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Batista DR, Coelho LS, Tanni SE, de Godoy I. Metal in biological samples from electronic cigarette users and those exposed to their second-hand aerosol: a narrative review. Front Med (Lausanne) 2024; 11:1349475. [PMID: 38841573 PMCID: PMC11150601 DOI: 10.3389/fmed.2024.1349475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Electronic nicotine delivery systems (ENDS) are gradually becoming more popular, particularly, among today's youth. Despite being marketed as safe by the tobacco industry, the notable absence of regulation in their composition is evident. Both the generated fluids and aerosol exhibit a wide variety of substances that are not yet fully identified. In addition to additives, the aerosol contains metals, the presence of which can be attributed to the excessive heating of metallic filaments used in vaporizing the liquid. Objective This review aimed to identify and describe studies that have assessed metal levels in biological samples obtained from electronic cigarette users and those exposed to their second-hand aerosol. This involved detailing the types and concentrations of metals identified and the biological samples in which the metals were detected. Methods Two independent researchers conducted searches in the MEDLINE and EMBASE databases to identify studies that measured the metal levels in human non-invasive biological samples from electronic cigarette users and second-hand exposure. Data were presented as a narrative review. Results In total, 18 articles were included in this review. Overall active and passive exposure to ENDS was related to higher levels of many metals, including lead and cadmium, in biological samples. ENDS users, in general, have lower metal concentrations in biological samples compared to the users of combustible cigarettes. Conclusion The exposure to primary and second-hand e-cigarette aerosol is related to higher metal concentrations in the biological samples. The adverse effects of this exposure on long-term users are yet to be determined.
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Affiliation(s)
- Diane Rezende Batista
- São Paulo State University (Unesp), Medical School, Botucatu, Department of Internal Medicine, Pulmonology Division, São Paulo, Brazil
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2
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Budden KF, Shukla SD, Bowerman KL, Vaughan A, Gellatly SL, Wood DLA, Lachner N, Idrees S, Rehman SF, Faiz A, Patel VK, Donovan C, Alemao CA, Shen S, Amorim N, Majumder R, Vanka KS, Mason J, Haw TJ, Tillet B, Fricker M, Keely S, Hansbro N, Belz GT, Horvat J, Ashhurst T, van Vreden C, McGuire H, Fazekas de St Groth B, King NJC, Crossett B, Cordwell SJ, Bonaguro L, Schultze JL, Hamilton-Williams EE, Mann E, Forster SC, Cooper MA, Segal LN, Chotirmall SH, Collins P, Bowman R, Fong KM, Yang IA, Wark PAB, Dennis PG, Hugenholtz P, Hansbro PM. Faecal microbial transfer and complex carbohydrates mediate protection against COPD. Gut 2024; 73:751-769. [PMID: 38331563 DOI: 10.1136/gutjnl-2023-330521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Chronic obstructive pulmonary disease (COPD) is a major cause of global illness and death, most commonly caused by cigarette smoke. The mechanisms of pathogenesis remain poorly understood, limiting the development of effective therapies. The gastrointestinal microbiome has been implicated in chronic lung diseases via the gut-lung axis, but its role is unclear. DESIGN Using an in vivo mouse model of cigarette smoke (CS)-induced COPD and faecal microbial transfer (FMT), we characterised the faecal microbiota using metagenomics, proteomics and metabolomics. Findings were correlated with airway and systemic inflammation, lung and gut histopathology and lung function. Complex carbohydrates were assessed in mice using a high resistant starch diet, and in 16 patients with COPD using a randomised, double-blind, placebo-controlled pilot study of inulin supplementation. RESULTS FMT alleviated hallmark features of COPD (inflammation, alveolar destruction, impaired lung function), gastrointestinal pathology and systemic immune changes. Protective effects were additive to smoking cessation, and transfer of CS-associated microbiota after antibiotic-induced microbiome depletion was sufficient to increase lung inflammation while suppressing colonic immunity in the absence of CS exposure. Disease features correlated with the relative abundance of Muribaculaceae, Desulfovibrionaceae and Lachnospiraceae family members. Proteomics and metabolomics identified downregulation of glucose and starch metabolism in CS-associated microbiota, and supplementation of mice or human patients with complex carbohydrates improved disease outcomes. CONCLUSION The gut microbiome contributes to COPD pathogenesis and can be targeted therapeutically.
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Affiliation(s)
- Kurtis F Budden
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Shakti D Shukla
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Kate L Bowerman
- School of Chemistry and Molecular Biosciences, Australian Centre for Ecogenomics, The University of Queensland, Brisbane, QLD, Australia
| | - Annalicia Vaughan
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, QLD, Australia
| | - Shaan L Gellatly
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - David L A Wood
- School of Chemistry and Molecular Biosciences, Australian Centre for Ecogenomics, The University of Queensland, Brisbane, QLD, Australia
| | - Nancy Lachner
- School of Chemistry and Molecular Biosciences, Australian Centre for Ecogenomics, The University of Queensland, Brisbane, QLD, Australia
| | - Sobia Idrees
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Saima Firdous Rehman
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Alen Faiz
- Respiratory Bioinformatics and Molecular Biology, School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Vyoma K Patel
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Chantal Donovan
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Charlotte A Alemao
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Sj Shen
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Nadia Amorim
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Rajib Majumder
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Kanth S Vanka
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jazz Mason
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Tatt Jhong Haw
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Bree Tillet
- Frazer Institute, University of Queensland, Woolloongabba, QLD, Australia
| | - Michael Fricker
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Simon Keely
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Nicole Hansbro
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Gabrielle T Belz
- Frazer Institute, University of Queensland, Woolloongabba, QLD, Australia
| | - Jay Horvat
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Thomas Ashhurst
- Sydney Cytometry, Charles Perkins Centre, Centenary Institute and The University of Sydney, Sydney, NSW, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia
| | - Caryn van Vreden
- Sydney Cytometry, Charles Perkins Centre, Centenary Institute and The University of Sydney, Sydney, NSW, Australia
- Ramaciotti Facility for Human Systems Biology, Charles Perkins Centre and The University of Sydney, Sydney, NSW, Australia
| | - Helen McGuire
- Ramaciotti Facility for Human Systems Biology, Charles Perkins Centre and The University of Sydney, Sydney, NSW, Australia
| | - Barbara Fazekas de St Groth
- Ramaciotti Facility for Human Systems Biology, Charles Perkins Centre and The University of Sydney, Sydney, NSW, Australia
| | - Nicholas J C King
- Sydney Cytometry, Charles Perkins Centre, Centenary Institute and The University of Sydney, Sydney, NSW, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia
- Ramaciotti Facility for Human Systems Biology, Charles Perkins Centre and The University of Sydney, Sydney, NSW, Australia
- Discipline of Pathology, Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Ben Crossett
- Sydney Mass Spectrometry, The University of Sydney, Sydney, NSW, Australia
| | - Stuart J Cordwell
- Sydney Mass Spectrometry, The University of Sydney, Sydney, NSW, Australia
- School of Life and Environmental Sciences, Charles Perkins Centre and The University of Sydney, Sydney, NSW, Australia
| | - Lorenzo Bonaguro
- Systems Medicine, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn, Germany
- Genomics and Immunoregulation, Life & Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
| | - Joachim L Schultze
- Systems Medicine, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn, Germany
- Genomics and Immunoregulation, Life & Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
- PRECISE Platform for Single Cell Genomics and Epigenomics, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) and the University of Bonn, Bonn, Germany
| | | | - Elizabeth Mann
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - Samuel C Forster
- Centre for Innate Immunity and Infectious Diseases and Department of Molecular and Translational Science, Hudson Institute of Medical Research and Monash University, Melbourne, VIC, Australia
| | - Matthew A Cooper
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Leopoldo N Segal
- Division of Pulmonary and Critical Care Medicine, Laura and Isaac Perlmutter Cancer Center, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Sanjay H Chotirmall
- Lee Kong Chian School of Medicine, Translational Respiratory Research Laboratory, Singapore
| | - Peter Collins
- Mater Research Institute, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Department of Dietetics & Food Services, Mater Hospital, Brisbane, QLD, Australia
| | - Rayleen Bowman
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, QLD, Australia
| | - Kwun M Fong
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, QLD, Australia
| | - Ian A Yang
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, QLD, Australia
| | - Peter A B Wark
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Paul G Dennis
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Philip Hugenholtz
- School of Chemistry and Molecular Biosciences, Australian Centre for Ecogenomics, The University of Queensland, Brisbane, QLD, Australia
| | - Philip M Hansbro
- Priority Research Centre for Healthy Lungs and Immune Health Research Program, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
- Centre for Inflammation, Centenary Institute, Sydney, NSW, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
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Gong JY, Ghosh M, Hoet PH. Association between metal exposure from e-cigarette components and toxicity endpoints: A literature review. Regul Toxicol Pharmacol 2023; 144:105488. [PMID: 37657743 DOI: 10.1016/j.yrtph.2023.105488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/03/2023]
Abstract
Electronic cigarette is often promoted and perceived as an 'healthy' alternative compared to conventional cigarettes. However, growing body of evidence indicate the possible adverse health effect associated with e-cigarette. Here we reviewed the literature with a focus on metal exposure in relation to e-cigarette use and related toxicity endpoints. Twenty-nine studies were identified for full text screening after applying the screening criteria of which 5 in vitro studies and 11 epidemiological studies were included for data extraction. Cr, Cu, Ni, Sn are the most found metal in all studies. In vitro, metal from e-cigarette (liquid or aerosols) induced cytotoxicity, oxidative stress, genotoxicity and pro-inflammatory responses. It was observed that the presence of nicotine can influence metal-induced in vitro toxicity. Based on epidemiological studies, the metal burden in e-cigarette users showed to be elevated in different populations (including e.g. NHANES). However, most often such studies were limited by the missing user characteristics, and information of other potential sources of metal exposure. In general, metals from e-cigarette use can be associated with toxicity endpoints but to uncover the metal related hazard of e-cigarette in users, more detailed data on metals in vapors and e-liquids; user habits and user demographics are needed.
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Affiliation(s)
- Jia-You Gong
- Laboratory of Toxicology, Unit of Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Manosij Ghosh
- Laboratory of Toxicology, Unit of Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.
| | - Peter Hm Hoet
- Laboratory of Toxicology, Unit of Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.
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Day PL, Wermers M, Pazdernik V, Jannetto PJ, Bornhorst JA. Detection of Cadmium and Lead in Kidney Stones. Associations with Patient Demographics, Stone Composition, and Smoking. J Appl Lab Med 2023; 8:330-340. [PMID: 36575923 DOI: 10.1093/jalm/jfac089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/06/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Kidney stones are a highly prevalent disease worldwide. Additionally, both environmental and occupational exposure to Pb and Cd continue to be prevalent globally and can result in renal toxicity. The objective of this study was to examine the potential presence of Pb and Cd in kidney stones, and to assess for correlation with demographic factors including smoking, gender, age, and kidney stone matrix composition. METHODS Patient kidney stones (n = 96) were analyzed using Fourier transform infrared spectroscopy to identify the stone constituents. Cd and Pb concentrations (µg/g) were determined by inductively coupled plasma mass spectrometry. Cd and Pb concentrations were correlated using bivariable and multivariable statistical analysis with demographic factors (age, gender, smoking status), and kidney stone composition. RESULTS Kidney stone Cd (median 0.092 µg/g, range 0.014 to 2.46) and Pb concentrations (median 0.95 µg/g, range 0.060 to 15.4) were moderately correlated (r = 0.56, P < 0.0001). Cd concentrations were positively associated with patient history of smoking, patient age, and calcium oxalate monohydrate levels while negatively associated with struvite and uric acid/uric acid dihydrate. Pb concentrations were positively associated with females and apatite levels while negatively associated with uric acid/uric acid dihydrate. After holding constant other stone type composition levels, smoking status, and age, both Pb and Cd were positively associated with apatite and negatively associated with uric acid/uric acid dihydrate, struvite, and calcium carbonate. CONCLUSIONS Cd and Pb kidney stone concentrations are associated with specific kidney stone types. Cd and Pb kidney stone concentrations are both associated with smoking.
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Affiliation(s)
- Patrick L Day
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Michelle Wermers
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Vanessa Pazdernik
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Paul J Jannetto
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Joshua A Bornhorst
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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Pisinger C, Rasmussen SKB. The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013687. [PMID: 36294263 PMCID: PMC9603628 DOI: 10.3390/ijerph192013687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND A high prevalence of dual use of e-cigarettes and conventional cigarettes has been reported across the world. METHODS A systematic search was carried out. We included original articles on any topic relevant to health, excluding mental health, in all languages. The PRISMA guidelines were followed. Both reviewers independently screened and read all publications. We compared dual use with exclusive smoking of conventional cigarettes (ESCC). RESULTS Fifty-two publications (49 studies) were included. Thirteen papers/10 studies were prospective. There was great heterogeneity across studies. Many methodological weaknesses, such as inaccurate exposure measurement, lack of adjustment for former tobacco consumption, and lack of significance testing were identified. Most prospective studies found dual use to be at least as harmful as ESCC. The longest follow-up was six years. Most of the best available cross-sectional studies found dual use associated with the same and, in several studies, significantly higher risk of self-reported symptoms/disease than in ESCC. The intensity of cigarette smoking seems associated with worse health. CONCLUSION Existing studies indicate that dual use is at least as, or probably even more, harmful than ESCC. Due to the predominance of cross-sectional studies and the methodological weaknesses we judged the overall certainty of the evidence as "low certainty".
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Affiliation(s)
- Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
- Danish Heart Foundation, 1120 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Sofie K. Bergman Rasmussen
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
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Motawee ME, Damanhory AA, Sakr H, Khalifa MM, Atia T, Elfiky MM, Maher M, Sakr HI. An electron microscopic and biochemical study of the potential protective effect of ginger against Cadmium-induced testicular pathology in rats. Front Physiol 2022; 13:996020. [PMID: 36262262 PMCID: PMC9574188 DOI: 10.3389/fphys.2022.996020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/05/2022] [Indexed: 01/10/2023] Open
Abstract
Background: Cadmium (Cd) is a toxic heavy metal used in many industries. Since the second half of the 20th century, legislation on Cd use was put to limit the exponential rise in its environmental levels. This study aimed to investigate Cd’s functional and ultrastructural changes on rats’ reproductive systems and the role of Zingiber officinale (Ginger) in protecting against Cd-induced toxicity. Methods: Thirty adult male albino rats were randomly assigned into three equal groups (n = 10); control, Cd-exposed/untreated, and Cd-exposed/Gin-treated. Rat testes were weighed, and testicular tissue sections were examined under the electron microscope. Semen analysis, morphological examination of spermatozoa, and serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone were measured. In addition, testicular tissue homogenates were analyzed for malondialdehyde (MDA), nitric oxide (NO), and reduced glutathione (GSH) levels. Results: Cd-induced significant reduction in the mean testicular weight and GSH levels and plasma testosterone, LH and FSH levels with a concomitant increase in testicular MDA and NO levels. There was also a deterioration in semen analysis parameters and spermatozoa morphology, with testicular structural damage in the form of architecture distortion and necrosis of seminiferous tubules and testicular interstitial cells. Daily administration of ginger for 4 weeks protected against CD-induced toxicity, preserving tissue architecture, improved plasma levels of testosterone, LH and FSH and testicular levels of GSH, and reduced testicular levels of MDA, NO. Conclusion: Ginger has a protective effect on Cd-induced deterioration of testicular tissue’s structural and functional integrity by improving testicular tissue antioxidant capacity and steroid production, which ameliorates sex hormone levels in the blood.
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Affiliation(s)
- Moustafa E. Motawee
- Department of Histology and Cytology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Medicine Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Ahmed A. Damanhory
- Medicine Program, Batterjee Medical College, Jeddah, Saudi Arabia
- Department of Biochemistry, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hany Sakr
- Department of Pathology and Laboratory Medicine, VAMC, Northeast Ohio Health Care System, Louis Stokes, Cleveland, OH, United States
| | - Mohamed Mansour Khalifa
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Medical Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tarek Atia
- Department of Histology and Cytology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohamed M. Elfiky
- Medicine Program, Batterjee Medical College, Jeddah, Saudi Arabia
- Department of Anatomy and Embryology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Muhammad Maher
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hader I. Sakr
- Medicine Program, Batterjee Medical College, Jeddah, Saudi Arabia
- Department of Medical Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
- *Correspondence: Hader I. Sakr,
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Hiler M, Weidner AS, Hull LC, Kurti AN, Mishina EV. Systemic biomarkers of exposure associated with ENDS use: a scoping review. Tob Control 2021:tobaccocontrol-2021-056896. [PMID: 34732539 DOI: 10.1136/tobaccocontrol-2021-056896] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/13/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This scoping review provides an overview of the existing literature on biomarkers of exposure from electronic nicotine delivery systems (ENDS) use and identifies gaps in existing knowledge. DATA SOURCES We searched two international databases (PubMed and Web of Science) to identify relevant studies published from August 2013 to February 2021. DATA SELECTION Studies were included if they assessed and compared biomarkers of exposure between exclusive ENDS users, non-users, exclusive cigarette smokers, dual users of ENDS and cigarettes or cigarette smokers who switch to ENDS. DATA EXTRACTION AND SYNTHESIS Of the 5074 studies identified, 188 studies met criteria and were selected for full-text screening. Of these, 27 studies were selected for inclusion and data extraction. CONCLUSIONS Consistent, although limited, evidence shows that exclusive ENDS users have elevated levels of biomarkers of certain volatile organic compounds (VOCs; eg, acrylamide and acrylonitrile), metals (eg, cadmium and selenium) and propylene glycol compared with non-users; however, evidence for biomarkers of other toxicants (eg, acrolein, benzene and chromium) is mixed. Biomarkers of most VOCs are lower in ENDS users compared with cigarette smokers, and cigarette smokers who switch to ENDS consistently show reductions in VOC biomarkers. Evidence comparing metal exposures from exclusive ENDS use, cigarette smoking and dual use is mixed and depends on the metal. ENDS and e-liquid characteristics as well as use patterns may be associated with elevated exposure to VOCs and metals. Additional rigorous, controlled studies can assess biomarker exposures from ENDS use and inform the overall risk-benefit of ENDS use for different user populations.
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Affiliation(s)
- Marzena Hiler
- Center for Tobacco Products, Office of Science, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Anna-Sophie Weidner
- Center for Tobacco Products, Office of Science, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Lynn C Hull
- Center for Tobacco Products, Office of Science, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Allison N Kurti
- Center for Tobacco Products, Office of Science, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Elena V Mishina
- Center for Tobacco Products, Office of Science, US Food and Drug Administration, Silver Spring, Maryland, USA
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8
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Olmedo P, Rodrigo L, Grau-Pérez M, Hilpert M, Navas-Acién A, Téllez-Plaza M, Pla A, Gil F. Metal exposure and biomarker levels among e-cigarette users in Spain. ENVIRONMENTAL RESEARCH 2021; 202:111667. [PMID: 34256077 DOI: 10.1016/j.envres.2021.111667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 05/11/2023]
Abstract
The use of electronic cigarettes (e-cigarettes) has increased due to the belief that they are healthier than tobacco cigarettes. E-cigarettes contain a metallic heating coil (composed of Ni, Cr, Al and other metals) to heat a solution (commonly called e-liquid) and convert it into an aerosol. This aerosol is inhaled (vaped) by the users who can be potentially exposed to a wide variety of metals. We investigated the possible transfer of metals from the coil to the e-liquid and the generated aerosol, and how the exposure to this aerosol can increase metal body burden in e-cigarette users. We recruited 75 e-cigarette users (50 who only vaped and 25 dual users who vaped and smoked) and 25 controls who neither vaped nor smoked. E-liquid samples before (dispenser e-liquid) and after (tank e-liquid) being added to their devices were collected. Aerosol samples were collected using a condensation method. All participants provided urine and hair samples. All samples were analyzed for metals by ICP-MS. We observed higher metal concentrations in the aerosol and tank e-liquid (in contact with the coil) compared to the dispenser e-liquid (before contact with the coil). The median concentrations for some of the metals with the most remarkable increases in aerosol and tank e-liquid vs. dispenser e-liquid were 36.90 and 62.73 vs. 18.29 μg/kg for Al; 6.71 and 28.97 vs. 0.98 μg/kg for Cr; 91.39 and 414.47 vs. 1.64 μg/kg for Ni; 738.99 and 744.24 vs. 16.56 μg/kg for Zn; and 10.17 and 22.31 vs. 0.88 μg/kg for Pb. We also found detectable and potentially high concentrations of other metals such as Mn, Cu, Sb and Sn. In urine, increases in the median levels (μg/g creatinine) in vapers/duals vs. controls were observed for some metals, including Cr (0.34/0.28 vs. 0.20), Cu (1.72/2.36 vs. 1.46), Sn (0.26/0.31 vs. 0.18) and Pb (0.39/0.44 vs. 0.22). In hair, there were no differences in metal concentrations among the three groups. In conclusion, e-cigarettes are likely a source of metals such as Cr, Cu, Ni, Pb or Sn. These metals come from the device, likely the heating resistance, as their concentrations were low in the dispenser e-liquid and higher in the aerosol and the e-liquid left in the tank. Although the exposure to e-cigarette aerosol can have an influence in the body burden of metals, aerosol metal levels were not clearly associated with metal levels in biological samples such as urine or hair in e-cigarette users in this study.
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Affiliation(s)
- Pablo Olmedo
- Department of Legal Medicine and Toxicology. School of Medicine, University of Granada, Granada, Spain
| | - Lourdes Rodrigo
- Department of Legal Medicine and Toxicology. School of Medicine, University of Granada, Granada, Spain
| | - María Grau-Pérez
- Area of Cardiometabolic and Renal Risk, Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Spain
| | - Markus Hilpert
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ana Navas-Acién
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - María Téllez-Plaza
- Department of Chronic Disease Epidemiology. Carlos III Health Institute, Madrid, Spain
| | - Antonio Pla
- Department of Legal Medicine and Toxicology. School of Medicine, University of Granada, Granada, Spain
| | - Fernando Gil
- Department of Legal Medicine and Toxicology. School of Medicine, University of Granada, Granada, Spain.
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AL-Qaysi WW, Abdulla FH. Analytical methods for the identification of micro/nano metals in e-cigarette emission samples: a review. CHEMICKE ZVESTI 2021; 75:6169-6180. [PMID: 34421189 PMCID: PMC8370834 DOI: 10.1007/s11696-021-01779-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 07/04/2021] [Indexed: 12/04/2022]
Abstract
In this review, numerous analytical methods to quantify the heavy and trace elements emitted from electronic cigarettes, cigarettes liquid and atomizer. The selection of a method was dependent upon the purpose, e.g., quantification or identification of elements only. The introductory part of this review focuses on describing the importance of setting up an electronic cigarettes- associated safety profile. The review dealt with studies that assessed elements in sizes ranging from nano to micro. The formation of different degradation chemical substances as well as impurity trends can be indicated through chemical investigation of metals in electronic cigarettes. Some studies have been covered that show the uses and benefits of. It is noticeable from all the collected sources that the minerals emitted from the smoke of e- cigs do not constitute any significant damage, as the percentage is very small, with the exception of minerals that may be emitted from the components of the device after heating it if the components of the e- cig are of poor specifications, except in the case of long-term accumulation. For this reason, an electronic cigarette can help smokers to quit smoking tobacco and replace it with electronic cigarettes smoke with distinctive flavors.
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Affiliation(s)
- Wafaa Waleed AL-Qaysi
- Institute of Analytical Chemistry, Chemo and Biosensors, University of Regensburg, Universitätsstraße 31, 93040 Regensburg, Germany
- Department of Chemistry, College of Science, University of Baghdad, Al-Jadriya campus, 10071 Baghdad, Iraq
| | - Fatma H. Abdulla
- Department of Chemistry, College of Science, University of Baghdad, Al-Jadriya campus, 10071 Baghdad, Iraq
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10
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Nicholson T, Scott A, Newton Ede M, Jones SW. The impact of E-cigarette vaping and vapour constituents on bone health. J Inflamm (Lond) 2021; 18:16. [PMID: 33952248 PMCID: PMC8097983 DOI: 10.1186/s12950-021-00283-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/25/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In contrast to cigarettes, electronic cigarette use (E-cigarettes) has grown substantially over the last decade. This is due to their promotion as both a safer alternative to cigarettes and as an aide to stop smoking. Critically, upon E-cigarette use, the user may be exposed to high doses of nicotine in addition to other compounds including flavouring chemicals, metal particulates and carbonyl compounds, particularly in highly vascularised tissues such as bone. However, there has been limited investigation into the impact of E-cigarette usage on bone physiology, particularly over extended time periods and there are no clinical recommendations regarding E-cigarette usage in relation to orthopaedic surgery. This literature review draws together data from studies that have investigated the impact of E-cigarette vapour and its major constituents on bone, detailing the models utilised and the relevant mechanistic and functional results. MAIN BODY Currently there is a lack of studies both in vivo and in vitro that have utilised E-cigarette vapour, necessary to account for changes in chemical composition of E-cigarette liquids upon vaping. There is however evidence that human bone and bone cells express nicotine receptors and exposure of both osteoblasts and osteoclasts to nicotine, in high concentrations may reduce their viability and impair function. Similarly, it appears that aldehydes and flavouring chemicals may also negatively impact osteoblast viability and their ability to form bone. However, such functional findings are predominantly the result of studies utilising bone cell lines such as MG-63 or Saos-2 cells, with limited use of human osteoblasts or osteoclasts. Additionally, there is limited consideration for a possible impact on mesenchymal stem cells, which can also play an import role in bone repair. CONCLUSION Understanding the function and mechanism of action of the various components of E-cigarette vapour in mediating human bone cell function, in addition to long term studies to determine the potential harm of chronic E-cigarette use on human bone will be important to inform users of potential risks, particularly regarding bone healing following orthopaedic surgery and injury.
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Affiliation(s)
- Thomas Nicholson
- grid.6572.60000 0004 1936 7486Institute of Inflammation and Ageing, MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Aaron Scott
- grid.6572.60000 0004 1936 7486Institute of Inflammation and Ageing, MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Matthew Newton Ede
- grid.416189.30000 0004 0425 5852The Royal Orthopaedic Hospital, Birmingham, B31 2AP UK
| | - Simon W. Jones
- grid.6572.60000 0004 1936 7486Institute of Inflammation and Ageing, MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, B15 2TT UK
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11
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Yan R, Chen XL, Xu YM, Lau ATY. Epimutational effects of electronic cigarettes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:17044-17067. [PMID: 33655478 DOI: 10.1007/s11356-021-12985-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 02/11/2021] [Indexed: 02/06/2023]
Abstract
Electronic cigarettes (e-cigarettes), since they do not require tobacco combustion, have traditionally been considered less harmful than conventional cigarettes (c-cigarettes). In recent years, however, researchers have found many toxic compounds in the aerosols of e-cigarettes, and numerous studies have shown that e-cigarettes can adversely affect the human epigenome. In this review, we provide an update on recent findings regarding epigenetic outcomes of e-cigarette aerosols. Moreover, we discussed the effects of several typical e-cigarette ingredients (nicotine, tobacco-specific nitrosamines, volatile organic compounds, carbonyl compounds, and toxic metals) on DNA methylation, histone modifications, and noncoding RNA expression. These epigenetic effects could explain some of the diseases caused by e-cigarettes. It also reminds the public that like c-cigarettes, inhaling e-cigarette aerosols could also be accompanied with potential epigenotoxicity on the human body.
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Affiliation(s)
- Rui Yan
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Xu-Li Chen
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
| | - Yan-Ming Xu
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China.
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China.
| | - Andy T Y Lau
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China.
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China.
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12
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McDonough SR, Rahman I, Sundar IK. Recent updates on biomarkers of exposure and systemic toxicity in e-cigarette users and EVALI. Am J Physiol Lung Cell Mol Physiol 2021; 320:L661-L679. [PMID: 33501893 DOI: 10.1152/ajplung.00520.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Electronic nicotine delivery systems (ENDS), or e-cigarettes, are emerging tobacco products that produce aerosols by heating e-liquids, which most often consist of propylene glycol and vegetable glycerin along with various flavoring compounds, bypassing the combustion that occurs in the use of traditional tobacco cigarettes. These products have seen a drastic increase in popularity in recent years both as smoking cessation devices as well as among younger generations, due in large part to the widespread perception among consumers that e-cigs are significantly less harmful to health than traditional tobacco cigarettes. Due to the novelty of ENDS as well as their rapidly increasing use, research into biomarkers of e-cig exposure and toxicity have lagged behind their popularity, leaving important questions about their potential toxicity unanswered. Research into potential biomarkers of acute and chronic e-cig use, and e-cigarette- or vaping-associated lung injury is necessary for informing both clinical and regulatory decision-making. We aim to provide an updated review of recent research into potential circulating, genomic, transcriptomic, and epigenetic biomarkers of exposure to and toxicity of e-cigs. We additionally highlight research areas that warrant additional study to gain a better understanding of health risks associated with ENDS use, as well as to provide validation of existing data and methods for measuring and analyzing e-cig-associated biomarkers in human and animal biofluids, tissues, and cells. This review also highlights ongoing efforts within the WNY Center for Research on Flavored Tobacco for research into novel biomarkers in extracellular vesicles that may be associated with short- and long-term ENDS use.
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Affiliation(s)
- Samantha R McDonough
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York
| | - Isaac Kirubakaran Sundar
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
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13
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Rodrigo G, Jaccard G, Tafin Djoko D, Korneliou A, Esposito M, Belushkin M. Cancer potencies and margin of exposure used for comparative risk assessment of heated tobacco products and electronic cigarettes aerosols with cigarette smoke. Arch Toxicol 2020; 95:283-298. [PMID: 33025067 PMCID: PMC7811518 DOI: 10.1007/s00204-020-02924-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 09/29/2020] [Indexed: 12/31/2022]
Abstract
Health risk associated with the use of combustible cigarettes is well characterized and numerous epidemiological studies have been published for many years. Since more than a decade, innovative non-combusted tobacco products have emerged like heated tobacco products (HTP) or electronic cigarettes (EC). Long-term effects of these new products on health remain, however, unknown and there is a need to characterize associated potential health risks. The time dedicated to epidemiological data generation (at least 20 to 40 years for cancer endpoint), though, is not compatible with innovative development. Surrogates need, therefore, to be developed. In this work, non-cancer and cancer risks were estimated in a range of HTP and commercial combustible cigarettes based upon their harmful and potentially harmful constituent yields in aerosols and smoke, respectively. It appears that mean lifetime cancer risk values were decreased by more than one order of magnitude when comparing HTPs and commercial cigarettes, and significantly higher margin of exposure for non-cancer risk was observed for HTPs when compared to commercial cigarettes. The same approach was applied to two commercial ECs. Similar results were also found for this category of products. Despite uncertainties related to the factors used for the calculations and methodological limitations, this approach is valuable to estimate health risks associated to the use of innovative products. Moreover, it acts as predictive tool in absence of long-term epidemiological data. Furthermore, both cancer and non-cancer risks estimated for HTPs and ECs highlight the potential of reduced risk for non-combusted products when compared to cigarette smoking.
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Affiliation(s)
- Gregory Rodrigo
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000, Neuchâtel, Switzerland
| | - Guy Jaccard
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000, Neuchâtel, Switzerland.
| | - Donatien Tafin Djoko
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000, Neuchâtel, Switzerland
| | - Alexandra Korneliou
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000, Neuchâtel, Switzerland
| | - Marco Esposito
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000, Neuchâtel, Switzerland
| | - Maxim Belushkin
- PMI R&D, Philip Morris Products S.A., Rue des Usines 56, 2000, Neuchâtel, Switzerland
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14
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Neu HM, Lee A, Brandis JEP, Patel V, Schneider A, Kane MA, Dalby RN, Michel SLJ. Cigalike electronic nicotine delivery systems e-liquids contain variable levels of metals. Sci Rep 2020; 10:11907. [PMID: 32681061 PMCID: PMC7368082 DOI: 10.1038/s41598-020-67789-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/10/2020] [Indexed: 11/17/2022] Open
Abstract
Electronic nicotine delivery systems (ENDS) are prefilled, battery-operated products intended to deliver nicotine to the user via an inhaled complex aerosol formed by heating a liquid composed of propylene glycol and glycerol, also referred to as vegetable glycerin and collectively called e-liquid, that contains nicotine and various flavor ingredients. Since their introduction in 2006, the number of ENDS on the market has increased exponentially. Despite their growing ubiquity, the possible health risks associated with ENDS use remain poorly understood. One potential concern is the presence of toxic metals in the e-liquid and aerosol. Herein, we report the evaluation of the metal content in the e-liquids from a series of commercially available cigalike ENDS brands (various flavors) determined using inductively coupled plasma mass spectrometry (ICP-MS) following e-liquid extraction. Each brand of cigalike ENDS was purchased at least three times at retail outlets in the Baltimore, Maryland metropolitan region over a period of six months (September 2017 to February 2018). This allowed for comparison of batch-to-batch variability. Several potentially toxic metals, including lead, chromium, copper, and nickel were detected in the e-liquids. In addition, high variability in metal concentrations within and between brands and flavors was observed . The internal assembled parts of each cartridge were analyzed by X-ray imaging, before dissembling so that the materials used to manufacture each cartridge could be evaluated to determine the metals they contained. Following washing to remove traces of e-liquid, lead, chromium, copper and nickel were all detected in the cigalike ENDS prefilled cartridges, suggesting one potential source for the metals found in the e-liquids. Collectively, these findings can inform further evaluation of product design and manufacturing processes, including quantification of metal concentrations in e-liquids over foreseeable storage times, safeguards against high concentrations of metals in the e-liquid before and after aerosolization (by contact with a metal heating coil), and control over batch-to-batch variability.
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Affiliation(s)
- Heather M Neu
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Angela Lee
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Joel E P Brandis
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Vyomesh Patel
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, USA
| | - Abraham Schneider
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Richard N Dalby
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Sarah L J Michel
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA.
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15
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Reilly SM, Cheng T, DuMond J. Method Validation Approaches for Analysis of Constituents in ENDS. TOB REGUL SCI 2020; 6:242-265. [PMID: 32789155 PMCID: PMC7416875 DOI: 10.18001/trs.6.4.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We assessed how many peer-reviewed publications reporting chemical quantities and/or yields from electronic nicotine delivery systems (ENDS) have included adequate method validation characteristics in the publication for appropriate interpretation of data quality for informing tobacco regulatory science. METHODS We searched 5 databases (Web of Knowledge, PubMed, SciFinder, Embase, EBSCOhost) for ENDS publications between January 2007 and September 2018. Of the 283 publications screened, 173 publications were relevant for analysis. We identified the publications that report a certain degree of control in data quality, ie, the publications that report marginally validated methods (MVMs). MVMs refer to the methods that: (1) report 3 or more International Conference on Harmonisation (ICH) method validation characteristics, (2) state the method was validated, (3) cite their own previous publication(s) that report MVMs, or (4) use a method within the accreditation scope of an accredited laboratory. RESULTS Overall, 97 publications (56%) report MVMs in their studies. This percentage also reflects the publication distribution for the majority of the 28 chemicals measured by MVMs. CONCLUSIONS This study highlights the need for reporting sufficient validation characteristics following appropriate guidance to ensure the accuracy and reliability of the published analytical data for proper data interpretations that may support policy.
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Affiliation(s)
- Samantha M Reilly
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Tianrong Cheng
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Jenna DuMond
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
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16
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Electronic nicotine delivery system design and aerosol toxicants: A systematic review. PLoS One 2020; 15:e0234189. [PMID: 32497139 PMCID: PMC7272070 DOI: 10.1371/journal.pone.0234189] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 05/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS; e-cigarettes), consisting of a battery, heating element and e-liquid, have evolved significantly with wide variation in design, components, operating powers, and chemical constituents. Generated aerosols have been reported to contain potentially toxic substances. We conducted a systematic review to assess what is known about the presence of toxicants in ENDS aerosols in order to inform how system design could mitigate risk. METHODS Articles reporting on or evaluating design characteristics of ENDS and aerosol constituents were included and summarized. RESULTS The search identified 2,305 articles, of which 92 were included after full-text review. Findings were grouped into 6 major categories of potentially harmful chemicals: carbonyls, volatile organic chemicals, trace elements, reactive oxygen species and free radicals, polycyclic aromatic hydrocarbons, and tobacco-specific nitrosamines. In general, higher concentrations of aerosol toxicants are associated with increased power or voltage. Aerosol toxicants are also associated with e-liquid flavoring agents existing as primary ingredients or as products of thermal degradation. CONCLUSIONS Improved ENDS design can reduce toxicant levels. Additional research is needed to develop a framework for optimizing system characteristics to minimize exposure, especially with respect to heating power and e-liquids. Both manufacturers and regulatory agencies have roles in reducing toxicants and potential health risks from ENDS.
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17
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Traboulsi H, Cherian M, Abou Rjeili M, Preteroti M, Bourbeau J, Smith BM, Eidelman DH, Baglole CJ. Inhalation Toxicology of Vaping Products and Implications for Pulmonary Health. Int J Mol Sci 2020; 21:E3495. [PMID: 32429092 PMCID: PMC7278963 DOI: 10.3390/ijms21103495] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022] Open
Abstract
E-cigarettes have a liquid that may contain flavors, solvents, and nicotine. Heating this liquid generates an aerosol that is inhaled into the lungs in a process commonly referred to as vaping. E-cigarette devices can also contain cannabis-based products including tetrahydrocannabinol (THC), the psychoactive component of cannabis (marijuana). E-cigarette use has rapidly increased among current and former smokers as well as youth who have never smoked. The long-term health effects are unknown, and emerging preclinical and clinical studies suggest that e-cigarettes may not be harmless and can cause cellular alterations analogous to traditional tobacco smoke. Here, we review the historical context and the components of e-cigarettes and discuss toxicological similarities and differences between cigarette smoke and e-cigarette aerosol, with specific reference to adverse respiratory outcomes. Finally, we outline possible clinical disorders associated with vaping on pulmonary health and the recent escalation of acute lung injuries, which led to the declaration of the vaping product use-associated lung injury (EVALI) outbreak. It is clear there is much about vaping that is not understood. Consequently, until more is known about the health effects of vaping, individual factors that need to be taken into consideration include age, current and prior use of combustible tobacco products, and whether the user has preexisting lung conditions such as asthma and chronic obstructive pulmonary disease (COPD).
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Affiliation(s)
- Hussein Traboulsi
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.T.); (M.A.R.); (M.P.); (J.B.); (B.M.S.)
| | - Mathew Cherian
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada; (M.C.); (D.H.E.)
| | - Mira Abou Rjeili
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.T.); (M.A.R.); (M.P.); (J.B.); (B.M.S.)
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Matthew Preteroti
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.T.); (M.A.R.); (M.P.); (J.B.); (B.M.S.)
- Department of Pathology, McGill University, Montreal, QC H3A 2B4, Canada
| | - Jean Bourbeau
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.T.); (M.A.R.); (M.P.); (J.B.); (B.M.S.)
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Benjamin M. Smith
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.T.); (M.A.R.); (M.P.); (J.B.); (B.M.S.)
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada; (M.C.); (D.H.E.)
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - David H. Eidelman
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada; (M.C.); (D.H.E.)
| | - Carolyn J. Baglole
- Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (H.T.); (M.A.R.); (M.P.); (J.B.); (B.M.S.)
- Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada; (M.C.); (D.H.E.)
- Department of Pathology, McGill University, Montreal, QC H3A 2B4, Canada
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC H3G 1Y6, Canada
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18
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Metal Concentration Assessment in the Urine of Cigarette Smokers Who Switched to Electronic Cigarettes: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061877. [PMID: 32183183 PMCID: PMC7143212 DOI: 10.3390/ijerph17061877] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/30/2022]
Abstract
Background: E-cigarettes (ECs) seem to be a less harmful alternative for conventional cigarettes, however, very little is still known about the exposure to some elements, which are the components of this device and may contaminate the nicotine liquid. The aim of this study is to assess whether e-cigarette users are more exposed to 12 elements detected in aerosol than non-smokers and conventional cigarette smokers, using their concentrations in urine as exposure biomarkers. Methods: A cross-sectional, group-based survey was carried out using 90 volunteers classified into groups of non-smokers, EC-only users, dual EC users-cigarette smokers and cigarette-only smokers. Using inductively coupled plasma mass spectrometry (ICP-MS) and electrothermal atomic absorption spectrometry (ETAAS), Cr, Ni, Co, Ag, In, Mn, Ba, Sr, V, Sb, Cd and Pb levels were measured in spot urine samples. Among the selected groups, a comparison was made using the analysis of covariance and correlations with EC usage pattern were assessed by multiple linear regression. Results: Element concentrations in urine of EC-users were not significantly different from the levels found in non-smokers and smokers. Only in the case of Ba, Ni and Sb was a significant correlation found in relation to some e-cigarette usage patterns. Conclusion: Transfer of the investigated elements to the EC aerosol was not found to be a substantial source of exposure in EC users who quitted smoking.
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Sobczak A, Kośmider L, Koszowski B, Goniewicz MŁ. E-cigarettes and their impact on health: from pharmacology to clinical implications. Pol Arch Intern Med 2020; 130:668-675. [PMID: 32155137 DOI: 10.20452/pamw.15229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Worldwide, cigarette smoking is the major cause of premature mortality and diseases that can be prevented. Given that people continue smoking despite associated health risks, delivering nicotine without combustion should be considered a valuable and much less harmful way to reduce the public health burden caused by smoking. E‑cigarettes could play such a role if they were proven to be less harmful than combustible cigarettes. Although the number of clinical trials and human studies assessing the safety of e‑cigarettes is limited, numerous in vitro and in vivo studies reported on the potential harmful effects of the aerosol generated from e‑cigarettes. This article reviews the results of major clinical trials and laboratory studies with regard to cancer as well as cardiovascular and respiratory risk associated with the use of e‑cigarettes. Additionally, it also discusses the potential application of e‑cigarettes as smoking cessation tools. Most studies have indicated so far that e‑cigarettes are less harmful, but this applies only to smokers who completely switched to e‑cigarettes. In the opinion of the authors, good-quality research is crucial to establish the tolerance, safety, efficacy, and harm reduction potential of new technologies. Considering a significant role that physicians and other health providers play in helping smokers, there is an urgent need for evidence‑based guidelines and recommendations for clinical practitioners on potential benefits and risks of e‑cigarette use.
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Affiliation(s)
- Andrzej Sobczak
- Department of General and Analytical Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland.
| | - Leon Kośmider
- Department of General and Analytical Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | | | - Maciej Ł Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
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20
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Lee JW, Kim Y, Kim Y, Yoo H, Kang HT. Cigarette Smoking in Men and Women and Electronic Cigarette Smoking in Men are Associated with Higher Risk of Elevated Cadmium Level in the Blood. J Korean Med Sci 2020; 35:e15. [PMID: 31920018 PMCID: PMC6955437 DOI: 10.3346/jkms.2020.35.e15] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/19/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND We investigated the association between blood concentration of cadmium and smoking status including use of electronic cigarettes (E-cigars). METHODS We used data from the Korea National Health and Nutritional Survey 2013 and 2016. A total of 4,744 participants (2,162 men and 2,582 women) were included and were categorized into five groups (Non-smokers, E-cigar non-users in past-smokers, E-cigar users in past-smokers, E-cigar non-users in cigarette-smokers and E-cigar users in cigarette-smokers). Cadmium blood concentration was categorized into tertiles. All sampling and weight variables were stratified, and analysis to account for the complex sampling design was conducted. RESULTS In both genders, the geometric cadmium concentration was significantly different according to smoking status (both genders, analysis of variance P value < 0.001). In men, E-cigar users were significantly higher than the non-smokers (P value = past-smokers, 0.017; cigarette-smokers, < 0.001) when fully adjusted. Compared with non-smokers, fully-adjusted odds ratios (95% confidence intervals) for the highest cadmium tertiles of E-cigar non-users in cigarette-smokers and E-cigar users in cigarette-smokers were 6.56 (3.55-12.11) and 5.68 (1.96-16.50) in men and 2.74 (1.42-5.29) and 1.29 (0.10-17.44) in women. CONCLUSION Conventional cigarette smoking in men and women and E-cigar use in men are associated with higher risk of elevated blood cadmium level. Preventive management of cadmium exposure monitoring in conventional cigarette-smokers and E-cigar users may be needed.
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Affiliation(s)
- Jae Woo Lee
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Yeseul Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Yonghwan Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - HyoSun Yoo
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hee Taik Kang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
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Belushkin M, Tafin Djoko D, Esposito M, Korneliou A, Jeannet C, Lazzerini M, Jaccard G. Selected Harmful and Potentially Harmful Constituents Levels in Commercial e-Cigarettes. Chem Res Toxicol 2019; 33:657-668. [PMID: 31859484 DOI: 10.1021/acs.chemrestox.9b00470] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A broad range of commercially available electronic cigarette (e-cigarette) systems were tested for levels of emissions of harmful and potentially harmful constituents (HPHC), with a particular focus on the carbonyls: acetaldehyde, acrolein, and formaldehyde. The tobacco-specific nitrosamines N'-nitrosonornicotine and 4-(methylnitrosamino)-1-(3-bipyridyl)-1-butanone; the elements arsenic, cadmium, chromium, lead, and nickel; benzene; 1,3-butadiene; and benzo(a)pyrene were also quantified. The results show that except for the levels of carbonyls, all types of e-cigarettes performed in a similar manner, and emission levels for HPHCs were generally not quantifiable. However, levels of carbonyls, especially formaldehyde, were highly variable. Overall, the lowest levels of formaldehyde were observed in cartridge systems, which generally achieved substantial reductions in yields in comparison with cigarette smoke. Formaldehyde levels in open tank systems were variable; however, the median formaldehyde levels across different brands were substantially lower than the formaldehyde levels in cigarette smoke. The results for variable-power devices operated at the highest voltage confirmed existing literature data regardless of orientation and differences in puffing regimes. Furthermore, our results show that many products deliver consistent HPHC yields over a broad range of testing conditions (with minimal variability from one device to another, under a range of puffing conditions). However, some products exhibit high variability in emissions of HPHCs. The use of air blanks is further highlighted to assess nonproduct-related contributions to HPHC levels to avoid misrepresentation of the data. Overall, our results highlight that some but not all electronic cigarettes deliver low levels of carbonyls consistently across the full e-liquid depletion cycle under different test conditions. The need for further research and standardization work on assessment of variable-voltage electronic cigarettes is emphasized.
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Affiliation(s)
- Maxim Belushkin
- PMI R&D, Philip Morris Products SA , Quai Jeanrenaud 5 , CH-2000 Neuchâtel , Switzerland
| | - Donatien Tafin Djoko
- PMI R&D, Philip Morris Products SA , Quai Jeanrenaud 5 , CH-2000 Neuchâtel , Switzerland
| | - Marco Esposito
- PMI R&D, Philip Morris Products SA , Quai Jeanrenaud 5 , CH-2000 Neuchâtel , Switzerland
| | - Alexandra Korneliou
- PMI R&D, Philip Morris Products SA , Quai Jeanrenaud 5 , CH-2000 Neuchâtel , Switzerland
| | - Cyril Jeannet
- PMI R&D, Philip Morris Products SA , Quai Jeanrenaud 5 , CH-2000 Neuchâtel , Switzerland
| | - Massimo Lazzerini
- PMI R&D, Philip Morris Products SA , Quai Jeanrenaud 5 , CH-2000 Neuchâtel , Switzerland
| | - Guy Jaccard
- PMI R&D, Philip Morris Products SA , Quai Jeanrenaud 5 , CH-2000 Neuchâtel , Switzerland
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Ohtsu M, Mise N, Ikegami A, Mizuno A, Kobayashi Y, Nakagi Y, Nohara K, Yoshida T, Kayama F. Oral exposure to lead for Japanese children and pregnant women, estimated using duplicate food portions and house dust analyses. Environ Health Prev Med 2019; 24:72. [PMID: 31805868 PMCID: PMC6896297 DOI: 10.1186/s12199-019-0818-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lead is a toxic metal abundant in the environment. Consumption of food contaminated at low levels of lead, especially by small children and pregnant women, raises a health concern. METHODS Duplicated food portions and drinking water were collected over 3 days from 88 children and 87 pregnant women in Shimotsuke, Tochigi, Japan. Participants were recruited in this study between January 2014 and October 2015. Dust was also collected from their homes. Lead concentrations were measured and consequent oral lead exposure levels were estimated for this population at high risk to environmental toxicants. Lead concentrations of peripheral and cord blood, taken from children and pregnant women, and were also analyzed. RESULTS Lead concentrations in food, drinking water, and house dust were low in general. Oral lead exposure to lead was higher for children (Mean ± SEM; 5.21 ± 0.30 μg/kg BW/week) than in pregnant women (1.47 ± 0.13 μg/kg BW/week). Food and house dust were main sources of lead contamination, but the contribution of house dust widely varied. Means ± SEM of peripheral and cord blood lead concentrations were 0.69 ± 0.04 μg/dL and 0.54 ± 0.05 μg/dL, respectively for pregnant women and 1.30 ± 0.07 μg/dL (peripheral only) in children. We detect no correlation between smoking situations and blood lead concentration in pregnant women. CONCLUSION We conclude that oral lead exposure levels for Japanese children and pregnant women were generally low, with higher concentrations and exposure for children than for pregnant women. More efforts are necessary to clarify the sources of lead contamination and reduce lead exposure of the population at high risk even in Japan.
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Affiliation(s)
- Mayumi Ohtsu
- Department of Environmental and Preventive Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Nathan Mise
- Department of Environmental and Preventive Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
| | - Akihiko Ikegami
- Department of Environmental and Preventive Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Atsuko Mizuno
- Department of Pharmacology, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yayoi Kobayashi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Yoshihiko Nakagi
- Department of Health Science, Asahikawa Medical University, Midorigaoka-higashi, Asahikawa, Hokkaido, 078-8802, Japan
| | - Keiko Nohara
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2, Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Takahiko Yoshida
- Department of Health Science, Asahikawa Medical University, Midorigaoka-higashi, Asahikawa, Hokkaido, 078-8802, Japan
| | - Fujio Kayama
- Department of Environmental and Preventive Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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Zhao D, Navas-Acien A, Ilievski V, Slavkovich V, Olmedo P, Adria-Mora B, Domingo-Relloso A, Aherrera A, Kleiman NJ, Rule AM, Hilpert M. Metal concentrations in electronic cigarette aerosol: Effect of open-system and closed-system devices and power settings. ENVIRONMENTAL RESEARCH 2019; 174:125-134. [PMID: 31071493 PMCID: PMC7079580 DOI: 10.1016/j.envres.2019.04.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/31/2019] [Accepted: 04/05/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Electronic cigarettes (E-cigarettes) generate aerosol containing metal contaminants. Our goals were to quantify aerosol metal concentrations and to compare the effects of power setting and device type (closed-system vs. open-system) on metal release. METHODS Aerosol samples were collected from two closed-system devices (a cigalike and pod) and two open-system devices (mods). Each open-system device was operated at three different power settings to examine the effect of device power on metal release. Concentrations of 14 metals in e-cigarette aerosol collected via droplet deposition were measured using inductively coupled plasma mass spectroscopy. Aerosol metal concentrations were reported as mass fractions (μg/kg) in the e-liquid. RESULTS For open-system device 1 (OD1), median arsenic (As), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), antimony (Sb), tin (Sn), and zinc (Zn) concentrations increased 14, 54, 17, 30, 41, 96, 14, 81, 631, and 7-fold when the device power was increased from low (20 W) to intermediate (40 W) setting. When the power was further increased from intermediate (40 W) to high (80 W) setting, concentrations of As, Cr, Cu, Mn, Ni, and Sb did not change significantly. For open-system device 2 (OD2), Cr and Mn concentrations increased significantly when device power was increased from low (40 W) to intermediate (120 W) setting, and then decreased significantly when power was further increased from intermediate (120 W) to high (200 W) setting. Among the four devices, aerosol metal concentrations were higher for the open-system than the closed-system devices, except for aluminum (Al) and uranium (U). For Cr, median (interquartile range) concentrations (μg/kg) from the open-system devices were 2.51 (1.55, 4.23) and 15.6 (7.88, 54.5) vs. 0.39 (0.05, 0.72) and 0.41 (0.34, 0.57) for the closed-system devices. For Ni, concentrations (μg/kg) from the open-system devices were 793 (508, 1169) and 2148 (851, 3397) vs. 1.32 (0.39, 3.35) and 11.9 (10.7, 22.7) from the closed-system devices. Inhalation of 0% and 100% of samples from OD1, 7.4% and 88.9% from OD2 by typical e-cigarette users would exceed chronic minimum risk levels (MRL) of Mn and Ni, respectively. No MRL exceedance was predicted for the closed-system devices. A large fraction of users of OD1 (100%) and OD2 (77.8%) would be exposed to Ni levels higher than those from reference tobacco cigarette 3R4F. CONCLUSIONS Our findings suggest that power setting and device type affect metal release from devices to aerosol which would subsequently be inhaled by users. Metal concentrations from open-system devices first increased with device power, and then leveled off for most metals. Open-system devices generate aerosol with higher metal concentrations than closed-system devices. These findings inform tobacco regulatory science, policy makers and health professionals on potential metal health risks associated with e-cigarette use, design and manufacturing.
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Affiliation(s)
- Di Zhao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Vesna Slavkovich
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Pablo Olmedo
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, Spain
| | - Bernat Adria-Mora
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Arce Domingo-Relloso
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Angela Aherrera
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Norman J Kleiman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Markus Hilpert
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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McElroy JA, Hunter MI. Cadmium: a new risk factor for endometrial cancer? Expert Rev Anticancer Ther 2019; 19:355-358. [DOI: 10.1080/14737140.2019.1596029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jane A. McElroy
- Family and Community Medicine Department, University of Missouri, Columbia, MO, USA
- Missouri University Research Reactor, University of Missouri, Columbia, MO, USA
| | - Mark I. Hunter
- Department of Obstetrics, Gynecology and Women’s Health, University of Missouri, Ellis Fischel Cancer Center, Columbia, MO, USA
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