– Source: Yahoo News
There are 2.5 million vapers in the UK. An estimated 30 million people have vaped in America, and there are many millions more around the world.
Two of them have experienced a case of lipoid pneumonia.
Both were former smokers.
Despite the numbers, some now believe e-cigarettes can cause lipoid pneumonia.
As we know, smoking carries a hugely increased risk of an early death. E-cigarettes, on the other hand, are significantly safer than tobacco cigarettes according to leading scientists.
And specialists in e-cigarette research fear that many smokers are now choosing to stick to tobacco cigarettes as a result of these stories.
To find out if vaping can pneumonia, we interviewed one of these experts, Professor Riccardo Polosa . In this interview he discusses lipoid pneumonia – and whether vapers need to worry about it.
About Professor Polosa,MD, PhD
Polosa is Director of the Institute for Internal Medicine & Clinical Immunology of the University of Catania (Italy). He is also in charge of the University Centre for Tobacco Research (University of Catania) & Honorary Professor of Medicine at Southampton University (UK). He and his team have led several studies on e-cigs.
Lipoid Pneumonia and Vaping
JD: How did the idea that vaping leads to lipoid pneumonia arise?
RP: Lipoid pneumonia is a rare respiratory illness that may occur from aspiration or inhalation of fatlike material in the lung; this has been reported in elderly people after accidental ingestion of oil-based laxatives.
There is no way vaping could put people at risk for lipoid pneumonia simply because vaporization of commercially available e-liquids do not contain fatlike material. However, I am aware of two reports of lipoid pneumonia that respiratory physicians in the US and subsequently in Spain have suggested being direct consequence of vaping.
After careful review of these clinical cases, I could identify a more plausible cause for these patients’ lipoid pneumonia. I do not understand why my colleagues incriminated vaping. Most probably, they (erroneously) reasoned that inhalation of vegetable glycerine in the e-liquid could have been the cause without considering that glycerin is not a lipid, but an alcohol. By definition alcohol cannot cause lipoid pneumonia.
There is no way vaping could put people at risk for lipoid pneumonia – Prof. Polosa
JD: Do vapers need to be worried about oils in e-cigarettes causing lipoid pneumonia?
RP: The presence of essential oils is not uncommon in some e-liquid flavourings (particularly in citric fruits, menthol). However, essential oils are not oils (not lipids) in a strict sense; the term “oil” in essential oil is a misnomer. Hence, they cannot cause lipoid pneumonia.
Essential oils are to be distinguished from aroma oils (essential oils dissolved in an oily solvent).
Clearly, the presence of essential oils may be potentially irritant and hypersensitivity could develop in susceptible individuals. But this is a different story.
JD: Are there any types of oil based flavourings that could lead to lipoid pneumonia?
Not that I am aware of (but see answer below).
JD: Do vapers need to take care when mixing their own e-liquids?
RP: In principle I do not recommend mixing because mistakes and contamination may happen at home.
In relation to accidental exposure to fatlike material, when blending their own DIY mixtures, vapers should make sure that flavouring solutions are free of fatlike material such as vegetable oil.
I have heard stories of essential oils (not fatlike material) sold in pharmacies for massage therapy that are dissolved in oily solvents (usually vegetable oil). This may be a problem because chronic inhalation of such DIY mixtures could theoretically lead to lipoid pneumonia.
JD: What consequences has this rumour lead to?
RP: The lipoid pneumonia case received such an emotional and widespread media coverage in Spain that Spanish vapers ended up being very concerned about the possibility of developing serious vaping-related lung diseases.
Spanish pneumologists have campaigned aggressively against e-cigs. These two factors have contributed to destroy the positive “image” of these products, to shift the perceptions of consumers from benefit to harm and – as a consequence – to the collapse of the e-cig market in that country.
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Campagna et al, Respiratory infections and pneumonia: potential benefits of switching from smoking to vaping, Pneumonia 2016 8:4, https://doi.org/10.1186/s41479-016-0001-2