Vitamin E Acetate ID'd in Lungs of Most Vaping Illness Patients

Vitamin E acetate was identified in almost all patients with electronic cigarette, or vaping, product use-associated lung injury (EVALI), and there has been a decrease in EVALI cases since a peak in September 2019, according to a study and a report published online in the New England Journal of Medicine.

Benjamin C. Blount, Ph.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues collected bronchoalveolar-lavage (BAL) fluids from 51 patients with EVALI in 16 states and from 99 healthy participants. The researchers identified vitamin E acetate in BAL fluid obtained from 94 percent of case patients but not in such fluid obtained from the healthy comparator group. Apart from coconut oil and limonene, which were found in one patient each, no other priority toxicants were found in BAL fluid from case patients or the comparator group.

Kathleen P. Hartnett, Ph.D., from the CDC in Atlanta, and colleagues used emergency department data from the National Syndromic Surveillance Program to assess trends and track the EVALI outbreak. The researchers found that the trend in emergency department visits with EVALI-related diagnostic codes changed during the week of June 9, 2019. The use of these codes increased weekly by an average of six visits per 1 million from the week of June 9, 2019, to the week of Sept. 29, 2019. The incidence of visits with these codes has decreased since the peak but remains higher than before June 2019.

"The incidence has not decreased to the rates that were observed before June 2019; therefore, there is a need for continued monitoring and prevention," Hartnett and colleagues write.

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