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Dr. Rahman gave a public talk on Air pollution, stress, and lung inflammation at the University of Nagpur, India Convocation Hall, Nagpur University on December 20, 2019.

https://thelivenagpur.com/2019/12/25/dr-rahman-from-nagpur-ranked-29-amongst-world-researchers/

https://timesofindia.indiatimes.com/city/nagpur/expertusing-chullah-as-harmful-as-smoking/articleshow/72909585.cms

https://thelivenagpur.com/2019/12/20/rtmnu-organizes-lecture-on-air-pollution-stress-and-inflammation/

New research appearing in the journal Scientific Reports unpacks the list of chemicals that comprise flavored e-liquids and pods used in vaping and details their harmful effects to lung tissue, including inflammation and genetic damage that could indicate long-term risk for respiratory disease and even cancer.

"While names like mango, cucumber, and mint give the impression that the flavors in e-juices are benign, the reality is that these sensations are derived from chemicals," said Irfan Rahman, Ph.D., a professor in the University of Rochester Medical Center's (URMC) Department of Environmental Medicine and lead author of the study. "These findings indicate that exposure to these chemicals triggers damage and dysfunction in the lungs that are a precursor to long-term health consequences."

Other than propylene glycol and vegetable glycerin, which form the base of vaping liquids, and nicotine, most manufacturers do not disclose the chemical compounds used to create the flavors in vaping products.

Employing mass spectrometry, the researchers identified almost 40 different chemicals present in various combinations in seven flavors manufactured by JUUL. These include hydrocarbons and volatile organic compounds, many of which have industrial uses and are known to be harmful if inhaled.

JUUL -- which accounts for more than 70 percent of all vaping product sales in the U.S. -- has recently halted sales of most of its flavored pods and several states, including New York, are in the process of banning these products. However, many other companies and independent vape shops continue to manufacture and sell an estimated 8,000 different flavored e-juices and pods.

In the study, researchers exposed human lung tissue -- including bronchial epithelial cells, which play an important role in the exchange of gases, and monocytes, an infection-fighting cell in the immune system -- to aerosolized vapor from the flavor pods. They observed that the chemicals provoked inflammation and degraded the integrity of the epithelial cells, a condition that could eventually lead to acute lung injury and respiratory illness. Exposure also damaged DNA in the cells, a potential precursor to cancer. The study showed that menthol flavor, which JUUL continues to sell, is equally as harmful as other flavors.

"Vaping technology has only existed for a short period of time and its use, particularly among younger people, has only recently exploded," said Rahman. "This study gives further evidence that vaping -- while less harmful than combustible tobacco in the short run -- is placing chronic users on the path to significant health problems later in life."

Rahman helps lead the WNY Center for Research on Flavored Tobacco Products (CRoFT), a partnership between researchers at URMC and Roswell Park Comprehensive Cancer Center in Buffalo to study the health effects of one of the fastest-growing trends in tobacco use. The Center is supported by a $19 million grant from the federal Food and Drug Administration's Tobacco Centers of Regulatory Science program.

Additional co-authors of the Scientific Reports study include Thivanka Muthumalage and Thomas Lamb with URMC, and Michelle Friedman the College of Brockport, State University of New York. The study was funded with support from the National Cancer Institute and CRoFT.

The diagnostic/treatment algorithm, published in The Lancet Respiratory Medicine, complements and expands upon early guidance from the Centers for Disease Control and Prevention for managing the condition. It was created by pulmonary and toxicology experts at the University of Rochester and the New York State Department of Health.

"This illness has been vexing for physicians across the country and we continue to see people suffering from the dangerous effects of vaping," said Daniel Croft, M.D., M.P.H., pulmonologist at the University of Rochester Medical Center's Strong Memorial Hospital. "We expect the guide will help minimize missed diagnoses as cold and flu season ramps up."

"As the Department of Health continues our investigation into this ongoing outbreak of vaping-associated illnesses, we are in close contact with health care providers across the state and are pleased to provide them with a new tool to help with proper diagnoses,"said Health Commissioner Howard Zucker, M.D., J.D. "We continue to urge New Yorkers to stop using vape products until the investigation is complete."

The nationwide epidemic began in the spring and to date, the CDC has charted more than 2,000 cases, including 40 deaths. The cause of the illness remains a mystery, though many patients used products containing THC, the psychoactive component in marijuana. Patients experience devastating lung injury, some requiring long hospitalizations and treatment in the intensive care unit, followed by a slow recovery.

Irfan Rahman might be area smoke shops' best customer.

In the last few years, Rahman has haunted local smoke shops, amassing what might the largest collection of vaping devices and supplies in the state. It could conceivably be a contender for the country's largest collection.

In a recent visit to Elite, a Henrietta vape shop and cigar store, Rahman barked rapid-fire orders directing store co-owner Gibran Mehta to add scores of oils to a mounting pile of vaping products as Mehta described the various flavorings and nicotine content of oils, taking occasional hits off an e-cigarette as he worked.

Despite his loyal patronage, Irfan laments, a couple of the smoke shops he frequents temporarily banned him.

"It was when they noticed this," says Rahman, holding out a tag dangling from a lanyard he wears around his neck. The tag identifies him as a URMC research scientist. Putting two and two together, he explains, some shop owners began to suspect that Rahman, a non-smoker and no fan of vaping, might be using his trove of vaping supplies to make a case against vaping.

Shop owners who banned him have now relented, but their fears are far from unfounded.

Vaping involves inhalation of nicotine or the cannabis-derived substances THC and CBD in a cloud of vapor rather than in smoke produced by "combustibles" like cigarettes, cigars or pipes. In vaping, a handheld, battery-operated device heats an oil emulsion containing nicotine, THC or CBD.

At URMC, Rahman heads a laboratory that is delving into vaping's possible ill effects. He also is part of a joint URMC-Roswell Park team working under a 2018 $19 million National Institutes of Health grant to study the effects of flavored tobacco. He is working with New York's Department of Health too.

Projects Rahman is currently leading include an investigation into the toxicology of flavored e-cigarettes and toxicity of nicotine delivered by e-cigarettes.

According to a new study by researchers at The Lundquist Institute and the University of Rochester, e-cigarette or vaping use can damage the lungs after as little as 3 days of use.

The study involved male and female mice that were exposed to aerosols vaped from e-cigarettes using propylene glycol as the "carrier fluid." Every day, the mice were exposed to the aerosols for 2 hours over the course of 3 days.

Sufficient damage to the lungs was seen in the mice after being exposed to the aerosols for 3 days, setting the stage for long-term chronic lung damage, according to the study authors. The damage occurred both with e-cigarettes containing nicotine and the propylene glycol carrier fluid.

The results also showed that more inflammatory responses to e-cigarettes containing both propylene glycol and nicotine occurred in female mice. The researchers suggested that women might be more vulnerable to negative health impacts from vaping.

In addition, the study provided novel insights to the lung damaging effects of vaping. This analysis was the first report of acute exposure to e-cigarette aerosol containing polyethylene glycol alone inducing oxidative stress in lungs. Vaping does not have to occur over a long period of time to be harmful, the researchers concluded.

University of Rochester Environmental Health Sciences Center members Daniel Croft, M.D., M.P.H., and Irfan Rahman, Ph.D., were featured on a Today Show segment about vaping-related lung injury. In the segment, Rahman is shown working in his lab while Croft discussed the symptoms associated with this condition.

Rahman uses cell, mouse, and human studies to investigate how flavoring chemicals used in vaping devices affect lung health. He also analyzes vaping liquid collected from patients and hospitals around the world to better understand its chemical makeup. Croft, a clinician researcher who focuses on inhalation toxicology, helps interpret the clinical relevance of findings from the lab and collaborates on a study to better understand respiratory effects in people who vape.

Unlawful. That's what the Vapor Technology Association and two chain stores are saying on the state ban on flavored e-cigarettes. They are asking the court to put the ban on hold while the case is litigated.

The first complaint was that it didn't go through the state legislature.
"Their second claim was the rapid way this was passed. One day's notice," lawyer Alan Knauf of Knauf Shaw Law Offices said.

Knauf says in the complaint, a big highlight was illegal THC cartridges that contain Vitamin E. The State Vapor Association and others say that's what's causing the deaths and health issues, not the regulated vaping flavors in stores.

"It's irrational to make this fast move without a scientific basis and basically shut down all these shops," Knauf said while phrasing the complaint.

At the University of Rochester Medical Center, they are getting down to the science behind the harmful effects of vaping. The idea that dangerous ingredients are only in illegal vaping products is being put to the test.

"(Vaping products) contain various chemicals, and there are hundreds of chemicals, and they are nasty chemicals," Dr. Irfan Rahman, a pulmonologist with the University of Rochester Medical Center, said.

Rahman said they're well aware of the Vitamin E components in some of the products; he says they clog up airways.

"It's like a 'bacon greasy stuff' in the lungs," Rahman said.

Rahman said they've identified two additional potentially harmful ingredients. What they are will be released in their vaping studies to the state.

In other studies, the American Lung Association has said that "e-cigarettes are not safe," but the American Cancer Society has said they're "likely to be significantly less harmful," than traditional cigarettes.

Irfan Rahman's laboratory sits at the end of a long hallway on the third floor of the University of Rochester's School of Medicine and Dentistry.

Inside, Rahman and a team of researchers take apart e-cigarettes. They analyze liquids that the devices turn into an inhalable vapor to try to figure out exactly what they're made of.

The lab's work has taken on growing importance as the number of deaths and injuries attributed to e-cigarettes across the country continues to rise.

"We are the national leaders in this research," Rahman said. "We are doing work here that can save lives. These are very, very grave health problems."

But their ability to do that has been thrown into question by New York state's ban on flavored e-cigarettes. Specifically, the state's emergency regulations ban the possession of flavored e-cigarette liquids, with no exception for researchers.

URMC shares a $19 million federal grant with the Roswell Park Comprehensive Cancer Center in Buffalo that funds the institutions' research into e-cigarettes. It's an emerging field that investigators said aims to discern how flavored tobacco products affect the body and mind.

The realization that the rules did not carve out an exception for researchers led the CEOs of URMC and Roswell Park to send a joint letter to Howard Zucker, the state health commissioner, urging him to allow their research to continue.

"This is the first ever federally funded research to look at flavored tobacco in such a comprehensive and systematic way," the CEOs wrote. "The outcomes of these studies will have significant implications for public health nationally."

Irfan Rahman's laboratory sits at the end of a long hallway on the third floor of the University of Rochester's School of Medicine and Dentistry.

Inside, Rahman and a team of researchers take apart e-cigarettes. They analyze the liquid that the devices turn into an inhalable vapor in an effort to figure out exactly what it's made of.

The lab's work has taken on growing importance as the number of deaths and injuries attributed to e-cigarettes across the country continues to rise.

"We are the national leaders in this research," Rahman said. "We are doing work here that can save lives. These are very, very grave health problems."

But New York state's action to ban flavored e-cigarettes last week threw their ability to do that research into question.

The state's emergency regulations ban possession of flavored e-cigarette liquids, with no exemption for research.

URMC shares a $19 million federal grant with the Roswell Park Comprehensive Cancer Center in Buffalo that funds the institutions' research into e-cigarettes. It's an emerging field that investigators said is designed around questions of how flavored tobacco products affect the body and mind.

The realization that the rules did not carve out an exception for researchers led the CEOs of Roswell Park and URMC to send a joint letter to Howard Zucker, the commissioner of the state health department, urging him to allow their research to continue.

A severe and puzzling lung disease linked to electronic cigarettes and other vaping devices has doctors across the country scrambling to diagnose and care for patients struggling to breathe. On Friday, the Centers for Disease Control and Prevention said the number of vaping-related illnesses jumped to at least 450 cases in 33 states and cautioned people about using e-cigarettes, especially those bought off the street.

As of Friday, five deaths from vaping-related respiratory illness were reported.

"These are not just cases or data points," said Jennifer Layden, chief medical officer of the Illinois Department of Health. "These are individuals who are suffering."

Health officials in California, Indiana and Minnesota each announced one death on Friday. The Minnesota Department of Health said the patient who died in that state was over 65. An investigation revealed the cause of death was linked to vaping illicit products containing THC, the psychoactive compound in marijuana.