Heavy Metal Injury Caused by Vaping Confirmed in First Case Study
Authorities in the US are still trying to determine what’s causing the vaping illness crisis, but one woman’s “cobalt lung” diagnosis may have provided a new clue.
Published on December 6, 2019

A new case study reports that a California woman developed a rare, incurable condition called cobalt lung after vaping for only six months.

The study, published Wednesday in the European Respiratory Journal, showed that the unidentified 49-year-old woman’s lungs featured permanent scars and “crackles.” Lab tests revealed that her lung tissue contained cobalt, aluminum, and lead. 

"This is the first known case of a metal-induced toxicity in the lung that has followed from vaping, and it has resulted in long-term, probably permanent, scarring of the patient's lungs," Dr. Rupal Shah, a researcher at the University of California-San Francisco and the study’s co-author, said in a press release.

However, researchers quickly highlighted that the damage seen in the woman’s lungs do not perfectly match the kind of injuries seen in EVALI or VAPI patients. EVALI patient’s lung screenings show oily build-ups on immune cells, indicating that an oil-based contaminant such as vitamin E acetate could be a culprit. A Mayo Clinic analysis from earlier this year found that EVALI patients also have severe “chemical burns” in the lung tissue, suggesting that some other contaminant, like hydrogen cyanide from residual fungicide fumes, could be contributing to the illness, as well.

Instead, the woman was diagnosed with giant cell interstitial pneumonia, which occurs when damaged lung cells essentially swallow up nearby healthy cells.

"It has a distinctive and unusual appearance that is not observed in other diseases," Dr. Kirk Jones, a professor of pathology at the University of California-San Francisco and another co-author on the case study, told NBC News. "When we diagnose it, we are looking for occupational exposure to metal dust or vapor, usually cobalt, as a cause."

Typically, doctors only screen for heavy metal toxicity if the patient works in a high-risk occupation, such as diamond processing or mining. But the woman in this case was a professional dog walker, and she didn’t seek medical help until her symptoms had progressed to an irreversible state.

EVALI, or e-cigarette-associated lung injury, is a mysterious illness that has hospitalized over 2,000 people in the US and has killed at least 50. State and federal health authorities are currently investigating the cause of the crisis, which has been linked to unregulated black market vapes, although new evidence indicates regulated vapes may cause the illness, too.

But where did the metal come from in this latest vaping case? Researchers suspect that the vape device’s heating coil released metallic fumes into the vaping oil. Lab tests confirmed that the woman’s vape oil contained high levels of nickel, aluminum, manganese, lead, cobalt, and chromium.

And unlike many other case studies involving the vaping-related illnesses, this one identified a single vape device brand: ZenPen. ZenPen, based in California, sells vaping devices, but it does not offer “vape juices” or vaping oil cartridges.

While this is the first published case study linking heavy metal lung injuries to vaping, a consulting firm based in Denver, Colorado reported earlier this week that lab analyses detected heavy metals in a vaping illness patient’s urine samples and his vape device. The consulting firm suspects that cadmium, another heavy metal often used to solder electrical parts in cheaper vape devices, could be a key culprit behind the vaping crisis.

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Randy Robinson
Based in Denver, Randy studied cannabinoid science while getting a degree in molecular biology at the University of Colorado. When not writing about cannabis, science, politics, or LGBT issues, they can be found exploring nature somewhere in the Rocky Mountains. Catch Randy on Twitter and Instagram @randieseljay
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