The first known death from a vaping-related lung illness occurred in Illinois, and now public health officials are trying a coordinated approach to gather information about this mysterious illness.
Earlier this month, the CDC urged doctors to ask about e-cigarette use when they talk to patients with an unclear respiratory or pulmonary illness and to report cases involving a vaping patient to state or local health departments. Now, the Illinois Department of Public Health has followed up with a clinical alert and has asked for a similar approach.
At OSF HealthCare, hospital and primary care leaders are heeding the alert and will be reporting any suspicious cases to public health officials. Pulmonologist Nadeem Ahmed of OSF Medical Group in Alton is alarmed one person has died and that the most seriously impacted patients nationwide have had extensive lung damage that required oxygen treatment and days on a ventilator.
State and federal health authorities are focusing on the role of contaminants or counterfeit substances as a likely cause of vaping-related illnesses, which have doubled from last week to 354 possible cases in 29 states, according to the Washington Post.
So far, no government agencies have issued product recalls, but they have urged the millions of Americans who use e-cigarettes to stop vaping. Those using it to stop smoking are being encouraged to contact their health professional about alternatives such as the patch or nicotine gum. Ahmed says vaping products are not subject to FDA review, so no one knows what exactly users are taking into their lungs.
He is also concerned users don’t realize caustic chemicals they’re inhaling can do permanent damage.
“They’re being inhaled at very, very high temperatures that can directly impact and damage the lungs. It can cause bleeding in the lungs. It can cause shortness of breath. It can cause pulmonary edema,” he said. Pulmonary edema is a potentially life-threatening buildup of fluid around the lungs.
Ahmed also worries about increasing use of vape pens to deliver THC, the high-producing ingredient in marijuana or cannabis-related oils. He says in Illinois, with recreational marijuana use becoming legal the first of the year, it could be, as he put it, “a perfect storm.”
“My fear, and I hope I’m wrong, is the availability of all these substances, through vaping, just kind of the mechanism of inhaling marijuana without being regulated by FDA and the other authorities that we’re going to see a lot more side effects and a lot more lung-related illnesses in the future,” Ahmed said.
U.S Sen. Dick Durbin (D-Illinois) and 13 of his colleagues have asked the federal Food and Drug Administration to better regulate companies that sell vaping products and e-cigarettes clearly marketed at kids with names like Cotton Candy and “Cookies N Cream. Cigarette companies are leveraging social media platforms, especially YouTube, to promote their products with videos in which vapers show a variety of tricks with hypnotic techno music pumping behind them.
Radiation Oncology Charge Nurse Karen Boyd says area high school administrators reached out asking for education because of what they saw as an epidemic of teen vaping. But Boyd says after researching the marketing and its significant impact, she realized they had to target even younger children.
“We were like, ‘No, we need to go into the middle schools.’ Then, it was like ‘We need to get into fifth and sixth grade because it’s starting there,’” Boyd said. The realization quickly struck her: “You need to get these kids young and at the source and nip it because that’s going to cure the epidemic.”
OSF ramping up e-cigarette education
The staff at OSF Saint Anthony’s reached out to others within the OSF Ministry as they researched and put together a PowerPoint presentation and piloted it with about 15 children at the Boys and Girls Club on Aug. 5. Boyd said the most powerful impact came from a visual box filled with things such as a bottle representing the formaldehyde often found in vape juice and a small tire that has some of the same ingredients inhaled through e-cigarette use. Also in the box — a piece of heavy metal, also a common ingredient in the liquid filling most vaping pods.
Boyd learned from presenter and Charge Nurse Trisha Clevenger it made an impact.
“She said that when she pulled those visuals out, the kids’ eyes got like this,” she said holding her hands in large circles around her eyes. “They were like, ‘No, no, not really and she’s (Clevenger) is like, ‘Yes, this is real. This is real.”
Boyd and a group of five trained OSF Mission Partners in Alton are also using materials from the American Cancer Society with information targeted to young people and another page geared toward parents and adults, many of whom have given feedback during OSF Saint Anthony’s smoking cessation support group that they switched to e-cigarettes.
Health professionals are advising those patients to just say no to that option. Ahmed suggested town hall meetings as well as educational sessions for state and federal lawmakers to spread the message that e-cigarettes contain addictive nicotine and can be even more harmful that smoking because of the unknown, unregulated chemicals and the fact that nicotine is highly concentrated with one vape pod equal to an entire pack of cigarettes.
The lack of knowledge among young people is supported by the most recent Illinois Youth Survey — an anonymous survey of eighth-, tenth- and twelfth-graders, which showed only a quarter of those students viewed vaping as harmful.