- Friday, 14 March 2014 18:17
Doctors, open your textbooks: glycerol CANNOT cause lipoid pneumonia (but other things can)
By Dr Farsalinos
Another story of a patient developing lipoid pneumonia from vegetable glycerine has been reported yesterday in Spain and is reproduced today by English-speaking media. Just like the case published in Chest Journal, the doctors attributed the case to glycerol based e-liquids (at least that is what the media report). But where is the truth in that?
In reality, if glycerol was causing lipoid pneumonia at a rate of only 1 case per year per millions of users (because millions are vaping glycerol-based liquids every day), that would make it an extremely safe chemical. However, the doctors and scientists should consult their textbooks before making such statements. To be exact, they should go back to chemistry books of secondary school. That will remind them that glycerol is an ALCOHOL, not a lipid. Therefore it is absolutely impossible that glycerol can cause lipoid pneumonia, even if it is aspirated in liquid form! That would violate basic chemistry laws!!
But why did those 2 cases appear? The e-cigarette may be the cause of this disease, but only under one condition: the patients were inhaling lipid (oil) based flavorings and e-liquids. We know that most flavors in the food industry are dissolved in oil (usually vegetable oil). These are perfectly safe for ingestion, but should NOT be used for inhalation. Inhaling oils can lead to lipoid pneumonia. Unfortunately, I have seen rare reports in the social media of vendors who are selling oil-based flavorings (or they use oil-based flavorings in the e-liquid). In some cases they present this “discovery” as a method to avoid the adverse effects of propylene glycol (in most, but not all, cases there are no adverse effects, just some irritating cough in some sensitive vapers). Other vendors may probably use it based on taste or even due to ignorance about the adverse effects of inhaling oils.
As you understand, this is an irresponsible behavior from these vendors; but even in this case it is not glycerol which should be blamed. Additionally, no impurity in glycerol can be the cause for lipoid pneumonia. Propylene glycol is also impossible to cause this disease. The lack of knowledge by some (obviously a very small minority of) vendors leads to these unfortunate events. Unfortunately, none can become an expert through Wikipedia or the internet, and none can be considered an expert just because he is a vaper. The industry should not be happy with these phenomena, but they seem to be inactive in ensuring that such vendors are excluded. However, scientists should be very careful on what they report. The issue of glycerol (also called glycerine) causing lipoid pneumonia is scientifically non-existent. The statements mentioned in the media about the case in Spain are exposing the scientists, who are obliged to know and understand basic chemistry laws.