Hi, there is no need to worry about this.
It looks as if your doctor is clutching at straws here, or is a confirmed ANTZ (anti nicotine and
tobacco zealot), in which case the facts will make no difference to his opinion; anyway, here are the facts just in case.
- Inhalation of 'PG' or 'glycerine' or both cannot cause lipoid pneumonia. I placed these names in inverted commas as they are inaccurate common names that do not fully represent their nature - the full common names are propylene glycol and glycerol. By the -ol suffix we can see they are alcohols, and it is regarded as impossible for inhalation of alcohols to cause LP, since it is caused by inhalation of oils.
- Their full chemical names (or one version of them) are (PG) = propane 1,2 diol; and glycerol = propane 2,3 triol. Again, see the alcohol designator.
- If an incident of an alcohol causing LP could be identified, the doctor who made the discovery would become feted. You would see medical journal articles, case studies, and above all: some evidence. It has never happened, and there is no evidence. An article in the National Enquirer with wild claims is not evidence.
- Ecig refills use PG and glycerol as the excipients. PG has been inhaled in asthma inhalers for decades without serious consequences (the minor issues include drying of the upper respiratory tract). Because of this, pharmaceutical companies who make medical inhalers are moving to a PG/glycerol mix, or all-glycerol - exactly as we use in ecigs. See Dow Chemical (esp. Dow Optim) for the details. If your doctor is suggesting that asthma inhalers cause lipoid pneumonia, then clearly he has taken leave of his senses.
- PG is also used for the carrier (excipient) in the nebulisers used by lung transplant patients. Taken together with the multiple decades of use in asthma and other inhalers, it is clear that these materials are safely inhaled by those in the most fragile health and with the most serious lung conditions.
There simply is no evidence for any association with lipoid pneumonia at all. No one has ever presented detail cell pathology that identified lipoid pneumonia as the condition involved when ex-smokers who had begun to vape presented with lung issues (or, equally, for asthma patients or lung transplant patients). Your doctor can consult several experts on these issues if he is so inclined - we can put you in touch if required. For example:
Prof R Polosa - pulmonary consultant, airway obstructive diseases specialist
Prof M Siegel - anti-
tobacco specialist
Dr K Farsalinos - consultant cardiologist, cardiac imaging specialist
Prof J Britton - world authority on tobacco control, chair of the Royal College of Physicians' tobacco group
Dr CV Phillips - THR scientist with two decades of experience of such issues
Prof I Burstyn - leading toxicologist who reviewed nearly 10,000 measurements in order to complete his exhaustive analysis of ecig toxicology, regarded as the authoritative work
Also see what they have written on this and related issues, for example:
Farsalinos:
Doctors, open your textbooks: glycerol CANNOT cause lipoid pneumonia (but other things can)
Siegel:
The Rest of the Story: Tobacco and Alcohol News Analysis and Commentary: German Cancer Research Center Lies about Health Effects of Electronic Cigarettes to Scare Users and Unfairly Influence EU Directive
Britton: "If all UK smokers switched to ecigs, we would save five million lives just among those alive today, just in the UK."
Burstyn:
BMC Public Health | Abstract | Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks
http://publichealth.drexel.edu/SiteData/docs/ms08/f90349264250e603/ms08.pdf
It is worth remembering that there are at least 25 million ecig users worldwide, ecigs were first sold in the West (in the UK) in 2005, and obviously we therefore have well over 50 million user-years experience with them (probably approaching 100 million user-years @Q1 2015). There are no confirmed cases of LP in any vaper. Even if there had been 10 confirmed cases, with full presentation of case details and cell pathology in order that any other condition or cause could be absolutely eliminated, then 10 cases in 100 million user-years is of no consequence - and especially since we are told that up to half of those millions of ex-smokers would have died anyway if they had continued to smoke.
Again, just to put this in the correct context: there are certainly millions of ex-smokers globally who have quit using an ecig, many of whom would not have quit at all otherwise. Let's assume there are only 5 million such ex-smokers (it is likely to be many more than this). So let's say hypothetically that 10 die from lipoid pneumonia. As 2.5 million would have died had they continued to smoke (if the figures we are given are correct), then clearly the issue is invisible and of absolutely zero importance.
However to make sure this argument is balanced, I personally (and no one else, as far as I am aware) believe there is an elevated risk for standard pneumonia in vapers who consume 100% VG refills and who are ex-smokers and who suffer from emphysema or COPD stage 3 or 4. This is because smokers with irreparably damaged lungs are at risk of developing pneumonia, and an all-VG refill is (in my opinion) not the best choice for such vapers, as they should inhale at least some PG (for its bactericidal, virucidal and hygroscopic qualities.) Of course, such persons should be using another THR product in any case, such as Snus. Emphysema patients continuing to inhale foreign materials is not really a sensible course of action.
Please note that there are hundreds of clinical trials, studies and papers on ecig use - a search just on PubMed brings up several hundred for example. Cherry-picking 1 out of 200 because it gives you the answer you like, even though it presents no evidence at all but simply an opinion, is not science - it is voodoo or something else, but not science.
'Miners' lung'
It is difficult to see how the lung diseases considered as the occupational diseases of miners can be connected to ecig use. These diseases are normally reported to be silicosis and pneumonicosis or pneumoconiosis, resulting from decades of inhaling high quantities of mineral dust. Prof Burstyn has not located any such connection.
However this could be some sort of confusion with 'paraffin lung', the fire-eater's occupational disease. It is caused by inhaling mineral oil vapour, is also called golden pneumonia, is properly called lipoid pneumonia, and is discussed above. A single incident of alcohol inhalation causing LP would be a world first, and has not occurred to date.
Japanese study
Again, there was a media frenzy over nothing. See Farsalinos:
E-cigarette aerosol contains 6 times LESS formaldehyde than tobacco cigarette smoke
Note: the UK's Daily Mail originally published an article stating this study found e-cigarettes contain 10 times more carcinogens than tobacco cigarettes. They were then forced to publish a retraction, and have now deleted the article.
Wet Lung
ARDS or pulmonary oedema ('wet lung') can be caused by severe injury, infection, or aspirating highly toxic chemicals such as in poison gas warfare.
It is interesting to see your doctor bring this up as it is the first example of this accusation levelled at vaping that I have seen. It seems to me that with over 50 million user-years experience of vaping, we would know more about this if it were any concern.
Nevertheless I will ask Prof Polosa to comment on this, in case there has been an incredibly rare case of it among the 25 million vapers worldwide (even rarer than the the LP accusation, for which there are only 3 reports) and it has not been widely reported. Because of its extreme rarity, if any such report has been made, and the normal cause being inhalation of large quantities of toxic chemicals (it is what wartime gas attack victims die of after inhaling mustard gas, chlorine gas etc), it is difficult to attach any significance to this suggestion.
----------------------------------------
This last issue is probably a very good guide to your doctor's position on these matters: the science is irrelevant as he appears to be some kind of fanatic.
Probably about the best case I have seen where finding a slightly more sane doctor would be helpful. Please look up the word 'iatrogenesis'. Equating vaping with trench warfare or 30 years of smoking cannot be regarded as normal behaviour and this doctor may even need professional help.
Although I would've not used 'complete', IMO it is kind of superfluous. "Vaping is about harm reduction, not harm elimination" is a great phrase. One that will definitely be added to my 'pro-vape armory'.
