"These results provide direct evidence of vitamin E acetate at the primary site of lung injury," said Anne Schuchat, deputy principal director of the Centers for Disease Control and Prevention. Recent evidence suggests that vitamin E acetate is "a very strong cause for concern".
The findings published on Friday do not exclude other possible compounds or ingredients that could cause lung injury. But Schuchat described the lab results as a "breakthrough" in the study. CDC has been tested for a variety of substances that may be present in the lung fluids of patients, including vegetable oils and petroleum distillates such as mineral oil.
However, she said, "No other potential toxins have been detected."
CDC officials found vitamin E acetate, an oil that was extracted from the vitamin, in all 29 samples of lung fluid taken from patients who became ill or died from lung injuries. THC, the psychoactive ingredient in marijuana, was also found in 23 patients, including three who claimed to have used no THC products. Nicotine was detected in 1
6 out of 26 patients. Most of the patients who fell ill at the outbreak have THC evaporated, it was said.
Vitamin E acetate, an oil derived from the vitamin, has been identified in previous tests by state and state laboratories for THC-containing Vape products. Many of these products have been procured on the illegal market, according to the authorities. Vitamin E acetate has been used as a cutting agent or additive on the cannabis black market in recent months to increase the amount of THC in vape cartridges, officials and industry experts said. Vitamin E acetate is a popular additive as it is colorless and odorless, has a similar viscosity to THC oil and is much cheaper.
The results are significant, as scientists were the first to associate results from product testing with clinical trials of patients, she said. The 29 patients come from 10 countries and represent a different geographical area. This makes the results "much more robust" than if all patients were from a single location.
"They help us to better understand the potential connections" that could contribute to the injuries, Schuchat said. "They tell us what got into the lungs of some of these patients."
Vitamin E acetate is found in many foods and cosmetics, especially skincare products. It is not known to cause damage when swallowed or applied to the skin, Schuchat said. However, heating and inhaling may interfere with normal lung function. Its properties may be associated with respiratory symptoms, many of which have been reported by patients: cough, shortness of breath and chest pain, officials and experts said.
Professor of chemistry Michelle Francl has described vitamin E acetate as fundamentally fat. Due to its molecular structure, it must "get pretty hot" for it to evaporate, said Francl, a professor at Bryn Mawr College. The boiling point of the substance is 363 degrees Fahrenheit, well above the boiling point of 212 degrees F.
Once the oil has heated to evaporate, it may decompose -what, "Francl said.
But officials still need to conduct further tests on the substance, including other people who had fumes and did not experience these injuries, Schuchat said. Officials also want to test a larger number of lung fluid samples from patients in different locations.
In order to better understand how vitamin E acetate could trigger the disease, animal studies would have to be carried out.
] The findings, which were also presented in a CDC report published on Friday, also reinforced the warnings of the health authorities about the use of e-cigarettes or steam products containing THC, especially those bought by the road.
CDC adheres to its recommendation that consumers consider waiving the use of all vaping and e-cigarette products, including those containing nicotine. This is because a small proportion of patients continue to claim the exclusive use of nicotine-containing products, Schuchat said.