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E-Cigarette Use Linked To ‘Cobalt Lung’

Cobalt Lung

A case study published in the European Respiratory Journal in December 2019 described a 49-year-old in California who developed hard-metal pneumoconiosis after using e-cigarettes for only six months. The disease is also known as “cobalt lung.” The National Institutes of Health describes the disease as a “rare but serious disease of the lungs associated with inhalational exposure to tungsten or cobalt dust.”

The patient is a dog trainer and sought medical assistance when he started experiencing side effects such as coughing and shortness of breath. His symptoms resembled those of e-cigarette and vaping-related injuries (EVALI). The patient’s lung scarring was not typical of EVALI, though. Researchers at the University of California, San Francisco (UCSF) tested the man’s vaping product once they saw this scarring. The researchers found cobalt, nickel, aluminum, manganese and lead in the e-cigarette liquid the man had been using. The white air spaces of the lung which allow oxygen to flow were filled up with inflammatory cells as a result of vaping this mixture of metals, according to Kirk Jones MD of UCSF.

“There was less room in [the] lungs to breathe,” Jones said.

“This is the first known case of a metal-induced toxicity in the lung that has followed from vaping and it has resulted in long-term, probably permanent, scarring of the patient’s lungs,” said UCSF’s Rupal Shah.

The patient was treated with steroids and has regained half of his lost lung function. The patient will probably have permanent lung scarring.

Jones explained that cobalt lung and EVALI progress differently: “With the EVALI cases, patients suffer an acute collapse and damage of the lung that comes on pretty quickly, probably over a few hours,” he said. “Whereas our case is more of an immune reaction. It’s kind of an allergic reaction…to the metal found in people who are susceptible to cobalt and the disease would develop over the course of weeks or months.”

Jones added that he fears this product is not the only one to contain cobalt. “I think that cobalt is probably in a lot of these e-cigarettes,” he said.

There were 2,506 United States cases of EVALI reported to Centers for Disease Control and Prevention (CDC) as of December, 2019. 54 deaths have resulted from EVALI.

A CDC-led study published in December 2019 found vitamin E acetate in the lung fluid samples of 48 of 51 EVALI patients.


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