What Caused the Vaping Lung Disease Outbreak 2019?

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Currently, a severe lung disease outbreak is primarily affecting teenagers and young adults in the United States. There have been roughly 2300 cases of e-cigarette or vaping-related acute lung injury across the US this year. And a few days ago, it has been reported that a canadian teenager allegedly developed a popcorn lung like disease through vaping. But what is popcorn lung and is it related to vaping? If not, what causes the current vaping outbreak?

Popcorn lung is an inflammatory condition that affects the lungs. This disease has been wildly described in microwave popcorn production plants, thereby giving it the name popcorn lung. In the world of medicine, we call popcorn lung bronchiolitis obliterans. From the term “bronchiolitis” we can deduce that the inflammation occurs in the small airways of the lung or bronchioles. Obliterans means that these airways are blocked due to the underlying inflammation. Symptoms also generally progress slowly over weeks to months and are not episodic, unlike asthma. Affected people might experience a dry cough, shortness of breath, or wheezing. Popcorn lung often occurs after lung transplantation or bone marrow transplantation. However, popcorn lung can also be caused by viruses or certain chemicals. This includes a compound which has been associated with the incidences in the microwave popcorn production plant cases, diacetyl. Diacetyl becomes dangerous when being inhaled.Since diacetyl is also a chemical found in many e-cigarette flavours, it is often seen as a possible cause of lung diseases in vapers. However, the levels of diacetyl are much higher in cigarettes and it is currently not very likely that diacetyl causes the US outbreak 2019.
Vitamin E acetate is a nutritional supplement that is not known to cause harm when ingested as a vitamin supplement. Similar to diacetyl, however, vitamin e acetate also might become harmful when inhaled. Vitamin e acetate is frequently used a diluent in THC cartridges (mostly found on the black market). About a month ago, a report by the US department of health and human service centers for disease control and prevention indicated that THC-containing products from Utah residents who suffer from e-cigarette or vaping use associated lung injury exhibit vitamin E acetate. Moreover, the New York State Department of Health found very high levels of vitamin E acetate in nearly all cannabis-containing samples. Some THC vapes (mostly found on the black market) might explain the US outbreak in 2019, however, a lot of research has yet to be conducted in order to fully understand and prevent further cases.

For your further research:
https://www.ncbi.nlm.nih.gov/books/NB...
https://www.ncbi.nlm.nih.gov/pubmed/2...
https://ehp.niehs.nih.gov/doi/10.1289...
https://www.cdc.gov/mmwr/volumes/68/w...
https://www.health.ny.gov/press/relea...
https://www.nature.com/articles/s4159...

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About Clemens Steinek:
CLEMENS STEINEK is a postgraduate student/youtuber (LifeLabLearner) who is currently conducting stem cell research in Germany.