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1 Million Adult Vapers in England Have Never Regularly Smoked

The AHA! Team — Fri, 15 Nov 2024 06:20:34 +0000

Priyanjana Pramanik, MSc. via News-Medical – This rapid increase between 2021 and 2024 was particularly among younger age groups. In a recent study published in The Lancet Public Health, researchers estimate trends in vaping among adults in the United Kingdom who have not smoked regularly. The health implications of vaping In the past, vaping or the use of e-cigarettes in England was primarily reported among current or former smokers trying to reduce or quit smoking. If vaping were only adopted by those who would otherwise smoke, the overall rate of smoking or vaping would remain constant or show signs of declining rather than increasing. The rising rate of vaping could be attributed to the widespread availability of disposable e-cigarettes in recent years, which has led to a rapid increase in vaping among regular and non-regular smokers. Although e-cigarettes may be less harmful than smoking, these devices contain toxic chemicals that the user consumes. In fact, several studies indicate that vapers are exposed to higher levels of toxicants than non-users. About the study Researchers collected data using a monthly cross-sectional survey across England, Wales, and Scotland to ensure a nationally representative sample. Approximately 2,450 individuals participated in the survey each month between 2016 and early 2024. The vaping status of adults who reported never regularly smoking was evaluated using questions about their current e-cigarette use, daily or non-daily e-cigarette use, as well as as the type of device and strength of nicotine used. Study participants also provided sociodemographic data such as gender, age, and social class, as well as lifestyle information such as alcohol consumption. Statistical models were used to calculate trends in the prevalence of smoking after adjusting for alcohol consumption and sociodemographic characteristics. These trends were then assessed according to age, with the prevalence of vaping compared before and after the increased availability of disposable e-cigarettes. Study findings The analysis included 94,107 unique never-regular smokers, as well as younger individuals who had never smoked. Vaping among never-regular smokers was stable at approximately 0.5% until 2021. From 2021 onwards, vaping increased rapidly to 3.5% in April 2024. This increased prevalence of vaping was primarily attributed to younger adults under the age of 24, 14.4% of whom vaped, as compared to those over the age of 48, less than 1% of whom vaped. Although age differences were significant, trends were similar across social class and gender. Alcohol consumption was positively correlated with vaping prevalence, with heavy drinkers more likely to vape at a rate of 22.1%. Comparatively, only 3% of low-risk drinkers and 1.3% of non-drinkers vaped. Throughout the analysis period, non-daily vaping was less common than daily vaping, but the prevalence of daily vaping was four times greater than that of non-daily vaping. Researchers also found clear indications that disposable e-cigarettes are implicated in these trends. In the post-disposable period, users were more likely to report longer vaping durations, with a reduced prevalence of short-term use. Since disposable devices have become more common, vapers are increasingly younger, heavier drinkers, and more likely to be female. There is also a pronounced shift towards disposable e-cigarettes and devices with higher nicotine strengths. More purchases were also reported from convenience stores or supermarkets, and fewer from vape shops. Conclusions The study findings demonstrate the significant rise in vaping rates in England over the past three years, specifically among those who are not regular smokers, as well as younger adults and heavier drinkers. In 2021, one in 200 never-regular smokers reported vaping. By April 2024, this rate increased to one in 28. Disposable e-cigarettes, which appear to appeal to younger adults and women, may encourage the use of higher nicotine strengths. The health impacts of these behavioral shifts may be significant, particularly among individuals who would not typically engage in vaping, which increases their exposure to toxins they would have otherwise avoided. Addressing these issues is associated with various challenges as policymakers seek to reduce vaping among non-smokers while ensuring that e-cigarettes are available and remain attractive to smokers who would like to quit. Stricter regulations on the appearance, pricing, and marketing of these products may support these public health efforts to reduce the appeal of vaping. Journal reference: Jackson, S.E., Shahab, L., Tattan-Birch, H., & Brown, J. (2024). Vaping among adults in England who have never regularly smoked: a population-based study, 2016–24. The Lancet Public Health. doi:10.1016/S2468-2667(24)00183-X To read the original article click here.

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Some E-Cigarette Chemicals Mimic Nicotine, Possibly Bypassing Regulation

The AHA! Team — Fri, 11 Oct 2024 08:21:24 +0000

Duke Health – In what appears to be an effort to bypass public health regulations covering vaping products, some tobacco companies have begun replacing nicotine in e-cigarettes with related chemicals that have similar properties but unknown health effects, Duke Health researchers report. In a research letter appearing Aug. 7 in JAMA, study authors at Duke and Yale University also found that the quantity of these chemicals, known as nicotine analogs, are not accurately disclosed on the packaging. “Vaping products containing nicotine are subject to federal laws that prohibit sales to people under the age of 21,” said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine. Nicotine analogs are currently not subject to the FDA process “Nicotine analogs are currently not subject to the FDA process and have not been studied for their health effects,” Jabba said. “Our analysis of some of these analog-containing vaping products sold in the U.S. found significant and concerning inaccuracies in the ingredients these products claim to contain and what they actually contain. Further, it’s possible manufacturers are attempting to avoid FDA tobacco regulation.” One chemical, known as 6-methyl nicotine, has been shown in rodent experiments to be far more potent than nicotine in targeting the brain’s nicotine receptors and more toxic than nicotine. Another, called nicotinamide, is marketed as targeting the same brain receptors as nicotine, despite evidence it does not bind to these receptors. The nicotine analogs were included in flavored e-cigarettes, which prior research has indicated are preferred by youths and those who vape for the first time. Jabba and colleagues, including co-senior author Sven Eric Jordt, Ph.D., analyzed an e-cigarette product sold under the brand name Spree Bar, which comes in at least nine flavors and is listed as containing 5 percent 6-methyl nicotine. Study results showed the actual amount of the chemical was about 88% less than labeled. The e-cigarettes also included an artificial sweetener that is up to 13,000 times sweeter than table sugar, and an artificial coolant that mimics menthol’s effects. A second brand of e-cigarettes — marketed as Nixotine, Nixodine, Nixamide and Nic-Safe – contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine. This brand did not include sweeteners or coolants. These products appear to be designed to circumvent the laws and regulations “These products appear to be designed to circumvent the laws and regulations in place to protect people — especially children — from the harmful effects of smoking and tobacco use,” Jordt said. “We do not know what these chemicals do when they are heated and inhaled. These are questions that should be answered before we allow products on the market.” In addition to Jordt and Jabba, study authors include Hanno C. Erythropel, Peter Silinski, Paul T. Anastas, Suchitra Krishnan-Sarin and Julie B. Zimmerman. Yale’s Tobacco Center of Regulatory Science received funding support for the study from the National Institute on Drug Abuse, which is part of the National Institutes of Health (U54DA036151), and the Center for Tobacco Products of the FDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA. To read the original article click here.

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FDA Bans Juul E-Cigarettes Tied to Teen Vaping Surge

AHA Publisher — Mon, 27 Jun 2022 07:00:15 +0000

Matthew Perrone via CBN News – WASHINGTON (AP) — Federal health officials on Thursday ordered Juul to pull its electronic cigarettes from the U.S. market, the latest blow to the embattled company widely blamed for sparking a national surge in teen vaping. The action is part of a sweeping effort by the Food and Drug Administration to bring scientific scrutiny to the multibillion-dollar vaping industry after years of regulatory delays. The FDA said Juul must stop selling its vaping device and its tobacco and menthol-flavored cartridges. Those already on the market must be removed. Consumers aren’t restricted from having or using Juul’s products, the agency said. To stay on the market, companies must show that their e-cigarettes benefit public health. In practice, that means proving that adult smokers who use them are likely to quit or reduce their smoking, while teens are unlikely to get hooked on them. The FDA noted that some of the biggest sellers like Juul may have played a “disproportionate″ role in the rise in teen vaping. The agency said Thursday that Juul’s application didn’t have enough evidence to show that marketing its products “would be appropriate for the protection of the public health.” A Juul representative did not immediately respond to a request for comment from The Associated Press. In a statement, the FDA said Juul’s application left regulators with significant questions and didn’t include enough information to evaluate any potential risks. The agency said the company’s research included “insufficient and conflicting data” about things like potentially harmful chemicals leaching from Juul’s cartridges. “Without the data needed to determine relevant health risks, the FDA is issuing these marketing denial orders.” Michele Mital, acting director of the FDA’s tobacco center, said in the statement. The agency has granted some e-cigarette applications. Since last fall, the agency has given its OK to tobacco-flavored e-cigarettes from R.J. Reynolds, Logic, and other companies. But industry players and anti-tobacco advocates have complained that those products account for just a tiny percent of the $6 billion vaping market in the U.S. Regulators repeatedly delayed making decisions on devices from market leaders, including Juul, which remains the best-selling vaping brand although sales have dipped. Last year, the agency rejected applications for more than a million other e-cigarettes and related products, mainly due to their potential appeal to underage teens. The American Lung Association called Thursday’s decision “long overdue and most welcome,” and cited Juul for stoking youth vaping. E-cigarettes first appeared in the U.S. more than a decade ago with the promise of providing smokers with a less harmful alternative. The devices heat a nicotine solution into a vapor that’s inhaled, bypassing many of the toxic chemicals produced by burning tobacco. But studies have reached conflicting results about whether they truly help smokers quit. And efforts by the FDA to rule on vaping products and their claims were repeatedly slowed by industry lobbying and competing political interests. The vaping market grew to include hundreds of companies selling an array of devices and nicotine solutions in various flavors and strengths. The vaping issue took on new urgency in 2018 when Juul’s high-nicotine, fruity-flavored cartridges quickly became a nationwide craze among middle and high school students. The company faces a slew of federal and state investigations into its early marketing practices, which included distributing free Juul products at concerts and parties hosted by young influencers. In 2019, the company was pressured into halting all advertising and eliminating its fruit and dessert flavors. The next year, the FDA limited flavors in small vaping devices to just tobacco and menthol. Separately, Congress raised the purchase age for all tobacco and vaping products to 21. But the question of whether e-cigarettes should remain on the market at all remained. The FDA has been working under a court order to render its decisions; anti-tobacco groups successfully sued the agency to speed up its review. FDA regulators warned companies for years they would have to submit rigorous, long-term data showing a clear benefit for smokers who switch to vaping. But all but the largest e-cigarette manufacturers have resisted conducting that kind of expensive, time-consuming research. While Juul remains a top seller, a recent federal survey shows that teens have been shifting away from the company. Last year’s survey showed Juul was the fourth most popular e-cigarette among high schoolers who regularly vape. The most popular brand was a disposable e-cigarette called Puff Bar which comes in flavors like pink lemonade, strawberry, and mango. That company’s disposable e-cigarettes had been able to skirt regulation because they use synthetic nicotine, which until recently was outside the FDA’s jurisdiction. Congress recently closed that loophole. Overall, the survey showed a drop of nearly 40% in the teen vaping rate as many kids were forced to learn from home during the pandemic. Still, federal officials cautioned about interpreting the results given they were collected online for the first time, instead of in classrooms. The brainchild of two Stanford University students, Juul launched in 2015 and within two years rocketed to the top of the vaping market. Juul, which is partially owned by tobacco giant Altria, still accounts for nearly 50% of the U.S. e-cigarette market. It once controlled more than 75%. On Tuesday, the FDA also laid out plans to establish a maximum nicotine level for certain tobacco products to reduce their addictiveness. In that announcement, the agency also noted that it has invested in a multimedia public education campaign aimed at warning young people about the potential risks of e-cigarette use. ___ AP Health Writer Tom Murphy contributed to this report. Copyright 2022 by The Associated Press. All rights reserved. To read the original article click here.

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New Studies Suggest Vaping Could Cloud Your Thoughts

AHA Publisher — Mon, 04 Jan 2021 08:00:57 +0000

University of Rochester Medical Center via EurekAlert – Two new studies from the University of Rochester Medical Center (URMC) have uncovered an association between vaping and mental fog. Both adults and kids who vape were more likely to report difficulty concentrating, remembering, or making decisions than their non-vaping, non-smoking peers. It also appeared that kids were more likely to experience mental fog if they started vaping before the age of 14. While other studies have found an association between vaping and mental impairment in animals, the URMC team is the first to draw this connection in people. Led by Dongmei Li, Ph.D., associate professor in the Clinical and Translational Science Institute at URMC, the team mined data from two major national surveys. “Our studies add to growing evidence that vaping should not be considered a safe alternative to tobacco smoking,” said study author Li. The studies, published in the journals Tobacco Induced Diseases and Plos One, analyzed over 18,000 middle and high school student responses to the National Youth Tobacco Survey and more than 886,000 responses to the Behavioral Risk Factor Surveillance System phone survey from U.S. adults. Both surveys ask similar questions about smoking and vaping habits as well as issues with memory, attention and mental function. Both studies show that people who smoke and vape – regardless of age – are most likely to report struggling with mental function. Behind that group, people who only vape or only smoke reported mental fog at similar rates, which were significantly higher than those reported by people who don’t smoke or vape. The youth study also found that students who reported starting to vape early – between eight and 13 years of age – were more likely to report difficulty concentrating, remembering, or making decisions than those who started vaping at 14 or older. “With the recent rise in teen vaping, this is very concerning and suggests that we need to intervene even earlier,” said Li. “Prevention programs that start in middle or high school might actually be too late.” Adolescence is a critical period for brain development, especially for higher-order mental function, which means tweens and teens may be more susceptible to nicotine-induced brain changes. While e-cigarettes lack many of the dangerous compounds found in tobacco cigarettes, they deliver the same amount or even more nicotine. While the URMC studies clearly show an association between vaping and mental function, it’s not clear which causes which. It is possible that nicotine exposure through vaping causes difficulty with mental function. But it is equally possible that people who report mental fog are simply more likely to smoke or vape – possibly to self-medicate. Li and her team say that further studies that follow kids and adults over time are needed to parse the cause and effect of vaping and mental fog. To read the original article click here.

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Study looks at Lung Injury and Vaping THC and Vitamin E Acetate

AHA Publisher — Sun, 15 Mar 2020 07:00:39 +0000

Dr. Liji Thomas, MD via News-Medical Net – The US has witnessed a spate of patients presenting with acute lung injury associated with e-cigarettes or vaping product use. A new study published in the journal JAMA Internal Medicine shows the pattern of the outbreak in California where recreational cannabis use is legal and which has among the maximum cases of the strange illness. Vaping is the practice of using electronic or e-cigarettes, which has exploded into prominence among the younger generation in the US. The basic principle is the heating of the liquid within the device’s canister to produce an aerosol that is then inhaled. The fluids may contain one or more of a variety of ingredients, including nicotine, various cannabis constituents, flavorings, and other chemicals. The chief danger of vaping is the lack of regulation.From August 2019 to date, over 2,700 patients have been reported with e-cigarette, or vaping, associated lung injury (EVALI) in all the states of the US. The Study The investigators used data on 160 patients admitted in hospital with EVALI between August 7 and November 8, 2019. The patient data came from treating doctors who reported them to the local health department, which in turn transmitted the information to the California Department of Public Health. The data included epidemiologic and laboratory data on the patients, who underwent interviews based on a standard format. The questions assessed the types of vaping products used, how often they were used, and how the patients acquired them. The vaping products provided for investigation by some of the patients also underwent testing for active ingredients. The Results The investigators found that among 160 patients with EVALI of whom approximately 60% were male, with a median age of 27 years, about half received intensive care, and a little less than a third had to be put on mechanical ventilation. Four of them died in hospital. Of the 160 patients, 86 were subject to interview. Among this group, 83% said they vaped products containing tetrahydrocannabinol (THC), which is the psychoactive component of cannabis. 43% had vaped products containing cannabidiol (CBD), another principal constituent of the same plant. 47% had vaped products containing nicotine. Of the 87 products that showed only the presence of THC, over 90% were prefilled cartridges but only 48% of nicotine-only cartridges. Where did they get the products from? 75% of them had got their THC-containing vaping products from friends, unlicensed vendors, and other informal sources. 87 vaping products tested were obtained from only 24 of the 160 patients. The results showed that 56% had THC. 84% of this subset had vitamin E or vitamin E acetate, but none of the nicotine-containing subset. Flavorings were added to 56% and 76% of the THC- and nicotine-containing products, respectively. The median period from the last use of the vaping product to the onset of EVALI symptoms and hospital admission was 3 and 5 days, respectively. About 40% had smoked or were smoking conventional cigarettes as well. Common symptoms included cough, shortness of breath, and fever with chills, besides one or more gut symptoms. Laboratory criteria of intense inflammation were present. Implications The pattern of use of vaping product by type, as well as the clinical features of the patients, were broadly similar to the overall trends seen in other US states. It is noteworthy that though California permits the recreational use of cannabis by adults, most of the THC-containing products came from informal sources. The authors emphasize, “These findings underscore the importance for all clinicians, including outpatient health care providers, to consider EVALI in patients with a history of vaping who present with typical findings of infection, as well as monitor their clinical course and respiratory status closely for decompensation, in accordance with CDC guidance.” Secondly, more female than male patients seemed to require ICU admission, suggesting that females fare worse on exposure to tobacco smoke and other environmental toxins. Thirdly, depression, and anxiety are the most common illnesses found in patients with EVALI in California, which could indicate that such patients vape at higher rates or that such patients are at higher risk of EVALI. Again, vitamin E or vitamin E acetate proved to be present in most products containing THC. The study concludes, “The California Department of Public Health recommends that individuals refrain from using any vaping or e-cigarette products, particularly THC-containing products from informal sources, while this investigation is ongoing.” To read the original article click here.

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Best Practice Treatment Guidelines Help Doctors Identify and Treat Vaping-Associated Lung Injuries

AHA Publisher — Tue, 19 Nov 2019 08:00:54 +0000

Intermountain Medical Center via EurekAlert – As the outbreak of lung injuries and deaths associated with e-cigarettes, or vaping, continues to spread across the U.S., researchers at Intermountain Healthcare in Salt Lake City have effectively developed a best practice treatment guide to quickly identify and treat patients who develop the new and potentially fatal respiratory injury, according to a new study. “This is still an ongoing outbreak, and not something we’ve seen with vaping before,” said Denitza Blagev, MD, a pulmonary and critical care physician at Intermountain Healthcare, who is the lead author of a new study that outlines best practices for treatment for patients with e-cigarette or vaping-associated lung injury (E-VALI). The study is published in the November 8, 2019, issue of The Lancet, one of the world’s best-known and most prestigious peer-reviewed medical journals. The lung injury diagnosis and treatment guidelines developed by Intermountain Healthcare clinicians are based on the cumulative clinical experience of treating more than 60 patients throughout the health system’s 24 hospitals and 215 clinics. The Intermountain guidelines recommend shorter courses of moderate-dose steroids for patients who are either treated as outpatients, or admitted to hospitals, and higher doses of intravenous steroids that are tapered more slowly for patients who are critically ill on admission. Clinicians also recommend close outpatient follow-up, as complications after initial recovery are recognized. “Through sharing the guideline, we’re reaching clinicians and keeping e-cigarette or vaping-associated lung injury on everyone’s minds, especially as we enter flu season and diagnosing vaping associated lung injury becomes more challenging,” said Dr. Blagev. “We now have a standardized approach to treat these patients, and we’re starting to learn about what the recovery and complications are,” she added. “Time will show us the long-term outcomes and the cause of this new disease, but in the meantime, the surest way to prevent lung injuries associated with e-cigarettes, or vaping, is not to vape.” In the study, Intermountain Healthcare researchers identified 60 E-VALI patients at 13 different Intermountain hospitals or clinics in Utah from June 27, 2019, through October 4, 2019. The diagnosis was defined by a history of vaping or e-cigarette use within 90 days prior to symptoms, abnormalities shown in chest imaging, and no other cause for these findings (such as pneumonia). While the majority of E-VALI patients were admitted to an intensive care unit, many weren’t critically ill and recovered more quickly. These patients typically had flu-like symptoms, shortness of breath, cough, chest pain, and abdominal symptoms such as nausea, vomiting, and abdominal pain. Most patients with lung injuries associated with e-cigarettes or vaping were treated with antibiotics (due to overlapping pneumonia symptoms), oxygen, and steroids. While specific infectious disease testing was negative for all of the patients, most received antibiotics, researchers reported. The Intermountain clinicians attribute the clinical improvement of the patients’ health to the positive effect of the steroids they received. Most patients started to show improvement within days, researchers noted, however, six of the patients — or 10 percent of those enrolled in the study — relapsed and had complications that required hospital readmission. The majority of patients who were readmitted to the hospital had been critically ill when they initially came in for care, and half of them had resumed vaping after discharge, researchers reported in the Lancet study. In the first study to report follow-up findings for these patients, Intermountain clinicians performed a short follow-up exam after two weeks and found that, although most patients had improved significantly, many had residual abnormalities. Only 23 percent of the patients still needed supplementary oxygen, but most still showed some signs of lung abnormalities on their imaging and breathing tests. These findings are helping physicians recognize what lung injuries associated with e-cigarettes or vaping look like — and helping them maintain a high degree of suspicion when they diagnose lung injuries in patients who’ve been vaping. “Being vigilant about obtaining a patient’s vaping history when they’re admitted and keeping it in mind throughout their hospital stay, is essential,” said Dr. Blagev. “For some patients in our study, their vaping history didn’t emerge until they were well into the course of their disease.” While the majority of E-VALI patients vaped THC, some reported only vaping nicotine. Intermountain researchers reported no clear pattern emerged in terms of vaping device or the source of the vaping liquids among the patients. Patients in the study reported obtaining vaping e-liquids from local dealers or vape shops, friends, or social medial apps. Without a known cause of e-cigarette or vaping-associated lung injury, current recommendations are to avoid all e-cigarette or vaping exposure, Intermountain researchers advised in the study. According to the U.S. Centers for Disease Control and Prevention, 1,888 cases of e-cigarette or vaping-associated lung injury have been reported in the United States, including 37 deaths in 24 states. In Utah, 109 cases of E-VALI have been confirmed, with another seven cases under investigation in the state, as of Oct. 28. Dr. Blagev and her colleagues at Intermountain began to see E-VALI patients early last summer. The first case at Intermountain was recognized by pulmonologist Dixie Harris, MD, who, through her work in the Intermountain TeleHealth Critical Care service, noticed a cluster of patients seeking treatment at multiple Intermountain hospitals throughout Utah. The Intermountain TeleHealth Critical Care service is a systemwide proactive monitoring and response center where intensivist physicians and critical care nurses monitor data on large patient populations and provide clinical decision support remotely as bedside staff care for individual patients in hospitals throughout the Mountain West. The Intermountain TeleHealth Critical Care service allowed the rapid formation of a centralized task force, which enabled tracking and public reporting of cases, and sharing of clinical expertise among clinicians, according to the study. “The use of the TeleHealth Critical Care service allowed us to recognize the outbreak much earlier than if we had only relied on reports of separate cases in individual hospitals,” Dr. Blagev noted. To read the original article click here.

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Harmful Metals Found in Vapors From Tank-Style Electronic Cigarettes

AHA Publisher — Mon, 30 Sep 2019 07:00:34 +0000

University of California – Riverside via EurekAlert – “Concentrations of the metals, such as lead, in the aerosols increased with more voltage,” Williams said. “Concentrations of some elements – chromium, lead, and nickel – were high enough to be a health concern. We found the concentrations of chromium, copper, lead, nickel, and zinc exceeded the proposed permissible exposure limit from the Occupational Safety and Health Administration.” RIVERSIDE, Calif. – A team of scientists at the University of California, Riverside, has found the concentration of metals in electronic cigarette aerosols – or vapor – has increased since tank-style electronic cigarettes were introduced in 2013. Electronic cigarettes, which consist of a battery, atomizing unit, and refill fluid, are now available in new tank-style designs, equipped with more powerful batteries and larger capacity reservoirs for storing more refill fluid. But the high-power batteries and atomizers used in these new styles can alter the metal concentrations that transfer into the aerosol. “These tank-style e-cigarettes operate at higher voltage and power, resulting in higher concentrations of metals, such as lead, nickel, iron, and copper, in their aerosols,” said Monique Williams, a postdoctoral researcher in the Department of Molecular, Cell, and Systems Biology, and the first author of the research paper that appears today in Scientific Reports. “Most of the metals in e-cigarette aerosols likely come from the nichrome wire, tin solder joints, brass clamps, insulating sheaths, and wicks – components of the atomizer unit.” The researchers examined six tank-style electronic cigarettes and found all the aerosols had metals that appeared to originate in the atomizers. Further, they found the model with fewest metal parts in its atomizer had the fewest metals in its aerosol. Of the 19 metals they screened, aluminum, calcium, chromium, copper, iron, lead, magnesium, nickel, silicon, tin, and zinc were from components in the atomizing units. “Concentrations of the metals, such as lead, in the aerosols increased with more voltage,” Williams said. “Concentrations of some elements – chromium, lead, and nickel – were high enough to be a health concern. We found the concentrations of chromium, copper, lead, nickel, and zinc exceeded the proposed permissible exposure limit from the Occupational Safety and Health Administration.” Chromium, lead, and nickel are known carcinogens. Prolonged exposure to chromium could cause gastrointestinal effects, nasal and lung cancer, respiratory irritation, and lung function impairment. Prolonged exposure to lead could produce vomiting, diarrhea, cardiovascular effects, and lung cancer. Nickel inhalation could cause lung disease, damage to the nasal cavity, lung irritation, lung inflammation, hyperplasia in pulmonary cells, and fibrosis. The researchers analyzed the following six tanks and their atomizers: Kangertech Protank, Aspire Nautilus tank, Kanger T3S tank, Tsunami 2.4, Smok tank, and Clone. They collected aerosols from these brands using two methods and found the total concentrations of metals varied, ranging from 43 to 3,138 micrograms per liter with the “impinger method” of collection and 226 to 6,767 micrograms per liter with the “cold trap method.” “When batteries with more power are used in these tank-style e-cigarettes, their atomizing units can heat to temperatures greater than 300 C, which could produce harmful byproducts,” said Prue Talbot, a professor of cell biology, who led the research team. “The presence of heavy metals, including some known carcinogens, in e-cigarette aerosols is concerning because with prolonged exposure they could cause adverse health effects. “Our data on tank-style e-cigarettes and the concentrations of metals they deliver may be useful to regulatory agencies, health care providers, and consumers,” she added. To read the original article click here.

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Mysterious Vaping Illness Characterized by Fat-Laden Cells in the Lung

The AHA! Team — Wed, 11 Sep 2019 07:00:00 +0000

University of Utah via EurekAlert (Salt Lake City) – Lung scans from patients with vaping illness look like a serious viral or bacterial pneumonia, but those tests come back negative. Instead, diagnosis has been based on exclusion of known causes of similar respiratory illnesses combined with knowing the patient has a history of vaping. Doctors have identified a previously unrecognized characteristic of the vaping-related respiratory illness that has been emerging in clusters across the U.S. in recent months. Within the lungs of these patients are large immune cells containing numerous oily droplets, called lipid-laden macrophages. (Lipid-laden macrophages found in patients with vaping-related respiratory illness. Oily lipids are stained in red. Photo via Andrew Hansen, MD, Jordan Valley Medical Center). The finding may allow doctors to definitively diagnose the nascent syndrome more quickly and provide the right treatment sooner. It could also provide clues into the causes of the new and mysterious condition. Investigators at University of Utah Health reported the findings in a letter published in the New England Journal of Medicine on Sept. 6. “While it is too soon to be sure, these lipid-laden macrophages may turn out to be useful to confirm or rule out this disease,” said the study’s senior author Scott Aberegg, M.D., a critical care pulmonologist at U of U Health. “They may also be helpful in understanding what is causing this illness,” Aberegg added. Watch a video of physicians and patients talking about their experiences with the vaping illness here. Lung scans from patients with vaping illness look like a serious viral or bacterial pneumonia, but those tests come back negative. Instead, diagnosis has been based on exclusion of known causes of similar respiratory illnesses combined with knowing the patient has a history of vaping. U of U Health investigators identified the lipid-laden macrophages in six out of six cases seen at University of Utah Hospital in Salt Lake City by the time of submitting the results for publication. The cells were found in samples after performing a procedure called bronchoalveolar lavage where fluid is squirted into a small section of the lungs and then collected for examination. Macrophages are a type of cell from the immune system that gather at sites of infection and perform the role of cleaning up debris. Staining them with a dye called Oil-red-O highlighted the oily droplets littered throughout these cells. Distinctive cells “These cells are very distinctive, and we don’t often see them. That made everybody start to think carefully about why they were there. Are they scavenging debris in the lungs that was introduced through vaping?” Aberegg said. Doctors at the U had the test performed on the first vaping patient treated at U of U Health in July 2019, after the referring doctor had suggested the patient could have lipoid pneumonia. The condition is diagnosed by screening for lipid-laden macrophages. After finding the marker in this patient, doctors performed the same test in subsequent patients suspected to have the vaping illness, and all were positive. Since submitting their findings for publication, the number of vaping illness cases with lipid-laden macrophages has risen to ten of ten patients examined, with new cases arriving weekly. The question remains as to whether the vaping respiratory illness is a type of lipoid pneumonia. Despite similarities, there are also differences. Unlike the vaping illness, classic lipoid pneumonia is typically seen in older individuals, typically caused by accidentally breathing in oil-based laxatives. Classic lipoid pneumonia also presents differently on x-rays of the lungs. Additional testing will need to be done to determine whether the vaping illness can be categorized as a new kind of lipoid pneumonia. “We need to determine if these cells are specific for the illness or whether they are also seen in vaping patients who are not ill and don’t have symptoms. If they are only seen in patients who get sick, we can begin to make some connections between what we’re seeing in the lipid laden macrophages and whatever components of the vaping oils may be causing this syndrome” Aberegg said. To read the original article click here.

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