A northwest suburban young man remains in the hospital suffering from a sudden and critical lung illness that could be linked to vaping.
ABC 7 Chicago and WGN News Wednesday September 4, 2019 highlighted two male patients — one from Gurnee (Adam Hergenreder) and one from Lincolnshire (Brian Krasne) — who are suffering with lung problems suspected of being caused by vaping. Both young males also used a THC-consuming method known as dabbing, which is a different method compared to vaping. Dabbing involves some combustion, while vaping involves vaporization. With combustion you can get some byproduct such as benzene or whatever might emanate from burnt metals and whatever emanates from charred product. If you add the variable of people dabbling with dabbing, even experts might not know exactly what is happening.
THC is Tetrahydrocannabinol — the principal psychoactive ingredient of cannabis.
On Thursday, CBS Chicago, NBC 5 Chicago and WGN News described a female patient (Piper Johnson) from New Lenox, Illinois who got sick shortly after she arrived at college in Colorado. After she was diagnosed with diffuse pneumonia, Piper Johnson admitted she consumed vaping e-cigarettes and consumed THC.
Popcorn Lung Risk from E-Cigarettes
flavorants such as diacetyl, a chemical linked to bronchiolitis obliterans (“popcorn lung,” so identified because of the incidence of the disease in workers at plants that used flavorants
containing diacetyl in microwave popcorn)
Cardinal News visited a vaping shop to discover what sales staff in the industry thought about the news of health problems related to vaping. Their reaction was that vaping using proper, regulated products is not the problem. They suspect the variety of problems are from black market products and possibly Juul. Black market products could be a problem because unregulated products produced by scrupulous manufacturers contain harmful chemicals. Workers at the shop said that Juul could be a problem because nicotine content in Juul product is higher than other e-cigarette brands. Juul contains 5% nicotine, almost double the amount of other brands. The vaping shop workers said some Juul customers are so addicted to nicotine that they swear at the personnel in the vaping shop when they learn that the shop doesn’t sell Juul.
Juul pods also contain a greater amount of benzoic acid, 44.8 mg/mL, as compared to other brands, which contain around 0.2 to 2 mg/mL. Constant exposure to benzoic acid can lead to coughing, sore throat, skin irritation with rash and redness, eye irritation and abdominal pain.
“Dabbing”, a relatively new form of THC use which utilizes Butane Hash Oil (BHO), an extraction of dried cannabis containing high levels of butane and terpene byproducts. The extraction process yields a waxy substance that is heated, vaporized and inhaled. We describe a lung injury as a result of BHO use.
Thursday, multiple media sources were reporting that Vitamin E acetate was present in products used in many of the cases that involved serious lung illnesses. Research shows that there are a variety of potential ingredients and byproducts of heat that could be causing injuries to lungs, including butane, excess THC, contaminated THC, products contaminated with pesticides, and heating process byproducts used to extract THC for consumption that include methacrolein and benzene. Methacrolein is a pulmonary irritant. Benzene is a well-known carcinogen. Benzene also causes a premature apoptosis, which is genetically programmed cell death. Ironically, both methacrolein and benzene are found in cigarette smoke. Proponents of vaping say that properly-made products and methods of vaping vaporize consumed products with no harmful effects, while improper manufacturing or improper methods of consumption cause the harmful effects.
Proponents of vaping also claim that properly regulated vaping products don’t introduce or produce harmful chemicals. Vaping shop personnel and owners are also worried about the confusion and negative effect the “vaping crisis” may have on another regulated product line that they claim is very helpful to people — CBD or Cannabidiol, which proponents claim help treat conditions like pain, insomnia, and anxiety.
Regarding the harmful aspects, there are THC cartridges for dab pens that are illegally sold on the street or online with unregulated, unknown ingredients and unknown manufacturing processes. THC is Tetrahydrocannabinol — the principal psychoactive ingredient of cannabis. Dabs or “wax” is a solid cannabis concentrate — most or all are extremely potent THC products. The customer purchasing on the street is not dealing with a legal source of the product, which leads to considerable doubt about what the customer is actually consuming. Ideally, from the perspective of the THC consumer wanting to get a buzz, the wax in these dab pen cartridges contains a form of THC concentrate made from the oil of hash, which is a resin that lines the surface of female marijuana plants. Dabbing pens can be used in public, and the user can get a buzz without most people knowing the difference between regular vaping without THC and dabbing to consume a potent dose of THC.
The waxy THC can also be consumed by inhaling after the blast from a specialized butane torch. The waxy TCH can be manufactured at home, which opens up the product to the blackmarket industry.
Scientific knowledge of the harmful effects of the black market products have been known for at least a decade.
Deaths Have Occurred
The Illinois Department of Public Health (IDPH) learned of the death of an individual who had recently vaped and was hospitalized with severe respiratory illness. Other deaths have been reported in other states. The number of cases of people reported to IDPH who have used e-cigarettes or vaped and have been hospitalized with respiratory symptoms has doubled in the past week, according to a report issued by the IDPH on August 23, 2019. A total of 22 people, ranging in age from 17-38 years, have experienced respiratory illness after using e-cigarettes or vaping, according to the Illinois Department of Public Health. IDPH is working with local health departments to investigate illnesses involving another 12 individuals. Affected individuals have experienced respiratory symptoms including cough, shortness of breath, and fatigue. Some also experienced vomiting and diarrhea. Symptoms worsened over a period of days or weeks before admission to the hospital.
“The severity of illness people are experiencing is alarming and we must get the word out that using e-cigarettes and vaping can be dangerous,” said IDPH Director Dr. Ngozi Ezike. “We requested a team from the Centers for Disease Control and Prevention (CDC) to help us investigate these cases and they arrived in Illinois on Tuesday.”
IDPH is also working with local health departments, other state health departments, and the Food and Drug Administration to investigate the names and types of e-cigarettes, vaping products, and devices, as well as where they were obtained.
According to the CDC, in many cases, including Illinois, patients have acknowledged to health care personnel recent use of tetrahydrocannabinol (THC)-containing products. However, no specific product has been identified in all cases, nor has any product been conclusively linked to illnesses. Even though cases appear similar, it is not clear if these cases have a common cause or if they are different diseases with similar symptoms.
Cases have been reported in Chicago and Champaign, Cook, DuPage, Kane, Lake, Madison, McHenry, Peoria, St. Clair, and Will counties.
IDPH advises that people who experience any type of chest pain or difficulty breathing after using e-cigarettes or vaping in the weeks or months prior to these symptoms should seek immediate medical attention. IDPH is also advising health care providers caring for patients with unexpected serious respiratory illness to ask patients and family members about any possible history of vaping or e-cigarette use.
A suburban teen is hospitalized, fighting to breathe, due to a lung infection his parents say was caused by vaping.
A southwest suburban New Lenox teen was on her way to begin college when her family says a vaping-related injury sent her to the ICU instead.
See also …
Weaver CV1, Liu SP, Lu JF, Lin BS. The effects of benzene exposure on apoptosis in epithelial lung cells: localization by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) and the immunocytochemical localization of apoptosis-related gene products. Cell Biol Toxicol. 2007 May;23(3):201-20. Epub 2006 Dec 14.
Anderson RP, Zechar K. Lung injury from inhaling butane hash oil mimics pneumonia. Respir Med Case Rep. 2019 Jan 4;26:171-173.
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