Expanding knowledge, awareness of vaping-related lung injury

Since the CDC declared e-cigarette or e-cigarette product use-related lung injury (EVALI) an epidemic in 2019, researchers have been working to understand its causes and harms, and how to stop the disease from rising. I have been working on

One such effort took place in 2021 in the form of a virtual workshop comprised of respiratory specialists, public health officials, epidemiologists and toxicologists. Together, 26 experts discussed the public health and regulatory response to EVALI, the clinical care of EVALI, the mechanisms that contribute to EVALI, and the necessary actions that speak to the health implications of EVALI.

These discussions and recommendations have been published as a report. Chronicles of the American Thoracic Society.

Helio has spoken Megan E. Dr. Lebri, Lead author of the report, Assistant Professor of Pediatrics at the University of North Carolina, Member of the Center for Environmental Medicine, Asthma and Lung Biology, and the rationale behind the workshop, Overcoming to Optimally Address EVALI You can learn more about the challenges you need. , and what actions can be taken to prevent her EVALI outbreaks in the future.

Helio: What motivated you to hold this virtual workshop on EVALI?

Lebri: This workshop was first proposed in 2020, shortly after the peak of the 2019 EVALI epidemic. Researchers and clinicians were concerned about the epidemic and wanted to launch it, given its seemingly rapid onset and how many people were affected nationwide. A panel of experts to investigate the factors that contributed to the epidemic and to identify ways to improve research strategies and infrastructure to prevent such large-scale events in the future. The workshop proposal was approved by the American Thoracic Society in early 2021 and was held several months after approval.

Healio: What are EVALI-related challenges? Was it covered/discussed in the workshop?

Lebri: The first big challenge we tackled as a group was how to conduct a workshop like this in a virtual environment. Historically, such major workshops were held face-to-face to enable dynamic discussion and interaction among workshop participants. So we had to devise a way to make the workshops as interactive and informative as possible to fit everyone’s schedules across the country.

• How the CDC investigates EVALI incidents now that it no longer collects nationally representative data.
• Strengthen physician education on asking patients about e-cigarette use and passive smoking.
• The challenge of continuously adapting research strategies to keep up with the rapidly evolving e-cigarette market.
• The need for more regulation and manufacturing standards on e-cigarettes to facilitate safety testing and ensure public health.and
• Continued investment in EVALI research is warranted as cases continue to be reported across the country, albeit less than at the peak of the epidemic.

Helio: According to a press release From UNC HealthcareWe have discussed the chemical composition of e-cigarettes and the role of vitamin E in the development of EVALI. What are the key takeaways from this conversation?

Lebri: First, I wanted to clarify that the majority of EVALI cases are associated with THC-based products, Vitamin E acetate, there have been several cases involving only nicotine-based products. It is considered. This argument is reinforced by the fact that EVALI cases are still being recorded in hospital systems across the country and, to the best of our knowledge, vitamin E acetate has been removed from marketed products.

This has led to discussions about the potential for increased regulation of compounds allowed in e-cigarettes and the development of manufacturing standards by the FDA, similar to what was done for tobacco. Additionally, there was discussion of the need for comprehensive safety testing of products before they hit the market. This has historically not happened with e-cigarettes, especially before his EVALI craze.

Since most vitamin E acetate-containing products also contained THC, we discussed the need to better understand the effects of inhaling THC-containing products on the lungs. understanding is limited. This is because there are strict federal restrictions on his THC use in federally funded laboratories under the Controlled Substances Act. Declassifying marijuana as a Schedule I substance, or exempting it from the requirement to use Schedule I substances for research purposes, would help scientists more easily study its health effects.

Helio: What are the critical needs and future areas of work that the workshop identified as necessary to prevent and respond to future EVALI outbreaks?

Lebri: Critical needs to prevent future EVALI events include strengthening e-cigarette regulation, including manufacturing standards, and curbing marketing to youth and young adults. Further work by researchers required includes the development of national case registries and biorepositories, ongoing safety and toxicity assessments as products on the market change, and investments in long-term research. will be Health Benefits of Ebari Identifying other potentially harmful additive chemicals in e-cigarettes.

Helio: How can doctors, healthcare workers, and the general public help fight EVALI?

Lebri: Physicians and healthcare workers can fight EVALI by seeking training in assessing patient exposure and by ensuring they screen patients for e-cigarette use. You can also propose and participate in clinical studies with her identified EVALI patients. This will ensure consistent follow-up evaluations with other researchers across the country to obtain useful, nationally representative datasets.

Health professionals as well as the general public can seek and disseminate knowledge about the known health effects of e-cigarette use, especially among youth and young adults. Also, anyone can advocate or provide grants to government legislators and his NIH for dedicated resources, such as national biorepositories and case registries, to help future him through the use of emerging inhaled products. EVALI or EVALI-like outbreaks can be prevented.

For more information:

Megan E. Dr. Lebri, You can contact me at [email protected]

References:

Lebri ME. An am Sorak Sok2022; doi:10.1513/AnnalsATS.202209-796ST.

UNC researchers are addressing the epidemic of e-cigarette or e-cigarette product use-associated lung injury (EVALI). https://news.unchealthcare.org/2023/01/unc-researchers-tackle-the-e-cigarette-or-vaping-product-use-associated-lung-injury-evali-epidemic/Published January 3, 2023. Accessed 01/04/2023.