Evaluation of Bronchoalveolar Lavage Fluid from Patients in an Outbreak of E-cigarette, or Vaping, Product Use-Associated Lung Injury - 10 States, August-October 2019
OPEN MMWR. Morbidity and mortality weekly report | 15 Nov 2019
BC Blount, MP Karwowski, M Morel-Espinosa, J Rees, C Sosnoff, E Cowan, M Gardner, L Wang, L Valentin-Blasini, L Silva, VR De Jesús, Z Kuklenyik, C Watson, T Seyler, B Xia, D Chambers, P Briss, BA King, L Delaney, CM Jones, GT Baldwin, JR Barr, J Thomas and JL Pirkle
CDC, the Food and Drug Administration (FDA), state and local health departments, and multiple public health and clinical partners are investigating a national outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). Based on data collected as of October 15, 2019, 86% of 867 EVALI patients reported using tetrahydrocannabinol (THC)-containing products in the 3 months preceding symptom onset (1). Analyses of THC-containing product samples by FDA and state public health laboratories have identified potentially harmful constituents in these products, such as vitamin E acetate, medium chain triglyceride oil (MCT oil), and other lipids (2,3) (personal communication, D.T. Heitkemper, FDA Forensic Chemistry Center, November 2019). Vitamin E acetate, in particular, might be used as an additive in the production of e-cigarette, or vaping, products; it also can be used as a thickening agent in THC products (4). Inhalation of vitamin E acetate might impair lung function (5-7).
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