Употреба на електронни цигари – скритата пандемия

Резюме

Вайпингът или процесът на вдишване и издишване на парата, образувана от изпаряване на течността в електронните цигари  е „новата“ мода сред учениците и младежите. Рекламирани доскоро като безопасен алтернативен вариант на обикновените цигари, електронният вариант също се оказва скрита заплаха за здравето. В този обзор авторите насочват вниманието на педиатрите към зачестяващите здравословни проблеми, които се крият зад вайпинга. За илюстрация подробно е разгледан много показателен случай на 17- годишен младеж от Канада.  По света вече е въведен и термин – „белодробни заболявания, асоциирани с електронните цигари и вайпинга“ (БЗАЕВ). Въпреки че пълно възстановяване от острите симптоми на БЗАЕВ е възможно, описани са и дългосрочни последици върху белодробната функция на тези пациенти. Педиатрите трябва да са внимателни при снемането на анамнеза при деца на и над 12 години за употреба на електронни цигари. При съмнение за БЗАЕВ препоръчваме проследяване от детски пулмолог с измерване на функционалните показатели и дифузионния капацитет в острото състояние и през следващите години.

Ключови думи: e-цигари, белодробно заболяване, подрастващи  

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Библиография

  1. Czoli CD, Hammond D, White CM. Electronic cigarettes in Canada: prevalence of use and perceptions аmong youth and young adults. Can J Public Health 2014;105:e97-102.
  2. Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, Lee M. 2014. Four hundred and sixty brands of e-cigarettes and counting: Implications for product regulation. Tob Control. 23 Suppl 3:iii3-9.
  3. Cooke A, Fergeson J, Bulkhi A, Casale TB (2015) The electronic cigarette: the good, the bad, and the ugly. J Allergy Clin Immunol Pract 3:498–505.
  4. Cullen KA, Gentzke AS, Sawdey MD, et al. e-Cigarette use among youth in the United States, 2019. JAMA 2019 November 5.
  5. Giovenco DP, Hammond D, Corey CG, Ambrose BK, Delnevo CD. 2015. E-cigarette market trends in traditional u.S. Retail channels, 2012-2013. Nicotine Tob Res. 17(10):1279-1283.
  6. Gentzke AS, Creamer M, Cullen KA, et al. Vital signs: tobacco product use among middle and high school students—United States, 2011–2018. MMWR Morbid Mortal Wkly Rep. 2019;68(6):157‐164.
  7. Gentzke AS, Wang TW, Jamal A, et al. Tobacco product use among middle and high school students—United States, 2020. MMWR Morbid Mortal Wkly Rep. 2020;69(50):1881‐1888.
  8. Cho YJ, Thrasher JF, Reid JL, Hitchman S, Hammond D. Youth self-reported exposure to and perceptions of vaping advertisements: Findings from the 2017 International Tobacco Control Youth Tobacco and Vaping Survey. Prev Med. 2019;126:105775. doi:10.1016/j.ypmed.2019.105775
  9. Mantey DS, Harrell MB, Case K, Crook B, Kelder SH, Perry CL. Subjective experiences at first use of cigarette, e‐cigarettes, hookah, and cigar products among Texas adolescents. Drug Alcohol Depend. 2017;173:10‐16.
  10. National Academies of Sciences, Engineering, and Medicine. Public health consequences of e-cigarettes. Washington, DC: National Academies Press, 2018.
  11. Lanza HI, Barrington-Trimis JL, McConnell R, et al. Trajectories of Nicotine and Cannabis Vaping and Polyuse From Adolescence to Young Adulthood. JAMA Netw Open. 2020;3(10):e2019181. Published 2020 Oct 1. doi:10.1001/jamanetworkopen.2020.19181
  12. National Academies of Sciences, Engineering, and Medicine. Health effects of marijuana: an evidence review and research agenda. Washington, DC: National Academies Press, 2017.
  13. Landman ST, Dhaliwal I, Mackenzie CA, Martinu T, Steele A, Bosma KJ. Life-threatening bronchiolitis related to electronic cigarette use in a Canadian youth. CMAJ. 2019 Dec 2;191(48):E1321-E1331. doi: 10.1503/cmaj.191402. Epub 2019 Nov 20. PMID: 31753841; PMCID: PMC6887563.
  14. E-cigarette use among youth and young adults. a report of the Surgeon General. Rockville (MD): US Department of Health Human Services; 2016.
  15. Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Atlanta: Centers for Disease Control and Prevention; updated 2019 Nov. 14. Available: www.cdc.gov/tobacco/basic_information/e-cigarettes/severe -lung-disease.html (accessed 2019 Nov. 14).
  16. Lewis N, McCaffrey K, Sage K, et al. E-cigarette use, or vaping, practices and characteristics among persons with associated lung injury — Utah, April–October 2019. MMWR Morb Mortal Wkly Rep 2019;68:953-6.
  17. Triantafyllou GA, Tiberio PJ, Zou RH, et al. Vaping-associated acute lung injury: a case series. Am J Respir Crit Care Med 2019 Oct. 1 [Epub ahead of print]. doi: 10.1164/rccm.201909-1809LE.
  18. Christiani DC. Vaping-induced lung injury. N Engl J Med 2019 Sept. 6 [Epub ahead of print]. doi: 10.1056/NEJMe1912032.
  19. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems. Public health consequences of e-cigarettes. Washington (DC): National Academies Press (US); 2018.
  20. Centers for Disease Control and Prevention (2019) Outbreak of lung injury associated with e-cigarette use, or vaping. https:// www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lungdisease. html. Accessed 31 Oct 2019.
  21. Layden JE, Ghinai I, Pray I et al (2019) Pulmonary illness related to e-cigarette use in Illinois and Wisconsin — preliminary report. N Engl J Med. https://doi.org/10.1056/NEJMoa1911614.
  22. Lim HB, Kim SH. Inhalation of e‐cigarette cartridge solution aggravates allergen‐induced airway inflammation and hyperresponsiveness in mice. Toxicol Res. 2014;30(1):13‐18.
  23. e-Cigarette use among youth and young adults: a report of the Surgeon General. Atlanta: Centers for Disease Control and Prevention, 2016 (https://www .cdc .gov/ tobacco/ data_statistics/ sgr/ e -cigarettes/ index .htm).
  24. Goriounova NA, Mansvelder HD. Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. Cold Spring Harb Perspect Med. 2012;2(12):a012120. Published 2012 Dec 1. doi:10.1101/cshperspect.a012120.
  25. Yuan M, Cross SJ, Loughlin SE, Leslie FM. Nicotine and the adolescent brain. J Physiol. 2015;593(16):3397-3412. doi:10.1113/JP270492
  26. Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Atlanta: Centers for Disease Control and Prevention, December 31, 2019 (https://www.cdc .gov/ lunginjury).
  27. Gotts JE, Jordt S‐E, McConnell R, Tarran R. What are the respiratory effects of e‐cigarettes? BMJ. 2019;366:366.
  28. Kienhuis AS, Soeteman‐Hernandez LG, Bos PM, Cremers HW, Klerx WN, Talhout R. Potential harmful health effects of inhaling nicotine‐free shisha‐pen vapor: a chemical risk assessment of the main components propylene glycol and glycerol. Tob Induc Dis. 2015;13(1):1‐6.
  29. Choi H, Schmidbauer N, Spengler J, Bornehag CG. Sources of propylene glycol and glycol ethers in air at home. International Journal of Environmental Research and Public Health. 2010;7(12):4213–4237.
  30. McCauley L, Markin C, Hosmer D. An unexpected consequence of electronic cigarette use. Chest. 2012;141(4):1110–1113.
  31. Klager S, Vallarino J, MacNaughton P, et al. Flavoring chemicals and aldehydes in e-cigarette emissions. Environ Sci Technol 2017;51:10806-13.
  32. Safety assessment and regulatory authority to use flavors: focus on electronic nicotine delivery systems and flavored tobacco products. Washington (DC): Flavor and Extract Manufacturers Association of the United States; 2013, revised 2016 Sept. 26.
  33. Clapp PW, Lavrich KS, van Heusden CA, Lazarowski ER, Carson JL, Jaspers I. Cinnamaldehyde in flavored e‐cigarette liquids temporarily suppresses bronchial epithelial cell ciliary motility by dysregulation of mitochondrial function. Am J Physiol Lung Cell Mol Physiol. 2019; 316(3):L470‐L486.
  34. Brass DM, Gwinn WM, Valente AM, et al. The diacetyl-exposed human airway epithelial secretome: new insights into flavoring-induced airways disease. Am J Respir Cell Mol Biol 2017;56:784-95.
  35. Park H-R, O’Sullivan M, Vallarino J, et al. Transcriptomic response of primary human airway epithelial cells to flavoring chemicals in electronic cigarettes. Sci Rep 2019;9:1400.
  36. Morgan DL, Jokinen MP, Price HC, et al. Bronchial and bronchiolar fibrosis in rats exposed to 2, 3-pentanedione vapors: implications for bronchiolitis obliterans in humans. Toxicol Pathol 2012;40:448-65.
  37. Palmer SM, Flake GP, Kelly FL, et al. Severe airway epithelial injury, aberrant repair and bronchiolitis obliterans develops after diacetyl instillation in rats. PLoS One 2011;6:e17644.
  38. Wu Q, Jiang D, Minor M, Chu HW. Electronic cigarette liquid increases inflammation and virus infection in primary human airway epithelial cells. PLOS One. 2014;9(9):e108342.
  39. Echevarria C, Sinha IP. Heterogeneity in the measurement and reporting of outcomes in studies of electronic cigarette use in adolescents: a systematic analysis of observational studies. Tob Control. 2017;26(3):247‐253.
  40. Madison MC, Landers CT, Gu BH, Chang CY, Tung HY, You R, Hong MJ, Baghaei N, Song LZ, Porter P, Putluri N, Salas R, Gilbert BE, Levental I, Campen MJ, Corry DB, Kheradmand F.   Electronic cigarettes disrupt lung lipid homeostasis and innate immunity independent of nicotine.  J Clin Invest. 2019 Sep 4. P44.ii: 128531. doi: 10.1172/JCI128531.
  41. Hopkins Tanne J (2019) Vaping: CDC investigates severe lung injuries. BMJ 366:l5228.
  42. McConnell R, Barrington‐Trimis JL, Wang K, et al. Electronic cigarette use and respiratory symptoms in adolescents. Am J Respir Crit Care Med. 2017;195(8):1043‐1049.
  43. Wang MP, Ho SY, Leung LT, Lam TH. Electronic cigarette use and respiratory symptoms in Chinese adolescents in Hong Kong. JAMA Pediatr. 2016;170(1):89‐91.
  44. Thirión‐Romero I, Pérez‐Padilla R, Zabert G, Barrientos‐Gutiérrez I. Respiratory impact of electronic cigarettes and “low‐risk” tobacco. Rev Investig Clín. 2019;71(1):17‐27.
  45. Mozun R, Ardura‐Garcia C, de Jong CC, et al. Cigarette, shisha, and electronic smoking and respiratory symptoms in swiss children: the Luis study. Pediatr Pulmonol. 2020;55(10):2806‐2815.
  46. King JL, Reboussin BA, Merten JW, Wiseman KD, Wagoner KG, Sutfin EL. Negative health symptoms reported by youth e‐cigarette users: results from a national survey of US youth. Addict Behav. 2020;104:106315.
  47. Corcoran A, Carl JC, Rezaee F. The importance of anti-vaping vigilance-EVALI in seven adolescent pediatric patients in Northeast Ohio. Pediatr Pulmonol. 2020; 55(7): 1719– 24.
  48. Sommerfeld CG, Weiner DJ, Nowalk A, Larkin A. 2018. Hypersensitivity pneumonitis and acute  respiratory distress syndrome from e-cigarette use. Pediatrics. 141(6).
  49. Nair N, Hurley M, Gates S, et al. Life‐threatening hypersensitivity pneumonitis secondary to e‐cigarettes. Arch Dis Child. 2020;105(11): 1114‐1116.
  50. Lilly CM, Khan S, Waksmundzki‐Silva K, Irwin RS. Vaping‐associated respiratory distress syndrome: case classification and clinical guidance. Crit Care Explor. 2020;2(2):0081.
  51. Agustin M, Yamamoto M, Cabrera F, Eusebio R (2018) Diffuse alveolar hemorrhage induced by vaping. Case Rep Pulmonol 2018:9724530.
  52. Khan MS, Khateeb F, Akhtar J, et al. Organizing pneumonia related to electronic cigarette use: a case report and review of literature. Clin Respir J. 2018;12(3):1295‐1299.
  53. Arter ZL, Wiggins A, Hudspath C, Kisling A, Hostler DC, Hostler JM. Acute eosinophilic pneumonia following electronic cigarette use. Respir Med Case Rep. 2019;27:100825.
  54. Davidson K, Brancato A, Heetderks P, et al. Outbreak of electroniccigarette‐associated acute lipoid pneumonia—North Carolina, July–August 2019. MMWR Morbid Mortal Wkly Rep. 2019;68(36): 784‐786.
  55. Viswam D, Trotter S, Burge PS, Walters GI (2018) Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes. BMJ Case Rep. https://doi.org/10.1136/bcr-2018-224350.
  56. ItohM, AoshibaK, HeraiYet al (2018) Lung injury associated with electronic cigarettes inhalation diagnosed by transbronchial lung biopsy. Respirol Case Rep 6:e00282.
  57. Attili AK, Kazerooni EA, Gross BH et al (2008) Smoking-related interstitial lung disease: radiologic-clinical-pathologic correlation. Radiographics 28:1383–1396.
  58. Franks TJ, Galvin JR (2015) Smoking-related “interstitial” lung disease. Arch Pathol Lab Med 139:974–977.
  59. Henry TS, Kligerman SJ, Raptis CA et al (2019) Imaging findings of vaping-associated lung injury. AJR AmJ Roentgenol. https://doi. org/10.2214/AJR.19.22251.
  60. Thakrar PD, Boyd KP, Swanson CP, Wideburg E, Kumbhar SS. E-cigarette, or vaping, product use-associated lung injury in adolescents: a review of imaging features. Pediatr Radiol. 2020 Mar;50(3):338-344. doi: 10.1007/s00247-019-04572-5. Epub 2020 Jan 2. PMID: 31897566
  61. Rossi G, Cavazza A, Spagnolo P et al (2017) The role of macrophages in interstitial lung diseases: number 3 in the series “Pathology for the clinician” edited by Peter Dorfmuller and Alberto Cavazza. Eur Respir Rev 26.
  62. Choi JW, Lee KS, Chung MP et al (2005) Giant cell interstitial pneumonia: high-resolution CT and pathologic findings in four adult patients. AJR Am J Roentgenol 184:268–272.
  63. Elicker BM, Jones KD, Henry TS, Collard HR (2016) Multidisciplinary approach to hypersensitivity pneumonitis. J Thorac Imaging 31:92–10.
  64. Betancourt SL, Martinez-Jimenez S, Rossi SE et al (2010) Lipoid pneumonia: spectrum of clinical and radiologic manifestations. AJR Am J Roentgenol 194:103–109.
  65. Bell MM (2015) Lipoid pneumonia: an unusual and preventable illness in elderly patients. Can Fam Physician 61:775–777.
  66. ButtYM, SmithML, Tazelaar HDet al (2019) Pathology of vapingassociated lung injury. N Engl J Med 381:1780–1781.
  67. Henry TS, Kanne JP, Kligerman SJ. Imaging of vaping-associated lung disease. N Engl J Med 2019;381:1486-7.
  68. Kreiss K, Gomaa A, Kullman G, et al. Clinical bronchiolitis obliterans in workers at a microwave-popcorn plant. N Engl J Med 2002;347:330-8.
  69. Kanwal R, Kullman G, Piacitelli C, et al. Evaluation of flavorings-related lung disease risk at six microwave popcorn plants. J Occup Environ Med 2006; 48:149-57.
  70. Schwarz MI, King TE. Interstitial lung disease, 5th edition. Shelton (CT): People’s Medical Publishing House; 2011.
  71. Walley SC, Wilson KM, Winickoff JP, Groner J. 2019. A public health crisis: Electronic cigarettes, vape, and juul. Pediatrics. 143(6).
  72. Artunduaga M, Rao D, Friedman J, Kwon JK, Pfeifer CM, Dettori A, Winant AJ, Lee EY. 2020. Pediatric chest radiographic and ct findings of electronic cigarette or vaping product use-associated lung injury (evali). Radiology.192778.
  73. Henry TS, Kligerman SJ, Raptis CA, Mann H, Sechrist JW, Kanne JP. 2020. Imaging findings of vaping-associated lung injury. AJR Am J Roentgenol. 214(3):498-505.
  74. Centers for Disease Control and Prevention (2019) Update: interim guidance for health care providers evaluating and caring for patients with suspected e-cigarette, or vaping, product use associated lung injury — United States, October 2019. https://www.cdc.gov/ mmwr/volumes/68/wr/mm6841e3.htm.

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