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How does lipoid pneumonia lead to acute respiratory distress syndrome (ARDS)?
The vaping illnesses that have been happening on the news in the United States are being caused by the federal prohibition on marijuana. Smugglers will legally go to recreational marijuana dispensaries in legal states and purchase cartridges that contain about a gram of "wax". Proper cartridges will use polyethylene glycol, polypropylene glycol, or vegetable glycerin to suspend the THC for vaporizing, but the smugglers have been known to open up the tank and remove some of the wax and refill the remaining volume with Vitamin E Oil. These tampered cartridges are then sold on the black market to recreational and medical consumers in illegal states.
The CDC Report: "Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products"
There are several ways to get ARDS (sepsis, pneumonia, trauma, pancreatitis, etc). Pathophysiologically, they all converge at alveolar insult. So however it happens, there's alveolar insult, cytokine release that recruits neutrophils, and the activated neutrophils release toxic mediators that destroy the alveolar membranes. So for your question specifically, the mineral oil in the vape cartridges (theoretically) is instigating an inflammatory reaction that destroys alveolar membranes.
Abstracts of the European Association of Poisons Centres and Clinical Toxicologists XXII International Congress*
Our ability to respond to the current challenges posed by chemical and biological warfare agents requires an understanding of the past. Despite repeated prior attempts to ban the use of poisons in warfare, the modern age of chembio warfare began during World War I on April 22, 1915 when the Germans released 150 tons of chlorine gas from 6000 cylinders directed at trenches full of Allied troops in Ypres Belgium. As many as 800 died and 2500–3000 were incapacitated from this revolutionary offensive weapon. As one observer noted: “The most stupendous change in warfare since gunpowder was invented had come and come to stay. Let us not forget that.” The Allies employed chlorine gas against the Germans that same year and soon thereafter a chemical arms race would ignite as the combatants worked to weaponize more potent chemicals and improve their delivery systems. By May 1916 the Germans started to use trichloromethyl chloroformate (diphosgene) in combat and by July 1917 added the vesicant agent mustard to their armamentarium. During the war the French used hydrogen cyanide and cyanogen chloride. Approximately one million of the 26 million World War I casualties were attributed to chemical weapons. Biological weapons were also employed during this war but to a far lesser extent. Glanders (pseudomonas) was successfully used as an antianimal biological weapon when a German agent infected 4500 mules in Mesopotamia. Early American endeavors at biochem weaponization during this period included an unsuccessful attempt to produce a ricin dust cloud. During the interwar period a variety of other chemical weapons were produced including white phosphorus, and the stockpiling of mustard (both nitrogen and sulfur mustard) and phosgene continued. In 1936, the first in a series of “nerve” agents were developed when Gerhart Schrader of I.G. Farbon discovered the first organophosphate agent. This chemical would become known as Tabun or GA (German agent A). Two years later Schrader also developed Sarin. Although these nerve agents were not used during World War II, by 1945 12,000 tons of tabun and 1000 pounds of sarin had been produced by the Germans. During the same time the U.S produced 20,000 tons of phosgene, 87,000 tons of mustard agent, 20,000 tons of Lewisite, 12,500 tons of cyanogen chloride and 560 tons of hydrogen cyanide. The chemical warfare agents that were used during this time included mustard bombs by the Italians during their offensive in Ethiopia, and mustard agent and Lewisite by the Japanese in China. The Germans found that hydrogen cyanide (zyclon-B) was a very effective means of mass killing in concentration camps. Japan also experimented with cholera, typhus, and plague in China. Since the end of the Second World War, chemical weapons have reportedly been used in a number of regional conflicts including the Yemen Civil War in the 1960s (mustard agent and possibly nerve agents), Vietnamese War (defoliants and non lethal riot control agents), Soviet–Afghanistan War of the 1980s, and Iraq–Iran War of the 1980s (mustard agent and tabun). Terrorists have also employed chemical and biological weapons. The best-known examples occurred when the Japanese religious cult, Aum Shinrikyo, released sarin in a residential area of Matsumoto Japan in 1994 (killing 7 and injuring 500) and again on the Tokyo subway in 1995 (killing 12, with 5550 seeking medical attention). Two notable bioweapon events in recent years were the outbreak of anthrax in Russia in 1979 and a mass intentional salmonella poisoning in Oregon in 1984. In April 1979, 94 people became ill and 64 died after anthrax spores were accidental released from a suspected Soviet biological weapons facility in Sverdlovsk, Russia (now Ekaterinburg). Seven hundred and fifty people developed food poisoning in Dallas, Oregon in 1984 when followers of the Indian guru Bhagwan Shree Rajneesh spiked salad bars at 10 restaurants with salmonella in an attempt to incapacitate voters in a local election. The surprise 9-11 attack on the world trade center has painfully taught us that, in addition to understanding the past, one must be increasingly vigilant and prepared for the unsuspected.