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Safety Cartridge Pen Safety

momofthegoons

Vapor Accessory Addict
Staff member
I've been concerned about the safety of cartridges for some time after learning that one of the premier cartridge makers here in Michigan was using coconut oil as their carrier. For those who are not aware, when inhaled, coconut oil can cause lipid pneumonia. But this article brings up new concerns with these cartridges.

Cannabis Cartridges Have a Heavy Metal Problem & It Is Worse Than Reported
As testing ramps up in legal marketplaces there are more concerns about just how safe vape pens are.

Woman-Vaping.jpg


Sales data from Eaze and Jane Technologies Inc. confirm that cannabis e-cigarettes (“vape pens”) account for nearly 25 percent of sales in California and other research by BDS Analytics and Arcview found that “vapes already made up more than half of total U.S. concentrate sales.” Considering that these devices did not exist until 2010 in their earliest incarnations, and did not see mass adoption on the consumer market until 2012/2014 (depending on location), these devices have taken the cannabis industry by storm. As with any new technology, while there are benefits there are also potential harms.

This month, California’s cartridge market was shaken to its core by a memo released by K Street Consulting, drawing attention to the fact that potentially 90 percent of cartridges dry test for actionable levels of lead under the state’s phase 3 heavy metals testing as required by reforms to the state’s medical and recreational cannabis programs. While many outlets been hyper-focused on lead, there are other heavy metals to be concerned about in these devices.

Big Trouble, Little Care in China
Sasha Robinson, a founder of Firefly Vapor and their former CTO, did extensive research on material components to create the Firefly 1. Robinson said they “were testing standard heating coil wires of different types,” including nichrome wire, a blend of nickel and chromium. After a month of testing, Robinson said he and his colleague noticed they had “skin rashes and itching issues, symptoms that were consistent with those of nickel poisoning,” but they were never checked out by a doctor. Nickel poisoning is a rare disease which can be hard to diagnose and, in extreme cases, can result in coma and epileptic seizures. While both nickel and chromium are heavy metals, neither one is being tested for under California’s phase 3 heavy metals testing (just cadmium, lead, arsenic, and mercury).

Since the developers at Firefly were not using filled cartridges, they could “see that there was dust in the heating chamber when we disassembled the device” and Robinson said he noticed that “after repeated heating and cooling cycles the nichrome wire begins to flake off as white powder,” which was then inhaled into their lungs.

“I don’t want to be an alarmist in this space, we are doing a lot of human experimentation with no studies,” Robinson said.

With that realization, Robinson and colleagues conducted a lot of research “on different materials that didn’t flake under heat cycling.” Ultimately, they put the whole company on hold for about three months to make sure they had a safe product.

“In the end, we did find one, but it was very difficult to find a supplier and we had to have our wire custom made,” Robinson said. “All of our coils are now made in the U.S.”

When it comes to prioritizing human health over company profits, Robinson said he feels that “China doesn’t think that way, they can’t afford to.”

Robinson described manufacturing in China as the “wild west” when it comes to the issues U.S. companies face in dealing with Chinese manufacturers,

“The challenge is that most [U.S. brands] don’t know and don’t want to know what they are made of, because then they become liable for it,” he said. “Their supplier can tell them a lie, like the coil is made of titanium, and then they can repeat the lie to consumers without ever verifying it. That happens a lot.” While much of the market has shifted from nichrome wire to safer components, some companies have not, and others may be repeating incorrect information about product safety given to them by their manufacturer.

A Cowboy of Quality Control
To learn more about China as the wild west of vape manufacturing, Cannabis Now spoke to a long-term “cowboy” of the quality assurance/quality control (QA/QC) testing scene in Shenzhen China, Andy Church. After 12 years doing QA/QC in China, Church founded Insight Quality Services, a company that ensures that what U.S. brands order is what they receive. When I brought up Robinson’s comment about material component deception, Church said it was a common occurrence.

“I think that it happens all the time, in manufacturing and sales, but that is not limited to China,” he said.

Church put the onus on the importer.

“If someone is telling you that a device is made of specific components it is up to the buyer to make sure that what they receive is what they ordered,” he said noting that, for cartridges and any other products, the way to verify is to “send samples in from the inspected lot to make sure the components are what they are meant to be.”

Are they Actually “Vape” Pens?
You may have noticed that this article refers to cartridge-style and all-in-one disposable pens not as “vape pens,” as most people do, but as “cannabis e-cigarettes” or simply as “devices.” This is because they all use appropriated e-cigarette technology, which was not designed for cannabis oils. As previously reported by Cannabis Now, the result is a product that doesn’t always vaporize and generally smolders or combusts the oil around the heating element, which can produce carcinogens and potentially other contaminants. Some higher quality disposable devices, such as the dosist pen, include a microprocessor to control the temperature, but in a market racing to the bottom to provide the lowest prices to overtaxed consumers, most brands do not have a way to control the temperature in their device. Robinson stated it about as bluntly as one can, “Those pens have no temperature control and very few electronic parts, most of the electronics are spent on charging the battery and making sure the battery doesn’t blow up in your face.”

While many people think there is a clear line between what is vaping and what is not, it is more of a gray area than black and white.

“There is no clear line between burning and vaping, it is a scientific measurement of particulates,” Robinson said alluding to the fact that there is no one accepted temperature. In fact, perhaps temperature isn’t even the best metric to use.

Heavy Metals Testing Outside of California
While much of the focus in cannabis vape pen testing is currently on California, it is not the only state to require heavy metals testing and soon Colorado will also be implementing the heavy metals testing requirements contained in that state’s regulations. Despite Colorado testing for the same four heavy metals, the allowable limits are much less restrictive. For example, while California only allows 0.5 parts per million (ppm) for lead, Colorado will allow 10 ppm.

To learn more about heavy metals testing limits in other states, Cannabis Now spoke to Sarah Krings-Lien, a senior consultant for Pistil + Stigma and the head researcher on their multi-year study on cannabis testing limits around the United States.

“The lack of scientific evidence on safe levels of heavy metals in cannabis has resulted in a patchwork of state testing requirements,” Krings-Lien said. “The majority of states require testing for just four heavy metals (inorganic arsenic, lead, cadmium and mercury), but a few states require testing for up to 10, including chromium, barium, silver, selenium, iron, manganese, nickel and zinc.”

In addition to the dramatic variance in the number of metals tested for, Krings-Lien said that the limits for each heavy metal vary significantly.

“For example, in five states the limit for lead in cannabis flower is 1 ppm or less, while two states allow up to eight times that amount,” she said.

Safer Alternatives
For cannabis users looking for safer devices, the dosist pen and Firefly are vaporizers that have been around for a few years and have a proven track record for safety and compliance. About four years ago Cannabis Now spoke to Seibo Shen, CEO of VapeXhale and Hanu Labs, who was one of the first C-level executives blowing the whistle on the materials safety issue.

“I’ll be the first to say that pens seem to be safer than smoking, but they may not be as safe as they are being marketed to be,” Shen said. “I wouldn’t say they are unsafe, but they can choose much safer and better materials to use in the cartridges.” Since the interview, Shen has created the Hanu Stone, a portable vaporizer about to hit the market, which he said was “designed to be ROHS and ROHS2 compliant, which are safety standards for hazardous materials.”

While California and Colorado brands may be fine using nickel and chromium in their devices for now, there is no guarantee that will last forever. For brands with a national footprint, or those that aspire to have one, it is important to meet the standards of the most restrictive state the company plans to operate in and meet the standards, rather than trying to save money by buying sub-par electronics and fail testing, or worse, suffering a recall, as just happened to one Michigan company whose products tested hot for arsenic and cadmium (among other chemicals).
 
I've been concerned about the safety of cartridges for some time after learning that one of the premier cartridge makers here in Michigan was using coconut oil as their carrier. For those who are not aware, when inhaled, coconut oil can cause lipid pneumonia. But this article brings up new concerns with these cartridges.

Cannabis Cartridges Have a Heavy Metal Problem & It Is Worse Than Reported
As testing ramps up in legal marketplaces there are more concerns about just how safe vape pens are.

Woman-Vaping.jpg


Sales data from Eaze and Jane Technologies Inc. confirm that cannabis e-cigarettes (“vape pens”) account for nearly 25 percent of sales in California and other research by BDS Analytics and Arcview found that “vapes already made up more than half of total U.S. concentrate sales.” Considering that these devices did not exist until 2010 in their earliest incarnations, and did not see mass adoption on the consumer market until 2012/2014 (depending on location), these devices have taken the cannabis industry by storm. As with any new technology, while there are benefits there are also potential harms.

This month, California’s cartridge market was shaken to its core by a memo released by K Street Consulting, drawing attention to the fact that potentially 90 percent of cartridges dry test for actionable levels of lead under the state’s phase 3 heavy metals testing as required by reforms to the state’s medical and recreational cannabis programs. While many outlets been hyper-focused on lead, there are other heavy metals to be concerned about in these devices.

Big Trouble, Little Care in China
Sasha Robinson, a founder of Firefly Vapor and their former CTO, did extensive research on material components to create the Firefly 1. Robinson said they “were testing standard heating coil wires of different types,” including nichrome wire, a blend of nickel and chromium. After a month of testing, Robinson said he and his colleague noticed they had “skin rashes and itching issues, symptoms that were consistent with those of nickel poisoning,” but they were never checked out by a doctor. Nickel poisoning is a rare disease which can be hard to diagnose and, in extreme cases, can result in coma and epileptic seizures. While both nickel and chromium are heavy metals, neither one is being tested for under California’s phase 3 heavy metals testing (just cadmium, lead, arsenic, and mercury).

Since the developers at Firefly were not using filled cartridges, they could “see that there was dust in the heating chamber when we disassembled the device” and Robinson said he noticed that “after repeated heating and cooling cycles the nichrome wire begins to flake off as white powder,” which was then inhaled into their lungs.

“I don’t want to be an alarmist in this space, we are doing a lot of human experimentation with no studies,” Robinson said.

With that realization, Robinson and colleagues conducted a lot of research “on different materials that didn’t flake under heat cycling.” Ultimately, they put the whole company on hold for about three months to make sure they had a safe product.

“In the end, we did find one, but it was very difficult to find a supplier and we had to have our wire custom made,” Robinson said. “All of our coils are now made in the U.S.”

When it comes to prioritizing human health over company profits, Robinson said he feels that “China doesn’t think that way, they can’t afford to.”

Robinson described manufacturing in China as the “wild west” when it comes to the issues U.S. companies face in dealing with Chinese manufacturers,

“The challenge is that most [U.S. brands] don’t know and don’t want to know what they are made of, because then they become liable for it,” he said. “Their supplier can tell them a lie, like the coil is made of titanium, and then they can repeat the lie to consumers without ever verifying it. That happens a lot.” While much of the market has shifted from nichrome wire to safer components, some companies have not, and others may be repeating incorrect information about product safety given to them by their manufacturer.

A Cowboy of Quality Control
To learn more about China as the wild west of vape manufacturing, Cannabis Now spoke to a long-term “cowboy” of the quality assurance/quality control (QA/QC) testing scene in Shenzhen China, Andy Church. After 12 years doing QA/QC in China, Church founded Insight Quality Services, a company that ensures that what U.S. brands order is what they receive. When I brought up Robinson’s comment about material component deception, Church said it was a common occurrence.

“I think that it happens all the time, in manufacturing and sales, but that is not limited to China,” he said.

Church put the onus on the importer.

“If someone is telling you that a device is made of specific components it is up to the buyer to make sure that what they receive is what they ordered,” he said noting that, for cartridges and any other products, the way to verify is to “send samples in from the inspected lot to make sure the components are what they are meant to be.”

Are they Actually “Vape” Pens?
You may have noticed that this article refers to cartridge-style and all-in-one disposable pens not as “vape pens,” as most people do, but as “cannabis e-cigarettes” or simply as “devices.” This is because they all use appropriated e-cigarette technology, which was not designed for cannabis oils. As previously reported by Cannabis Now, the result is a product that doesn’t always vaporize and generally smolders or combusts the oil around the heating element, which can produce carcinogens and potentially other contaminants. Some higher quality disposable devices, such as the dosist pen, include a microprocessor to control the temperature, but in a market racing to the bottom to provide the lowest prices to overtaxed consumers, most brands do not have a way to control the temperature in their device. Robinson stated it about as bluntly as one can, “Those pens have no temperature control and very few electronic parts, most of the electronics are spent on charging the battery and making sure the battery doesn’t blow up in your face.”

While many people think there is a clear line between what is vaping and what is not, it is more of a gray area than black and white.

“There is no clear line between burning and vaping, it is a scientific measurement of particulates,” Robinson said alluding to the fact that there is no one accepted temperature. In fact, perhaps temperature isn’t even the best metric to use.

Heavy Metals Testing Outside of California
While much of the focus in cannabis vape pen testing is currently on California, it is not the only state to require heavy metals testing and soon Colorado will also be implementing the heavy metals testing requirements contained in that state’s regulations. Despite Colorado testing for the same four heavy metals, the allowable limits are much less restrictive. For example, while California only allows 0.5 parts per million (ppm) for lead, Colorado will allow 10 ppm.

To learn more about heavy metals testing limits in other states, Cannabis Now spoke to Sarah Krings-Lien, a senior consultant for Pistil + Stigma and the head researcher on their multi-year study on cannabis testing limits around the United States.

“The lack of scientific evidence on safe levels of heavy metals in cannabis has resulted in a patchwork of state testing requirements,” Krings-Lien said. “The majority of states require testing for just four heavy metals (inorganic arsenic, lead, cadmium and mercury), but a few states require testing for up to 10, including chromium, barium, silver, selenium, iron, manganese, nickel and zinc.”

In addition to the dramatic variance in the number of metals tested for, Krings-Lien said that the limits for each heavy metal vary significantly.

“For example, in five states the limit for lead in cannabis flower is 1 ppm or less, while two states allow up to eight times that amount,” she said.

Safer Alternatives
For cannabis users looking for safer devices, the dosist pen and Firefly are vaporizers that have been around for a few years and have a proven track record for safety and compliance. About four years ago Cannabis Now spoke to Seibo Shen, CEO of VapeXhale and Hanu Labs, who was one of the first C-level executives blowing the whistle on the materials safety issue.

“I’ll be the first to say that pens seem to be safer than smoking, but they may not be as safe as they are being marketed to be,” Shen said. “I wouldn’t say they are unsafe, but they can choose much safer and better materials to use in the cartridges.” Since the interview, Shen has created the Hanu Stone, a portable vaporizer about to hit the market, which he said was “designed to be ROHS and ROHS2 compliant, which are safety standards for hazardous materials.”

While California and Colorado brands may be fine using nickel and chromium in their devices for now, there is no guarantee that will last forever. For brands with a national footprint, or those that aspire to have one, it is important to meet the standards of the most restrictive state the company plans to operate in and meet the standards, rather than trying to save money by buying sub-par electronics and fail testing, or worse, suffering a recall, as just happened to one Michigan company whose products tested hot for arsenic and cadmium (among other chemicals).
Maryland tests MJ flower for eight different heavy metals....but they do NOT test extractions for metals. F'd up, yeah?
 
Growing Concerns about Cannabis Vape Cartridge Additives

Cutting-Vape-Pen-In-article%20image%201.jpg

How much do we really know about the additives included in your vape pen?
E-cigarettes, both with cannabis and tobacco oils in them, rely on additives to standardize the potency of oils and to change their viscosity so that their cartridges do not clog or leak.

There are several different additives that companies use including propylene glycol (PG), polyethylene glycol (PEG), vegetable glycerin (VG), medium-chain triglycerides (MCT), and even terpenes.

Complicating matters further, PEG comes in a nearly unlimited range of molecular weights, each with different known uses, risks, and consistencies; simply put, the bigger the number after the PEG the higher the molecular weight, and more solid it will be.

Most cannabis e-cigarettes that use PEG appear to use PEG 400.

Problems with PEG, PG and VG
A 2017 study published in the Journal of Alternative and Complementary Medicine looked into the amount of the carbonyls such as acetaldehyde, acrolein, and formaldehyde produced by vapes containing PG, PEG, VG, and MCT.

That study found PEG 400 produced the most carbonyls, followed by PG, and that MCT and VG produced comparably negligible amounts.

In an interview following up on his study, Dr. Matthew DiDonato discussed the gravity of his research, saying, “To my knowledge, this is the first study examining the byproducts of vaporized MCT, which is why, given its prevalence in vaporizable cannabis products, we felt it was important to determine its safety as a thinning agent.”

When speaking at the Institute of Cannabis Research Conference 2017, Harvard-educated physician, Dr. Jordan Tishler, expressed concerns that “PEG can become a carcinogen and PG can polymerize, coating the lungs in plastic and provoking an immune response.”

Dr. Jeffrey Raber, the CEO and CVO of The WercShop, echoed some of the concerns raised in the 2017 JACM article, saying “We do know that PEG, VG, PG ... produce formaldehyde and other deleterious agents.”

Some of the deleterious agents Dr. Raber spoke of could be acetals, which are the product of PG and certain flavor chemicals combining, which can happen even without heating.

Arnaud Dumas De Rauly is another important voice raising concerns about these additives.

Dumas De Rauly is the CEO and Co-Founder of the Blinc Group, a vapor products incubator; he is also the Secretary General of European and International relations at FIVAPE in France, the Chairman of the ISO/TC 126/SC 3 Vape and Vapor Products, and one of the world’s most renowned experts in vape technology.

After his years of working in the vape space, Dumas De Rauly feels that “PEG should never be used, and PG is the safest” thinning agent to use.

Despite that, in the U.S. “80% of the nicotine market uses VG and 20% uses PG, and that is reversed in Europe.”

Dumas De Rauly said the reason for VG's popularity is that “VG means a bigger cloud,” while on the other hand “PG means you have a better flavor.”

One thing we do know about PEG is that it can be used as a molecular “glue” to reattach severed nerves as part of a head/body transplant (which is currently being attempted).

Mixed Opinions About MCT
While Dr. DiDonato's research seemed to prove MCT oil as a safe thinning agent when compared to PG and PEG, that study just looked at the amount of carbonyls produced, not at the possibility of lipoid pneumonia.

Lipoid pneumonia is a condition caused by fat particles (lipids) entering the lungs.

Dr. Jeffrey Raber, the CEO and CVO of The WercShop, mentioned his concerns about it during his keynote at the 2018 Terpenes and Testing World Conference (TTWC).

“MCT oil can lead to lipid pneumonia,” said Dr. Raber, adding that “your lungs aren’t made to process oils.”

In a follow-up interview, Dr. Raber expanded on his TTWC keynote: “When we talk about lipid pneumonia, we don't know if it will happen with these lipids, so it’s best to err on the side of caution.”

The main issue he brought up was that “We don't have any data on the effects,” which means that “we don't know how much is too much when it comes to consumption.”

Without any research, there is no way to say if two grams of distillate a day is safe or if a safe amount is two puffs on a cannabis e-cigarette.

In the end, Dr. Raber's advice to manufacturers was straightforward: “Don't put things in there you weren't inhaling before.”


The Trouble with Terpenes

Cutting-Vape-Pen-In-article%20image%202.jpg

Every thinning agent has positives and negatives. None of them have enough research regarding inhalation.
In his TTWC keynote, Dr. Raber said “Terpenes would be the best dilution agents, as they are natural,” they are something that was always inhaled when people smoked cannabis, not a new additive.

Terpenes are part of the essential oils of plants and are responsible for many of the aromas of cannabis and other plants.

While he advocated for using terpenes, Dr. Raber clarified in a follow-up interview that, “we still don’t know what safe consumption rates are for vaporized terpenes.”

He added that “like it or not, we are all in a running experiment, and we are the subject.”

Dr. Raber was clear that there is a “concern over when enough is enough, which is hard to tell.”

Dr. Tishler echoed Dr. Raber's concerns, saying: “Some companies are adding terpenes, but we have no research to show that super concentrated terpenes are any safer than PG or PEG.”

Concentrated terpenes may even have a corrosive effect on the device itself.

This is exactly why more manufacturers are moving away from plastic cartridges.

Justin Pentelute is the CEO of EvolutionZ Consulting, a group that owns the cannabis oil and cartridge company The Clear, one of the pioneers of the cannabis cartridge market who initially used plastic cartridges.

Pentelute discussed why they switched to using glass CCELL cartridges:

“In any plastic cartridge you will get leeching from the terpenes, even cannabis-derived terpenes, not all but most will have some acidic value.”

CCELL Cartridges are quickly becoming standard across the industry due to their higher quality.

He compared it to soda, “It is no different than coca cola, we drink it all the time but it will take rust off a nail, that is similar to how these terpenes work. They are good for you but they are acidic.”

Rene Suarez is a veteran of the e-cigarette space and the CEO of Orchid Essentials, a company that uses terpenes as the thinning agent in their CCELL cartridges.

Suarez also spoke of the potential leeching effects of terpenes.

“I know that in old vape cartridges we used to have plastic tanks and there were some flavors that were more acidic and they would leech the tank and could crack them,” said Suarez, adding one big example: “Cinnamon flavoring cannot go in a plastic tank.”

Beyond some terpenes being more acidic than others, some have been shown to have specific medical issues associated with them. The first terpene to attract attention for negative health effects was diacetyl, a butter-scented terpene which arises as a byproduct of creating cultured dairy products.

Diacetyl first came to attention as an additive to microwave popcorn, where some workers received toxic levels of exposure resulting in a condition called “popcorn lung,” which resulted in new FDA and OSHA regulations.

Diacetyl is not just used in microwaved popcorn anymore, and was found in 75% of e-cigarettes examined in a 2015 Harvard University study which noted negative health impacts from inhaled diacetyl.

In 2018, a study published in the American Heart Association's journal, Arteriosclerosis, Thrombosis and Vascular Biology, found that diacetyl and eight other terpenes impaired “nitric oxide production, which inhibits inflammation and clotting and regulates blood vessel enlargement in response to blood flow.”

Over time, that could contribute to heart damage and other health impairments.

Other than diacetyl, the researchers looked at acetylpyridine (burnt flavor), cinnamaldehyde (cinnamon), dimethylpyrazine (strawberry), eucalyptol (spicy cooling), eugenol (clove), isoamyl acetate (banana), and vanillin (vanilla).

While the study was looking at tobacco e-cigarettes, these terpenes are also used in cannabis e-cigarettes and, in some cases, like eucalyptol, they are naturally occurring in the cannabis plant.

So What's Safest?
It seems like every thinning agent out there has some potential drawbacks and health issues associated with it, but with all of them, we need more research to know the specifics.

Out of five additives looked at in this article, PG and VG seem to be the safest options to use, or possibly terpenes, as long as they are not terpenes shown to have negative health impacts.

Dumas De Rauly had some advice for regulators, “If there is one thing that should be tested for it should be an emissions test,” which means measuring what comes out of a used vape, rather than the oil that goes into it.

“No one is eating the oil, it is being vaporized, so that should be tested and an emissions study is required in both Europe and the US for nicotine vapes.”
 
This article pertains to e-cig vaping.... but could certainly apply to concentrate cartridges as well since they aren't sure what's causing the contamination.



Study Finds Signs Of Bacteria And Fungi In Many Vaping Products

0425_e-cigs-1000x645.jpg

E-cigarettes appear on display at Vape store in Chicago in 2014. (Nam Y. Huh/AP)

Many e-cigarette products show signs of contamination by what could be called e-bugs.

Harvard researchers who tested vaping cartridges and e-liquid products with high nicotine content made by the 10 most popular e-cigarette brands report widespread evidence of bacteria or fungi previously linked to lung problems.


The study, out Wednesday in the journal Environmental Health Perspectives, found signs of bacterial contamination in nearly a quarter of the products tested, and fungal contamination in more than 80%.

David Christiani, a Harvard T.H. Chan School of Public Health professor, says that while the level of exposure is low, the research adds an additional "buyer beware" for users of e-cigarettes. Vaping has exploded among American teens to the point that the U.S. surgeon general has called it an "epidemic."

"The production is not standardized," Christiani says, "and the contents can vary widely. And they can contain a number of agents that are toxic, that can be harmful to health, in addition to nicotine."

He says more research is needed on a wider sampling of vaping products and their effects on human health. The study examined the brands most popular in 2013, and bought them in 2015-16, he says.

Here are a few edited excerpts from our conversation:

How would you sum up your findings?

We looked at e-cigarette products to see if there was any contamination by microbial agents — specifically bacteria or fungi. And so we looked at products that those organisms make, known as endotoxins or glucans. And we found them present for bacterial contamination in about 23% of the products overall. The fungi was present in 81% of the products.

So what's your message to the public?

This just adds one more "buyer beware," that you’re actually inhaling material that has chemical contamination in many cases, and in this case, biological contamination as well — for agents that have been known to cause inflammation and damage to the airways in other settings.

It should be clear that those are usually occupational settings at much higher levels than what we’re measuring here. But still, they are present. And we don’t know what long-term, repeated, cumulative use would mean for someone’s lungs from just e-cigarettes alone.

How would you describe the level of risk for e-cigarette users?

These are low levels of exposure — lower than in tobacco products or traditional cigarettes and lower than in the occupational environment. So this is pretty low-level exposure, but it’s not trivial. In totality, this is added to what we already know are contaminating these products, including a bunch of chemical compounds. So now you add endotoxins and glucans on top of that, and we know from other studies that glucans and endotoxins are not good for your lungs.

Are there studies looking at vaping effects on human health?

They’re coming out now. The literature is starting to really blossom. Long-term studies will take time, just like with other environmental agents, but there is a lot of work going on in e-cigarette exposure in humans, and what even short-term responses — like inflammatory responses — might indicate.

Is the fundamental problem the production practices, or is this contamination inevitable given the materials?

We actually don’t know. We’re not sure at which steps the contamination is taking place. The only thing we can say is that we looked at two different kinds of materials; one was cartridges and one was a free-flowing liquid. And the cartridges had a higher level of contamination than the free-flowing liquid did.

The cartridges usually use cotton wicks. And we know from my previous work in the textile industry that cotton material is more heavily contaminated with compounds like endotoxins. So in that case, it might be right in the wick.

What's your next step?

We’d like to do more human studies of both active and passive exposure to vaping. It might show some of the short-term clinical effects that we’re concerned about.

The other problem is there’s so much variability. We took the top 10-selling brands, but I think there needs to be a larger representative sample of products to confirm these findings. There also need to be studies that figure out what the sources and roots of contamination are. And lastly, the human health effects.
 
Officials list pot vape brands reported in US outbreak

NEW YORK, NY – Health officials investigating a nationwide outbreak of vaping illnesses have listed, for the first time, the vape brands most commonly linked to hospitalizations.

Most of the nearly 2,300 people who suffered lung damage had vaped liquids that contain THC, the high-inducing part of marijuana.

In a report released Friday, the U.S. Centers for Disease Control and Prevention listed the products most often cited by patients, noting that some of them said they vaped more than one.

Dank Vapes was the brand used by 56% of the hospitalized patients nationwide.

Dank is not a licensed product coming from one business, it is empty packaging that can be ordered from Chinese internet sites. Illicit vaping cartridge makers can buy the empty packages and then fill them with whatever they choose.

Other product names at the top of the list from CDC were TKO (15%), Smart Cart (13%) and Rove (12%).

“It's not likely that a single brand is responsible for this outbreak,” said Brian King, a senior CDC official on the investigation.

Some of the brands cited by the CDC are sold in states with legalized marijuana. But counterfeits of those legitimate brands have flooded the market around the country, forcing some to redesign their packaging.

Bill Loucks, co-founder of TKO Products, said his company sells only to licensed dispensaries in California, but the company gets emails asking about TKO-branded cartridges purchased elsewhere.

“If you bought them outside of California ... you are the proud owner of fakes," Loucks said in an email.

The CDC also said Friday that the worst of the outbreak may be over. Preliminary data indicates hospitalizations peaked in mid-September and have been declining since, officials said.

Investigators want more data until they feel certain the outbreak is waning. If it is, there may be more than one reason, including growing public caution about vaping or perhaps a change in what cartridge makers are putting into them, King said.

But cases are still coming in, with 2,291 reported this year — including 176 that joined the tally in late November. Every state has reported cases, and 25 states and the District of Columbia have reported a total of 48 deaths.

Symptoms include trouble breathing, chest pain, fatigue and vomiting. About half the patients are people in their teens or early 20s.

The outbreak appears to have started in March. CDC officials have gradually come to focus their investigation on black-market THC cartridges.

An analysis of about 1,800 of the hospitalized patients found about 80% said they used at least one THC product. Last month, CDC officials said they had narrowed in on a culprit — a chemical compound called vitamin E acetate that has been commonly found in the lungs of sick patients and in the products they vaped.

Vitamin E acetate is a thickening agent that's been added to illicit THC vaping liquids. But it's possible it also may have been added to vaping liquids containing CBD, another cannabis extract, King said. About 1% of the patients said they had vaped CBD products only.

The agency is recommending that people do not use any electronic cigarettes or vaping products that contain THC, especially those obtained from friends, family members or black market dealers.

However, 13% of patients said they vaped only nicotine. CDC officials are continuing to look at nicotine-containing vapes, and to advise caution about all types of vaping products until the investigation is concluded, King said.
 
Not sure if this is just more scare tactic or sensationalism.... these cases are unconfirmed and 'likely linked to marijuana vaping products'..... but they don't know if other products were used by these people.

6 People in Massachusetts Reportedly Sick After Using Vapes From Licensed Source

Massachusetts’ medical marijuana program might have a vaping problem.

Health officials in Massachusetts revealed this week that six patients have suffered illnesses likely linked to marijuana vaping products purchased from dispensaries. Those reports, which are unconfirmed, are alarming, given that they stem from regulated products, and not those purchased from the illicit market.

The reported illnesses also come a week before Massachusetts Gov. Charlie Baker is slated to lift a temporary ban on all vaping products. Baker issued an emergency order banning the products back in September amid a nationwide epidemic that saw dozens of individuals die and thousands more fall seriously ill from vaping. Three vaping-related fatalities have occurred in Massachusetts.

“One of the experts said that, ‘We don’t have time to wait. People are getting sick and the time to act is now.’ I couldn’t agree more,” Baker said at the time.

The temporary ban is set to be lifted on December 11, although it will come with new restrictions governing the sale of e-cigarettes and other vaping products that were etched out in legislation signed by Baker. The governor’s administration also said that the state Department of Health will present new regulations surrounding the sale of vaping products on the same date.


According to the state government website, the new legislation signed by Baker “includes a number of restrictions on the sale of tobacco products, including limiting the sale of flavored nicotine vaping products to licensed smoking bars where they may only be smoked on-site,” while also giving the Department of Health “new authority to regulate the sale of nicotine vaping products, to ensure the public is informed about the potential dangers of vaping and to implement other provisions of the law in order to protect the public health.”

The six new illnesses reportedly stemming from regulated marijuana vaping products remain shrouded in mystery. The Boston Herald reported that the state health department “did not specify which products were linked to the six cases or which dispensaries they were purchased from, leaving marijuana users with little answers as to whether the vapes they legally purchased, before the ban, are safe.”

That prompted Shaleen Title, a commissioner at the Massachusetts Cannabis Control Commission, to call for more information.
“Obviously, some urgent next questions here: What products did they report using/from where? Did they also report using unregulated products?” Title tweeted Friday. “Looking forward to working further with MA health officials and grateful for their collaboration toward our common goal of public health.”
 
I don't know... but this seems like sort of a stretch to me.

Terpenes in marijuana vaping products may produce toxic chemicals

The natural terpenes in marijuana are removed during distillation to produce pure THC for e-liquids and concentrates, and then added back in for taste and smell.

Terpenes, removed from marijuana during distillation, are often added back to e-liquids used for vape cartridges and other products for taste and smell. Photo by Bengoodwin15/Pixabay


Terpenes, removed from marijuana during distillation, are often added back to e-liquids used for vape cartridges and other products for taste and smell. Photo by Bengoodwin15/Pixabay


Dec. 10 -- Natural compounds added to marijuana-derived vaping liquid produce toxic chemicals in the vapor that users inhale, a new lab study reports.

The compounds, known as terpenes, are added into pure THC distillations to dilute the product and provide the vapor with aroma and taste, said senior researcher Robert Strongin, a professor of organic chemistry at Portland State University in Oregon.

Samples of lab-created e-liquids and "dabs" -- waxy pot concentrates -- produced a variety of toxic chemicals when they were heated, Strongin and his colleagues found.

Those chemicals included benzene, a known carcinogen, and an air pollutant called methacrolein, Strongin said. Others included xylenes, toluene, styrene and ethylbenzene.

There's concern that these toxins could harm users, particularly teenagers whose bodies and brains are still developing, Strongin said.

Terpenes are found in the essential oils of some plants, particularly conifers and citrus. They are the compound that "gives cannabis its very distinctive smell," he said, noting that pure THC doesn't have any scent.

Nearly 2,300 Americans have been sickened and 48 have died due to a lung injury that hampers and sometimes completely restricts a person's ability to draw breath, according to the U.S. Centers for Disease Control and Prevention.

The CDC has identified one compound, vitamin E acetate, as a chemical of concern in those cases. It's most often used as a thickening agent in vaping products containing THC, the ingredient in marijuana that causes intoxication.

But some experts have wondered whether terpenes also play a role, said Dr. Mangala Narasimhan, regional director of critical care medicine at Northwell Health in New Hyde Park, N.Y.

"That's what everyone is talking about now, that some of this might be the terpenes being burned at such high temperatures and us not knowing what the side effects are," she said.

The natural terpenes in marijuana are removed during the distillation process used to produce pure THC, Strongin said. Other terpenes are added back in to make sure the product smells like pot.

Manufacturers also use terpenes to thin the pure cannabinoids that are being distilled from marijuana plants, he added.

"THC and CBD are very, very viscous. It's really hard to use pure versions of those," Strongin said. "They're almost solid, very sticky and gummy and oily. Terpenes are more liquid, and adding them makes the cannabinoids more tractable and easier to manage."

To test whether terpenes would produce toxins when heated, the researchers created e-liquids and dabs containing 90 percent THC and 10 percent terpenes.

They then heated or burned their creations and captured the vapor for analysis.

Narasimhan said additives like terpenes are of particular concern because they have been linked to lung injuries.

Another organic compound called diacetyl is used to create a buttery taste. More than a decade ago, it was found to cause lung damage in popcorn factory workers who breathed in the chemical, Narasimhan said.

Her hospital has seen at least 40 cases of patients with vaping-related lung injury, and the vast majority were users of off-label THC e-liquids.

Narasimhan warns against using off-label vaping products.

"The off-label stuff can be mixed with anything," she said. "We have no idea what it's mixed with, and we have no idea what happens to the mixture at these high temperatures."

The new study was recently published in the journal ACS Omega.
 
Not sure if this is just more scare tactic or sensationalism.... these cases are unconfirmed and 'likely linked to marijuana vaping products'..... but they don't know if other products were used by these people.

6 People in Massachusetts Reportedly Sick After Using Vapes From Licensed Source

Massachusetts’ medical marijuana program might have a vaping problem.

Health officials in Massachusetts revealed this week that six patients have suffered illnesses likely linked to marijuana vaping products purchased from dispensaries. Those reports, which are unconfirmed, are alarming, given that they stem from regulated products, and not those purchased from the illicit market.

The reported illnesses also come a week before Massachusetts Gov. Charlie Baker is slated to lift a temporary ban on all vaping products. Baker issued an emergency order banning the products back in September amid a nationwide epidemic that saw dozens of individuals die and thousands more fall seriously ill from vaping. Three vaping-related fatalities have occurred in Massachusetts.

“One of the experts said that, ‘We don’t have time to wait. People are getting sick and the time to act is now.’ I couldn’t agree more,” Baker said at the time.

The temporary ban is set to be lifted on December 11, although it will come with new restrictions governing the sale of e-cigarettes and other vaping products that were etched out in legislation signed by Baker. The governor’s administration also said that the state Department of Health will present new regulations surrounding the sale of vaping products on the same date.


According to the state government website, the new legislation signed by Baker “includes a number of restrictions on the sale of tobacco products, including limiting the sale of flavored nicotine vaping products to licensed smoking bars where they may only be smoked on-site,” while also giving the Department of Health “new authority to regulate the sale of nicotine vaping products, to ensure the public is informed about the potential dangers of vaping and to implement other provisions of the law in order to protect the public health.”

The six new illnesses reportedly stemming from regulated marijuana vaping products remain shrouded in mystery. The Boston Herald reported that the state health department “did not specify which products were linked to the six cases or which dispensaries they were purchased from, leaving marijuana users with little answers as to whether the vapes they legally purchased, before the ban, are safe.”

That prompted Shaleen Title, a commissioner at the Massachusetts Cannabis Control Commission, to call for more information.
“Obviously, some urgent next questions here: What products did they report using/from where? Did they also report using unregulated products?” Title tweeted Friday. “Looking forward to working further with MA health officials and grateful for their collaboration toward our common goal of public health.”
So, first....nobody doing anything illegal...like illegal MJ carts....will every lie about it, right? I mean, what BS and later they retracted this statement and said that yes, at least some of the six did indeed use illegal carts. I think I may have posted it under MA thread. Just hysterical, irresponsible horseshit.

I don't know... but this seems like sort of a stretch to me.
Terpenes in marijuana vaping products may produce toxic chemicals
The natural terpenes in marijuana are removed during distillation to produce pure THC for e-liquids and concentrates, and then added back in for taste and smell.

Terpenes, removed from marijuana during distillation, are often added back to e-liquids used for vape cartridges and other products for taste and smell. Photo by Bengoodwin15/Pixabay


Terpenes, removed from marijuana during distillation, are often added back to e-liquids used for vape cartridges and other products for taste and smell. Photo by Bengoodwin15/Pixabay


Dec. 10 -- Natural compounds added to marijuana-derived vaping liquid produce toxic chemicals in the vapor that users inhale, a new lab study reports.

The compounds, known as terpenes, are added into pure THC distillations to dilute the product and provide the vapor with aroma and taste, said senior researcher Robert Strongin, a professor of organic chemistry at Portland State University in Oregon.

Samples of lab-created e-liquids and "dabs" -- waxy pot concentrates -- produced a variety of toxic chemicals when they were heated, Strongin and his colleagues found.

Those chemicals included benzene, a known carcinogen, and an air pollutant called methacrolein, Strongin said. Others included xylenes, toluene, styrene and ethylbenzene.

There's concern that these toxins could harm users, particularly teenagers whose bodies and brains are still developing, Strongin said.

Terpenes are found in the essential oils of some plants, particularly conifers and citrus. They are the compound that "gives cannabis its very distinctive smell," he said, noting that pure THC doesn't have any scent.

Nearly 2,300 Americans have been sickened and 48 have died due to a lung injury that hampers and sometimes completely restricts a person's ability to draw breath, according to the U.S. Centers for Disease Control and Prevention.

The CDC has identified one compound, vitamin E acetate, as a chemical of concern in those cases. It's most often used as a thickening agent in vaping products containing THC, the ingredient in marijuana that causes intoxication.

But some experts have wondered whether terpenes also play a role, said Dr. Mangala Narasimhan, regional director of critical care medicine at Northwell Health in New Hyde Park, N.Y.

"That's what everyone is talking about now, that some of this might be the terpenes being burned at such high temperatures and us not knowing what the side effects are," she said.

The natural terpenes in marijuana are removed during the distillation process used to produce pure THC, Strongin said. Other terpenes are added back in to make sure the product smells like pot.

Manufacturers also use terpenes to thin the pure cannabinoids that are being distilled from marijuana plants, he added.

"THC and CBD are very, very viscous. It's really hard to use pure versions of those," Strongin said. "They're almost solid, very sticky and gummy and oily. Terpenes are more liquid, and adding them makes the cannabinoids more tractable and easier to manage."

To test whether terpenes would produce toxins when heated, the researchers created e-liquids and dabs containing 90 percent THC and 10 percent terpenes.

They then heated or burned their creations and captured the vapor for analysis.

Narasimhan said additives like terpenes are of particular concern because they have been linked to lung injuries.

Another organic compound called diacetyl is used to create a buttery taste. More than a decade ago, it was found to cause lung damage in popcorn factory workers who breathed in the chemical, Narasimhan said.

Her hospital has seen at least 40 cases of patients with vaping-related lung injury, and the vast majority were users of off-label THC e-liquids.

Narasimhan warns against using off-label vaping products.

"The off-label stuff can be mixed with anything," she said. "We have no idea what it's mixed with, and we have no idea what happens to the mixture at these high temperatures."

The new study was recently published in the journal ACS Omega.

Now, as to this.....please note, do you see a temperature anywhere in this article. Like, at what temp did they drive it to get these compounds formed by pyrolysis??

Just another breathless fucking headline with no real meat to evaluate, I think.
 
VAPI anniversary: Killer chemicals still on the streets

The Oregon Liquor Control Commission (which oversees cannabis) is moving to ban additives like artificial ‘grape ape’ flavor in legal THC vapes. The action comes this month after a report found that 23 state residents got sick and two died of vaping associated pulmonary injury (VAPI) between June and December of 2019.

Oregon’s move comes as a reminder that one year after the first reports of VAPI, the issue of tainted vapes has not gone away. A wide variety of chemical cutting agents may contaminate vape cartridges. The overwhelming majority of them are in the illicit market, where’s there’s no testing. However, confirmed tainted vapes have popped up in legal states Michigan, and Oregon.

Some Oregon THC vapers have been inhaling not only flavoring but what amounts to burnt olive oil—a substance called “squalene” that can cause lipid pneumonia. Evidence of squalene turned up in four independent lab reports, which were published at the OLCC’s technical expert advisory meeting on July 27.

Scientists at the FDA Forensic Chemical Center found squalene—which can also be derived from shark liver oil—in at least one legal cannabis product. The Centers for Disease Control tested another seven legal cannabis items associated with VAPI cases, and detected squalene in all seven.

By contrast, New York’s illicit market THC vapers last year were inhaling not one but two toxic oils—vitamin E acetate and squalene—according to lab reports presented at the OLCC meeting.

kyle-degraw-vape-carts-honeycut-2.jpg

A hospitalized VAPI patient holds used vape cartridges obtained from the illicit market. (Courtesy Kyle DeGraw)

VAPI-Lungs-Before-and-After-Treatment-courtesy-U-Utah.png

Sickened lungs show up as cloudy on the left x-ray, and clear after treatment of one suspected VAPI patient in Utah. (Courtesy University of Utah)

The list of adulterants in the Oregon market didn’t stop at squalene. By vaping artificial flavorings, THC vapers may have been inhaling “a plethora of dangerous compounds” not listed on the label, experts told the OLCC. Oregon labs ChemHistory and CannaSafe tested five popular artificial flavorings and found undisclosed safety hazards in all of them: vitamin E acetate and vitamin E, but also MCT oil (coconut oil), squalene, and bisabolene.

The new Oregon rule would prohibit any “inhalable cannabinoid product” from containing non-cannabis-derived substances, including flavors, non-cannabis terpenes, and/or chemicals that alter a legal THC product’s “consistency, texture, or viscosity.”

The non-cannabis ingredient ban seems likely to pass later this month.

VAPI/EVALI epidemic explained
From 2019 through this year, Leafly has investigated the decade-old, simmering issue of contaminated vapes. That controversy finally boiled over in August 2019, turning into a national mass injury series—not an ‘epidemic’— that killed 68 people and sickened 2,803 others.

Leafly found negligent vape-additive sellers who diverted a variety of cosmetics and dietary supplement ingredients into the nation’s mostly illicit THC vape supply chain.

Our news team called industry experts, then went out and purchased, and tested suspected vape carts, and additives. Our labs identified vitamin E acetate as the lead culprit among a gang of toxins injuring American lungs. Those toxins still exist in the street’s THC vape supply, albeit at lower potencies than in 2020.

Safe to eat, not to huff
Last summer’s VAPI outbreak was caused largely by illicit vape cart manufacturers looking to lower costs and increase profits by using thinning agents that actually “thickened” the look of the cartridge oil—deceiving consumers into believing the carts contained more THC than they actually did.

But thickeners weren’t the only contaminants. Some cartridges contained artificial flavorings that mimicked the aroma molecules of cannabis, which are called terpenes. These fake terpenes often promise tastes like fruity pebbles, bubble gum, or grape.

While flavors are generally recognized as safe (GRAS) for eating, it’s “false and misleading” to suggest they’re safe to inhale, according to a July 24, 2020, statement by the Flavor and Extract Makers Association.

False-and-misleading-to-suggest-vape-flavor-safety-FEMA-2020.jpg

Flavor makers told Oregon that people shouldn’t smoke bubble gum flavor unless it’s proven safe.

For one, food flavors haven’t been tested on human lungs. They might contain impurities that are safe to eat, but not heat and huff—like squalene.

“We’re concerned that squalene is being detected and these other ingredients are being detected. We’re concerned about third-party terpene sellers who obfuscate and hide harmful ingredients,” OLCC Marijuana Program Policy Analyst Anthony Geltosky told Leafly. “Oregon licensees don’t know what’s in third-party terpenes.”

What is squalene? And why is it in a legal Oregon vape?
Squalene is essentially a skin cream ingredient being misused to cut vape flavors or raw THC oil.

Squalene can also be extracted from olive oil, which allows third-party producers to label the oil “botanically derived.”

The manufacturer’s safety data sheet for squalene includes a warning not to breathe it. The same data sheet advises anyone nearby to wear a respirator if it’s on fire. So think about what’s happening inside a vape pen that heats the oil up to several hundred degrees.

Squalene is associated with exogenous lipoid pneumonia—one of the many indicators of VAPI.

Terpene sellers were coy
ChemHistory Technical Director Patrick Trujillo told regulators that terpene makers have been “coy” about exactly what’s in the runny, clear, smelly liquids. Manufacturers claim the chemical makeup of their mixture is “proprietary” and “labs can only guess at what isn’t listed on the label.”

So ChemHistory of Milwaukie, OR, bought five “commercially available products off the internet from sites commonly used by the recreational system,” Trujillo said.

In solutions listed as containing or mimicking the tastes of myrcene, Fruity Pebbles, and geraniol, Trujillo expected to find the “truly nasty stuff”—vitamin E.
Fruity-Pebbles-terps-with-unknowns-in-danger-zone.jpg

A commercial Fruity Pebbles terpene mixture had unknown ingredients in the ‘danger zone,’ ChemHistory and CannaSafe told the OLCC. (OLCC, 2020)

ChemHistory-test-of-commercial-geraniol-yields-problems.jpg

Bad company: Mystery ingredients that look like heavy oil in a commercial geraniol terpene bottle. (OLCC, 2020)

Instead, he found “massive peaks of unknowns” with troubling characteristics. The solutions boiled only at high temperatures. They were heavy molecules that got deep into the lung, and they were in a “risky area” on the gas chromatograph, close to MCT oil, vitamin E, and squalene.

Some manufacturers of popular terpenes like limonene and myrcene may advertise them as 99% pure, but that 1% can have all sorts of other things in it, Trujillo said.

ChemHistory-report-to-OLCC-July-2020-terp-taints.jpg

Commercial terpenes ordered online had stuff in there that wasn’t terpenes and is associated with lung harm. (OLCC, 2020)

Squalene on the West Coast, vitamin E on the East Coast
ChemHistory’s results both align with and add to our understanding of lab results from the New York Department of Health, the FDA’s Forensic Chemistry Center, and findings from the CDC.

We know now that drug dealers who cut cocaine with baby aspirin, or heroin with fentanyl, will cut THC vape oil with beard cream. It’s a way to boost profits at the expense of customer safety.

In New York, state public health sleuths took samples from VAPI victims and tested their disposable vape cartridges. When they found evidence of vitamin E, they “became aware of the internet lore and an on-line cannabis diluent industry, with numerous cannabis oil diluents available for purchase,” their report states.

Then, New York health officials purchased and tested six diluent thickeners from MassTerpenes, Floraplex’s Uber Thick, and Honey Cut. “Three of the products were found to be essentially pure vitamin E acetate,” the July 23, 2020, report states.

NYDOH-report-to-OLCC-July-2020-VEA.jpg

A New York Department of Health slide presented to the OLCC with pictures of suspicious additives. (OLCC, 2020)


Colorless, odorless, impossible to distinguish
“[Vitamin E acetate]-based diluents were touted as tasteless and odorless thickeners that are miscible with cannabis oil in all proportions and produce a desirable cloud on vaping. Upon visual inspection, it is nearly impossible to distinguish between a cartridge containing high-grade cannabis oil and one heavily cut with [Vitamin E acetate],” wrote David Spink, Ph.D., NYDOH Deputy Director of the Division of Environmental Health Sciences.

“Two other products were found to be primarily squalane,” the report states. “Another product is primarily α-bisabolol.”

Lung and chemical experts say this stuff is at least “probably bad,” and potentially “highly toxic.”

Spink’s team found a “strong correlation” between VAPI and the use of at least one cannabis vaporizer cartridge containing vitamin E acetate [VEA]. “The illicit vaporizer fluids associated with VAPI cases can be characterized as heavily cut with diluents, most notably VEA,” they concluded.

Cells-Found-in-Lungs-of-Patients-with-Vaping-Illness-777x635-courtesy-Andrew-Hansen-MD-Jordan-...jpg

Rare, oil-laden immune cells extracted from a VAPI patient in Utah (left). On the right, a normal macrophage. (Courtesy Andrew Hansen, Jordan Valley Medical Center

In some cases the vape injury looks like lipoid pneumonia; in or other cases it can present as a chemical burn.

Lipoid pneumonia can be caused by huffing oil-based substances like mineral oil, squalene, Vaseline, olive oil, sunflower oil, and liquid paraffin, experts state. And vitamin E acetate “has similar chemical and physical properties to compounds such as white mineral oil that are known to cause lipoid pneumonia,” New York reports.

A 2020 FDA study in mice replicated vitamin E vaping lung injury by exposing 30 animals to different aerosols or pure air over two weeks and then examining their lung tissue. The lab study recreated hallmarks of VAPI, like lung liner damage, and immune cells gunked up with oil, called ‘lipid-laden macrophages.’

“It is possible that VEA is causative or contributes to the development of lipoid pneumonia,” Spink concludes. “There is no evidence that vaping large quantities of compounds such as VEA is safe for human health.”

More than vitamin E acetate injuries
The OLCC meeting reports confirm what Leafly published beginning in August of 2019 through February 2020—that vitamin E might be a major culprit, but there are also secondary and tertiary toxins, or their heated byproducts, that can injure the lungs, at lower amounts, in lower levels, over longer periods of time.

All you need is 12 parts per million of the stuff to get a lethal, slow-onset blistering of lung tissue.
Even small amounts of vitamin E can be heated to form “highly toxic” ethenone, according to Oregon Deputy State Epidemiologist Dr. Ali Hamade, and Portland State University Department of Chemistry Professor Dr. Robert Strongin. They told the OLCC that ethenone is similar to chemical warfare agents ketene and phosgene; all you need is 12 parts per million of the stuff to get a lethal, slow-onset blistering of lung tissue.

Ketene is also hard to detect because it’s so reactive.

“You’ll never find it in [lung fluid], it reacts with the first thing it sees,” Strongin said.

“Ketene is terrible stuff,” and it’s “very plausible” ketene has injured unsuspecting vapers, he said.

Strongin-report-to-OLCC-July-2020-on-Ketene.jpg

Vaping vitamin E could catalyze the equivalent of mustard gas—melting the user’s lung tissue over hours and days. (OLCC, 2020)

The naughty list is long
Also on the naughty list: the whole class of heavy, oily cutting agents—MCT oil, pine rosin, the variations are endless. They’re all used to secretly dilute raw THC oil or a terpene mix.

The legal cannabis industry, and traditional cannabis culture, have generally resisted using non-cannabis ingredients in cannabis products, especially inhaled ones, PSU chemistry professor Strongin told the OLCC. Rather, e-cigarette makers championed the diversion of food flavors and cosmetics made for the stomach and skin into millions of human lungs.

“The last thing I want to do is hurt anybody’s industry or company,” Strongin said. However, “there are probably 10,000 products for different flavors or mixtures of the same chemical. Wouldn’t you think that the odds are that eventually, somebody is going to create some formulation that is going to make people really sick since the inhalation toxicity is not known? It was a matter of time.”

By contrast, “cannabis has been smoked for thousands of years–but there were no known instances of EVALI until relatively very recently. Why?” Strongin said.

Notorious-tainted-street-brand-Dank-Vapes-comes-in-many-flavors.jpg

Poisonous illicit vape cart brand Dank Vapes comes in many flavors, thanks to commercial terpene sellers. (David Downs/Leafly)

What took the OLCC so long?
OLCC Director of Analytics & Research TJ Sheehy told Leafly that Oregon is moving as fast as it scientifically can to clamp down on unlisted toxins. In 2019, when the OLCC implemented an emergency ban, vape flavor sellers challenged the move in court and won an injunction halting the ban.

Federal cannabis prohibition also slowed the process, Sheehy said. Because it’s so legally problematic to handle cannabis, too few labs are set up to study cannabis vaping, novel additives, aerosol generation, lung deposition, and pyrolytic byproducts—especially highly volatile ones like ketene. “I think everything waterfalls off of that main problem,” Sheehy said.

In response, the OLCC hopes to beef up in-state lab capabilities to better scout for the next vitamin E or squalene.

Killer still on the lose
The CDC stopped tracking VAPI deaths in February as the coronavirus epidemic eclipsed the issue. But sporadic vape injuries continue to be reported this summer.

Up until Monday, anyone with a credit card and a physical address could import up to $800 of vitamin E acetate cutting agent, and counterfeit vape brand packaging from an overseas seller, and pay no tax, with minimal documentation, the Wall Street Journal reported Aug. 3. If you ordered by Sunday, you could be selling toxic counterfeit vapes on social media by mid-month.

Shop-Legal.-Counterfeits-being-sold-in-LA-in-July.jpg

Shop licensed: Counterfeit, empty vape cartridges mimic most major, legitimate brands. Leafly obtained this advertisement from a Los Angeles area seller in July 2020. (David Downs/Leafly)

Leafly still gets weekly text message pictures of counterfeit packaging for sale in downtown L.A.—any of it could fool a consumer.

“The nature of the problem is not one that goes away on its own,” Sheehy said. “It really is whack-a-mole. Once vitamin E is named and shamed it goes to something else.

What is a consumer to do?
Toxic adulterants can be avoided if consumers follow a few rules of thumb.

Avoid illicit THC vapes entirely. Online counterfeits of popular brands are rampant, so just because it looks like a Rove and your buddy says he got it from a cousin who got it in a legal state does not mean it actually is one. Shop only in legal stores with posted license numbers verified by the state.

Buy legal vapes that contain only cannabis ingredients. Watch out for questionable, vague ingredients like: “natural flavors” or “botanically derived terpenes.” Derived from what? By whom? When? Sold by whom? At what purity?

Vapes are just a small fraction of legal cannabis options. Fast-acting alternatives can include vaping regular cannabis flowers in a device like a Pax 3, just smoking flowers in a joint or pipe, or extracts like bubble hash or rosin, as well edibles, drinks, topicals, tinctures, transdermals and more.
 
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Most Legal Marijuana States Had Fewer Vaping-Related Lung Injuries, Study Finds

States that have enacted marijuana legalization were generally less likely to see spikes in vaping-related lung injuries that occurred over the past year compared to states where cannabis remains prohibited, according to a new study.

The paper, published Tuesday in the journal Addiction, seems to bolster arguments from reform advocates that legalizing and regulating marijuana mitigates the risk to consumers of using contaminated and potentially dangerous products.

The study also concluded that apart from state policies, “neither higher adult vaping rates nor higher rates of recent cannabis use predicted increased” e-cigarette or vaping product use-associated lung injury, or EVALI.

“If e-cigarette or marijuana use per se drove this outbreak, areas with more engagement in those behaviors should show a higher EVALI prevalence,” Abigail Friedman, the study’s author and an associate professor at the Yale School of Public Health, said in a press release. “This study finds the opposite result.”

In fact, some of the earliest adopters of adult-use cannabis legalization ranked among the lowest in terms of reported lung injuries from the outbreak, with fewer than one in 100,000 cases for residents aged 12 to 64.

The average state prevalence for these lung injuries was 1.4 cases per 100,000 residents in that age group.

By contrast, none of the states with the highest rate of cases have recreational marijuana markets in place.

“A negative relationship between EVALI prevalence and rates of pre-outbreak vaping and marijuana use suggests that well-established markets may have crowded-out use of riskier, informally sourced e-liquids,” the press release on the study says. “Indeed, the five earliest states to legalize recreational marijuana—Alaska, California, Colorado, Oregon and Washington—all had less than one EVALI case per 100,000 residents aged 12 to 64. None of the highest EVALI-prevalence states—Utah, North Dakota, Minnesota, Delaware and Indiana—allowed recreational marijuana use.”

“Only one of the ten states where recreational cannabis use was legal prior to 2020 is in the top quintile (Massachusetts), with several such states in the lowest quintile (Nevada, Washington, Colorado, and Alaska).”
A ban on smokeable cannabis products in two of the states with the most cases that only allow medical marijuana could also have contributed to the lung injuries by leaving consumers with options only available in the illicit, unregulated market.

“If such policies induced people who previously smoked cannabis to switch to vaping THC e-liquids (e.g., to evade detection of illicit use), that behavior change could have increased effected states’ EVALI incidence when contaminated e-liquids entered their markets,” the study says.

Friedman, the new paper’s author, elaborated in an email to Marijuana Moment.

“Medical and recreational marijuana policies’ implications for public health are likely to depend, not simply on whether a policy is present or not, but on how the policy is structured,” she wrote. “Policymakers need to pay careful attention to marijuana policy attributes: which types of cannabis products are and are not allowed; how product safety will be assessed and ensured; licensing and enforcement mechanisms; etc.”

“These regulatory details are critical, and may affect both the licit and illicit markets for cannabinoids,” she said.

All told, the Centers for Disease Control and Prevention has identified more than 2,800 cases and 68 deaths related to contaminated vape products. The agency has identified vitamin E acetate added to illicit market cartridges as being “strongly linked” to the spate of vaping-related lung injuries.

“These findings are consistent with evidence linking the EVALI outbreak to vitamin E acetate and informally purchased or modified THC e-liquids, as opposed to use of well-established nicotine e-cigarettes,” the study states. “Specifically, if a nationally marketed and commonly used vaping product caused these illnesses, one would expect a positive relationship between vaping rates and the disease.”

“Absent this association, geographically distinct clusters of elevated EVALI prevalence are more consistent with a dangerous additive in regionally distributed e-liquids (e.g., those purchased off the street). Indeed, this mechanism might explain the negative association with states’ rates of vaping and cannabis use if a strong market for legal nicotine e-liquids or cannabis crowds out black-market products.”

A separate study published in April similarly found that people in states where recreational marijuana is legal were significantly less likely to experience vaping-related lung injuriesthan those in states where cannabis is still banned.

The conflict between state and federal marijuana laws actually inhibited research into how to address EVALI cases, complicating shipments of vaping specimens, a top CDC official said late last year.
 
THE VAPING CRISIS ONE YEAR LATER
Scientists identify synthetic cannabinoid adulterants in CBD vape oil cartridges, warn of "devastating toxicological consequences."

It wasn’t so long ago that a frightening new lung disease linked to vaping dominated the news cycle. Although it might feel like a distant episode to Americans overwhelmed by COVID-19, during the summer of 2019 the vaping crisis became a national obsession. The Centers for Disease Control (CDC) issued an alarming report that attributed a sudden outbreak of deaths and pulmonary injuries to the consumption of harmful e-cigarettes and cannabis vape pen cartridges.

By February 2020, sixty-eight people in the United States, including teenagers and seniors, had died because of this mysterious respiratory illness and nearly 3000 were hospitalized with problems ranging from shortness of breath to severe nausea and coughing up blood. The CDCidentified vitamin E acetate, a thickening agent added to poor quality cannabis oil extracts, as the likely culprit in cases of respiratory failure linked to vaping.

But the CDC stopped tracking vaping-related incidents shortly after the onset of the COVID-19 pandemic. Medical scientists turned their attention to the highly infectious coronavirus, which also kills by damaging the lungs – and does so in ways that aren’t easy to distinguish from the telltale signs of vaping.

COVID-19 and EVALI (the CDC’s acronym for e-cigarette or vaping-related lung injuries) have similar symptoms and share a common lethal mechanism. Severe cases of both diseases involve acute respiratory distress triggered by an immune system gone haywire. Medical scientists refer to this potentially fatal immune syndrome as a “cytokine storm.”

VITAMIN E ACETATE
We know that a voracious coronavirus can induce a cytokine storm. But what do we actually know about vitamin E acetate and vaping?

According to the CDC: “Vitamin E acetate is strongly linked to the EVALI outbreak. Vitamin E acetate has been found in [vape] product samples tested by FDA and state laboratories and in patients’ lung fluid samples tested by CDC from geographically diverse states.”

The CDC stopped tracking vaping-related incidents shortly after the onset of the COVID-19 pandemic.

EVALI patients have been diagnosed with lipid pneumonia, a rare inflammatory condition that occurs when fat or oil enters the alveolar sacs of the lungs. This causes symptoms similar to other kinds of pneumonia, which is usually triggered by a bacterial, fungal or viral infection.

In a 2020 mouse study, vitamin E acetate appeared to replicate the lipid-associated lung damage of EVALI, lending support to the CDC’s contention that vitamin E acetate is a causative factor in vaping-related lung disease. Investigative reporting by Leafly also zeroed in on vitamin E acetate “among a gang of toxins” identified in illicit vape cartridges, including squalene, a skin cream ingredient, that shouldn’t be inhaled.

But a commentary in the New England Journal of Medicine, coauthored by a team of Mayo Clinic physicians, cast aspersions on the vitamin E acetate hypothesis, noting that the pathology of vaping-associated lung illness “is poorly understood” and that “few reports of vaping-associated lung injury have included histopathological findings.” A histopathological diagnosis is based on direct examination of diseased tissue or cells under a microscope.

Upon inspection, some cases of vaping-associated lung injury look more like a chemical burn than lipid suffocation – which suggests that additives other than vitamin E acetate are responsible for damaging lung tissue. Accordingly, another group of doctors advised in a letter to the Journal of American Medicine that the presence of lipid-laden immune cells in the lungs “should be interpreted with caution because it may merely be a marker of exposure rather than a marker of toxicity.”

VAPE OIL ADDITIVES
Project CBD has been beating the drum about potential hazards of vape oil additives for several years. Thinning agents, such as propylene glycol and polyethylene glycol, and all manner of flavoring additives (staples of the ultra-processed food industry) are approved by the Food and Drug Administration (FDA) as safe for oral consumption. But many of these FDA-authorized texturizing agents and artificial flavors are poisonous when heated and inhaled.

Many FDA-approved artificial flavors and texturizing agents are poisonous when heated and inhaled.

A 2018 study by scientists at the University of Rochester found that exposure to commonly used vape oil and e-cigarette flavoring agents is toxic to white blood cells. Among the worst offenders is diacetyl, a chemical added to e-cigarette and vape oil cartridges to simulate a creamy, buttery or vanilla-like flavor. Inhaling this chemical is known to cause “popcorn lung,” a crippling and sometimes fatal respiratory illness.

A report by Yale University researchers showed that combining chemical flavoring agents is more dangerous than exposure to a single additive. All bets are off when you also add thinning and thickening agents, like propylene glycol and vitamin E acetate, into the mix. It’s not known to what extent these sketchy chemical cocktails contributed to last year’s EVALI outbreak – or if they are a factor in sporadic cases of vaping-related lung injury that continue in the COVID-19 era with little comment from the CDC.

In Under the Radar: Synthetic Cannabinoids and Vaping Related Lung Injuries, a special report published in November 2019, Project CBD drew attention to another group of dangerous compounds that have been overlooked by the CDC. An extensive literature review by Adrian Devitt-Lee, Project CBD’s chief science writer, found several examples of case reports that involved exposure to “synthetic cannabinoids,” a class of difficult-to-detect and potentially lethal research-turned-street compounds, which wreak havoc by disrupting the endocannabinoid system. All of these case reports showed a consistent set of symptoms (ground glass opacities, ruptured blood vessels, oxygen deprivation as lungs fill with fluid, etc.) that align with the CDC’s diagnostic criteria for vaping-related pulmonary disease.

SYNTHETIC CANNABINOIDS
A recent study by University of Mississippi scientists in the Journal of Dietary Supplements confirmed the presence of synthetic cannabinoid adulterants in illicit vape oil cartridges. The Mississippi investigators analyzed the content of 25 commercially available hemp-derived vape oil products. Of these, thirteen products contained less than 50 percent of the amount of cannabidiol (CBD) that was indicated on the label; only 3 products contained within 20 percent (plus or minus) of the CBD content claimed on the label; and 3 “CBD” products had no measurable cannabidiol whatsoever.

University of Mississippi scientists confirmed the presence of synthetic cannabinoid adulterants in illicit vape oil cartridges.

“From the consumer’s perspective,” the authors noted, “over-labeling not only misrepresents the product but also signifies fraudulent business practices.” Even more disconcerting “was the frequency with which CBD vaping products were adulterated with synthetic cannabinoids.” Four out of 25 randomly selected CBD vape products sold in the Magnolia State contained synthetic cannabinoids that pose “a serious risk for adverse health effects” with “devastating toxicological consequences,” according to the University of Mississippi researchers.

It’s uncertain whether this small study is emblematic of the prevalence of synthetic cannabinoid adulterants within the sprawling, unregulated, international vape market. But this much is clear: synthetic cannabinoids warrant careful scrutiny when considering the multiple factors that may contribute to vaping-related lung injuries and how best to respond to this ongoing public health issue.

If synthetic cannabinoids are indeed a missing piece of the EVALI puzzle, as Project CBD proposed last year, then why does vitamin E acetate keep popping up as “a marker of exposure rather than a marker of toxicity” in vape oil cartridges? Because it’s cheaper for bad actors who make fake cannabis oil to start with a thinning agent like propylene glycol, spike it with a tiny dose of a super-potent synthetic cannabinoid, and then add a glop of vitamin E acetate to thicken the liquid so it has the right consistency for a vape pen.

UNREGULATED MARKETS
Vaping is a convenient, discreet, fast-acting, and easy-to-titrate method of consuming cannabis. Fortunately there are good quality vape options for consumers who live in states where cannabis is legal for adult use. But the pickings are slimmer and riskier in “CBD-only” states, where whole plant cannabis oil extracts are not yet available through regulated channels.

Vitamin E acetate is seemingly everywhere because poor quality vape products proliferate in the unregulated CBD and cannabis oil market. In addition to vitamin E acetate, illicit CBD vape cartridges typically include a CBD isolate dissolved in a carrier oil (usually MCT, glycerin or propylene glycol) that’s not safe to heat and inhale. Such products are just a mouse click away and can be purchased at gas stations, head shops, and other storefronts that also sell nicotine e-cigarettes, which are laced with many of the same flavoring and texturizing additives found in unlicensed CBD and cannabis oil blends.

Cannabis has been smoked for centuries without causing the freakish and sometimes fatal symptoms linked to toxic vape oil exposure. According to a recent Yale University School of Public Health study, vaping-related lung disease is much less prevalent in states that have legalized cannabis. Consumers in the five states with the highest per capita incidence of EVALI do not have access to regulated, lab-certified vape oil products made by state-licensed manufacturers.

The bottom line: the existence of a legal, regulated cannabis market, warts and all, reduces the use of dangerous vape oil cartridges.

FOOTNOTES
  1. Centers for Disease Control and Prevention, “Sounding the Alarm: The Public Health Threat of E-Cigarettes,” Sept. 25, 20019
  2. Centers for Disease Control and Prevention, “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products,” Feb. 25, 2020.
  3. Centers for Disease Control and Prevention, “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products,” Feb. 25, 2020.
  4. David Downs, “VAPI anniversary: Killer chemicals still on the streets,” Leafly, Aug. 4, 2020.
  5. Yasmeen M Butt, MD, et al, “Pathology of Vaping-Associated Lung Injury,” New England Journal of Medicine, Oct. 31, 2019.
  6. Kulothungan Gunasekaran, et al “Lipid-Laden Macrophages in Cannabinoid Oil Vaping Associated Lung Injury,” Letter to the editor, The American Journal of Medicine, https://doi.org/10.1016/j.amjmed.2019.11.025
  7. Muthumalage, Thivanka, et al. “Inflammatory and Oxidative Responses Induced by Exposure to Commonly Used e-Cigarette Flavoring Chemicals and Flavored e-Liquids without Nicotine.” Frontiers in Physiology, 11 Jan. 2018, www.frontiersin.org/articles/10.3389/fphys.2017.01130/full.
  8. Eythropel, Hanno C, et al. “Formation of Flavorant–Propylene Glycol Adducts With Novel Toxicological Properties in Chemically Unstable E-Cigarette Liquids.” Nicotine and Tobacco Research. 2019 Aug 19;21(9):1248-1258. doi: 10.1093/ntr/nty192.
  9. Adrian Devitt-Lee, “Under the Radar: Synthetic Cannabinoids and Vaping Related Lung Injuries,” published online Nov. 11, 2019, https://www.projectcbd.org/reports/synthetic-cannabinoids/intro.
  10. Bill J. Gurley, et al, “Content versus Label Claims in Cannabidiol (CBD)-Containing Products Obtained from Commercial Outlets in the State of Mississippi,” Journal of Dietary Supplements, published online 20 May 2020, https://doi.org/10.1080/19390211.1766643.
  11. Colin Poitras, Yale School of Medicine, “Rates of E-cigarette and Marijuana Use Not Associated with Larger Outbreaks of Vaping-Related Lung Injuries, YSPH Study Finds, Aug. 25, 2020.
 
I have a couple carts and pods left but I've decided to move on from them. I actually picked up a distillate cart from an MD dispensary about 1.5 weeks ago and it is by far the strongest cartridge I've ever used. We're talking 3 decent but not huge puffs and I'm not really functional for a couple of hours. I'm still going to stick with capsules, tinctures and RSO syringes and I'll just use concentrates in the Sai/Sequoia or on my banger/coil from Shane for breakthrough pain.
 

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