Hypersensitivity pneumonitis
For some reason, the media is awash with the story of a 16yr-old Nottingham teen who contracted hypersensitivity pneumonitis three years ago
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by Dave Cross
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Doctors Nair, Hurley, Gates, Davies, Chen, Todd, Fairclough, Bush, Mahendra Bhatt write about “a previously healthy 16-year-old boy presented to the emergency department with a 7-day history of fever, cough and increasing difficulty breathing despite oral antibiotics and inhaled salbutamol.”
“He had smoked cannabis a year previously but not recently. He had no recent bird or farm animal exposure or any recent travel,” they continue. “Further questioning revealed that he had recently started to use e-cigarettes fairly frequently, using two different liquids, purchased over the counter.”
He did not confess to using any other liquids such as those linked to similar outbreaks in the United States.
The UKVIA (U.K. Vaping Industry Association) responded: “We fully support Public Health England’s position that vaping is 95% less harmful than smoking. Smoking causes more than 200 premature deaths in England every single day, and vaping has been proven to make it more likely that people will make that potentially life-changing switch away from cigarettes.”
“The UK vaping industry takes youth access prevention extremely seriously. Fortunately, we do not have the issues in this country which we see in others, such as the United States. Action of Smoking and Health found that the proportion of young people who have never smoked who vape at least weekly is very low (0.2% of 11-18 year olds in 2018).”
“We are aware of a recently reported illness in Nottingham. In this case, both the British Lung Foundation and the UK Centre for Tobacco and Alcohol Studies believe an allergic reaction may have been to blame. Thankfully, cases such as this are very rare.”
“In the last week the Centres for Disease Control (CDC) linked recent health issues in the US to vitamin E acetate. Products containing this ingredient, such as illicit THC liquids, are illegal under the UK’s stringent safety regulations. We encourage consumers to always use reputable retailers when purchasing their products.”
“Vaping remains a transformative, harm-reduction tool for the UK’s 7+ million smokers.”
Dr Nick Hopkinson, British Lung Foundation Medical Director and Reader in Respiratory Medicine at Imperial College London, said: “It’s possible the patient’s illness could have been due to an allergic response to a component of e-cigarette vapour. However, in this kind of condition it can often be difficult to make an accurate diagnosis or know for certain what the cause is. This kind of lung disease can sometimes occur spontaneously without any obvious trigger.”
“In Britain, 3.6 million people vape and youth use remains low. If this was a common problem or a significant risk we would expect many more cases. The US outbreak seems to be related to use of specific products. Unless there has been a cluster of other cases in the same area – which is unlikely to have been missed – this case seems more likely to relate to an individual being allergic rather than a particularly toxic chemical in e-cigarette vapour.”
“Advice remains that smoking carries a huge health risk and smokers need to quit if at all possible. While vaping is not completely safe, the important thing to remember is smoking is far more harmful. The vast majority of people who use e-cigarettes do so to quit smoking. E-cigarettes are one of the many tools available to help people quit. Anyone looking to stop smoking should speak to their GP or local stop smoking adviser or have a look online for NHS Smokefree [link].”
“If people switch completely from smoking to vaping they will substantially reduce their health risk as e-cigarettes do not contain tobacco and any harmful components are present at a much lower level. People who do switch should try to quit vaping in the long term too, but not at the expense of relapsing to smoking – and non-smokers should not take up vaping.”
Professor John Britton, Director of the UK Centre for Tobacco & Alcohol Studies and Consultant in Respiratory Medicine, University of Nottingham, said: “It’s not absolutely clear what has happened here, but it looks like an allergy to an inhaled substance. There have been a very small number of cases of this condition reported in vapers worldwide, so I think we can conclude that it happens but is thankfully very rare.”
“This is worrying, and the risk needs to be acknowledged, but in absolute terms it is extremely small – and, crucially, far smaller than that of smoking. The advice remains the same: if you smoke, switch to vaping; if you don’t smoke, don’t vape.”
“The authors say, ‘we consider e-cigarettes as ‘much safer than tobacco’ at our peril’. I strongly disagree. Smoking kills half of long-term smokers. Rare conditions like this need to be recognised, but there is no comparison: vaping is far less risky.”
Rosanna O’Connor at Public Health England said: “We continue to keep the evidence under review, including all safety and health concerns reported to the e-cigarette regulator, the Medicines and Healthcare products Regulatory Agency. However, smoking kills half of life-long smokers and accounts for almost 220 deaths in England every day. Our advice remains that, while not completely risk free, UK regulated e-cigarettes carry a fraction of the risk of smoked tobacco.”
Related:
- U.K. Vaping Industry Association - [link]
- “Life-threatening hypersensitivity pneumonitis secondary to e-cigarettes” by Nisha Nair et al. – [link]
- Vaping nearly killed me, BBC – [link]
Dave Cross
Journalist at POTVDave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.
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