Early results of an experimental vaping study show significant lung injury from e-cigarette devices with nickel-chromium alloy heating elements.
The findings, from the study with rodents, remained consistent, with or without the use of nicotine, vitamin E oil, or tetrahydrocannabinol (THC). Health experts had previously thought these factors contribute to the life-threatening respiratory problem.
Researchers observed these early results, reported in the Journal of American Heart Association, during a larger study designed to explore the effect of e-cigarette and other vaping product use on the cardiovascular system.
While conducting experiments, researchers observed e-cigarette or vaping product use-associated lung injury (EVALI) immediately after switching from a vaping device with a stainless steel heating element, to one that used nickel-chromium alloy.
“The results were so impactful, we felt it imperative to release the initial findings early so that electronic cigarette users could be cautioned sooner, especially considering e-cigarette users are at increased risk of COVID-19,” says senior author Robert A. Kloner, chief science officer for the Huntington Medical Research Institutes (HMRI) and professor of medicine at the University of Southern California.
“THE HARMS ASSOCIATED WITH E-CIGARETTES AND VAPING SIMPLY CANNOT BE OVERSTATED.”
The switch in devices occurred in September 2019, when the e-cigarette device the team used went off market and they used a substitute device as an alternative. The new device was physically compatible with the original exposure system, but the heating element changed from stainless steel to a nickel‐chromium alloy.
“Within an hour of beginning an experiment, we observed evidence of severe respiratory distress, including labored breathing, wheezing, and panting,” says Michael Kleinman, professor of occupational and environmental medicine at the University of California Irvine School of Medicine and member of the UCI Center for Occupational and Environmental Health.
“After analyzing lung tissue from subjects in the study, we found them to be severely compromised and observed other serious changes such as lung lesions, red blood cell congestion, obliteration of alveolar spaces, and pneumonitis in some cases.”
The current research aimed to study the impacts of breathing in e-cigarette vapors on heart function in a well-established pre-clinical experimental model. Over the course of nearly a year, none of the subjects exposed to vapors from the stainless steel devices, both with and without additives, contracted respiratory distress and only one showed a less than 10% area of inflammation in the lungs.
Once researchers introduced the new device, affected subjects showed severe respiratory distress, with labored breathing, wheezing, and panting. The lung injury occurred without nicotine, THC, or Vitamin E additives; and may also have been related to higher wattage of power settings on the e-cigarette devices.
The researchers will follow up these preliminary studies with additional future studies to systematically try to determine the cause of the lung problem.
“While further research is needed, these results indicate that specific devices and power settings may play a key role in the development of EVALI as much as the additives do,” says Kloner. “The harms associated with e-cigarettes and vaping simply cannot be overstated.”
Studies have proved that vaping causes increased blood pressure, endothelial dysfunction, and the risk of myocardial infarction and stroke. Heating elements in commercially available e-cigarettes are usually made of stainless steel, nickel‐chromium or nichrome, Kanthal nickel, or titanium.
Health experts recognized a condition, dubbed “e‐cigarette or vaping product use–associated lung injury” (EVALI) in the United States in June 2019 and it peaked in September 2019. In March 2020, there were 2,800 US cases of EVALI and 68 deaths reported. Patients were typically young males and users of e-cigarettes or vaping products whose CT scans revealed lung inflammation and injury. Of note, EVALI can mimic many of the features of COVID-19 pneumonia.
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