Second-hand smoke generated by combustion and electronic smoking devices used in real scenarios: Ultrafine particle pollution and age-related dose assessment

Evaluation of the Submicron Particles Distribution Between Mountain and Urban Site: Contribution of the Transportation for Defining Environmental and Human Health Issues

Transportation is one of the main causes of atmospheric pollution, especially in downtown big cities. Researchers usually point their attention to gaseous and/or particulate matter pollutants. This paper investigated the role of submicron particles, particularly the fraction ranging between 5–560 nm, in aerosol chemistry for identifying the contribution of autovehicular traffic and investigating the doses deposited in the human respiratory tract. Measurements carried out by two Fast Mobility Particle Sizer (FMPS, TSI) analyzers were simultaneously performed at two different sampling sites (an urban and a mountain site) during workdays and weekends in July. The total particle number (2–2.5 times higher in the urban site), the aerosol size distribution (different modes during the day), and the ultrafine/non-ultrafine particle ratios (ranging between 2–4 times between two sites) were investigated and discussed in relationship to the high autovehicular traffic in Rome and the almost null anthropogenic emissions at the mountain site, as well as the differing contributions of both to the “fresh nucleation” and to “aged aerosol”. Furthermore, the regional cumulative number doses deposited in the human respiratory tract were studied for both sites: The difference between the urban/mountain site was very high (up to 15 fold), confirming the pollutant role of transportation.

Public Facility Utility and Third-Hand Smoking Exposure without First and Second-Hand Smoking According to Urinary Cotinine Level

Third-hand smoke (THS) causes pathological changes in the liver, lungs, and skin. THS exposure can be ubiquitous, chronic, and unconscious. However, little is known about THS exposure in public facilities and its susceptible population. This paper aimed to identify which public facilities and socio-demographic groups were especially vulnerable to THS. Data from 1360 adults obtained from Korean National Environmental Health Survey I (2009–2011) were analyzed. To study the sole effect of THS, we restricted the study population to those participants who had never smoked and who had no exposure to second-hand smoke. The assessed variables included the type and frequency of public transportation, frequency of use of 12 different public facilities, and 8 socio-demographic factors. Urinary cotinine was used as a biomarker. T-tests and analysis of variance were used for univariate analyses, while generalized linear regression was used for multivariate analysis. Frequent use of public transportation, bars, internet cafés, and participants with low levels of education, divorced or bereaved, living in multi-unit houses, and with smokers within the family were associated with significantly high urinary cotinine levels. These findings indicate that the frequent use of public transportation, certain public facilities and certain socio-demographic factors can result in high THS exposure.

Evidences of copper nanoparticle exposure in indoor environments: Long-term assessment, high-resolution field emission scanning electron microscopy evaluation, in silico respiratory dosimetry study and possible health implications

A variety of appliances operated by brush electric motors, widely used in indoor environments, emit nanoparticles (NPs). Due to electric arc discharge during the operation of such motors, some NPs contain copper (Cu). Their dimensions are the same of those found in brain tissue samples by other authors who speculated their possible translocation to brain through olfactory bulb. Cu has been reported to play an important role in the etiopathogenesis of Alzheimer's disease. Thus, the present study was performed to 1. estimate by means of Multiple-Path Particle Dosimetry model the doses of NPs released by electric appliances that can potentially deposit on the olfactory bulb; 2. investigate the morphology and the composition of particles emitted by some electric appliances daily used in indoor environments; 3. monitor for a long time period the Cu contamination of indoor environments due to this kind of appliances. About 10⁶-10⁷ NPs deposit on the olfactory bulb during the operation (1.5-6 min) of such appliances, with a major contribution due to 10-20 nm NPs. HR-FESEM characterization confirmed the presence of such NPs, that were observed both as individual particles (20-40 nm) and aggregated to form particles in the μm sizes range. XEDS microanalysis revealed the presence of Cu together with other elements. Relevant daily contamination of indoor environments due to these appliances has been confirmed by monitoring throughout a year the Cu content of PM₁₀ samples collected both indoor and outdoor private dwellings. Cu was present in great part as an insoluble form. This means that, following protracted exposure, Cu NPs of such origin may undergo tissue accumulation. This is cause of concern because general population is chronically exposed to such Cu nanoparticles in indoor environments and in view of the role assigned to Cu in the development of neurological disorders.

Environmental tobacco smoke exposure among electronic cigarette users

INTRODUCTION

Exposure to environmental tobacco smoke (ETS) from combustible tobacco products causes various diseases and makes quitting smoking more difficult. However, little is known about exposure of e-cigarette users to ETS from combustible tobacco products. This study aimed to investigate e-cigarette users' exposure to ETS from tobacco smokers.

METHODS

The association between ETS exposure frequency and different types of smokers including e-cigarette users was examined using ordered logistic regression analysis and nationally representative survey data on 28,765 individuals who were interviewed in the Canadian Tobacco, Alcohol and Drugs Surveys conducted during 2013 and 2015. Survey respondents were classified into one of five smoker types: smokers of tobacco only, dual users of tobacco and e-cigarettes, users of e-cigarette only, former smokers and never smokers. The analyses were conducted using the entire sample and by age group.

RESULTS

Young to mid-age (15-54) dual users of both regular cigarettes and e-cigarettes have higher ETS exposure than even tobacco smokers. Young to mid-age single users of e-cigarettes are less exposed to ETS than tobacco smokers, but still have higher ETS than never smokers. At older age (55+), both dual and single e-cigarette users face similar risks of ETS exposure as tobacco smokers.

CONCLUSIONS

E-cigarette users are at high risk of ETS exposure. Policies that target the behaviour of e-cigarette users as well as the environments surrounding them to address their high ETS exposure risk would be beneficial.

Cigarette smoke induces ROS mediated autophagy impairment in human corneal epithelial cells

Cigarette smoke is an important indoor air pollutant which has deleterious effects on human health. Continued daily exposure to cigarette smoke has been attributed to the risk factor of ocular surface diseases. However, the mechanisms underlying the ocular surface damage are not fully elucidated. In this study, exposure to cigarette smoke extract (CSE) induced a dose- and time-dependent cytotoxicity in human corneal epithelial (HCE) cells, supported by the observation of reduced cell viability, increased apoptotic cells, elevated intracellular oxidative stress and loss of mitochondrial transmembrane potential. In addition, CSE exposure led to the impairment of proteostasis and autophagy, which resulted in the accumulation of ubiquitinated proteins as aggregates in peri-nuclear spaces. Furthermore, the autophagy inducer, cysteamine was shown to attenuate the CSE induced cell damage, oxidative stress and mitochondrial dysfunction in HCE cells. Moreover, cysteamine inhibited the formation of ubiquitin-positive aggregates around the peri-nuclear region, through regulating the autophagic activity of HCE cells. Similar to in vitro experiments, cigarette smoke induced proteostasis and autophagy impairment in corneal epithelial cells could be rescued by cysteamine in a cigarette smoke-exposed murine model. Therefore, this study may provide first evidence that dysfunction of autophagy contributes to the pathogenesis of ocular surface diseases associated with cigarette smoke exposure. Besides, it also suggests the potential therapeutic value of cysteamine in the prevention and treatment of cigarette smoke induced ocular surface injury. CSE induces cytotoxicity and accumulation of ubiquitinated proteins in HCE cells due to impairment of proteostasis and autophagy, which can be rescued by cysteamine.

Particulate Matter Emissions of Four Different Cigarette Types of One Popular Brand: Influence of Tobacco Strength and Additives

The inhalation of particulate matter (PM) in second-hand smoke (SHS) is hazardous to health of smokers and non-smokers. Tobacco strength (amount of tar, nicotine, and carbon monoxide) and different additives might have an effect on the amount of PM. This study aimed to investigate the influence of tobacco strength or additives on PM. Four cigarette types of the brand Marlboro with different strengths and with or without additives were analyzed in comparison to the 3R4F reference cigarette. SHS was generated by an automatic environmental tobacco smoke emitter (AETSE) in an enclosed space with a volume of 2.88 m³. PM concentrations (PM10, PM2.5, PM₁) were measured with a laser aerosol spectrometer followed by statistical analysis. The two strongest Marlboro brands (Red and Red without additives) showed the highest PM concentrations of all tested cigarettes. The measured mean concentrations Cmean of PM10 increased up to 1458 µg/m³ for the Marlboro Red without additives (PM2.5: 1452 µg/m³, PM₁: 1263 µg/m³). The similarly strong Marlboro Red showed very similar PM values. The second strongest type Marlboro Gold showed 36% (PM10, PM2.5) and 32% (PM₁) lower values, respectively. The "lightest" type Marlboro Silver Blue showed 54% (PM10, PM2.5) or 50% (PM₁) lower PM values. The results indicate that the lower the tar, nicotine, and carbon monoxide amounts, as well as the longer the cigarette filter, the lower are the PM levels. An influence of additives could not be determined.

[Systematic analysis of the scientific literature on heated tobacco]

INTRODUCTION

The tobacco industry (TI) reports that heated tobacco reduces risk of tobacco use and will replace cigarettes. An analysis of the scientific literature was conducted in order to enlighten professionals and decision-makers.

METHOD

After a Medline query in February 2018, a systematic analysis was conducted.

RESULTS

Of the 100 papers published in 2008-2018, 75 have authors affiliated or linked to TI. Emissions contain gases, droplets and solid particles, so are smokes. The main products are: THS2.2 (Iqos®) which heats mini-cigarettes at 340°C, the THP1.0 (Glo®) which heats at 240°C sticks delivering about half as much nicotine, Ploom® which uses reconstituted tobacco microcapsules heated at 180°C. Under the experimental conditions, there is a reduction of toxic emissions and biological effects, but the expected risk reduction is not demonstrated. Symptoms related to passive smoking are described. The 4 epidemiological articles report that heated tobacco is used in 10 to 45% of cases by non-smokers and demonstrate the effectiveness of TI promotion campaigns. Thus, the THS2.2 is more a gateway to smoking (20%) than an exit door (11%); moreover, it is not expected risk reduction among the 69% who are mixed users.

CONCLUSIONS

While reducing emissions is documented, reducing the risk to the smoker who switches to heated-tobacco remains to be demonstrated. On the other hand, the worsening of the global tobacco risk related to the promotion of the products by the TI is anticipated, justifying that the authorities take the appropriate measures to control the promotion of heated tobacco.

The influence of three e-cigarette models on indoor fine and ultrafine particulate matter concentrations under real-world conditions

Electronic cigarette (e-cigarette) use has steadily increased since 2010. Indoor e-cigarette use exposes bystanders to a new source of particulate matter (PM) air pollution. Elevated short-term exposures to PM with a lower measuremented aerodynamic diameter (≤2.5 μm), PM_2.5 and ultrafine particles (UFPs) have been linked to increased risk of adverse respiratory and cardiac events. This exposure study estimated concentrations of PM_2.5 and UFPs from indoor e-cigarette use at 0.5 meters (m) and 1 m away from an e-cigarette user and investigated whether these indoor concentrations varied across three common e-cigarette models. One e-cigarette user tested three different e-cigarettes containing the same nicotine solution on three separate occasions and measured concentrations on PM_2.5 and UFPs at 0.5 and 1 m in a ∼38 m³ office. Continuous measures of PM_2.5 and UFPs were taken for 5.5 min before e-cigarette use, then the user puffed seven times for 6.5 min (exposure), and for 10 min after ceasing e-cigarette use. Following the initiation of e-cigarette use, levels of PM_2.5 increased 160-fold at a distance of 0.5 m, and 103-fold at 1 m. The corresponding increases in UFP counts were 5.2, and 3.0-fold higher, respectively. The PM_2.5 concentrations and UFP counts between e-cigarette models were statistically significantly different at 1 m, but not at 0.5 m. There was substantial variability between distances, e-cigarettes, and replicates. This study indicates that e-cigarette vapors influence PM_2.5 and UFPs concentrations/counts at close proximity distances indoors; additional research is needed to characterize the composition of those particles and evaluate the impacts of other e-cigarette solutions on indoor air quality.

Second-hand aerosol from tobacco and electronic cigarettes: Evaluation of the smoker emission rates and doses and lung cancer risk of passive smokers and vapers

Smoking activities still represent the main, and preventable, cause of lung cancer risk worldwide. For this reason, a number of studies were carried out to deepen and better characterize the emission of cigarette-generated mainstream aerosols in order to perform an a-priori evaluation of the particle doses and related lung cancer risks received by active smokers. On the contrary, a gap of knowledge still exists in evaluating the dose and risk received by passive smokers in indoor private micro-environments (e.g. homes). For this purpose, in the present paper, an experimental campaign was performed to evaluate the exposure to second-hand aerosol from conventional and electronic cigarettes and to estimate the consequent dose received by passive smokers/vapers and the related lung cancer risk. Measurements of exposure levels in terms of particle number, PM10 and black carbon concentrations, as well as particle size distributions, were performed in a naturally ventilated indoor environment during smoking activities of tobacco and electronic cigarettes. The particle emission rates of smokers and vapers, for the different aerosol metrics under investigation, were evaluated. Moreover, for a typical exposure scenario, the dose received by the passive smokers/vapers in a naturally ventilated indoor micro-environment was estimated through a Multiple-Path Particle Dosimetry (MPPD) model able to assess the particle dose received in the different tracts of the respiratory systems. Furthermore, on the basis of scientific literature data about mass fraction of carcinogenic compounds contained in cigarette-emitted particles (i.e. Heavy Metals, Benzo-a-pyrene and nitrosamines) and the estimated doses, the excess life cancer risk (ELCR) for passive smokers/vapers was evaluated. Cumulative respiratory doses for passive smokers were up to 15-fold higher than for passive vapers. The ELCR for second-hand smokers was five orders of magnitude larger than for second-hand vapers.

["Heat not burn" tobacco devices as new tobacco industry products: health risks]

Increased tobacco control measures in recent years have directed the tobacco industry to develop alternative tobacco products, such as "heat not burn" (HnB) tobacco devices that are implied to be less hazardous than conventional cigarettes. There are extensive studies from manufacturers available, which show that the emissions of HnB tobacco devices have significantly lower levels of harmful substances compared to conventional cigarettes. In addition, manufacturers have published studies to investigate whether switching from a conventional tobacco cigarette to the HnB product reduces possible health risks.The purpose of this report is to review current studies by manufacturers and independent institutions as well as to discuss possible reduced health hazards.The German Federal Institute for Risk Assessment (BfR) has carried out its own studies of selected analytes in the emissions of one HnB product confirming the lower levels of harmful substances in the emissions. The results are consistent with data from other independent studies. The nicotine content in the emissions is in the same range as the nicotine emissions of conventional cigarettes, which suggests a comparable addictiveness and dependence potential. Manufacturers have reported mutagenic effects of emissions by HnB tobacco devices that, however, are considerably weaker compared to conventional cigarettes. Nevertheless, the use of the HnB tobacco product remains associated with health risks.Switching from conventional cigarettes to tobacco heaters can significantly reduce the consumer's exposure to harmful substances. However, this article also illustrates that it is still unclear to what extent the reduced levels lead to lowered health risks. Therefore more independent studies, but also long-term studies, are needed.

Environmental Electronic Vape Exposure from Four Different Generations of Electronic Cigarettes: Airborne Particulate Matter Levels

Electronic cigarettes (e-cigs) were introduced into the market in 2006 and their technological features have evolved substantially over time. Currently, there are four different generations of e-cigs that are broadly considered less harmful than the use of combusted tobacco products although passive exposure to aerosols often occurs in public spaces and indoor environments. The study aim was to evaluate the levels of airborne particulate matter (PM) emitted during the use of all the four generations of e-cigs, testing different use modalities. PM₁₀, PM₄, PM_2.5 and PM₁ were measured through a Dusttrak ™ II Aerosol Monitor, for a total of 20 independent experiments. All tested e-cigs devices produced PM during their use, and PM₁₀ was almost made of PM₁ size fraction. In addition, we observed a progressive increase in PM emission from the first to the fourth generation, and an upward trend of PM₁ emitted by the fourth generation e-cig with an increase in the operating power. The results showed that, whatever the model adopted, passive vaping does occur. This finding supports the need for legislative interventions to regulate the e-cigs use in public places and other enclosed environments, in order to protect the health of any subject who is potentially exposed.

The effect of flavor content in e-liquids on e-cigarette emissions of carbonyl compounds

The effect of flavors on carbonyl compound (CC) emission factors (EF) from electronic cigarettes (ECs) vaping was investigated at the default vaping (voltage) setting in all experiments using a total of 21 lab-made e-liquid samples (five different types of retail flavorant bases: beverage/dessert/fruit/mint/tobacco). Each flavorant base was added to a separate unflavored base composed of a 1:1 mixture of propylene glycol/vegetable glycerol (PG/VG) at four levels (5/10/30/50% (v/v)). The e-liquid CC levels increased linearly with flavorant base content, 1.3-10.5 times (R²: 0.762-0.999). The vaping CC EFs increased linearly with flavorant base content (if ≥ 10%) from 1.0 to 92 times (R²: 0.431-0.998). For flavorant base content of 0%, 5%, and 10%, the EFs ranged from undetected to 0.11 μg puff^-1 (acetone). The 40-year cancer risk due to formaldehyde (70 kg EC user inhaling 5% flavorant base content e-liquid: 120 puffs day^-1) is estimated to be 2.0E-06 (highest) compared to 1.0E-06 for the 1:1 PG:VG base. Most formaldehyde vaped from the fruit flavored e-liquid was the flavorant base. The CC concentrations in EC liquids (before vaping) were approximately linear with e-liquid flavorant base content. Retail e-liquid product information labels should be guided to provide a complete list of all ingredients, their concentrations, and carbonyl compound EFs.

Characterization of airborne particles emitted by an electrically heated tobacco smoking system

Smoking activities were recognized as a main risk factor for population. Indeed, mainstream smoke aerosol is directly inhaled by smokers then delivering harmful compounds in the deepest regions of the lung. In order to reduce the potential risk of smoking, different nicotine delivery products have been recently developed. The latest device released is an electrically heated tobacco system (iQOS®, Philip Morris) which is able to warm the tobacco with no combustion. In the present paper a dimensional and volatility characterization of iQOS-generated particles was performed through particle number concentration and distribution measurements in the mainstream aerosol. The experimental analysis was carried out through a condensation particle counter, a fast mobility particle sizer and a thermo-dilution sampling system allowing aerosol samplings at different temperatures. Estimates of the particle surface area dose received by smokers were also carried out on the basis of measured data and typical smoking patterns. The particle number concentrations in the mainstream aerosols resulted lower than 1 × 108 part. cm-3 with particle number distribution modes of about 100 nm. Nonetheless, the volatility analysis showed the high amount of volatile fraction of iQOS-generated particles, indeed, samplings performed at 300 °C confirmed a significant particle shrinking phenomena (modes of about 20 nm). Anyway, the particle number concentration does not statistically decrease at higher sampling temperatures, then showing that a non-volatile fraction is always presents in the emitted particles. The dose received by smokers in terms of non-volatile amount of particle surface area was equal to 1-2 mm2 per puff, i.e. up to 4-fold larger than that received by electronic cigarette vapers.

Assessment of industry data on pulmonary and immunosuppressive effects of IQOS

Introduction

Heated tobacco products are being touted as novel reduced-harm tobacco products by tobacco companies. In the USA, Philip Morris International submitted a modified risk tobacco product (MRTP) application to the US Food and Drug Administration in 2016 in which it purports that its heated tobacco product, I-Quit-Ordinary-Smoking (IQOS), is associated with reduced harm compared with conventional cigarettes.

Methods

We reviewed Philip Morris International’s MRTP application to assess the pulmonary and immune toxicities associated with IQOS use in both animal and human studies.

Results

Among rats exposed to IQOS, there was evidence of pulmonary inflammation and immunomodulation. In human users, there was no evidence of improvement in pulmonary inflammation or pulmonary function in cigarette smokers who were switched to IQOS.

Conclusion

IQOS is associated with significant pulmonary and immunomodulatory toxicities with no detectable differences between conventional cigarette smokers and those who were switched to IQOS in Philip Morris International’s studies. Philip Morris International also failed to consider how dual use and secondhand aerosol exposure may further impact, and likely increase, the harms associated with these products.

Particle-related exposure, dose and lung cancer risk of primary school children in two European countries

Schools represent a critical microenvironment in terms of air quality due to the proximity to outdoor particle sources and the frequent lack of proper ventilation and filtering systems. Moreover, the population exposed in schools (i.e. children) represents a susceptible population due to their age. Air quality-based studies involving students' exposure at schools are still scarce and often limited to mass-based particle metrics and may thus underestimate the possible effect of sub-micron particles and particle toxicity. To this purpose, the present paper aims to evaluate the exposure to different airborne particle metrics (including both sub- and super-micron particles) and attached carcinogenic compounds. Measurements in terms of particle number, lung-deposited surface area, and PM fraction concentrations were measured inside and outside schools in Barcelona (Spain) and Cassino (Italy). Simultaneously, PM samples were collected and chemically analysed to obtain mass fractions of carcinogenic compounds. School time airborne particle doses received by students in classrooms were evaluated as well as their excess lung cancer risk due to a five-year primary school period. Median surface area dose received by students during school time in Barcelona and Cassino resulted equal to 110mm² and 303mm², respectively. The risk related to the five-year primary school period was estimated as about 2.9×10^-5 and 1.4×10^-4 for students of Barcelona and Cassino, respectively. The risk in Barcelona is slightly higher with respect to the maximum tolerable value (10^-5, according to the U.S. Environmental Protection Agency), mainly due to toxic compounds on particles generated from anthropogenic emissions (mainly industry). On the other hand, the excess lung cancer risk in Cassino is cause of concern, being one order of magnitude higher than the above-mentioned threshold value due to the presence of biomass burning heating systems and winter thermal inversion that cause larger doses and great amount of toxic compounds on particles.