New research have strengthen prior findings on the link between vitamin E acetate and EVALI (E-cigarette or vaping product use-associated lung injury).

For the study, published in the New England Journal of Medicine, the US Centers for Disease Control and Prevention (CDC) analysed bronchoalveolar lavage (BAL) fluid from 51 EVALI patients from 16 states and compared it to BAL fluid from 99 healthy individuals.

Vitamin E acetate, also found in product samples tested by the Food and Drug Administration (FDA) and state laboratories, was identified in BAL fluid from 48 of 51 EVALI patients but was not found in any BAL fluid from healthy people.

In both groups, no other toxicants except coconut oil and limonene were found in BAL fluid.

"These findings support the conclusion that vitamin E acetate is a potential causative agent of EVALI, and that is an important discovery as decisions are made about how to best regulate the rapidly evolving e-cig industry," said researcher Peter Shields from Ohio State University in the US.

According to the researchers, BAL samples were collected by the CDC from public health laboratories and health departments across the US.

These samples were received from hospital clinical teams that had collected the samples to guide clinical management decisions.

According to the study, the research team provided BAL fluid samples from 99 healthy comparison subjects collected between 2015 and 2019 as part of a tobacco product study unrelated to the ongoing CDC investigation of EVALI.

In October 2019, the research team reported the first evidence that even short-term vaping causes concerning inflammation in the lungs in the medical journal Cancer Prevention Research.