Discover the new disease caused by e-cigarettes

this TO EVALUATEA medical condition first described by science in 2019 is a serious respiratory illness associated with its use. electronic cigarette. Its name comes from the English abbreviation of the term E-cigarette Use Associated Lung Injury.

Although it is a new disease and has some features that scientists still do not understand, one thing is already known: In the most severe cases, it can lead to death.

Also known as vape or electronic smoking devices, e-cigarettes produce an aerosol by heating a liquid that may or may not contain nicotine (an addictive active ingredient in tobacco). The liquid used in the device may contain other substances that help produce the aerosol inhaled by the user and their relatives.

The sale, import and advertisement of all types of electronic cigarette devices have been banned in Brazil since 2009.

While studies show vaping benefits as it does less damage to the lungs when used in place of traditional cigarettes, science shows the device harms non-smokers teens and adults alike.

Pulmonologist Paulo Corrêa says, “Since it is a dirty, polluted chemical environment with about two thousand different chemicals and most of these substances are unknown, it cannot be said that there is no safety in using electronic cigarettes.” He is a Professor at the Brazilian Society of Chest Diseases and Thysiology (SBPT) Scientific Commission on Smoking and Federal University of Ouro Preto (UFOP).

The CDC, the U.S. Centers for Disease Control and Prevention, EVALI epidemic It peaked in September 2019. By February 2020, there were 68 confirmed deaths caused by the new disease – more than 2,800 hospitalizations in total from the condition in the country during the same period, according to the agency’s data.

Most, if not all, cases were related to e-cigarette use containing tetrahydrocannabinol (THC), a psychoactive substance found in marijuana. However, Corrêa says there are users who have developed the disease even without using this compound. “There is a list of chemicals that are candidates for the causes of EVALI and are under investigation,” says the doctor.

According to the CDC, data collected during the disease outbreak that began in 2019 suggests that vitamin E acetate has been linked to the disease. This compound is a synthetic form of vitamin E found in THC vape products that can damage the lungs if inhaled.

In a study published in 2020 in The New England Journal of Medicine, one of the most important in the health field, vitamin E acetate was found in the lung fluid of 48 of 51 EVALI patients who participated in the study. The same substance was not found in the lungs of healthy people.

Brazil has already registered cases of diseases related to electronic cigarettes

A voluntary reporting system developed by Anvisa in 2019 shows that 8 cases of illness related to the use of electronic devices for smoking have occurred. The last recording was made in April 2022.

“The form was created with the help of medical associations from the description of a number of health events related to e-cigarette use in different countries of the world,” Anvisa said.

Also, according to the agency, the available data on e-cigarette use comes from studies and research conducted in Brazil by various initiatives.

Corrêa says EVALI has been deleted in response to the pandemic’s emergency Covid-19. “Coronavirus and Flu [gripe] It can cause respiratory conditions very similar to those triggered by EVALI,” he says.

For this reason, Corrêa says that the diagnosis of EVALI should only be made against PCR-type tests that are negative for covid-19 and influenza. In addition, the clinical picture and imaging tests should be compatible with known patterns of the disease.

What are the symptoms and how is EVALI treated?

Symptoms of the disease include cough, chest pain, shortness of breath, fever and chills. In addition to these symptoms, the patient may also experience weight loss, abdominal pain, nausea, vomiting and diarrhea.

According to Corrêa, the first step in treatment is to stop using the device; Depending on the severity of the case, a prescription of corticosteroids and oxygen (such as mechanical ventilation) may be necessary.

Controlling EVALI and other evils that e-cigarettes can cause in Brazil is no easy task. Despite the current sales ban, devices are still bought and used in the country.

Another factor is the lack of systematic monitoring of device-related disease cases. According to Corrêa, experts from the Brazilian Society of Pulmonology and Thysiology (SBPT) have asked Anvisa at least twice to create a mandatory reporting system. For Corrêa, voluntary reporting is ineffective in this situation.

“Epidemiological situation [da EVALI] It is unknown in Brazil, it is necessary to have an official notification system from Anvisa or the Ministry of Health”, says Corrêa. The pulmonologist concludes his words by saying, “The Ministry of Health has remained silent on issues related to electronic devices for smoking.”

The ministry says by email that there has been a request from Anvisa to register Diseases related to the use of Electronic Devices for Smoking (DEFS) and work is ongoing.