Carefully inserting a long, thin probe down the throat of Gregory Rodriguez, Dr. Mangala Narasimhan sucked out jelly-like, yellow clots that nearly killed the 22-year-old college student, who was now breathing with the help of a ventilator.
Describing the clots, Narasimhan a lung specialist and director of critical care medicine at Northwell Health in New Hyde Park, New York said: “It really was gross.” The young boy’s case is an extreme example of the different types of lung illnesses that have sickened nearly 1,479 people, and claimed about 33 lives of those who vaped THC, nicotine or combined both for creating a new flavor.
Last month, Rodriguez’s lungs failed to the extent where Narasimhan’s team had no choice but to oxygenate his blood for several days by pumping it out via his neck and into an artificial lung.
After vaping an average of one cart of a day of Dank Vapes brand marijuana extract that he purchased illegally online. This counterfeit brand, investigators say is responsible for many of the lung injuries; however, no one device or substance has been linked to all these cases.
“I guess I put too much trust in them. They just seemed so legit. I never thought that someone would put poisons inside a vape cart, never through they would put a person’s life at risk to save a few bucks,” said Rodriguez.
Meanwhile, scientists and government doctors are leaving no stone unturned in a bid to find the real cause of the outbreak, which was initially blamed on tainted vape oil that contained cannabis or some sort of nicotine extracts. Researchers and regulators are personally examining various vape devices, many of which are made in China with any third-party or U.S. government safety checks.
Vapers who often see vape products as a cessation tool for getting rid of the smoking addiction, end up doing more harm to their bodies than they normally would be smoking a traditional cigarette. Vapers are probably inhaling a toxic combination of atomized oils, an aircraft de-icing chemical, and toxic heavy metals created from the heating elements used to make the “smoke.”
Vape Products Under Scrutiny
Scientists and experts say additives that are found in vaping liquid, or e-juice, as well as the poisonous materials in the devices, are enough to cause serious health problems, even death in some cases when they are heated and transferred to the vaper in the form of an aerosol.
Dr. Tony Casolaro, a former clinical chief of the pulmonary medicine branch at the National Institutes of Health says, “This appears to be an unforeseeable mixture of elements resulting from the combination of metal, heat, THC, and liquid, causing very different lung injuries.” Dr. Casolaro is now a clinical professor at Georgetown University’s medical school.
While some vape pens (e-cigarettes) undergo severe testing before reaching the consumers, many are assembled by online retailers, vaping enthusiasts, or mom-and-pop shops. E-cigarettes have been floating around the market for over a decade with more and more variants hitting store shelves in recent years. As a result, the bulky, refillable devices have been replaced by compact, hard-to-hack models with negligible regulations of how they are manufactured or the substance they might release when heated.
Vaping expert Arnaud Dumas de Rauly says, “if you’re buying cheap hardware from China, you never know what’s going on there.” de Rauly, who is helping develop international regulations added that “in a certain sense, I’m happy we are having this vaping crisis. It points the finger at some things that should not be in these products.”
The FDA (Food and Drug Administration) said it has over 725 samples comprising vaping products and devices that contain e-juice, packaging, and almost empty containers to test and the Centers for Disease Control and Prevention is also establishing standards for how to test what a user inhales.
A large number of vapers who were sickened said they were using marijuana-based products; however, a few of them said they used only nicotine-based vape juice. Vape pens are compatible with cannabis or THC-based oil or nicotine liquid. The juice comes in a bottle that the user can top up his/her tank with, or in the form of a pre-packaged cartridge, based on the design.
The device does not vaporize the liquid but instead transforms it into an aerosol. According to experts, an otherwise harmless substance that might cause no damage to your body if rubbed or consumed becomes entirely different when it is heated on a metal or ceramic coil. On top of that, the device itself could be releasing toxic chemicals, especially if they are bonded either with lead or cadmium solder.
In a February 2018 report, Johns Hopkins University environmental health professor Ana Rule concluded that the heating coil is most likely the source of inhaled metals. She researched refillable vape devices that had metal coils.
Rule says, the coil is ideally made using “complex metal alloys,” however, other parts of the device may release metals. The machine used to derive the THC from marijuana plants, or the THC from marijuana plants or even the solder used to connect metal parts inside the vape device could be the other sources of inhaled metals.
The results imply that “several metals are being transferred from the device to the e-liquid in the tank as well as to the aerosol that is inhaled by the user,” she said in her report.
Columbia University associate professor of environmental health sciences Markus Hilpert said metal coils when tested on refillable devices seemed to lack their original shine within just a few weeks of use. This suggests they had become oxidized. Metals can then combine with the e-juice after the device is heated.
His team adopts a technique for collecting aerosol directly from devices, which is required to differentiate components inhaled from the liquids. In several aerosol samples that were aerosol samples, the researchers detected levels of carcinogenic metals in fumes well above the minimal risk levels for safe air set by the Department of Health and Human Services.
Those levels are not contained in regulations for the aforesaid devices and manufacturers trying to get away with this might be using lead or cadmium-based solder, along with other dangerous metals, according to experts who were consulted by USA TODAY.
Cannabis testing facility Colorado Green labs owner Frank Conrad recently claimed that cadmium has “the motive. In other words, it could be the root of lung illnesses. Stream of vapors can effortlessly carry heavy metal particles, without hitting the melting point of the metals, he said.
Founder and CEO of Straight Hemp Products, Devin Alvarez says his products use ceramic heating coils, along with other high-quality components since they are relatively safer than metal coils that can dissolve when heated. “Looking at the hardware is critical as it can be a source of harm for the user if not chosen properly,” Alvarez said.
He believes there’s a need for regulating the industry, alongside the hardware, probably through UL, which is a global safety certification company run by the FDA (Food and Drug Administration).
“Vaping is a nascent technology and the cannabis industry has the knowledge, but not the infrastructure to regulate itself. That’s why we’re looking to partner with the federal government and anyone else regulating,” said Alvarez.
Chief executive of vape company The Blinc Group, Dumas de Rauly says testing labs that are searching for contaminants might not have the kind of pieces of equipment required to detect these toxic components. They could use a puff” machines to duplicate real-world use, he added. He further pointed out that different labs have come up with divergent results for the same products manufactured by his company.
“When you change states, you have different molecules in play. When things are heated and transported as aerosols, they can become toxic,” Dumas de Rauly said.
“Standardization standards committee on vaping products. The Swiss-based ISO is a non-profit group that establishes standards for everything from food safety to shipping containers and the strength of bolts used on railroads,” he added.
Standardized testing, according to Dumas de Rauly would make a notable difference as far as helping regulators figure out what’s causing the outbreak is concerned.
“Who knows what’s happening,” Hilpert, the Columbia University professor says. “It’s like a gigantic uncontrolled experiment where the people it’s tested on include millions of young people.”
Narasimhan, who is an eyewitness of the lung illnesses, says the answers aren’t concrete at the moment. A lot of people vaped without any sort of incidents occurring for years, she added.
“A year ago, the same number of people vaped, and we weren’t seeing this. Something has changed. Something has changed in the product and I wish I knew what it was,” she said. “We don’t know how to stop it because we don’t know what’s causing it.”
Juul dominated the e-cigarette industry, prompting the FDA to deem teen vaping an epidemic. Amid the upsurge in vaping-linked illnesses, the United States banned the sale of flavored vape pen products, hoping to restrict the illness that sweeps across the country.