002·

440citations

·K. Kreiss et al.

Evaluation of Flavorings-Related Lung Disease Risk at Six Microwave Popcorn Plants

Microwave popcorn workers at many plants are at risk for flavoring-related lung disease, with peak exposures potentially hazardous even when ventilation maintains low average exposures.

Observational StudyHighly Cited

2006·

137citations

·Richard Kanwal et al.

Burden of respiratory abnormalities in microwave popcorn and flavouring manufacturing workers

Diacetyl-related respiratory abnormalities are a substantial burden in microwave popcorn and flavoring manufacturing workers, with a similar approach potentially quantifying the burden in other industries using diacetyl.

Observational StudyRigorous Journal

2018·

10citations

·Ethan D. Fechter-Leggett et al.

Occupational Lung Disease Risk and Exposure to Butter-Flavoring Chemicals after Implementation of Controls at a Microwave Popcorn Plant

Implementing controls at a microwave popcorn plant significantly reduced exposure to butter-flavoring chemicals and decreased lung disease risk for most workers.

Observational Study

2011·

47citations

·Richard Kanwal et al.

Fixed obstructive lung disease in workers at a microwave popcorn factory--Missouri, 2000-2002.

Microwave popcorn factory workers exposed to flavorings are at risk for developing fixed obstructive lung disease.

Case Report

2002·

30citations

Popcorn worker's lung: in vitro exposure to diacetyl, an ingredient in microwave popcorn butter flavoring, increases reactivity to methacholine.

Diacetyl, an ingredient in microwave popcorn butter flavoring, increases sensitivity to methacholine in vitro, potentially contributing to the development of "popcorn worker's lung" in popcorn workers.

In Vitro Study

2006·

43citations

·J. Fedan et al.

Exhaled Nitric Oxide Measurement in Workers in a Microwave Popcorn Production Plant

Exhaled nitric oxide levels are significantly lower in microwave-popcorn workers with high flavoring exposure, but their usefulness as markers of lung injury in this population remains unclear.

Observational Study

2006·

20citations

·M. Akpinar-Elci et al.

“Popcorn worker’s lung” in Britain in a man making potato crisp flavouring

"Food flavourer's lung" may be a more appropriate diagnostic label for individuals exposed to 2,3-butanedione (diacetyl) in the production of food flavourings.

Case Report

2008·

14citations

·D. Hendrick

Diacetyl in Foods: A Review of Safety and Sensory Characteristics

Diacetyl in microwave popcorn is not known to cause lung disease in workers and its dietary exposure is below health concerns, with common airborne levels from microwave popcorn well below established limits to protect workers.

Literature ReviewHighly Cited

2015·

84citations

·S. Clark et al.

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