September 9, 2019 – Health officials in the U.S. are investigating an outbreak of lung injuries and deaths related to the use of e-cigarettes and other vaping products. , Elkan Blout Professor of Environmental Genetics at Harvard T.H. Chan School of Public Health, discussed his research on the dangers of vaping and his recent NEJM editorial on the topic.
Q: Earlier this year, you co-authored a study about . Does that research give us any insights into what might be causing the current rash of respiratory distress cases among people who use e-cigarettes and vaping products?
A: Possibly. The biologically-related contaminants we found in our research add to a long list of that are in e-cigarette fluids. These contaminants, though they are related to bacteria and fungi, are not causing infections—they are substances produced even by non-living organisms and these agents cause severe inflammation. The recent epidemic reveals that the majority (about 80-84%) of affected people used a combination of marijuana-related and nicotine types of products. So, the resultant mixture may well be responsible for the rapid lung injury response, as opposed to a single toxin. Also, it’s important to note that these cases may resemble infections, but they are not. The pattern of the current epidemic is inflammatory lung injury.
Q: From your perspective as a physician, what’s unique about this cluster of cases and what troubles you about it?
A: What we are seeing is an epidemic of a non-infectious pneumonia-like syndrome that can be severe enough to result in death and is precipitated by a short-term exposure—in this case, the use of vaping products. The pattern of inflammation in the lung varies widely patient to patient, as does the severity of the different types of inflammation, which suggests maybe more than one offending toxin is responsible. This makes it hard for doctors to treat such illnesses. But supportive care and steroids (like prednisone) seem to be effective in many, if not most cases, even when we do not know the specific cause.
A: It needs to be multipronged. There needs to be a response from medical professionals to discourage the use of these products and quickly report suspected cases to the U.S. Centers for Disease Control and Prevention. There needs to be a response from local public health departments to increase awareness about the dangers of vaping, especially the potential hazards of mixing THC or CBD products with nicotine e-cigarettes. We need to educate young people about the harmful effects of vaping. Lastly, the general public and public health professionals alike should report suspected products to the .