CDC Investigations
Identify Vitamin E Acetate As “Culprit Of Concern” In The Vaping Lung
Injury Outbreak
Discovery Called A
“Breakthrough”
CDC laboratory
investigations of 29 samples of lung washings from patients with
e-cigarette vaping product associated lung injury (EVALI) have found
vitamin E acetate in all 29 samples . CDC Principal Deputy Director
Anne Schuchat speaking during a telebriefing for the media called
the findings “a breakthrough in the investigations”.
She added that that
the samples came from patients from ten different states which made
the findings more robust in incriminating vitamin E acetate. Also,
vitamin E acetate has been identified in samples tested by the Food
and Drug Administration and some state health department laboratories.
Other Toxicants?
The CDC lab
investigated many other substances which might serve as potential
toxicants in the vaping products such as plant oil, petroleum
distillates such as mineral oil, medium-chain triglyceride oils and
terpenes. No other potential toxicants were detected in the samples
tested so far.
Cannabis
Another significant
finding is that tetrohydrocannabinol (THC), the principal psychoactive
component of cannabis, was found in 23 of 28 samples tested,
reaffirming earlier leads that EVALI is more likely in products
containing this ingredient.
Nevertheless, CDC is
being cautious and not saying that all cases of EVALI are caused by
Vitamin E acetate. There may be more than one cause.
Illinois Data
Speaking at the same
telebriefing, Illinois chief medical officer and state epidemiologist
Jennifer Layden reported on state investigations which found
that the majority of their cases had used THC containing products,
particularly prefilled cartridges obtained from informal sources such
as friends or family members. Cases reported using numerous different
products and had a high frequency of use.
Comparison Group
To create a control
group, Illinois investigators created an online survey for Illinois
adults who use e-cigarette or vaping products and using the same
questions that were asked of EVALI patients. Researchers were looking
for risk factors associated with being an EVALI case. Some 4,631 adult
Illinois residents who were recent e-cigarette users completed the
survey. Among respondents, 94% used nicotine containing products and
21% reported use of THC containing products. Compared to vaping
residents in the same age group, EVALI patients were 2 times more
likely to report exclusive use of THC products, to use them more
frequently, and to be 9 times more likely to obtain the products from
informal sources such as a dealer off the street or a friend.
Recommendations
According to Layden,
these findings reinforce current national recommendations not to use
e-cigarette or vaping products that contain THC especially those from
informal sources. Since a small proportion of EVALI cases report only
exposure to nicotine-containing e-cigarette or vaping products,
halting the use of all e-cigarette or vaping products is considered
the prudent action to take at this time until information is more
certain about the causative agent(s).
Key Facts about Vitamin E Acetate
-
Vitamin E acetate might be used as an additive, most
notably as a thickening agent in THC-containing e-cigarette, or
vaping, products.
-
Vitamin E is a vitamin found in many foods, including
vegetable oils, cereals, meat, fruits, and vegetables. It is also
available as a dietary supplement and in many cosmetic products,
like skin creams.
-
Vitamin E acetate usually does not cause harm when
ingested as a vitamin supplement or applied to the skin. However,
previous research suggests when vitamin E acetate is inhaled, it may
interfere with normal lung functioning.
Source:
Centers for Disease Control and Prevention
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