Angela Aherrera1, Pablo Olmedo2, Maria Grau-Perez2, Stefan Tanda3, Walter Goessler3, Stephanie Jarmul4, Rui Chen4, Joanna E Cohen5, Ana M Rule4, Ana Navas-Acien6. 1. Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA. Electronic address: aaherre2@jhu.edu. 2. Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA; Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York, NY, USA. 3. Institute of Chemistry Analytical Chemistry, University of Graz, Austria. 4. Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA. 5. Institute for Global Tobacco Control, Johns Hopkins University, Baltimore, MD, USA; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Johns Hopkins University, Baltimore, MD, USA. 6. Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA; Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York, NY, USA; Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
Abstract
BACKGROUND: Nickel (Ni) and chromium (Cr) are components of e-cigarette heating coils. Whether e-cigarettes increase metal internal dose, however, is unknown. We assessed the association of e-cigarette use patterns and of e-liquid and aerosol metal concentrations with Ni and Cr biomarker levels in e-cigarette users from Maryland. METHODS: We recruited 64 e-cigarette users from December 2015 to March 2016. We collected urine, saliva, and exhaled breath condensate (EBC), data on e-cigarette use, and samples from their e-cigarette device (dispenser e-liquid, aerosol, and tank e-liquid). RESULTS: Median Ni and Cr levels were 0.73 and 0.39μg/g creatinine in urine, 2.25 and 1.53μg/L in saliva, and 1.25 and 0.29μg/L in EBC. In adjusted models, tertiles 2 and 3 of aerosol Ni concentrations were associated with 16% and 72% higher urine Ni and 202% and 321% higher saliva Ni compared to the lowest tertile. Tertile 3 of aerosol Cr levels were associated with 193% higher saliva Cr. An earlier time to first vape in the morning and more frequent coil change were associated with higher urine Ni. Tertile 2 of e-liquid consumption per week and voltage were associated with higher saliva Ni levels than tertile 1. CONCLUSION: Positive associations of Ni and Cr aerosol concentrations with corresponding Ni and Cr biomarker levels indicate e-cigarette emissions increase metal internal dose. Increased e-cigarette use and consumption were also associated with higher Ni biomarker levels. Metal level standards are needed to prevent involuntary metal exposure among e-cigarette users.
BACKGROUND:Nickel (Ni) and chromium (Cr) are components of e-cigarette heating coils. Whether e-cigarettes increase metal internal dose, however, is unknown. We assessed the association of e-cigarette use patterns and of e-liquid and aerosol metal concentrations with Ni and Cr biomarker levels in e-cigarette users from Maryland. METHODS: We recruited 64 e-cigarette users from December 2015 to March 2016. We collected urine, saliva, and exhaled breath condensate (EBC), data on e-cigarette use, and samples from their e-cigarette device (dispenser e-liquid, aerosol, and tank e-liquid). RESULTS: Median Ni and Cr levels were 0.73 and 0.39μg/g creatinine in urine, 2.25 and 1.53μg/L in saliva, and 1.25 and 0.29μg/L in EBC. In adjusted models, tertiles 2 and 3 of aerosol Ni concentrations were associated with 16% and 72% higher urine Ni and 202% and 321% higher saliva Ni compared to the lowest tertile. Tertile 3 of aerosol Cr levels were associated with 193% higher saliva Cr. An earlier time to first vape in the morning and more frequent coil change were associated with higher urine Ni. Tertile 2 of e-liquid consumption per week and voltage were associated with higher saliva Ni levels than tertile 1. CONCLUSION: Positive associations of Ni and Cr aerosol concentrations with corresponding Ni and Cr biomarker levels indicate e-cigarette emissions increase metal internal dose. Increased e-cigarette use and consumption were also associated with higher Ni biomarker levels. Metal level standards are needed to prevent involuntarymetal exposure among e-cigarette users.
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