A vitamin E chemical is probably at least partially responsible Outbreak of vaping-chromosomal lung disease that has caused 380 cases of lung disease and six deaths in the US. The vitamin E acetate or tocopheryl acetate supplement is now at the center of US government research into this vapor-associated disease that has occurred in recent months. In other countries, no similar phenomenon was reported.

There is no evidence of infectious disease in patients, which is why the US Centers for Disease Control and Control (CDC) have concluded that exposure to chemicals is the most likely cause. The CDC works closely with the Food and Drug Administration (FDA) and state and local health agencies to identify the products or substances that may be behind this outbreak.

An image shows the structure of tocopheryl acetate

Many of the samples tested by the FDA have been identified as evaporation products containing the psychoactive component of cannabistrahydrocannabinol (THC). Most samples containing THC also contained significant amounts of vitamin E acetate.

It is not known that vitamin E acetate is harmful when taken orally as a vitamin supplement or applied to the skin. However, data on the inhalative effects are limited. Experts said the oil-like properties of vitamin E acetate could be linked to observed symptoms, and US health officials continue to investigate the health effects of inhalation.

In recent months, steam US producers have started to use vitamin E acetate as a thickener in THC oils to allow them to evaporate, according to Linda Bauld, a public health expert at the University of Edinburgh so far was not involved investigation of this phenomenon. "Manufacturers of e-cigarette products, especially in the illicit market, have switched to using a vitamin E acetate form, which is often used as a thickener in cosmetic products," she says Chemistry world, "You actually have a contaminant that causes a serious, serious health problem – it covers your lungs."

immune activation

Peter Openshaw, Professor of Experimental Medicine at Imperial College London, says there are plausible reasons to believe that inhaling vitamin E compounds could explain the explosion of lung disease in the US. "The acetate has a vaporization point within the range achieved with e-cigs," he explains. "There are studies that prove that vitamin E has immunological effects that match the case descriptions."

Openshaw suggests that these lung diseases may be related to the inhalation of oil or oil-water mixtures and that they trigger immune activation and cause local inflammation in the lungs and in some cases systemic inflammation. He says, however, that this does not prove that it is all vitamin E acetate.

The FDA is now calling on the public to avoid buying "on the street" steam products and not using THC oil or to modify or add substances purchased in stores. However, the CDC goes one step further and urges the public to avoid using e-cigarette products altogether. American Lung Association President and CEO Harold Wimmer warned, "E-cigarettes are not safe and can cause irreversible lung damage and lung disease. Nobody should use e-cigarettes or other tobacco products. "

Enger British regulations

In the UK, no similar lung disease pattern has occurred. Unlike the United States, all UK e-cigarette products are subject to strict Regulatory Agency (MHRA) regulations for pharmaceuticals and healthcare products. The agency runs a "yellow card" system that collects unwanted reactions related to nicotine-containing e-cigarettes and encourages vapers to report health issues.

The MHRA tells Chemistry world The agency claimed to have received 12 spontaneous reports of adverse reactions to nicotine-containing e-cigarettes between the end of August 2018 and the end of August 2019. However, on the basis of the evidence reported in these cases, the Agency considers that these reports are not indicative of severe or dangerous lung injury similar to that reported in the US.

"Our advice remains that e-cigarettes make up a fraction of the smoking risk, and consuming e-cigarettes makes it much more likely that you will successfully stop than relying on your willpower," says the MHRA. Nevertheless, the agency says it is important to use regulated e-liquids in the UK and never run the risk of vaporizing self-made or illegal e-liquids.

The deaths have led the Trump administration to announce that the FDA plans to impose a federal ban on all non-tobacco-flavored e-cigarettes. "We intend to clear the market for flavored e-cigarettes in order to reverse the deeply worrying epidemic of adolescent e-cigarette consumption affecting children, families, schools and communities," said Alex Azar, secretary for health and social services ,

Michael Siegel, a tobacco researcher at Boston University's Public Health School, points out that the vast majority of reported lung diseases and deaths in the US are related to illicit THC vaping cartridges purchased from the black market rather than flavored E's Cigarettes or vaping in general. He fears that the proposed federal ban on flavored e-cigarettes would create a black market for flavored e-liquids.

The American Public Health Association (APHA) strongly supports the proposed FDA ban and wishes for further expansion. "We have not worked long enough to see the actual effects of fumes on people's lungs," says APHA Executive Director Georges Benjamin Chemistry world, He suggests that it is irresponsible at this point to replace tobacco with e-cigarettes.