Washington, DC: Representatives at the US Centers for Disease Control have for the first time identified vitamin E acetate as a “very strong culprit of concern” in EVALI (e-cigarette or vaping product use-associated lung injury). The agency’s announcement, issued on Friday, comes after health officials found the oil in the lungs of 29 patients who were sickened following their use of portable e-liquid vaporizers.
Writing in the agency’s journal Morbidity and Mortality Weekly Report, investigators concluded, “Based on these data from 29 patients, it appears that vitamin E acetate is associated with EVALI.”
Anne Schuchat, principal deputy director at the Centers for Disease Control and Prevention, added, “These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs.”
In early September, health officials in New York State publicly acknowledged finding high levels of Vitamin E oil in products suspected of being linked to the lung illness, which has been associated with over 2,000 cases nationwide and 39 fatalities.
The online publication Leafly.com has issued several extensive reports regarding the recent rise in popularity of vitamin E among illicit market vendors of e-liquid products. Their reporting indicates that beginning in late 2018, some vendors began to use the oil as an additive in an effort to thicken the consistency of their e-liquids and to mask dilution. Leafly’s latest reporting on the issue appears online.
Other investigations have suggested that at least some lung-related injuries may be the result of the presence of a specific metal-binding agent in certain types of portable cartridges. Some have separately speculated that synthetic cannabinoids, which are occasionally added to unregulated products by unscrupulous manufacturers, may be to blame.
The CDC’s latest advisory does not rule out the possibility that other possible agents may also be playing a role in the illness, but affirms, “This is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries.” The agency adds, “The latest national and state findings suggest products containing THC, particularly from informal sources like friends, or family, or in-person or online dealers, are linked to most of the cases and play a major role in the outbreak.”
Full text of the CDC’s November 8 advisory is online. Full text of the MMWR report is online.