A VAPING-related lung disease which has killed 17 people is caused by chemical burns similar to gas poisoning, experts fear.
More than 800 people have now been struck down with a mysterious illness linked to e-cigarettes in the US – leaving health bosses scrambling for answers.
Finally, researchers from the Mayo Clinic have manged to review lung biopsies from e-cigarette users who were suspected to have the vaping lung injury.
They believe that the lung injuries were most likely caused by direct toxicity or tissue damage from noxious chemical fumes – similar to those seen in industrial accidents.
It comes as the death toll hit 17 last night, when health bosses in Alabama declared its first victim.
Meanwhile, the first Brit reported to have died from the vaping-related lung illness was named as Terry Miller, 57, from Gateshead, Tyne and Wear.
In this latest research, published in The New England Journal of Medicine, experts likened the injuries to when someone is exposed to a toxic chemical spill, or when soldiers breathed in deadly mustard gas during WW1, reports the Star Tribune.
Brandon Larsen, a surgical pathologist at Mayo Clinic Arizona, and a national expert in lung pathology, told DailyMail.com: “I don’t think anything can be ruled out in terms of potential culprits or things that are not causing [these injuries].
“But the kind of pattern we’re seeing most closely resembles the kind of toxic inhalation we would see from somebody who has been involved in a big industrial accident with a chemical spill and toxic fumes that are inhaled and produce something like a chemical burn to the lung tissues and airways.”
It seems to be some kind of direct chemical injury, similar to what one might see with exposures to toxic chemical fumes, poisonous gases and toxic agents
Brandon Larsensurgical pathologist, Mayo Clinic
The team found no evidence of tissue injury caused by accumulation of lipids – fatty substances such as mineral oils – which has been suspected as a possible cause of the mysterious disease, they said.
Dr Larsen added: “While we can’t discount the potential role of lipids, we have not seen anything to suggest this is a problem caused by lipid accumulation in the lungs.
“Instead, it seems to be some kind of direct chemical injury, similar to what one might see with exposures to toxic chemical fumes, poisonous gases and toxic agents.”
Of the 17 biopsies that were examined, two were from Mayo Clinic patients while the others were from hospitals around the country that were sent to the medical centre for further investigation.
All of the patients had vaped, and 71 per cent had vaped with marijuana or cannabis oils.
They all showed acute lung injury, including pneumonitis, and two of the patients died.
Dr Larsen, senior author of the study, said: “We were not surprised by what we found, regarding toxicity.
“We have seen a handful of cases, scattered individual cases, over the past two years where we’ve observed the same thing, and now we are seeing a sudden spike in cases.
“Our study offers the first detailed review of the abnormalities that may be seen in lung biopsies to help clinicians and pathologists make a diagnosis in an appropriate clinical context.”
Vaping-associated lung injury can be difficult to diagnose, unless clinicians and pathologists are armed with information beforehand, Dr Larsen says.
He added: “This is a public health crisis, and a lot of people are working frantically around the clock to find out what the culprit or culprits could be – and what chemicals may be responsible.
“Based on what we have seen in our study, we suspect that most cases involve chemical contaminants, toxic byproducts or other noxious agents within vape liquids.”
We suspect that most cases involve chemical contaminants, toxic byproducts or other noxious agents within vape liquids
Brandon LarsenMayo Clinic
In the meantime, the public should heed what leading medical organisations and public health agencies are saying about the dangers of vaping.
“Everyone should recognise that vaping is not without potential risks, including life-threatening risks, and I think our research supports that,” he says.
“It would seem prudent based on our observations to explore ways to better regulate the industry and better educate the public, especially our youth, about the risks associated with vaping.”
Scientists in the UK say the research shows that the outbreak of lung diseases appears to be caused by contaminants rather than flavoured e-liquids, which have recently been banned in some US states.
Prof Linda Bauld, Professor of Public Health at the University of Edinburgh, said: “What the researchers found were not chronic adverse effects – i.e. those that have built up over a long period and cause disease – but instead evidence of an outbreak that is similar to poisoning.
“This provides further evidence that it is extremely unlikely, if not impossible, that flavoured nicotine e-liquids of the type that have been used by millions of people around the world for up to a decade (including in the UK) are causing these injuries.
“Instead contaminants look like they are to blame. Most of the evidence points to adulterants in cannabis vaping but other products may be involved.
“Recent bans in the USA of all flavoured vaping products are not going to prevent further cases like these if the culprit is contaminated products bought on the black market.
“Indeed bans may make the problem worse by restricting access and driving people to illicit sources.”
Surge in cases
The US Centers for Disease Control has stated that there are now 805 confirmed cases of people being struck down with the mysterious and life-threatening lung disease in the US.
Earlier this week, it was revealed that a man from Nebraska died in May before the epidemic in the US was officially reported.
Last week, three victims were reported in Mississippi, Georgia and Florida.
Prior to that, there were two deaths in California, two in Kansas, two in Oregon, and one each in Illinois, Indiana, Minnesota and Missouri, according to the CDC.
The growing death toll has prompted officials to launch a criminal investigation.
How safe are e-cigarettes in the UK?
In the UK, e-cigarettes are tightly regulated for safety and quality.
They’re not completely risk free, but they carry a small fraction of the risk of cigarettes.
E-cigarettes do not produce tar or carbon monoxide, two of the most harmful elements in tobacco smoke.
The liquid and vapour contain some potentially harmful chemicals also found in cigarette smoke, but at much lower levels.
While nicotine is the addictive substance in cigarettes, it’s relatively harmless.
Almost all of the harm from smoking comes from the thousands of other chemicals in tobacco smoke, many of which are toxic.
Nicotine replacement therapy has been widely used for many years to help people stop smoking and is a safe treatment.
There’s no evidence so far that vaping causes harm to other people around you.
This is in contrast to secondhand smoke from smoking, which is known to be very harmful to health.
However, they are still struggling to identify a single product or chemical in e-cigarettes behind the outbreak.
Mitch Zeller, a director at the Food and Drug Administration, said: “The focus is on the supply chain.”
The illness was first reported in April and all patients are known to have used e-cigarettes — some containing the cannabinoid THC.
A report from the Medicines and Healthcare Products Regulatory Agency in the UK says 200 health problems are linked with e-cigarette use.
The health watchdog has recorded 74 reports of health problems suspected to have been caused by e-cigarettes since 2014.
Of them, 49 were classified as “serious”.
Experts are now calling on a national system to record every problem associated with e-cigarettes, according to the Sunday Times.
But the MHRA insisted all health problems are reviewed, adding that they are not concrete proof of the side effects of vaping.
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