If you or some of your close friends have recently or ever used vaping products or e-cigarettes, it’s very likely that you’ve heard about the recent outbreak of EVALI. However, if you don’t belong to this group, you may wonder what EVALI is.
Well, EVALI isn’t something interesting as its fancy name sounds. Instead, EVALI is a severe, sometimes fatal, illness in the lungs that is related to the use of vaping products, and it’s the acronym for E-cigarette, or Vaping, product use-Associated Lung Injury.
The Outbreak
Since June 2019, several cases of severe lung infections had suddenly arisen in healthy individuals across multiple states, and health department officials gathered to analyze these cases. Various symptoms were noted, which included shortness of breath, fever, and inflammation in the lungs. One common thing that these public health experts found was that almost all of these patients reported recent use of e-cigarette or vaping products.
In August, with the involvement of the Centers for Disease Control and Prevention (CDC), these cases were officially recognized as the EVALI. Since then, EVALI has obtained wide awareness among the general population as well as the clinicians, and many more cases have been reported. In total, over 2,000 patients have been identified as EVALI patients with most of them (~1,800) being hospitalized. Moreover, as of Dec 3, 2019, close to 50 EVALI-related deaths have been confirmed in 25 states and the District of Columbia.
The Possible Cause
Although it was identified that these illnesses were associated with the use of e-cigarettes or vaping products, which ingredient(s) in them contributed to the illness? Just to name a few, common chemicals found in e-cigarettes or vaping products include nicotine, propylene glycol, acetyaldehyde, formaldehyde, acrolein, diacetyl, benzene, and heavy metals. These ingredients or most of them had been in these products probably since their invention. Why didn’t they cause lung diseases if they were to blame?
Laboratory analyses of fluid samples collected from EVALI patients’ lungs revealed that all of these samples had vitamin E acetate, which is a thickening additive in some e-cigarettes and vaping products that contain tetrahydrocannabinol (THC). Consistent with these laboratory results, further summary of patient interviews revealed that 80% of EVALI patients reported using THC-containing products.
Vitamin E is a natural chemical found in many foods, including vegetable oils, meat, fruits, cereals, and vegetables, and it won’t cause any health problems if it’s consumed orally. However, when vitamin E acetate is inhaled, which shouldn’t happen naturally, it will negatively impact normal lung functions by causing various respiratory and inflammatory symptoms.
The CDC and many non-federal research groups are investigating the possible contributions of other ingredients in relation to the EVALI. Thus, it is possible that chemicals other than vitamin E acetate can play a causal role in the etiology of the EVALI.
The Implications
Although e-cigarettes or vaping products are considered to be safer than conventional combustible cigarettes, people need to be cautious with their choices of e-cigarettes or vaping products. In particular, they should not use THC-containing e-cigarettes or vaping products, and they should not modify the products by adding any substances whose safety is not evaluated by the federal agencies.
Last but not the least, vape safely if you have to use any nicotine or vaping products.
