Evidence map›Paper›PMID 31491072›Full record

ArticleThe New England journal of medicine2020

Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Final Report.

Jennifer E Layden, Isaac Ghinai, Ian Pray, Anne Kimball, Mark Layer, Mark W Tenforde, Livia Navon, Brooke Hoots, Phillip P Salvatore, Megan Elderbrook and 8 more

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in The New England journal of medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04616313 (Novel Pulmonary Imaging of Lung Structure and Function in Symptomatic and Asymptomatic E-cigarette Smokers), which is not on this map. Cited by 401 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
401citing papers in PubMed, 5 pooled it
88.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04616313 recruitingnot on this mapstarted 2023, after this paper: background citation

Novel Pulmonary Imaging of Lung Structure and Function in Symptomatic and Asymptomatic E-cigarette Smokers

TypeobservationalSponsorWestern University, CanadaRan2023 to 2027Enrolled150ConditionsE Cigarette UseArmsHyperpolarized Xenon-129 MRI of the lungs, Computed Tomography (CT), Pulmonary Function Tests (PFT), Cardiopulmonary exercise testing (CPET), Sputum analysis
3 · Its place in the literature

Who cites it

401 citing papers in PubMed, 5 syntheses or guidelines pooled it, 897 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Lung Damage Caused by Heated Tobacco Products and Electronic Nicotine Delivery Systems: A Systematic Review.International journal of environmental research and public health · 2021
    Pooled it
  6. Trial
  7. Article
  8. E-cigarette use and Barrett's esophagus: evaluating a new risk in the era of vaping.Esophagus : official journal of the Japan Esophageal Society · 2026
    Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. The triple-hit hypothesis: exploring pulmonary e-cigarette, PMEuropean respiratory review : an official journal of the European Respiratory Society · 2026
    Review
  14. Vaping-related lung disease: a narrative review.Journal of thoracic disease · 2026
    Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

341 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 10 institutions in 1 country.

Jennifer E LaydenFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Isaac GhinaiFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Ian PrayFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Anne KimballFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Mark LayerFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Mark W TenfordeFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Livia NavonFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Brooke HootsFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Phillip P SalvatoreFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Megan ElderbrookFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Thomas HauptFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Jeffrey KanneFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Megan T PatelFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Lori Saathoff-HuberFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Brian A KingFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Josh G SchierFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Christina A MikoszFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Jonathan MeimanFrom the Illinois Department of Public Health, Springfield (J.E.L., I.G., L.N., M.T.P., L.S.-H.); the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (I.G., I.P., A.K., M.W.T., P.P.S.), National Center for Environmental Health (M.L.), the Division of State and Local Readiness, Center for Preparedness and Response (L.N.), the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (B.H., J.G.S., C.A.M.), and the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion (B.A.K.), Centers for Disease Control and Prevention, and Emory University School of Medicine (M.L.) - all in Atlanta; and the Wisconsin Department of Health Services (I.P., M.E., J.M.), the Wisconsin Division of Public Health, Bureau of Communicable Disease (T.H.), and the Department of Radiology, University of Wisconsin School of Medicine and Public Health (J.K.) - all in Madison.
Illinois Department of Public Health · USNational Center for Injury Prevention and Control · USWisconsin Department of Health Services · USCenter for Surveillance, Epidemiology, and Laboratory Services · USEpidemic Intelligence Service · USNational Center for Chronic Disease Prevention and Health Promotion · USNational Center for Environmental Health · USOffice of Readiness and Response · USUniversity of Wisconsin–Madison · USWisconsin Division of Public Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundE-cigarettes are battery-operated devices that heat a liquid and deliver an aerosolized product to the user. Pulmonary illnesses related to e-cigarette use have been reported, but no large series has been described. In July 2019, the Wisconsin Department of Health Services and the Illinois Department of Public Health received reports of lung injury associated with the use of e-cigarettes (also called vaping) and launched a coordinated public health investigation.

methodsWe defined case patients as persons who reported use of e-cigarette devices and related products in the 90 days before symptom onset and had pulmonary infiltrates on imaging and whose illnesses were not attributed to other causes. Medical record abstraction and case patient interviews were conducted with the use of standardized tools.

resultsThere were 98 case patients, 79% of whom were male; the median age of the patients was 21 years. The majority of patients presented with respiratory symptoms (97%), gastrointestinal symptoms (77%), and constitutional symptoms (100%). All case patients had bilateral infiltrates on chest imaging. A total of 95% of the patients were hospitalized, 26% underwent intubation and mechanical ventilation, and two deaths were reported. A total of 89% of the patients reported having used tetrahydrocannabinol products in e-cigarette devices, although a wide variety of products and devices was reported. Syndromic surveillance data from Illinois showed that the mean monthly rate of visits related to severe respiratory illness in June through August of 2019 was twice the rate that was observed in the same months in 2018.

conclusionsCase patients presented with similar clinical characteristics. Although the definitive substance or substances contributing to injury have not been determined, this initial cluster of illnesses represents an emerging clinical syndrome or syndromes. Additional work is needed to characterize the pathophysiology and to identify the definitive causes.

Indexed as

Electronic Nicotine Delivery SystemsAdolescentAdultDisease OutbreaksDronabinolFemaleHospitalizationHumansIllinoisLeukocytosisLungLung InjuryMaleMiddle AgedPopulation SurveillanceRadiography, ThoracicDronabinol

Identifiers

PMID31491072
OpenAlexW2971846128

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