Vitamin E Acetate and the Vaping Injury Epidemic: Lessons Learned about Identifying the Cause of Inhalation Injuries:
A recent epidemic of lung injuries related to vaping has put more than 2,000 people across the country and killed at least 39. As the outbreak progresses, it has become clear that vaping products containing THC play a role, but the exact cause isn’t as obvious. Finally, in early November the Centers for Disease Control and Prevention announced that vitamin E acetate is a possible culprit after federal officials found the oil in the lung fluids of 29 of the victims.Vitamin E acetate is a synthetic form of vitamin E and is used in nutrition supplements and skin creams. However, it isn’t safe to inhale because of how sticky it is. Vitamin E acetate can stick in the lungs, interfering with lung function. The CDC emphasized that its investigation isn’t over yet. The CDC tested for a range of substances, including plant oils and mineral oils, and while vitamin E acetate is the prime suspect, that doesn’t mean that there aren’t other compounds causing the lung injuries.Manufacturers of THC vape products use the oil to thicken products or as a cheap cutting agent. While many of the products that caused harm were black market or informal products, legitimate producers of THC vaping products may be using vitamin E acetate as well. Because marijuana and THC are regulated on a state-by-state basis, it results in a patchwork of inconsistent rules and standards. State regulators haven’t been looking for vitamin E acetate. So, what can these vaping illnesses teach us about inhalation injuries and finding their cause?
- Information Should be Shared
Sharing information between health care providers and state and federal government agencies helped identify that vaping was associated with these mysterious lung illnesses. Ultimately, a public health crisis can’t be avoided unless front line health care providers know that it’s happening.
- Confounding Factors
Sometimes the cause of an inhalation injury isn’t crystal clear. With the current vaping crisis, while vitamin E acetate is strongly suspected as the culprit, there could be other compounds causing harm as well. Now that states have begun checking for the oil in THC vaping products, they’ve found from 50% to 89% of these products contained vitamin E acetate. But there could be other harmful ingredients at play as well. This is often the case with many inhalation injuries.
- Federal Regulation Can Play an Important Role
A patchwork of state regulations may have led to the current vaping inhalation injury emergency. Because THC is not a legal substance across the country, there is no federal regulation of THC products, no FDA testing, and no universal regulatory standards. Hopefully, this crisis will lead to more comprehensive safety standards for everyone.
