Health Effects of Trace Metals in Electronic Cigarette Aerosols—a Systematic Review

Abstract

Electronic cigarettes (ECs) are essentially nicotine delivery devices that mimic the appearance of a conventional cigarette (CC). Lately, they have been marketed as tools for quitting smoking. Even though they are promoted as safe alternatives to CC, they are not devoid of hazardous components. Literature reveals that the EC aerosols and e-liquids are a potential source of elements that induce and promote development of chronic conditions. These include trace metals which are leached from their core assembly. Some of these metals like nickel, chromium, cadmium, tin, aluminum, and lead are potential carcinogens. They have been associated with fatal conditions like lung and sinonasal cancer. Besides, they may have adverse effects on oral tissues like periodontal ligament and mucosa where they may trigger chronic periodontitis and oral cancer. However, there is only trivial evidence related to health hazards of metals released from ECs. With this background, the present review first focuses on the structure of the ECs followed by an appraisal of the data from experimental studies about the metals released in EC aerosols and their associated health hazards.

Vaping Is Not Safe: A Case of Acute Eosinophilic Pneumonia following Cannabis Vapor Inhalation

“…Youth describe the contents of vaping oils as harmless "water vapor, " which may be "good" for them [21]. e vapor from these vaping devices may contain particulate matter, as well as chemicals such as carbonyls, volatile organic compounds, and toxic metals, which have been linked to dyspnea, cough, upper airways irritation, asthma, pneumonia and lung cancer [22,23]. Inhaling aerosols has been shown to increase airway resistance and decrease FEV1 in healthy nonsmokers [24].…”

Metal/Metalloid Levels in Electronic Cigarette Liquids, Aerosols, and Human Biosamples: A Systematic Review

“…Reviews on e-cigarettes have summarized e-cigarette development (Cooke et al 2015;Glasser et al 2017), their impact on decreasing smoking use (Kalkhoran and Glantz 2016;Rahman et al 2015), health and physiological effects Pisinger and Døssing 2014;Zucchet et al 2017), and effects of vaping on indoor air quality (Fernández et al 2015;Zainol Abidin et al 2017). Some of these reviews reported on metal levels; in addition, two systematic reviews have specifically evaluated metals/metalloids in cig-a-like cartomizers (Mishra et al 2017) and in e-cigarette aerosols (Gaur and Agnihotri 2019). Overall, previous reviews reporting on e-cigarette-related metal/metalloid levels focused on aerosols, e-liquids, or human biosamples, separately.…”

A Summary of In Vitro and In Vivo Studies Evaluating the Impact of E-Cigarette Exposure on Living Organisms and the Environment

“…Vaporized e-liquid solution is contaminated with various metals, such as aluminum, arsenic, cadmium, chromium, copper, iron, manganese, nickel, lead and zinc, which pose a threat to human health [44]. In addition, trace metals can also be delivered to the aerosol through components of the electronic nicotine delivery system, such as the atomizer and batteries; this contamination may be exacerbated by the high temperatures involved in the production of the aerosol [45]. Part of the heavy metals present in vapor, such as lead, are derived from Nicotiana tabacum, the source of nicotine in tobacco, which absorbs pollutants from the environment during its growth [46].…”