Federal health officials say they have had a breakthrough in investigating vaping-related lung injuries after finding vitamin E acetate in all 29 lung fluid samples tested, although they haven’t ruled out other potential causes.
“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,” Anne Schuchat, M.D., principal deputy director of the Centers for Disease Control and Prevention (CDC), said Friday. “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.”
The findings come after several months of investigation into lung injury cases, which have reached 2,051 with 39 deaths. Most patients have vaped products containing tetrahydrocannabinol (THC), and vitamin E acetate is a known diluent in these products.
“Vitamin E acetate usually does not cause harm when swallowed as a vitamin supplement or is applied topically to the skin,” Dr. Schuchat said. “However, previous non-CDC research suggests that when vitamin E acetate is inhaled it may interfere with normal lung function.”
The CDC tested 29 bronchoalveolar lavage fluid samples from people with vaping-related lung injuries in 10 states. Vitamin E acetate was detected in all 29 samples, and no other toxins were found, according to a new Morbidity and Mortality Weekly Report.
In addition, 23 of 28 samples showed evidence of THC use, although officials said it is possible other patients used THC without detection. Evidence of nicotine use was found in 16 of 26 samples.
Dr. Schuchat said the results show a link between vitamin E acetate and the lung injuries but is not enough to prove it caused them, and the investigation will continue.
“It’s important to note these findings do not rule out other possible compounds or ingredients that may be causing these lung injuries,” Dr. Schuchat said. “There may be more than one cause of the outbreak.”
Another new Morbidity and Mortality Weekly Report from the CDC and Illinois Department of Public Health looked at that state’s vaping trends and risk factors for lung injuries using data from an online survey of 4,631 adults.
About 94% vaped nicotine, 21% vaped THC and 11% reported vaping both. Young adults were most likely to use products containing THC.
Researchers also compared 519 survey respondents ages 18-44 to 66 people of the same age who experienced vaping-related lung injuries. Those with lung injuries were more likely to only vape THC, vape more than five times a day and buy vaping products from friends or off the street. They also were more likely to use Dank Vapes, which authors described as “a class of largely counterfeit THC-containing products.”
“These findings reinforce current recommendations not to use e-cigarette, or vaping, products that contain THC and not to use any e-cigarette, or vaping, products obtained from informal sources,” authors wrote. “In addition, because the specific compound or ingredient causing lung injury is not yet known, CDC continues to recommend that persons consider refraining from use of all e-cigarette, or vaping, products while the outbreak investigation continues.”