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

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Baldwin, Grant T. ; Barr, John R. ; Blount, Benjamin C. ; Briss, Peter A. ; Chambers, David ; Cowan, Elizabeth ; De Jesus, Victor R. ; Delaney, Lisa J. ; Gardner, Michael ; Jones, Christopher M. ; Karwowski, Mateusz P. ; King, Brian A. ; Kuklenyik, Zsuzsanna ; Morel-Espinosa, Maria ; Pirkle, James L. ; Rees, Jon ; Seyler, Tiffany ; Silva, Lalith ; Sosnoff, Connie ; Thomas , Jerry ; Valentin-Blasini, Liza ; Wang, Lanqing ; Watson, Cliff ; Xia, Baoyun
• Description:
  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. 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 (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. Inhalation of vitamin E acetate might impair lung function. ... These findings reinforce CDC's recommendation that persons should not use e-cigarette, or vaping, products containing THC, especially those obtained from informal sources such as friends or family, or those from the illicit market, where product ingredients are unknown or can be highly variable. Until the relationship of vitamin E acetate and lung health is better characterized, it is important that vitamin E acetate not be added to e-cigarette, or vaping, products. CDC will continue to update guidance, as appropriate, as new data become available from this outbreak investigation. Erratum: MMWR 2020 Jan 31; 69(4):116. In the report "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" names of the members of the Lung Injury Response Team and persons in Acknowledgments were omitted. The names are included in this erratum. [Description provided by NIOSH]
• Subjects:
  Chemistry Electrical Equipment And Supplies Hazardous Substances Laboratories Lipids Lung Lung Diseases Occupational Health Public Health Respiratory System Respiratory Tract Diseases Safety Smokers Solvents Tobacco Products

  More +
• Keywords:
  Humans; Cigarette smoking; Vapors; Lung; Lung disorders; Lung disease; Pulmonary disorders; Pulmonary effects; Pulmonary system disorders; Safety education; Chemical hazards; Electronic devices; Public health; Health protection; Partnership; Recommendations; Hazardous drugs; Laboratory testing; Sampling; Chemical analysis; Lipids; Lung function; Inhalation; Oils; Toxic materials
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• DOI:
  https://doi.org/10.15585/mmwr.mm6845e2
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Publisher:
  Centers for Disease Control and Prevention (CDC) (U.S.)
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; Connecticut ; Hawaii ; Illinois ; Maryland ; Michigan ; Minnesota ; Texas ; Utah ; Wisconsin ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 6 ; OSHA Region 8 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  EPRO - Emergency Preparedness and Response Office
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  2 pdf pages
• Volume:
  68
• Issue:
  45
• NIOSHTIC Number:
  nn:20057796
• Citation:
  MMWR 2019 Nov; 68(45):1040-1041
• Email:
  bkb3@cdc.gov
• CAS Registry Number:
  2H-1-Benzopyran-6-ol, 3,4-dihydro-2,5,7,8-tetramethyl-2-(4,8,12-trimethyltridecyl)-, 6-acetate (CAS RN 7695-91-2) ; Glycerides, C8-10 (CAS RN 85409-09-2) ; Tetrahydrocannabinol (CAS RN 1972-08-3)
• Federal Fiscal Year:
  2020
• Peer Reviewed:
  False
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR) National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:733f546ac7db798b9afa0f0edeb1f4d20a4212dcf45a600823d9b0cb56e167cbb77f27307077882b79d9bba4bbdb2ebec0313d51c72d7b3a1b1a8f839849ef33
• Download URL:
  https://stacks.cdc.gov/view/cdc/248481/cdc_248481_DS1.pdf
• File Type:
  [PDF - 71.38 KB ]