A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist
by
Anna Tzortzi 1,2,*, Melpo Kapetanstrataki 1,*, Vaso Evangelopoulou 1 and Panagiotis Behrakis 1,2,3
Anna Tzortzi 1,2,*, Melpo Kapetanstrataki 1,*, Vaso Evangelopoulou 1 and Panagiotis Behrakis 1,2,3
1
George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece
2
Institute of Public Health, The American College of Greece, 17B Ipitou Street, 10557 Athens, Greece
3
Pulmonary Department, Athens Medical Center, Distomou 5-7, Marousi, 15125 Athens, Greece
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(7), 2248; https://doi.org/10.3390/ijerph17072248 (registering DOI)
Received: 24 February 2020 / Revised: 20 March 2020 / Accepted: 25 March 2020 / Published: 27 March 2020
Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016–2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.
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Keywords:
electronic cigarette; vaping; e-vaping acute lung injury (EVALI); VAPI; e-cigarette explosion; nicotine intoxication
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- Supplementary File 1:
ZIP-Document (ZIP, 70 KB)
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Externally hosted supplementary file 1
Doi: 10.5281/zenodo.3719142
Link: https://zenodo.org/record/3719142#.XnSpS3JS9PY
Description: 1. PRISMA checklist for systematic reviews 2. Revised supplementary table summarizing clinical presentation, laboratory workup and diagnostic characteristics of e-cigarette related clinical cases, by type of injury, included in the submitted manuscript.
MDPI and ACS Style
Tzortzi, A.; Kapetanstrataki, M.; Evangelopoulou, V.; Behrakis, P. A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist. Int. J. Environ. Res. Public Health 2020, 17, 2248.
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