Good morning all,

As we remain on-schedule, we will not meet in-person for lecture on Friday (15 Nov).  I'd like instead to offer you several pieces of recent science news:

We have considered issues surrounding vaping several times this terms, most recently the alarming and poorly-understood severe respiratory distress that has developed in otherwise healthy individuals who vape.  After several months of investigation, our CDC (Centers for Disease Control and Prevention) have released a report that appears to identify the likely cause of his distress syndrome: vitamin E acetate, and oily compound used as a additive in some vaping products.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6845e2.htm?s_cid=mm6845e2_w

Vitamin E and its derivatives are lipophilic (fat soluble), which allows them to interact with cell membranes more easily than most biological compounds (which are hydrophilic, or lipophobic).  Multiple samples of lung tissue from persons afflicted with vaping-associated respiratory distress have revealed this compound adhering to the lung surface.  If you remember our discussions on lung structure/function, we described the exchange surface between the alveoli and the capillaries of the lungs as being as thin as possible (essentially, two single-cell layers of epithelium), to allow as much gas diffusion across them as possible.  Now, imagine that same surface covered with a sticky, oily residue - it's easy to see that gas exchange could be severely impaired.

There may be other substances contributing to this distress syndrome, and not all experts are convinced that vitamin E acetate is the culprit.  But, the evidence is accumulating, and it appears likely to be the primary cause of the cases investigated so far.

https://www.nytimes.com/2019/11/08/health/vaping-illness-cdc.html

If you do vape, check your products - do they list this as an additive?  Can you select other materials that do not?

Juul, one of the largest companies producing vaping products, recently agreed to stop making some kinds of flavored vaping products, as they and others in the industry were being accused of improper marketing toward minors:

https://www.cnn.com/2019/11/07/health/juul-mint-pods-bn/index.html

One young person with vaping-associated respiratory distress recently was forced to undergo a double lung transplant:

https://www.reuters.com/article/us-health-vaping-transplant/michigan-boy-17-gets-double-lung-transplant-after-damage-from-vaping-idUSKBN1XN04R

Vaping seems like a habit to be avoided at all costs, in my view.  Our lung tissue is simply not designed to handle contact with things other than atmospheric gases.  In a few years, we may look back at this as a trend that appeared, and briefly flourished, before its significant health implications were well-understood.  I suspect that regulations around vaping will get tighter and tighter, and the available evidence suggests that our public health would be best served by limiting access to vaping materials and more carefully regulating their contents.


Have a great rest of the week - see you on Monday for Chapter 22 (DNA Biology and Technology).

Sincerely,
Dr. Nealen

Good morning all,

The results of our vaping survey are in!

We had 93 responses in total.

Almost exactly 2/3 (61/93) respondents said that they do not vape.
Almost exactly 1/3 (32/93) respondents reported that they did vape at least one per week.

Those respondents who did not vape rated its danger as 8.1 out of 10.

Those who do vape rated its pleasurability as 6/10, and its danger as 7.3/10. 
(interesting that users ranked the pleasurability lower than the danger, isn't it?)

Those who vape do so an average of 12x per week (range:1-100 times per week).

17/31 (42%) of those who vape do check the source/ingredients, while the majority (17/31, 55%) do not.

The vaping materials used (and the number of people who reported using them) are

don't know    1
Juul     2
mint    3
nicotine    3
blueberry    1
tobacco    12
other    12


These findings reflect much of what is reported in the recent news:
- vaping is very popular among college-age students
- additives or alternatives to tobacco are prominently used
- users pay relatively little attention to the ingredients or sourcing of vaping products.


These are dangerous trends!  That one can directly and intentionally infuse nicotine is especially worrisome, as is the fact that users do not know with great confidence the source or identify of the other compounds that are inhaling.  Our lungs are designed for exposure to atmospheric gases only - introducing any other compounds is potentially quite risky. 

We will continue to discuss this topic, and I will continue to pass along more information.  Education and effort are the keys to behavioral change - with any luck, we can increase awareness of the dangers of vaping and reduce its prevalence.  The numbers of vaping-associated cases of severe respiratory distress and mortality continue to climb - please be aware of the dangers, and use that knowledge to make good choices about your health.

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Sincerely,
Dr. Nealen

Good morning all,

As a follow-up to the news article I last sent, here are a couple of updates on this developing story:

Severe illness and unexplained deaths associated with vaping have continued to occur, and, while no definitive cause has been identified, the majority of cases seem to be linked to the inhalation of vaping substances that are coating or irritating the lining of the lungs, preventing proper gas exchange.   Vaping materials often have additives, such as flavorings or oils, that are the prime target.  A number of persons suffering respiratory distress after vaping seem to have oils lining their lung surface.  As one researcher put it, 'The lungs are designed to encounter gases only.  Inhalation of other substances is inherently risky'.

https://www.nytimes.com/2019/09/07/health/vaping-lung-illness.html

https://www.washingtonpost.com/health/2019/09/07/what-we-know-about-mysterious-vaping-linked-illnesses-deaths/?tid=pm_national_pop

I understand that vaping is quite popular, and I worry (a lot) about how dangerous it is.  It is trendy and new, but not well regulated, and too recent to have been well studied.  I suspect there will be much more news on this topic, and likely soon many more regulations about what can or cannot be included in vaping materials.  I hope that you do not vape - but if you choose to do so, please be informed, for your own safety.   

Sincerely,
Dr. Nealen

Good evening all,

As I mentioned in lecture on Wednesday, we are still on track schedule-wise, and do not have a chapter planned for Friday of this week.  Thus, let's not meet in person for class tomorrow.  Instead, I'm passing along (below) a link to a recent news article that I would like you to read, about some of the dangers associated with vaping, a topic that is certainly of the latest health issues of concern.  As a former smoker, I know first-hand the 'rush' associated with nicotine; as a physiologist, I know too well the dangers associated with inhaled substances.  To me, vaping seems to present dangerous levels of both.

I will occasionally pass along science and health news articles of this type during the semester.  My purpose in doing so is to help you to become more aware of topics at the interface of biology and society, and also to help you assess how you obtain your science and health news.

Those of us working in science obtain our scientific news, quite often, directly from the original sources: the people conducting the studies and reporting the results.  They publish their findings in science journals, or present them at conferences. 

Most people do not obtain science news directly, but hear news via secondary sources, such as news releases from scientific organizations, or news stories from the major news outlets.  These secondary reports often are then carried by tertiary outlets (smaller/other reporting sources, including news aggregators and media feeds).

Along the way from source to audience, science news is normally distilled (a lot) - much of the detail is excluded or simplified, and the reports often are boiled-down to singular take-home messages, which may (or may not) be good representations of the original work.

When you browse the links that I will forward, or when you access science and health news on your own, I'd encourage you to delve a little bit deeper into them, to read more than just the summaries, and to follow links back to original sources when possible.  I'd also encourage you to think a little about the translation of news from source to consumer, and the reputability of the news outlets that you use. 

You will not be formally tested on any of the material in the news stories that I will send you, but I do hope that the material in them makes its way into our conversations. 

This first link is from the New York Times, which provides one of the best (e.g., best funded and most reliable) secondary sources of science and health news.  They do limit access to only a handful of free articles each month, so I will use them sparingly.

https://www.nytimes.com/2019/08/23/health/vaping-death-cdc.html

Here's wishing you all a safe and enjoyable Labor Day weekend - see you next week.

Sincerely,
Dr. Nealen