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Published on: August 25, 2018
Severe Lung Injury Associated With Use of e-Cigarette, or Vaping, Products-California, 2019
Amy Heinzerling1,2, Christina Armatas1, Ellora Karmarkar2,3
1Center for Healthy Communities, California Department of Public Health, Richmond.
E-cigarette, or vaping, product use-associated lung injury (EVALI) affected 160 Californians, with most using THC products from informal sources. Vitamin E acetate was common in THC products, but other causes of EVALI remain possible.
Area of Science:
- Public Health
- Pulmonology
- Toxicology
Background:
- E-cigarette, or vaping, product use-associated lung injury (EVALI) has led to over 2700 hospitalizations in the U.S. since August 2019.
- California has a high number of EVALI cases and a legal adult-use cannabis market, making it a key area for investigation.
Purpose of the Study:
- To characterize the clinical presentation of EVALI patients in California.
- To identify specific vaping product exposures linked to EVALI in this population.
Main Methods:
- A case series was conducted, analyzing data from 160 hospitalized EVALI patients reported in California between August and November 2019.
- Standardized interviews assessed vaping habits and product sources; tested products analyzed for ingredients.
Main Results:
- The study included 160 patients (62% male, median age 27). 46% required intensive care, and 29% needed mechanical ventilation; 4 deaths occurred.
- Of interviewed patients, 83% vaped THC products, 43% vaped CBD products, and 47% vaped nicotine products.
- Vitamin E acetate was found in 84% of tested THC-containing products obtained from informal sources.
Conclusions:
- Clinical outcomes and vaping behaviors in California patients mirror national trends, with a high prevalence of THC product use from informal sources.
- While Vitamin E acetate was frequently detected in THC products, other causes for EVALI may exist.
- Public health officials advise against using any vaping products, especially THC products from informal sources.
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