The EVALI epidemic, or e-cigarette, or vaping, product use-associated lung injury, is still ongoing, and people are still suffering from it. Rashelle Bernal was one of almost 3000 people hospitalized during 2019 and early 2020 with severe lung damage from vaping, becoming part of what is now known as the EVALI epidemic. For her, the aftermath is a reality that she has to live with. More than three years later, she still finds herself in the emergency department, unable to breathe correctly.
In 2019 and 2020, hospitals notified the public of outbreaks of vaping-related lung injuries. News headlines reported e-cigarettes were killing teens from Texas to the Bronx. Investigators at the US Centers for Disease Control and Prevention (CDC) tracked most of the cases to vitamin E acetate, an additive in illicit cannabis vaping products intended to promote the metabolism of tetrahydrocannabinol (THC). However, even though the CDC stopped tracking EVALI in February 2020, harm from vaping, including EVALI, has continued.
EVALI Epidemic: The Statistics
In April 2020, the agency's National Center for Health Statistics (CDC/NCHS) implemented a diagnostic code, U07.0, for healthcare professionals in the United States to diagnose EVALI for the first time. The code is also used for lung damage related to the use of electronic cigarettes and "dabbing" — a method of inhaling cannabis. Damage could include inflammation of the lungs, pulmonary hemorrhage, and eosinophilic pneumonia.
The incidence of these diagnoses appears to have risen sharply since 2020. In the last three months of 2020, 11,300 medical claims included the U07.0 code. That figure rose to 22,000 in 2021 and hit 31,600 in 2022, according to data compiled for and provided to Medscape by Komodo Health, a healthcare technology company that holds a database of more than 330 million US patients from Medicare, Medicaid, and commercial insurers' medical, pharmacy, and laboratory claims.
Even though EVALI cases are rising, Usha Periyanayagam, MD, MPH, head of clinic product and real-world evidence for Komodo and a former emergency medicine physician, said, "We're still seeing a number of patients diagnosed with vaping disorders, but it's not top of mind."
The Reality for EVALI Patients
Devika Rao, MD, a pediatric pulmonology specialist at UT Southwestern Medical Center in Dallas, has cared for most of her EVALI patients in the hospital, with the most recent case in early 2023. But in January, for the first time, she saw an EVALI patient in an outpatient clinic. The person had not been admitted to the hospital — like most were pre-pandemic. And like most who were seen during the pandemic, this patient had milder symptoms, not requiring intubation or take-home oxygen.
For people like Rashelle Bernal, the consequences of vaping are permanent. Her pulmonologist from that time described the harm from the vape ingredients as an oil spill in her lungs. Eventually, the toxins would probably clear, but she will likely wrestle with the injuries for a very long time. If she gets sick, anything that irritates her lungs, she gets winded and cannot breathe correctly. Something as simple as pollen in the air could cause her to get a bacterial infection or other issues.
Conclusion
The EVALI epidemic is not over yet. People are still suffering, and we need to remain vigilant to prevent further cases. There is a need for continuous research and public education to understand the dangers of vaping and the harm it can cause to the lungs. It is essential to spread awareness about EVALI and its long-lasting effects on the human body, even years after exposure. We must also take steps to protect vulnerable populations, such as teens and young adults, who are more likely to take up vaping.
As a society, we must work together to prevent further cases of EVALI and provide support to those already affected by it. It is crucial to prioritize public health and safety and take steps to prevent further harm from vaping and other harmful substances.
FAQs
What is EVALI?
EVALI is the epidemic of e-cigarette, or vaping, product use-associated lung injury.What causes EVALI?
Most EVALI cases have been linked to the use of e-cigarette or vaping products containing THC, particularly those obtained from informal sources.What are the symptoms of EVALI?
Symptoms of EVALI can include shortness of breath, chest pain, cough, fever, fatigue, and gastrointestinal symptoms such as nausea, vomiting, and diarrhea.How can EVALI be prevented?
The best way to prevent EVALI is to avoid using e-cigarette or vaping products.Is vaping safer than smoking cigarettes?
No, vaping is not safer than smoking cigarettes. Both can cause harm to the lungs and overall health.