TY  - JOUR
PY  - 2019//
TI  - Characteristics of e-cigarette, or vaping, products used by patients with associated lung injury and products seized by law enforcement -Minnesota, 2018 and 2019
JO  - MMWR: Morbidity and mortality weekly report
A1  - Taylor, Joanne
A1  - Wiens, Terra
A1  - Peterson, Jason
A1  - Saravia, Stefan
A1  - Lunda, Mark
A1  - Hanson, Kaila
A1  - Wogen, Matt
A1  - D'Heilly, Paige
A1  - Margetta, Jamie
A1  - Bye, Maria
A1  - Cole, Cory
A1  - Mumm, Erica
A1  - Schwerzler, Lauren
A1  - Makhtal, Roon
A1  - Danila, Richard
A1  - Lynfield, Ruth
A1  - Holzbauer, Stacy
SP  - 1096
EP  - 1100
VL  - 68
IS  - 47
N2  - During August 9-October 31, 2019, 96 patients were classified as having e-cigarette, or vaping, product use-associated lung injury (EVALI) by the Minnesota Department of Health (MDH); other patients are being investigated for case classification and exposures. Among 58 patients interviewed, 53 (91%) reported obtaining tetrahydrocannabinol (THC)-containing products from informal sources such as friends, family members, or in-person or online dealers. Using gas chromatography-mass spectrometry (GCMS), the MDH Public Health Laboratory (PHL) analyzed 46 THC-containing e-cigarette, or vaping, products obtained from 12 EVALI patients for various potential toxicants, including vitamin E acetate, which has recently been detected in some THC-containing products and in samples of lung fluid from EVALI patients (1-4). To explore whether vitamin E acetate is a recently added component in THC-containing products, MDH tested ten products seized by law enforcement in 2018, before the EVALI outbreak, and 20 products seized in 2019, during the outbreak. Twenty-four products obtained from 11 EVALI patients from 2019 contained vitamin E acetate. Among the seized products tested by MDH, none seized in 2018 contained vitamin E acetate, although all tested THC-containing products seized in 2019 tested positive for vitamin E acetate. These chemical analyses of products obtained from EVALI patients and of products intended for the illicit market both before and during the outbreak support a potential role for vitamin E acetate in the EVALI outbreak; however, the number of products tested was small, and further research is needed to establish a causal link between exposure to inhaled vitamin E acetate and EVALI. Collaboration between public health jurisdictions and law enforcement to characterize THC-containing products circulating before the recognition of the EVALI outbreak and during the outbreak might provide valuable information about a dynamic market. These Minnesota findings highlight concerns about e-cigarette, or vaping, products that contain THC acquired from informal sources. Because local supply chains and policy environments vary, CDC continues to recommend not using e-cigarette, or vaping, products that contain THC or any e-cigarette, or vaping, products obtained from informal sources. E-cigarette, or vaping, products should never be used by youths, young adults, or pregnant women.* Until the relationship between inhaled vitamin E acetate and lung health is better characterized, vitamin E acetate should not be added to e-cigarette, or vaping, products.<p />  <p>Language: en</p>
LA  - en
SN  - 0149-2195
UR  - http://dx.doi.org/10.15585/mmwr.mm6847e1
ID  - ref1
ER  -