Preliminary results of a new study indicate lung damage from vaping may originate from the metals within the heating elements of the e-cigarette devices.

The Journal of the American Heart Association published the initial findings that show e-cigarette devices that use heating elements made of nickel-chromium alloy can cause severe lung impairment more so than when the heating elements are made of stainless steel.

A research team from the University of California, Irvine (UCI) School of Medicine and the Huntington Medical Research Institutes (HMRI) had been conducting a study on vaping and the impacts on the cardiovascular system.

During the experiments, a certain e-cigarette device the researchers had been using was removed from the marketplace and replaced with a different one that mimicked the previous device’s output, but had the heating element switched from stainless steel to the nickel-chromium alloy. The manufacturing change reportedly happened in September 2019.

Heating Element Lung Damage from Vaping

Robert A. Kloner, MD, PhD, senior author and chief science officer for HMRI and professor of medicine at UCI, said the team was compelled to release the findings regarding the dangers of the nickel-chromium heating element before their research was complete. He said they felt it was important to let people know of the heating element’s impact on lung health, especially because people who vape are at an increased risk of contracting COVID-19.

Researchers said the heating element proved problematic no matter what type of material was used in the vaping devices. Whether vaping e-liquids contained nicotine, vitamin E acetate made with canola, soy or corn oil, or tetrahydrocannabinol (THC), the heating element was a deciding factor in the amount of lung damage from vaping.

“Within an hour of beginning an experiment, we observed evidence of severe respiratory distress, including labored breathing, wheezing and panting,” said Michael Kleinman, Ph.D., professor of occupational and environmental medicine at UCI School of Medicine and member of the UCI Center for Occupational and Environmental Health. “After analyzing lung tissue from subjects in the study, we found them to be severely compromised and observed other serious changes such as lung lesions, red blood cell congestion, obliteration of alveolar spaces, and pneumonitis in some cases.”

Heating Elements and EVALI

In the summer of 2019, a condition called e-cigarette or vaping product use-associated lung injury (EVALI) made more than 2,800 people in the U.S. sick with lung inflammation and injury. At the time, many of the vaping incidents that led to the hospitalization due to EVALI appeared to be associated with THC products that contained vitamin E acetate. The CDC continues to identify vitamin E acetate as the primary cause of EVALI.

“While further research is needed, these results indicate that specific devices and power settings may play a key role in the development of EVALI as much as the additives do,” said Dr. Kloner.

EVALI was recognized as severe and sometimes deadly lung infection that appeared suddenly, often in young people who were known to be healthy. Shortness of breath, fever, a rapid heartbeat, rapid and shallow breathing, chest pain and a cough led many patients to need hospitalization.

Many of the lung samples indicated that THC was found to be a factor in the development EVALI, but the CDC advised patients to stop using all e-cigarettes.

Another factor could be the level of heat needed to aerosolize vitamin E acetate, which needs to reach 363 degrees Fahrenheit. According to the Insider, that’s quite a bit hotter than most people generally vape.

THC-containing e-liquids often use oily vitamin E acetate to help suspend the THC. If the e-cigarettes used to create vapor from these solutions needs to become extraordinarily hot, this means any nickel-chromium alloy heating element could be releasing more damaging material, too.

Even though the vitamin E acetate is only meant as a delivery system for the THC, the oil particles could cause clogging in the lungs. As part of the body’s immune response, inflammation and fluid collection to try to flush away the oil from the lungs could result in pneumonia, according to Professor Robert Tarran of the University of North Carolina Marisco Lung Institute when he spoke with Insider in September 2019.

The number of American youth who vape has increased exponentially, much to the alarm of parents, health care workers and educators. The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) reported in 2019 that more than one in four high schoolers and one in 10 middle school students used e-cigarettes in the past 30 days when asked.