Popcorn lung, legit risk or fearmongering?

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davettn

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If you want a worthwhile read the below is a great one :

Question about diketones. self.Deeper_DIY

submitted 29 days ago by Fawgmachine

I've recently been expanding and I'm wondering what the actual facts are about diketones. I have never experienced anything negative and I've been hearing as of late that its all blown up by the media.

I've also seen that cigarettes have 100 times (I've seen up to 7000?) as much diketones than you would with an equivalent amount of nicotine, and (unless its below the obvious average amount consumes by us vapers) you would overdose on nicotine way before the diketones would even do anything.

I'm thinking some people are weaker to these partially as some people say high diketone flavors make them cough (unless its placebo which is very well possible), because it has no effect on me. Anyways I was just wondering what we do know for sure. I tend to keep my juices diketone free or very little at most just to be safe.

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  • D-Juice 12 points 29 days ago*

    Big Food has muddied the waters very effectively.

    Summary of the problem by Farsalinos. The background to this is discussed in more detail below.

    NIOSH investigated most of the microwave popcorn production capacity in the US along with various other outlets using diacetyl-containing flavourings and a Dutch factory producing diacetyl. Their 2010 report is here:http://www.cdc.gov/niosh/docket/archive/pdfs/NIOSH-245/0245-081211-draftdocument.pdf

    The pattern of disease was very similar across all sites with evidence of an exposure-response relationship (end of chapter 3 summarises evidence of causality). There was also some evidence of a group at higher risk of respiratory damage but the risk was broadly proportional to total exposure. That is, ten years' exposure to one unit was roughly equivalent to one year's exposure to ten units (although obviously, a short period of high exposure leads to harm sooner than the same total exposure over a longer time period). This is a reasonable rule of thumb when calculating your personal risk tolerance based on the ballparks outlined below.

    Bronchiolitis obliterans ("popcorn lung") is a rare endstage disease, reduced lung function was much more common. The cell damage seen in factory workers is very similar to that seen in smokers with COPD. NIOSH used spirometry (FEV1 and FVC) to assess lung function, the same method as used to measure lung function in smokers and to diagnose COPD. Compared to smokers in the general population, smoking factory workers had 2-3 times the risk of reduced lung function. Compared to non-smokers in the general population, non-smoking factory workers had 10-15 times the risk of reduced lung function.

    NIOSH recommended an occupational exposure limit of 5ppb in air, which they estimated would limit the risk to 1 in 1000 workers developing seriously reduced lung function due to workplace exposure over a 45 year working lifetime. The limit for acetyl propionyl could not be set lower than 9.3ppb, the limit of quantification in air.

    Farsalinos et al translated these limits in breathed air to ug (millionths of a gram) in vaped juice by considering how much air is breathed in by the average adult over 8 hours. They made two errors: one was to use 9.3ppb for AP when NIOSH wanted to set it at 5ppb based on evidence of similar risk to diacetyl from animal studies, the other was not adjusting for 7 days a week instead of 5. So their numbers of 65ug/day and 137ug/day should probably both be around 50ug/day for equivalent exposure but the details aren't as important as the ballparks; it isn't very precise and it never will be because we don't experiment on humans with the intention of trying to harm them.

    Pack-a-day smokers are exposed to around 7000ug/day, roughly 100 times the (5 day a week) NIOSH limit. Adjusting for 7 days a week and multiplying up the 0.1% risk threshold from the NIOSH work gives a back of an envelope prediction for the incidence of serious respiratory disease in pack-a-day smokers of 14% over 45 years. The actual observed incidence of COPD in smokers over a lifetime is 15-30%.

    So there's not a whole lot of room for vaping to be magically different. It is up to you to decide how much risk you want to take and this will depend on your personal risk vs reward trade off. People with reduced lung function or a diagnosis of COPD due to smoking are at much higher risk. If you choose to use high volumes of diketones it would be a good idea to ask your doctor to monitor your respiratory health. This is measured relative to population norms for your age and sex so it should give you a decent early warning of any harms you are accumulating due to exposure.

    Note that the numbers above are per day. Diketone content is usually reported as ppm (parts per million) or ug/ml or ug/g. All of these are roughly equivalent and the amount needs to be multiplied by the number of mls you expect to vape in a day to estimate your daily exposure from that juice.

    ADDENDUM

    There have been claims made that the factory workers were exposed to powdered diacetyl and that this is the actual problem. This is inconsistent with the evidence across sites using diacetyl in liquid, paste or powder flavourings, including a site that manufactures diacetyl (a liquid at room temperature). Furthermore, this specific question has been studied and the results suggest that, if anything, powder may present a lower risk compared to wet formulations. The following quote is from this handy bulletin that also summarises the flavours which are likely to contain diacetyl (in Table 1 at the end):

    A study comparing the concentration of diacetyl emissions from heated butter flavoring powders, pastes, and liquids found that the heated liquids and pastes produced higher airborne concentrations of diacetyl (26). However, substitution of a flavoring based only on its form as a powder should be done with caution. During a NIOSH investigation of a California flavoring manufacturing plant, the highest airborne exposure to diacetyl and acetoin occurred in the powder flavoring production area (7). Inhalation of respirable particles containing powdered flavoring substances may deliver flavoring substances deep into the lung. Further study is needed to determine the effects of these particles, including their potential to contribute to adverse respiratory effects (26). Employers should minimize each worker's exposure to all forms (powder, liquid or pastes) of diacetyl, butter flavorings, or other flavourings containing diacetyl.Auxx 2 points 29 days ago

    Great response!


    SolanaceaeEnthusiast 2 points 27 days ago

    Ahh yes , as tou touched on. Lots of people say "well more exists in tobacco smoke and no smokers get popcorn lung"

    Its because the doctors look at a pack a day smoker for 20 years with all the symptoms of copd and doagnose copd , since both copd and bronchiolitis obliterans are incurable why would they keep digging for a different diagnosis that presents the same and has the same prognosis?D-Juice 2 points 27 days ago*

    Exactly. "Popcorn lung" only exists as a diagnosis because someone was puzzled about a non-smoker getting such severe lung disease. Most of the clusters were only found for the same reason: if it's a smoker you don't ask why, non-smokers are a puzzle for conscientious doctors and competent occupational health authorities.


    D-Juice 1 point 21 days ago*

    Just reading through this article and found an apt quote:

    In the Texas coffee cases, a pulmonologist happened to question why a man in his 30s who didn't smoke suddenly had the lung capacity of a 70-year-old. He asked where the man was employed and what chemicals he worked with. The doctor ultimately identified four more workers with the same devastating lung disease. All five had been exposed to diacetyl.

    Coffee roasters’ health at risk from toxic compound

    I'm a little wary of this article as a whole (although it is a reasonable romp through the history), it doesn't really add much new, although it is useful here as the 2013 Texas coffee cluster isn't in the main (2011) NIOSH report. I think it may be exaggerating some of the dangers of very low exposures. There does seem to be a subgroup of people who are very sensitive to diketones but we don't yet know much about why.

    The authors of this article suggest it is to do with high peak exposures but there is no real evidence of that AFAIK. NIOSH simply identify them as a subgroup who are hard to study because they don't tend to stay in the job long, for obvious reasons. They did set a short-term exposure limit of 31ppb for 15 minutes (the 5ppb is an 8 hour time-weighted average) but the STEL is based on caution and no evidence.

    They seem to lean more towards a 'human variation' explanation in the NIOSH report and there is a recent study (of smokers) which suggests that this may be right: http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(15)00283-0/abstractSolanaceaeEnthusiast 1 point 21 days ago

    Do we have other options for buttery / creamy flavor? The dx free stuff must have something else? Is it also questionable healthwise?D-Juice 2 points 21 days ago*

    Forgot your Q about health risks.

    For butyric acid (and I do not know if FA use it), nothing proven to be long-term AFAIK. A respiratory irritant but that is a problem for workers forced to breathe it in all day. Vapers call it throat hit and can stop using it if it is uncomfortable.

    There have been some concerns about butyric acid combined with diketones but I'm not sure they apply to vaping. Explained in detail here:

    The Perfumer's Apprentice has a brief note about it on their custard's page:Perfumer's Apprentice


    D-Juice 1 point 21 days ago

    I like creamy flavours and I use FlavourArt almost exclusively. I assume there is butyric acid in there, it is a common substitute but you need to be a bit careful, it's like vomit at higher concentrations so two flavours containing it could get a bit much.

    FlavourArt Fresh Cream is exactly like the real thing, perhaps a bit less mouthfeel but the cool, creaminess is perfect. They have a bunch of other creams, I like Vienna Cream mixed with Chococomint and sometimes a bit of fresh cream to smooth it. But I am an erratic mixer, I don't really do recipes so I am not the best person to ask.

    Pretty sure /u/abdada posted a mouthfeel thing t'other day.








    joesphaa 1 point 28 days ago

    Believe the only issue with the study was they didn't control for factory workers who smoked cigarettes, which given the time of the study and the demographic, it is more than likely that quite of few of them did.D-Juice 1 point 28 days ago

    That's a lie spread by ChemRisk on behalf of Big Food. I've even quoted the different relative risks for smokers and non-smokers in the post above. Smoking was included in the model.joesphaa 2 points 28 days ago

    I checked the study and from what I read it seems like they controlled for that. Thanks for clearing up my misconception :)D-Juice 2 points 28 days ago

That was a hell of a read. Fantastic info though
 
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skoony

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There have been claims made that the factory workers were exposed to powdered diacetyl and that this is the actual problem. This is inconsistent with the evidence across sites using diacetyl in liquid, paste or powder flavourings, including a site that manufactures diacetyl (a liquid at room temperature). Furthermore, this specific question has been studied and the results suggest that, if anything, powder may present a lower risk compared to wet formulations. The following quote is from this handy bulletin that also summarises the flavours which are likely to contain diacetyl (in Table 1 at the end):

"Pneumoconiosis is one of a group of interstitial lung disease caused by breathing in certain kinds of dust particles that damage your lungs.

Because you are likely to encounter these dusts only in the workplace, pneumoconiosis is called an occupational lung disease.

Pneumoconiosis usually take years to develop. Because your lungs can't get rid of all these dust particles, they cause inflammation in your lungs that can eventually lead to scar tissue.
The disease appears in different forms, depending on the type of dust you inhale. One of the most common forms is black lung disease, also known as miner's lung. It’s caused by breathing in coal dust. Another is brown lung, which comes from working around dust from cotton or other fibers. Other types of dusts that can cause pneumoconiosis include silica and asbestos. Diacetyl, the compound used to give movie popcorn its buttery flavor, also can lead to the disease. This is known as popcorn lung."
Pneumoconiosis | Johns Hopkins Medicine Health Library
Apparently the fine folk's at John Hopkins Medicine disagree.
:2c:
Regards
Mike
 

crxess

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I hear of a few cases of vapers ending up with popcorn lung. How does it come about? I'd assume disastrous misuse of equipment?

It hasn't put me off at all but it's not very great reading.

I couldn't possibly prove it to be true. They were just things I read using Google back when I started. As you know Google is a fountain of truths ;)

I just saw it as an article when I Googled 'vaping pros and cons'

Admittedly it was way before I joined here when I knew virtually nothing about it

Oh that's good then. I've really gotten into vaping lately rather than something I do on and off and just wanted to cover my bases and get in the know about it all

Maybe so. But I won't learn anything unless I get taken up on it

Yeah you're right. I think I'll stick to getting my info from here from now on

As you have read -
Propaganda is a Tool
Cut and Paste is a Tool
Tools are used to complete a Task/Agenda
Tools are often Miss used

A Concern, Never fully studied, exist with specific chemicals in Flavorings due to uncommon onset illness in factory workers.

A factory Setting Condition is being used in as yet unfounded Consumer Scare tactics.

Mocking Birds are Blindly spreading the Fear to all they know.

Medical reports so far show -
No reports of Popcorn Lung from Smoking
No reports of Popcorn Lung from Vaping
No report of Popcorn Lung from Diacetyl produced naturally in human sweat :ohmy:

Reading and Comprehension are not mutually inclusive, so thank you for continuing to attempt to understand.
:2cool:

Herb, you couldn't have simply addressed the Question> Vapers have gotten Popcorn lung?

-0-:blink:
 

Nimaz

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Most of health hazards put forward about vaping to date are speculative or theoretical at best because of the detection of chemical compounds which may present risks, chemicals often detected in unrealistic experimental conditions. Diacetyl is one of these compound that have been associated with popcorn lungs in the work place, but never in vaping. Diacetyl is easily avoidable for vapers who have concerns. Searching for accurate information about health topics related to vaping is very challenging because there is an overwhelming illusion of factual risks, which after careful reading appear redundant and poorly funded. Now, consider the fact that cigarettes have never been design to become safer products, but rather more addictive and therefore more harmful. In contrast, we have reasonable control over the vaping products (so far) allowing users and manufacturers to evolve and develop products toward greater health safety, and significant progress have been performed already.
 

sofarsogood

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The public health crowd despises vaping with a passion. They must work late searching, searching, for any hint of a disease trend. I bet the CDC has an underground bunker command center full of people devoted to a 24/7 search for evidence that ecigs cause illness. Apparently they haven't got anything yet. But even if vaping was the same risk as smoking I would still vape because it is a superior experience and I save $250 a month.
 

Bad Ninja

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Here we go again.
Lol

No cases of popcorn lung have ever been linked to vaping.

The popcorn lung issue is pure propaganda based on terribly bad anecdotal evidence.

The entire theory counts on the reader to not do any research or use any common sense.

In fact every single person who got "popcorn lung" was a heavy smoker with years of industrial level exposure.
None were vapers.

The risks are 100+ times greater with smokers, who haven't had a problem until they worked in an industrial environment with heavy chemical exposure.


Btw,
There is far more anecdotal evidence linking cigarette smoking to "popcorn lung" than vaping.
 
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beckdg

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Postulation, speculation and unjustified correlation does not make a case where there are no known actual cases.

Show me a case of popcorn lung directly resulting from vaping and I'll screen my flavors with unfettered diligence and warn the world at large.

Until then :vapor: ...
why bother?

Tapatyped
 

ReigntheGamer

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I'm glad this came up since I finally have some real world data not something cooked up in a lab by some scientist with unknown motives.

Since I began vaping a little over a year ago I have been vaping a juice with diketones daily, and I mean all day everyday. I recently had a cat scan and x-rays of my chest done and both the upper and lower lobes of my lungs are "unremarkable".

But this just confirmed what I believe to be true and that is diketones for whatever reason when smoked or vape do not produce the same results as they do in an industrial setting.
 
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