Evidence is mounting that vitamin E acetate is the culprit in the outbreak of vaping-related illnesses that has sickened more than 2,500 people and killed at least 54, federal health officials said Friday.
Health officials have now found vitamin E acetate in the damaged lungs of 48 out of 51 patients who had fallen ill or died of lung injuries, said Anne Schuchat, principal deputy director at the Centers for Disease Control and Prevention. The vast majority used products containing THC, the psychoactive ingredient in marijuana.
By comparison, no vitamin E acetate was found in the lung fluids of any of 99 healthy individuals in a comparison group. Those people either vaped nicotine exclusively, or only smoked cigarettes, or said they never smoked.
The findings are significant because they reinforce the link between vitamin E acetate and the vaping-related lung disease and represent the first time health officials have compared results from patients' damaged lungs to those of healthy people.
At the same time, health officials warned of a disturbing development: Dozens of patients were re-hospitalized shortly after discharge and another seven died after being discharged, suggesting that the illness must be closely monitored and may worsen.
The vitamin E acetate findings were published in the New England Journal of Medicine, one of four reports released Friday, two in the NEJM and two released by Centers for Disease Control and Prevention. Together, the reports provide the most detailed look at the evidence supporting vitamin E acetate as the most likely cause of the national outbreak that began this summer, the way the compound may be causing lung damage, and the risk factors for re-hospitalization and deaths after leaving the hospital.
Last month, the Centers for Disease Control and Prevention announced a "breakthrough" discovery when officials identified vitamin E acetate in the lung fluids of 29 people. It was first direct evidence of the compound at the primary site of injury within the lungs.
The report on vitamin E acetate also said the chemical process that occurs when the compound is heated through vaping can disrupt normal lung function, "providing a possible mechanism by which vitamin E acetate could cause respiratory dysfunction," the researchers wrote.
Another potential harmful effect occurs when a reactive compound is created during the vaping process. "That has the potential to be a lung irritant, depending on concentration," the report said.
Vitamin E acetate's presence in the supply of THC-containing products and use among patients who have fallen ill and died also aligns with the timing of the outbreak, which began in June and peaked in mid-September. In Minnesota, THC-containing products seized by law enforcement during 2018, before the outbreak, did not contain vitamin E acetate. But 20 out of 20 THC-containing products seized by law enforcement during September, at the peak of the outbreak, contained vitamin E acetate.
The study noted that the finding is consistent with industry websites that suggest the addition of vitamin E acetate, which has a viscosity like that of pure THC oil, began to appear in the black market in late 2018 or early 2019, and gained popularity in 2019. "Cutting THC oil with vitamin E acetate has been reported to be common in the illicit market," the study said.
The Food and Drug Administration has said most of the THC product fluids linked to patients contain vitamin E acetate, with concentrations ranging from 23 to 88%. By contrast, the FDA has found no vitamin E acetate in 197 nicotine products analyzed so far.
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December 21, 2019 at 01:28AM
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Evidence mounts that vitamin E acetate is to blame for vaping-related illnesses, deaths - Houston Chronicle
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