Pulmonologist explains the dangers of vaping

RADNOR >> Dr. Clarke Piatt, a pulmonologist at Bryn Mawr Hospital, is sounding the alarm about the sudden emergence of vaping-related illness that is hitting young patients.

As of Oct. 1, there were 18 vaping-related deaths in 48 states and the U.S. Virgin Islands and 1,080 cases of vaping related lung disease, according to the Centers for Disease Control. Two patients at Bryn Mawr Hospital had been treated for the vaping-related condition by mid-September, he said, and eight in the Main Line Health system.

Because many of the vaping-related illnesses have been associated with THC, the Food and Drug Administration (FDA) warned consumers Friday to stop vaping with TCH, which is derived from marijuana.

Piatt, a Radnor resident, spoke to the township Board of Health recently and also taped a Radnor TV interview with township health officer Marie Carbonara on the topic. He said that he felt compelled to speak out and warn people, both as a parent and as a physician.

Hallmarks of the new ailment include patients coming into the emergency room with shortness of breath, chest pain, a nonproductive cough and stomach ailments. Other symptoms include fatigue, fever and weight loss. Their oxygen levels are extremely low and X-rays show damage to their lungs, Piatt said. But treating them as doctors would for pneumonia with antibiotics and steroids does not seem to help. Some patients get worse and need to be placed on heartlung machines to help them breathe.

The problem seems to be e-cigarettes and other vaping devices that now deliver a bigger dose of the substances that were loaded into them, he said. Black market or offlabel THC, could be a culprit. Indeed, the CDC noted that most patients reported using products that contained THC.

Some of the vaping products use propylene glycol, which is also used to de-ice airplanes.

“You can imagine what this can do to your lungs,” Piatt said. Vitamin E is also used as a medium in vaping, he said.

“We know all these cases should be reported to Poison Control,” he said. “We’re basically solving a medical mystery now.”

While the e-cigarettes started with the intention of helping people to stop smoking, they have begun to be used for recreation and that can be very dangerous, especially for young people. Kids in elementary school and middle school have been reported to use e-cigarettes and become addicted to nicotine. Flavored cartridges, now banned by some states, appeal to kids, he said.

Unlike with smoking, kids tend to think that vaping is okay to do, he said. Parents need to warn their children about the dangers of e-cigarettes.

The CDC reports that the percentage of children using e-cigarettes has risen by 75 percent over the last two years, he said.

“The internet is quite an open market for this,” said Piatt.

Linda Schanne, chair of the Health Board, said that her son told her he sees other students who are vaping in the back of classrooms and in bathrooms.

“I think getting the word out there is critically important,” said Schanne.

“From the frontline of medicine I’ve not seen anything like this in my career in medicine,” Piatt told Carbonara later. And because this epidemic is new the medical community does not know what the long-term health effects of vaping will be. However, he said, there is also an immediate concern of people becoming addicted to nicotine.

“There’s an exponential change in this,” said Piatt. “In part, because of the technology, with the advent of (new) batteries, the ability to mass produce these products quickly and get it out through the internet,” said Piatt.

Meanwhile, the Pennsylvania Department of Health reported nine confirmed and 12 probable cases of lung injury associated with vaping in the state. An additional 63 cases under investigation as vaping related. Pennsylvania has one confirmed death from lung injury associated with vaping.

“The lung injury cases are very serious, life-threatening and even fatal,” said Dr.Rachel Levine, secretary of health for Pennsylvania, in a press release. “We do not yet know what is making people sick, and whether the illnesses are related to products being used, or potentially the delivery of those products. I strongly urge everyone who is vaping illegally bought products, in particular those with THC, to stop. In addition, there could be possible risks with legally purchased products. We want to warn people that investigations are ongoing and we advise they use extreme caution before using any vaping product at this time.”

Vaping as part of a medical marijuana program can carry risks and concerned patients should talk to their doctors, Levine said.

Both New Jersey and Delaware also have one case of vaping-related death each. Some 70 percent of those patients with lung damage from vaping were male; 80 percent were under age 35 and 16 percent were under 18 years old, according to the CDC. And 21 percent were 18 to 20 years old.