Tests show that the contaminant found in cannabis-based vaping products is associated with lung diseases
The US Centers for Disease Control and Prevention and the US FDA are working tirelessly to investigate cases of serious respiratory illnesses associated with the use of e-cigarette products. Last week, we learned of the death of an adult in Illinois who had been hospitalized for a serious respiratory illness following the use of an electronic cigarette product. Health officials and the federal government who investigated mysterious vaping-related lung diseases found the same chemical in samples of cannabis-containing products used by sick people in different parts of the country who used different brands of cannabis. products in recent weeks.
The chemical is an oil derived from vitamin E. Investigators from the US Food and Drug Administration discovered that cannabis oil in cannabis products was in samples taken from patients who became ill across the United States. United. FDA officials shared this information with state health officials during a phone briefing this week, according to several officials who took part in the call.
This same chemical was also found in almost all the samples of sick patients in New York in recent weeks, said a spokeswoman for the state health department.
Although this is the first common item found in samples from across the country, health officials said it was too early to know if this caused these types of lung infections
Vitamin E is also present in some foods such as almonds, olives, canola oil or jojoba. The vitamin-derived oil, known as vitamin E acetate, is commonly available as a nutritional supplement and is used in topical skin treatments. It is not known to be harmful when ingested as a vitamin supplement or applied to the skin. Its name seems harmless, experts said, but its molecular structure could make it dangerous if inhaled. Its properties similar to those of oil could be associated with the types of respiratory symptoms reported by many patients: cough, shortness of breath and chest pain, said the officials.
"Previous tests in New York had taught us that they had found vitamin E acetate, but the fact that the FDA talks about it as part of its overall test plan was the most remarkable thing we have heard, "said one official who listened to the briefing. was not allowed to speak in public.
The FDA also told national authorities on Wednesday that its laboratory tests did not reveal any abnormalities in nicotine-based products collected from sick patients, according to another person who took part in the appeal.
The survey was particularly difficult for the health authorities. "We do not know what we're looking for," an official at the Centers for Disease Control and Prevention, who heads theinvestigation , said last week.
Officials are trying to come up with a coherent definition of the disease and a standardized system for collecting information from states. Unlike some infectious diseases, such as measles, which must be reported to federal authorities, states are not required to report suspected cases of spray-related diseases to Centers for Disease Control and Prevention, which lead to investigation.
State health services report new cases weekly. At August 27, there were 215 possible cases reported by 25 states. Additional reports of lung disease are under study, according to CDC officials.
Wednesday, the Oregon health authorities have declared the death of a young adult following severe respiratory disease, had used an electronic cigarette containing cannabis oil purchased from a legal clinic. It is the second nationwide vaping death and the first to be linked to a product purchased in a store. Illinois officials reported the first death last week. They did not specify what type of product was used in this case.
Health authorities have indicated that they focus on the role of contaminants or counterfeit substances as a likely cause of vaping-related lung disease. Many patients told managers and clinicians that they had bought cannabis products on the street. Many of those who became ill said they had sprayed products containing marijuana, but others said they used traditional nicotine electronic cigarettes. Some say they use both. The authorities have indicated that they do not exclude adulterants in nicotine vaping products.
Although the FDA has discovered a common chemical in laboratory tests and the well-known Wadsworth Center in New York offers a potential trail, officials have warned that they are far from understanding what makes people so sick. .
A spokesman for the FDA said the agency "is looking for potential leads regarding any component or component involved." The FDA analyzes samples for a wide range of chemicals, including nicotine, THC, other cannabinoids, "cutting agents" that can be used to dilute liquids, other additives, pesticides, opioids , poisons and toxins. THC is the component of marijuana that makes users high.
"The number of samples received continues to increase and we now have more than 100 samples to test," FDA spokesman Michael Felberbaum said Thursday.
"No substances, including vitamin E acetate, were identified in all tested samples," he added. "It is important to note that identification of the compounds in the samples will be part of the puzzle, but will not necessarily answer questions about causality."
Not all samples are suitable for testing. The FDA has analyzed 12 viable nicotine samples and 18 products with viable THCs, state officials said. Vitamin E acetate has been found in 10 18-based THC products.
"This is the only thing that appeared to appear in 10's 18 cannabis products," said a state official who took part in the appeal.
The results from the federal labs seem to confirm New York's findings. Late last week, his lab discovered "very high levels of vitamin E acetate in almost all the samples" tested. More than a dozen samples have been tested, said Thursday a spokesman for the Department of Health. At least one product containing vitamin E acetate has been associated with each patient who has submitted a product for testing, the department said.
"Vitamin E acetate is not an approved additive for the vaping samples licensed by the New York State Medical Cannabis Program and has not been observed in the nicotine products tested. As a result, vitamin E acetate is now a key "part of the investigation, said New York State Health Commissioner Howard Zucker in a statement released Thursday.
As of Thursday, 34 doctors had reported in New York cases of severe pneumonia in patients aged 15 to 46 years old who used at least one anti-vapors product containing cannabis before falling ill. All patients reported recent use of various products against steam, officials said. Many are believed to be counterfeit recreational spray products containing cannabis available in other states.
The second death report highlighted the danger of this lung disease. "It was surprising that the patient suddenly appeared without any other underlying health problem and became sick enough to die from this syndrome," said Ann Thomas, physician at the Oregon Health Authority.
Vape refers to the growing practice of inhaling vapors from an electronic cigarette device, which often involves heating a liquid that may contain nicotine, marijuana or other drugs.
Vitamin E acetate is essentially fat, said Michelle Francl, a chemistry professor at Bryn Mawr College. Its molecular structure means that you have to "heat it warm enough" to vaporize. Its boiling point is 363 degrees Fahrenheit, which is well above the boiling point of 212 F degrees of water and nearly four times higher than normal body temperature.
Once the oil is heated enough to vaporize, it can potentially decompose and "now, you breathe who-knows-what," Francl said.
When this vapor cools down in the lungs, it returns to its original state at this temperature and pressure, which means "it has now covered the inside of your lungs with this oil," she said. declared.
In Utah, clinicians treated several patients with acute lung injury who were diagnosed with a rare condition called lipoid pneumonia with symptoms including chest pain and difficulty breathing. These patients had abnormal immune cells filled with lipids, the doctors said.
Unlike the human digestive tract, which can degrade and get rid of foreign substances, the lungs are not designed to treat anything but gases, experts said.
Laura Crotty Alexander, a researcher on lung inflammation and e-cigarettes at the University of California San Diego School of Medicine, explained that it is not so obvious that the chemical where its by-products are so toxic.
"We have not looked at the toxicity of vitamin E in the lungs," she said. "The lungs are designed to exchange gas molecules; they are not designed to be exposed to other chemicals. "
When lung cells die, this often causes an inflammatory response and "other cells have to enter and clean the cell debris," said Alexander. But the lungs are very delicate. When additional cells enter the room, "they hinder the exchange of gas," she said. This makes it more difficult to bring oxygen into a person's blood. Inflammation can cause fluid to accumulate in the lungs, making breathing difficult for someone, she explained.