Lung problems linked to vaping
DEAR DOCTOR: What’s going on with that outbreak of lung disease that’s hitting people who vape?
DEAR READER: You’re not alone in your concerns. Federal health officials have said that close to 200 cases of a serious lung disease that appears to be associated with vaping have been reported. There now also appears to have been at least one death caused by this illness, an adult male in Illinois, according to officials in the state.
The Centers for Disease Control and Prevention is investigating reports from 22 states to date. Most cases involve males ranging in age from 17 to 38. The U.S. Food and Drug Administration is continuing to investigate a potential link between the use of e-cigarettes and serious neurological symptoms, including seizures, fainting and tremors.
Symptoms of the respiratory illness include pressure or tightness in the chest, shortness of breath and difficulty breathing that becomes progressively worse. Some patients also have experienced fever, weight loss, nausea, fatigue and diarrhea. Imaging tests of the patients’ lungs have all revealed abnormalities, including areas of increased density, known as opacities.
In some cases, patients have required mechanical ventilation to aid in breathing and have improved after treatment with corticosteroids. An 18-year-old man in Florida who vaped went to a hospital emergency room and learned he had a hole in his right lung, which had caused it to collapse. Tests for infectious agents have been largely negative, which has added to the mystery of what is causing the disease. One behavior all patients have had in common is recent vaping.
The challenge is that the similarities end there. The patients had inhaled a variety of products, including cannabis-based products, nicotine and homemade substances. They had used a number of different vaping devices. They had purchased the products in a variety of stores and via several different online retailers. This has led investigators to turn their attention to the delivery system of vaping devices.
E-cigarettes work by using a coil to superheat a liquid and turn it into an aerosol, which is then inhaled. These super-fine particles can then be drawn deep into the lungs. Vaping liquids contain numerous volatile organic chemicals and other substances, not all of which are identified on the packaging. Some of them are known to be potentially harmful. The flavorings used in vaping liquids also contain numerous compounds whose long-term health effects are unknown.
As federal and state health officials continue to investigate, medical professionals and the public have been asked to report any vaping-related symptoms or illnesses, along with specifics about the products that were used, to state health authorities.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.
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