The vast majority of California EVALI patients bought their vaping products from illegal sources, according to new research. In fact, 98 percent of the patients bought illegal products, with only one in 86 making a legal purchase.
98 Percent of EVALI Patients Bought Illegal Products
Doctors from the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CADPH) analyzed data collected by CADPH to determine vaping exposure and clinical characteristics in hospitalized EVALI patients. Treating doctors reported the data between August 8, 2019, and November 8, 2019.
The researched examined the medical data of 160 patients and survey data from 86 of those patients (54 percent). Patients completed the survey using a standardized questionnaire.
62 percent of the 160 total patients were male. The median age of patients was 27 years, while their ages ranged from 14 to 70. 46 percent of patients were admitted to the intensive care unit, 29 percent required mechanical ventilation, and four patients died.
Of the 86 patients the team interviewed directly: 83 percent vaped THC products; 43 percent vaped CBD products; and 47 percent vaped nicotine products. (There is overlap because some products contained more than one.)
The patients also reported active ingredients, brand, flavor, and type for each product they used during the 90 days before they were hospitalized. Patients gave cartridges, pods, and vapes to officials and indicated the exact purchase locations for each product. This resulted in the team collecting 130 products from the 86 EVALI patients they interviewed directly.
Of the 130 products the team collected, 87 were THC only, and 91 percent of them were pre-filled carts. There were 25 nicotine only products, but only 48 percent of them were pre-filled cartridges. 56 percent of the THC cartridges were labeled indicating they contained flavoring agents, with 76 percent of the nicotine carts labeled that way.
Where Patients Bought Vaping Products
Interestingly, patients often used unlicensed dispensaries and pop up shops to purchase products. About 33 percent reported buying products from a dispensary, but only 25 percent said the dispensary was licensed by the state.
In addition, the team conducted further research into the issue and found that only one of 86 patients actually purchased their products from a licensed, adult-use dispensary. In most cases, patients were unable to source where they bought faulty products, or purchased them from pop up sources.
The team then went on to analyze the products they collected. Vitamin E or vitamin E acetate was present in 84 percent of the vapes. 67 percent of carts containing THC also contained low levels of pesticides. For heavy metals, all products except one tested lower than 100 parts per billion; the one that failed tested positive for nickel.
Takeaways from the study are that most of the contaminated products came from illegal sources. The data supports the theory that vitamin E acetate is connected to EVALI, but there is enough ambiguity there that more research is needed.