Metals from vaping devices may have left California woman with scarred and permanently damaged lungs
Metals found in vaping devices may have permanently damaged the lungs of a California e-cigarette user, according to a case report. The damage to the user's lungs is caused by a rare lung disease, typically seen in industry metal workers, according to doctors who treated the patient.
Doctors suspect that the rare lung disease called hard-metal lung disease may have links with vaping. The condition, which mostly affects people who work with "hard metals", such as cobalt or tungsten, in jobs like tool sharpening, diamond polishing or making dental prosthetics, damages the lungs and result in breathing difficulties, says the study.
People getting exposed to cobalt dust is extremely rare outside of a few specific industries. This is the first known case of metal-induced lung toxicity linked to vaping that has resulted in long-term, probably permanent, scarring of the patient's lungs, according to Dr. Rupal Shah, assistant professor from the University of California, San Francisco, US, and one of the doctors who reported the case.
"Research on e-cigarettes is still less developed than it is for smoking. However, there are a number of new studies showing that vaping affects the lungs and, in addition, we are now beginning to see patients diagnosed with acute vaping-related lung disease," says editorial co-author Jørgen Vestbo, Professor of respiratory medicine at the University of Manchester, UK.
The most recent case reported by Shah and team is of a 49-year-old California woman, who experienced symptoms -- shortness of breath, coughing and wheezing -- associated with vaping-related lung disease or EVALI. As of November 20, the Centers for Disease Control and Prevention has reported that EVALI has affected 2,290 people, killing 47 people in the US.
But there was something else at play there. The doctors ruled out EVALI, after inspecting a sample from the patient's lung tissues. The cells in her lungs looked damaged and unusually large. Her damaged cells had swallowed up other lung cells, creating giant cells — a pattern that's typically found in patients with hard-metal lung disease.
"As the patient did not have any known exposure to hard metal, we identified the use of an e-cigarette as a possible cause," says Kirk Jones MD, Clinical Professor of Pathology.
So the researchers tested the patient's personal vaping device used with cannabis. The vaping device released vapors containing cobalt and other toxic metals such as nickel, aluminium, manganese, lead and chromium.
The source of metals in vapour from other e-cigarettes could be coming from the heating coils found in vaping devices, rather than from any particular type of refills, suggests earlier research.
"We think that only a rare subset of people exposed to cobalt will have this reaction," Dr Shah explains. But patients will experience problems only after damage to the lungs become irreversible, as it did with this patient, he adds.
The the case report was published in the European Respiratory Journal.