The CDC has uncovered a promising culprit potentially to blame for the ongoing vaping crisis that has now exceeded 2,000 cases and claimed 39 lives across the US. While cautioning that there may not be a single cause for the outbreak and further research is needed to establish a causal link, the CDC has identified vitamin E acetate as the prime suspect responsible for e-cigarette and vaping product associated lung injury (EVALI).
In a telebriefing on Friday, Dr. Anne Schuchat, Principle Deputy Director of the CDC, revealed that lab tests on fluid samples taken from the lungs of 29 patients with EVALI, known as bronchoalveolar lavage (BAL) samples, all contained vitamin E acetate. THC was also found in 82 percent of the samples, and nicotine was found in 61 percent.
"These new findings are significant because for the first time, we have detected a potential toxin of concern – vitamin E acetate – in biologic samples from patients with lung injuries associated with the use of e-cigarette or vaping products," said Schuchat. "These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs. And the samples reflect patients from states across the country."
Vitamin E acetate is primarily used to dilute vaping liquids that contain THC, but may also be found in vaping products that don't contain THC. However, it's possible all 29 patients tested may have used THC products despite THC being found in only 23 of the 29 BAL samples. This is because, as Dr. Jim Pirkle from the CDC's Environmental Health Labs points out, THC doesn't hang around in lung fluid, whereas vitamin E acetate does.
Although vitamin E acetate is widely – and safely – taken orally as a vitamin supplement or applied to the skin in a cream, Schuchat says that previous non-CDC research suggests that it may interfere with normal lung function when inhaled. However, further research is needed before any causal link between vitamin E acetate and EVALI can be established.
But in the meantime, Schuchat emphasizes the importance of following the CDC's previous recommendation to not use vaping products that contain THC, especially products sourced from the internet, illicit markets, friends or family, because a high number of EVALI patients report obtaining THC-based pre-filled cartridges from such "informal sources."
Schuchat added that it's still possible that some vaping products sold from licensed marijuana dispensaries in some states may contain vitamin E acetate, either intentionally or unintentionally. Although stressing that the majority of EVALI cases are related to products from informal sources, Schuchat admitted, "this is a very severe disease which can be fatal and I don’t think we know enough yet to completely take the dispensaries out of the question." However, she believes state regulators are currently reviewing their regulations in light of the ongoing crisis.
The CDC is continuing its investigations to confirm whether vitamin E acetate is indeed to blame for the current outbreak of lung injury across the US, or whether some other compound or combination of compounds are to blame.
Source: CDC