Health officials did not disclose many details about the patient, the New York Times reported. What we know is that “the person was an adult who had vaped recently and then succumbed to a severe respiratory illness.”
The only thing linking these patients with severe pulmonary distress, in fact, is vaping — and yet health officials are mostly baffled. Among the CDC, FDA and other pulmonary specialists, there’s no clear answer. The problem could be non-federally controlled e-juice chemicals, “bootleg THC oil” or something else entirely.
While health officials scramble to find what exactly is causing “vaping sickness,” I spoke to Dr. Osita Onugha, director of thoracic surgery research at the John Wayne Cancer Institute in Santa Monica, California, about what casual vapers (like, frankly, most of us) should know.
Lungs and Inflammation 101
It’s important that we understand how our lungs work, Onugha says. Our lungs are filters: They take the air we breathe, filter it and deliver oxygen to the blood in exchange for CO2. “That’s why if you walk into a place high in smog, it filters the smog particles out so you can breathe in oxygen,” he says. “The more concentrated particles you put into the lungs, the more the filter has to work.”
In other words, just like a dirty filter on an air conditioner, the more our lungs are clogged with debris and particles, the harder they have to work. “The body tries to clear these particles, which creates all this inflammation,” Onugha explains. “Inflammation in the lung, especially chronic inflammation, can cause other problems, which lead to other problems and so on.”
Like what? Chronic inflammation can lead to cancer, the doctor says. Less severe is a condition called acute respiratory distress syndrome, or “ARDS.” It manifests in shortness of breath and difficulty breathing, Onugha says. People with inflamed lungs will “have difficulty walking, or get tired and winded not after exercising on a treadmill or Peloton, but just walking from their house to the car.”
If your lungs get so inflamed that they can’t take in oxygen, you end up on a ventilator, which lifts the burden of your tired lungs by pumping oxygen into them. But even then, the doctor says, “if the ventilator isn’t enough to support you, when it’s giving all the oxygen it can possibly can, you can ultimately die.”
Vaping Sickness Symptoms and Lung Conditions
It shouldn’t be a surprise, then, that inhaling unknown chemicals might do some damage to the lungs. “I tell patients very clearly that there is no way you can imagine vaping is good for you just looking at it,” the doctor tells me. “Taking all that smoke and putting it into your lungs, there is no way that’s good for you.”
He continues: “People put whatever concoction of different chemicals into their vaping cigarette, and everybody is using different chemicals and vaping totally different volumes,” he continues, “and yet we’re still in the very early stages of understanding specifically all the problems that vaping causes.”
Potential Causes of Vaping Sickness
There are too many variables in how much we vape and what we vape for medical professionals to pinpoint precisely what’s causing people’s lungs to malfunction, Onugha says. Two people might vape the same e-juice, but “one person might not get symptoms; the other might end up in the ICU on the ventilator. Each person’s body can react differently to irritants, which can really cause massive inflammation.”
That said, there are a few things doctors can point to. Vaping is “dose-dependent,” Onugha says. “So the more you smoke, the higher the concentration of chemicals or irritants are in your lungs, the more likely you’ll see the effect, and the more severe the effect is.”
“We also know that there are some carcinogens in preservatives [used in e-juices] like formaldehyde,” he continues. “Even though they’re used in small amounts, we know such preservatives can definitely cause inflammation and irritation to the lungs and airway.”
Vaping Sickness: What We Don’t Know
People have been vaping for years. Why is this suddenly an issue?
According to Onugha, this might simply be the first sign that the medical profession is catching up. More and more doctors “are writing case reports and writing their observations that are coinciding with what multiple other people are seeing,” he says, and slowly but surely, they’re connecting the dots. “It took us about 20 to 30 years to be able to prove that smoking causes lung cancer,” Onugha says. “And even then, early on, a lot of doctors could [only] say anecdotally.”
Another problem is that patients don’t disclose their vaping habits when they have medical appointments the same way they talk about smoking and drinking. “They’ll come in and say they’re short of breath, and we have to eliminate all medical problems before we’d even consider vaping,” the doctor explains. And thus another potential data point slips by.
Chances are, Onugha thinks, the problem will get worse before it gets better — especially as the number of people vaping continues to rise, according to the World Health Organization.
How bad is vaping? What chemicals are in the fluid causing these symptoms, and in five or 10 years, could they develop into worse, more sinister issues, like lung cancer? We still don’t know. But Onugha won’t be surprised if, “two or five years from now, we start discussing more deaths associated with it.”