Characteristics of lung injuries associated with vaping

New research looks at the lung injuries caused by vaping or e-cigarette use. The report suggests that Tetrahydrocannabinol or THC, the principal psychoactive constituent of cannabis, could be the main culprit behind this lung damage. The report on the research was published this week in the Morbidity and Mortality Weekly Report (MMWR) from the Centre for Disease Prevention and Control (CDC).

Image Credit: Oneinchpunch / SHutterstock
Image Credit: Oneinchpunch / Shutterstock

There have been 805 cases of lung injuries due to e-cigarette use reported until September 24, 2019 says the CDC. These have come from 46 different states and the U.S. Virgin Islands. There have been 12 deaths due to these injuries and these were from 10 different states. The average age of the cases was 23 years and 62 percent of the cases were between ages 18 and 34 years. Two in three of the cases were men.

The researchers behind the report explain that the lung injuries reported after use of e-cigarettes have been found after use of THC related products and nicotine containing products. This report is the first of its kind that reveals the types of cases of lung injuries reported to the CDC. The gender, age, substances used in the e-cigarettes has all been reported here for the first time. Another MMWR released from Wisconsin and Illinois shows similar findings says the CDC. The CDC recommends on the basis of these reports that individuals should abstain from using e-cigarettes especially those that contain THC. Robert R. Redfield, MD, director of the CDC said in a statement, “CDC is committed to finding out what is causing this outbreak of lung injury and death among individuals using vaping products. We continue to work with FDA and state partners to protect the nation from this serious health threat.”

The team of researchers at the CDC says that they would publish more data as they are gathered. Hundreds of cases across the nation might have been missed in the preliminary report. This report from the CDC came from 514 persons across the nation who had used the e-cigarettes and suffered lung injuries. The report states that 77 percent of the population reported using THC containing products with or without nicotine in addition. In addition 36 percent and 16 percent reported exclusive use of THC containing or nicotine e-cigarettes respectively. The CDC report from Illinois and Wisconsin also added that the THC containing cartridges for vaping were acquired from illegal dealers, off street vendors, friends and family members.

The state partners on the panel who prepared the report included Anne Schuchat, principal deputy director, CDC, Jennifer Layden, chief medical officer and state epidemiologist, Illinois Department of Public Health and Jon Meiman, chief, Bureau of Environmental and Occupational Health, Wisconsin Department of Health Services.

According to Dr. Schuchat the CDC has an ongoing in depth research “that spans nearly all states, involving serious life threatening disease in young people who report use of wide variety of products and substance in a dynamic marketplace for e-cigarettes or vaping products, which may have a mix of ingredients, complex packaging and supply chain, and includes potentially illicit substances in any given state.” She added that most users are unaware of what is present in the e-cigarette cartridges or the solution. Further, she said, “many of the products and substances themselves can be modified by a supplier or user.  They can be obtained from brick-and-mortar stores, online retailers, on the street, or through social sources.” She said, “We do not know yet what exactly is making people sick.  For example, whether solvents or adulterants are leading to lung injury or whether cases stem from a single supplier or multiple ones.  The illnesses we have been seeing are serious.”

Dr. Jon Meiman from Wisconsin next said that Illinois and Wisconsin are one of the worst affected states with this problem. He added that their team was attempting to identify the drugs that were common in all the cases of the lung injuries. He said, “In total we interviewed 86 patients across both states.  Approximately two-thirds of patients were under 25 years of age and were predominantly male.  The illness among interviewed patients was severe with nearly 60% admitted to an intensive care unit.”  

Dr. Jennifer Layden from Illinois also thanked the patients and family members of those that came forth to help this investigation. She said, “Similar to previous reports and national findings released today we continue to find most patients with vaping related lung injury report the use of THC based products with or without the use of nicotine-based products.  However there does remain a proportion of individuals who continue to report only using nicotine-based products.” She added that of the 86 interviews, they found “234 unique e-cigarette or vaping products across 87 different brands.” She said, “pre-filled THC cartridges labelled under the brand name Dank Vapes was most common with 66% of all patients reporting this name”. She also said that many of the patients had used more than one brand before they fell ill. Those on THC based products had used an average of around 2.1 products and those on nicotine products has used an average of 1.3 different brands.

The panel was asked about the steps taken by authorities to understand and cut off the supply chain. Dr. Schuchat answered the question saying, “The states are working closely with FDA and DEA and CDC is working closely as well.  The information about products is being, as well as products that exist are being provided for laboratory testing at FDA’s forensic laboratory, supply chain traced back would to be done either through FDA or DEA depending and CDC is basically in very close communication with our partners across government.” She added that the marketplace at present was dynamic and she wanted “families talk to their kids and people trying to get these products understand the potential risks.”

Dr. Ananya Mandal

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Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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