Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

CDC says stop vaping as mystery lung condition spreads

techcrunch.com

Post reply on HN
Print view View original

151–160 of 310 posts

Re: CDC says stop vaping as mystery lung condition spreads

#151

Post by Retric »

Reelin wrote: post #147
Retric wrote: post #127

Earlier quoted context omitted.

Fog machines also use a glycol solution, and have been shown to be harmful. Thus vaping glycol may not be safe. https://www.cdc.gov/niosh/hhe/reports/pdfs/1990-0355-2449.pd...

The report you linked shows quite the opposite, actually. They concluded: > Based on the results of this study, there is no evidence that theatrical "smoke," at the levels found in the theaters studied, is a cause of occupational asthma among performers. That being said, chronic exposure is probably not good for you. From a health perspective, don't inhale anything other than air!

Asthma is only one of many possible heath impacts. It was associated with others, just not Asthma.

When compared to actors from the non-"smoke" productions, actors from two or more of the four productions utilizing theatrical "smoke" reported experiencing a significantly greater prevalence of nasal symptoms (sneezing, runny or stuffy nose), respiratory symptoms (cough, wheeze, breathlessness, chest tightness), and mucous membrane symptoms (sore throat, hoarseness, dry throat, itchy/burning eyes, dry eyes) during their performances for the week prior to the survey.

The final line is: The quantity and frequency of use of the various fogs during a performance should be minimized.

PS: A method of action was suggested to be the breakdown of glycol due to high temperature.

Re: CDC says stop vaping as mystery lung condition spreads

#152

Post by zelienople »

Several things have failed to show up in the comments that might illuminate this discussion.

(1) The condition is called lipoid pneumonia, which comes from inhaling organic fats and oils.

(2) The CDC reports and early studies indicate that the condition has appeared in some people who only vaped with nicotine in glycerol (which is also sometimes called glycerin or glycerine).

(3) Glycerol (the Christmas molecule--HO HO HO) is a type of alcohol called a polyol, meaning that it has multiple (in this case, three) hydroxyl groups on a carbon chain.

(4) Glycerol is not a fat and cannot be responsible, on its own, for lipoid pneumonia.

(5) However, glycerol is the precursor to fat synthesis in the body: triglycerides, for example, are fats metabolized from glycerol.

(6) The reaction of glycerol -> triglycerides in the body is catalyzed by nicotine-containing enzymes mostly present in the liver, but expressed to a lesser extent in every cell.

(7) The reaction of carboxylic acid (derived from CO2) with glycerol creates fatty acid esters through the process of acid-catalyzed esterification.

(8) The key unanswered question is where does the fat that is found in the macrophages (a type of white blood cell whose function is to engulf and digest foreign substances) that is the sine qua non of lipoid pneumonia come from.

(9) Many vapers are formerly heavy smokers, meaning that they have some degree of chronic lung disease, that they retain CO2, and are very likely to have respiratory acidosis.

(10) Elevated CO2 also occurs in many other circumstances, such as opioid use and sleeping in poorly ventilated conditions.

(11) If the early reports are correct that lipoid pneumonia is occurring in vapers who have only used nicotine in glycerol with no flavoring or impurities, then we must ask the question: Is glycerol being converted to fatty acids in lung cells by NAD-mediated enzymatic conversion or acid-catalyzed esterification in the presence of high CO2 levels and acidity?

Re: CDC says stop vaping as mystery lung condition spreads

#153

Post by whatisthiseven »

Retric wrote: post #127
Reelin wrote: post #117

Earlier quoted context omitted.

> > The other is almost entirely a mixture of Propylene Glycol and Vegetable Glycerin. > What an extraordinary meaningless statement. Not at all. The point being made is that we're dealing with a product composed primarily (99%) of two chemicals that are very clearly established as safe for human consumption (propylene glycol is commonly _injected_). As such, it seems unreasonable to assume absent evidence that the c…

Fog machines also use a glycol solution, and have been shown to be harmful. Thus vaping glycol may not be safe. https://www.cdc.gov/niosh/hhe/reports/pdfs/1990-0355-2449.pd...

Here is the conclusion of that study to save a click:

"Based on the results of this study, there is no evidence that theatrical "smoke," at the levels found in the theaters studied, is a cause of occupational asthma among performers. Some of the constituents of theatrical "smoke," such as the aerolized glycols and mineral oil, could have irritative or mucous membrane drying properties in some individuals. Therefore, it is reasonable to minimize exposures by such means as relocating "smoke" machines to avoid exposing actors to the direct, concentrated release of the aerosols, minimizing the amount of "smoke" necessary for the production, and using only fog fluids approved by the manufacturers of the machines. The glycols used should be at the level of "food grade" or "high grade." Glycol-based systems should also be designed to heat the fog fluids only to the lowest temperature needed that achieve proper aerolsolization. This would help to avoid overheating the fluid and minimize the generation of decomposition products."

Re: CDC says stop vaping as mystery lung condition spreads

#154

Post by Scoundreller »

johngrefe wrote: post #33

I had a startup in Vaping(nicotine) and am still fairly in touch with the industry. There has been no major innovation in nicotine eliquid that would cause a sudden cluster of issues. It's stayed pretty constant since 2013 with the exception of Salt Nicotine, which Pax labs has a gras study published for. The majority of cases seems to be THC carts where it can be confirmed. One case was confirmed from a dispensary i…

VitE can be used as an antioxidant/preservative.

VitC is too, but E is fat soluble.

Re: CDC says stop vaping as mystery lung condition spreads

#155

Post by protonimitate »

milofeynman wrote: post #15

The thing causing this outbreak seems to have been someone using a vitamin e oil to increase the potency of their thx carts up to 95% or so. [0] I also believe they were out of Chicago. Or at least they shipped a lot of carts to Chicago/Illinois and then they spread out from there. But this is just from the cases I've read. Also from today Doctors have identified previously unrecognized characteristic of the vaping-r…

I don't know if the vitamin e thing has been totally confirmed yet. This is from the New England Journal of Medicine published 3 days ago (Sep 6, 2019)

>Until the investigation into the cause of this epidemic of vaping-induced respiratory injury is complete, no conclusions can be drawn as to which compound or compounds are the causes of injury. [0]

Until they confirm or deny which compound(s) or mixtures are leading to these effects, don't assume any carts are safe to use (even if they're not "black market").

https://www.nejm.org/doi/full/10.1056/NEJMe1912032

Re: CDC says stop vaping as mystery lung condition spreads

#156

Post by protonimitate »

zelienople wrote: post #152

Several things have failed to show up in the comments that might illuminate this discussion. (1) The condition is called lipoid pneumonia, which comes from inhaling organic fats and oils. (2) The CDC reports and early studies indicate that the condition has appeared in some people who only vaped with nicotine in glycerol (which is also sometimes called glycerin or glycerine). (3) Glycerol (the Christmas molecule--HO…

I think >(9) Many vapers are formerly heavy smokers, meaning that they have some degree of chronic lung disease, that they retain CO2, and are very likely to have respiratory acidosis.

Is important to add to the discussions. A lot of articles are pointing the finger at THC carts. They may be the catalyst but according to this NEJM article[0]:

>About 80% of the persons who vaped and became ill reported having used both nicotine products and tetrahydrocannabinol (THC) or cannabidiol (CBD) products.

That's for 215 acute cases and 2 deaths that they cited.

[0]https://www.nejm.org/doi/full/10.1056/NEJMe1912032

Re: CDC says stop vaping as mystery lung condition spreads

#157

Post by _fullpint »

johngrefe wrote: post #33

I had a startup in Vaping(nicotine) and am still fairly in touch with the industry. There has been no major innovation in nicotine eliquid that would cause a sudden cluster of issues. It's stayed pretty constant since 2013 with the exception of Salt Nicotine, which Pax labs has a gras study published for. The majority of cases seems to be THC carts where it can be confirmed. One case was confirmed from a dispensary i…

> While many of the patients, but not all, reported recent use of THC-containing products, some reported using both THC- and nicotine-containing products. A smaller group reported using nicotine only.

That’s directly from the CDC. They should probably stop using the word e-cigarette especially due to the fact nobody using the THC vapes calls them that.

Re: CDC says stop vaping as mystery lung condition spreads

#158

Post by JoeAltmaier »

_fullpint wrote: post #157
johngrefe wrote: post #33

I had a startup in Vaping(nicotine) and am still fairly in touch with the industry. There has been no major innovation in nicotine eliquid that would cause a sudden cluster of issues. It's stayed pretty constant since 2013 with the exception of Salt Nicotine, which Pax labs has a gras study published for. The majority of cases seems to be THC carts where it can be confirmed. One case was confirmed from a dispensary i…

> While many of the patients, but not all, reported recent use of THC-containing products, some reported using both THC- and nicotine-containing products. A smaller group reported using nicotine only. That’s directly from the CDC. They should probably stop using the word e-cigarette especially due to the fact nobody using the THC vapes calls them that.

Curious linguistic detail: they need to use the word that people using THC vapes expect them to use for clear communications to occur. As a stuffy international organization, they'd be expected to use something that sounds like a technical term. Vs for instance, some slang or cool-kid term.

Re: CDC says stop vaping as mystery lung condition spreads

#159

Post by julianlam »

pavelludiq wrote: post #148
DanBC wrote: post #104

Earlier quoted context omitted.

> Agreed, there's a lot of FUD, but a lot of it is coming from sources that give me a lot of hesitation to doubt (lots of public health leaders, tobacco control groups, WHO people) None of these sources are saying that vaping is comparable to smoking in terms of harms caused. They're saying that some harm is caused, and that we don't know what harms are caused, and so the precautionary principle means we should make…

> we should make sure that non-smokers do not take up vaping How about we let adults do as they please instead. The most anybody should ever do about vaping is warn people that maybe it's not the safest thing in the world. Instead in the EU we have a ridiculous law that makes it illegal to sell nicotine liquid in container bigger than 10ml, which means that if I don't want to spend twice what I used on cigarettes, I…

Letting adults do as they please is a common refrain, but when you're living in a country with subsidized healthcare, the government has an incentive (at the macro level) to not let you do stupid things that raise healthcare costs, which are then passed on to the population at large.

In America, you break it, you buy it. Everywhere else, I have no problem with a bit of governmental oversight to make sure people don't hurry themselves to a quicker and more expensive death.

Re: CDC says stop vaping as mystery lung condition spreads

#160

Post by lonelappde »

zelienople wrote: post #152

Several things have failed to show up in the comments that might illuminate this discussion. (1) The condition is called lipoid pneumonia, which comes from inhaling organic fats and oils. (2) The CDC reports and early studies indicate that the condition has appeared in some people who only vaped with nicotine in glycerol (which is also sometimes called glycerin or glycerine). (3) Glycerol (the Christmas molecule--HO…

> nicotine-containing enzymes mostly present in the liver

Nicotine from ingested smokee/vape/tobacco, or from other natural human physiology?

Post reply on HN