By Dr. Fred Wagshul
Medical Director—The Lung Center of America
The seven (and counting) people who died recently from lung illnesses caused by vaping did not have to die. Furthermore, those now suffering from the toxic effects of using e-cigarettes may have contracted irreversible lung disease—and that didn’t have to happen either.
That’s because when flavored e-cigarettes came on the market, it was already well known that a chemical used to enhance flavored e-cigarettes had been linked to incidences of death, lung damage and disease years before.
This is what happened:
In the early 2000s, diacetyl—the buttery-flavored chemical in foods like popcorn and dairy products—was linked to deaths and serious, irreversible lung disease in hundreds of workers at a microwave popcorn factory. The disease most of the workers contracted was bronchiolitis obliterans—commonly referred to as “popcorn lung.” Almost immediately, the major popcorn manufacturers stopped using diacetyl.
Though it was well known that diacetyl caused popcorn lung, e-cigarette manufacturers added it to the “e-juice” liquid to enhance the flavorings they used to attract more consumers—with their sites trained on the youth market. It is likely that those who died from e-cigarette use succumbed to the lethal effects of the diacetyl along with other aerosolized particles they inhaled. A 2015 study of flavored e-cigarettes found that 39 out of 51 brands contained diacetyl. The same study also found that most of these brands also contained acetoin and 2,3 pentanedione — both toxic chemicals.
How did this happen? It happened because the e-cigarette industry only came under the regulatory control of the U.S. Food and Drug Administration (FDA) in 2016. There had been calls for regulation of the e-cigarette industry years earlier.
In the summer of 2009, the FDA issued a warning discouraging the use of electronic cigarettes, saying they may be marketed to young people, lack appropriate health warnings and that they contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze.
That same year, Action on Smoking and Health in the United States (ASH-US) filed a petition to the FDA calling for FDA regulation of electronic cigarettes.
In 2010, American Medical Association (AMA) urged the FDA to regulate e-cigarettes as drug delivery devices.
And in 2014, six U.S. senators called for the FDA to adopt aggressive warning labels for e-cigarettes.
In the end, people died and hundreds have lung disease as a result of vaping. Let’s look at the symptoms and treatment options for those who contracted lung disease by vaping.
Symptoms— They include wheezing (unrelated to bronchitis or asthma); dry cough; shortness of breath (especially with physical activity); unexplained fatigue and rapid breathing.
Causes— In addition to the use of e-cigarettes, other causes of popcorn lung can include metallic fumes from construction or industry, nitrous oxide (laughing gas), fumes from cleaning chemicals such as ammonia or chlorine, and certain respiratory infections.
Treatment—There are some treatment options for popcorn lung—such as macrolide antibiotics, steroids, immunosuppressive drugs, supplemental oxygen, and even lung transplant. The prognosis for a person with popcorn lung largely depends upon the cause, and how quickly the disease is progressing.
BOTTOM LINE— First, avoid ALL factors that can increase your chances of contracting popcorn lung—including and especially the use of e-cigarettes or other tobacco or vaping products. And demand tighter regulations on e-cigarettes from your congressional representatives. These senseless deaths and contraction of lung diseases CAN be avoided.