Health officials have identified a possible culprit behind the spate of vaping-related illnesses that have sickened thousands: vitamin E acetate.

The chemical — used as an additive or thickening agent in some vaping products — turned up in every sample of lung fluid collected from 29 patients with vaping-related illness, the Centers for Disease Control and Prevention reported Friday. While vitamin E acetate is used in supplements and skin creams and does not seem to cause harm when swallowed or used topically, previous research suggests that inhaling vitamin E acetate might impair people’s lung function.

The finding marks a significant development in an investigation that has left federal and local health officials scrambling to find a cause as the number of vaping illnesses recorded nationally has continued to climb. Health officials said that the findings need to be confirmed, including through animal studies, and that it’s too soon to rule out other possible causes.

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“These new findings are significant because for the first time, we have detected a potential toxin of concern — vitamin E acetate — in biologic samples,” said Anne Schuchat, principal deputy director of the CDC. But, she added, “there’s more work to do.”

There have been 2,051 confirmed and probable cases of the illnesses, dubbed EVALI, across 49 states, Washington, D.C., and the U.S. Virgin Islands. There have been 40 deaths tied to the outbreak, which is believed to have started earlier this year.

“The trend in cases appears to be downward, but we understand that some states are still hard hit and this continues to be a very active investigation,” Schuchat said.

The latest samples were collected through a process in which fluid is pushed into the lungs and then collected for analysis. Lab testing found THC, the ingredient that gives marijuana users a high, in 23 of 28 patient samples — including those from three patients who said they hadn’t vaped THC products. The CDC said the lack of THC in five of those samples does not definitively indicate the patients didn’t use the drug, because THC can be difficult to detect in samples taken from lungs.

The testing also detected nicotine in 16 of 26 samples. (When there wasn’t enough liquid to run every analysis, labs prioritized tests for cannabinoids and vitamin E acetate.) Researchers also looked for other potentially harmful additives during the testing — such as plant oils — but didn’t find notable levels of any in the patient samples.

It isn’t clear how widespread the use of vitamin E acetate is in e-cigarette and vaping products. Schuchat said the substance might be unintentionally introduced to vaping products or intentionally added to dilute vaping liquids and cut down on the amount of THC added to a product.

Health officials continue to urge the public to avoid vaping and in particular, to avoid products that contain THC or that were purchased from informal sources.

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  • Photo is of a device used to vaporize e-liquid. This is not the type of device that is being used to vaporize THC cartridges. If you need a photo of one, please contact me and I will provide one royalty free!

  • Nice summary of recent findings.
    I think you also need to include that not one case of medical marijuana vapes from licensed dispensaries has been implicated.
    One sample from a recreational dispensary has been to be toxic
    The public does not quite get that the carrier oil is the problem
    We need a lot more research to understand long term sequelae.

  • I know there is an issue with THC vapes!!without question!
    Seems to cause stunt lung function,as it returns a few days after vaping stops,a progressive diminishing function that if continued ,,i can see how it can cause a life threatening situation and i feel. Vapes should be banned immediately,as far as nicotine vapes i have no experience with them but if they are similar toTHC vapes in composition,would consider them equally as dangerous,
    I speak from experience with Thc vapes,4 months of semi steady use which had me close to hospitalization,please push to ban this product and save lives!!!

    • Lets not throw the baby out with the bathwater. Vaping is magnitudes safer than traditional smoking and hundreds of thousands of people’s health has improved dramatically when they switched to vaping. But vaping is not risk free.

      Buy properly manufactured and certified vape liquid from a reputable company and use that. Stay away from the dodgy stuff that is so easy to get hold of. Vape liquid contains propyl glycol which is used as a propellant in asthma inhalers and also in baby milk. It also contains water soluble vegetable glycerine, nicotine as sold to suppliers of pharmaceutical smoking cessation aids, and flavouring. Flavouring is where trouble can creep in. Reputable companies use flavours known to be laboratory tested and safe. These are UK and EU standards, so when in doubt, buy liquids from those sources. You can’t expect to use illegal cannabis in any kind of oil, manufactured by shady drug dealers, and get away with no health problems.

  • Hi Megan, great article. I’m a former health journalist in Canada and wonder if this problem with vaping may be linked to what’s called lipoid pneumonia from the oils. There’s been medical research on the aspiration of oils, even olive oil, vegetable oils or petroleum jelly such as in vaporizing rubs, that have been found to cause lung inflammation and damage. That’s why it’s not recommended to put such cold products in the nostrils, which some people do to relieve nasal congestion. Oils can also be aspirated into the lungs during gastro reflux. I like diffusers but have read some natural oils in diffusers can be be bad for young children and pets. There’s an article in the Journal of American Medicine on lipid pneumonia and also some info on Health Line at https://www.healthline.com/health/lipoid-pneumonia

  • Your late on this article miss Megan Thielking maybe talking about prevention and what to look out for would be nice. I’m having way too many friends die

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