Metal Concentration Assessment in the Urine of Cigarette Smokers Who Switched to Electronic Cigarettes: A Pilot Study

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.

Transfer of Metals to the Aerosol Generated by an Electronic Cigarette: Influence of Number of Puffs and Power

“…Humans are typically exposed to metals through a variety of pathways, including ingestion or inhalation of contaminated soil, dust, bioaccumulation in food, water, pesticides, and other sources [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Recent studies have shown that some of the metals found in electronic cigarettes accumulate in the central nervous system of mice after exposure, appear in various biomarkers of e-cigarette users, and have been shown to cause cellular damage [ 1 , 8 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

A systematic review comparing the health effects of dual use of electronic and conventional cigarettes with health effects of exclusive smoking of conventional cigarettes

“…Most of the studies that reported the same or higher tobacco consumption in DUs as in ESCC found signi cantly worse health outcomes in DUs than in ESCC (11,17,26,55,58,62). None of the studies where DUs reported smoking a lower number of CPD than ESCC found signi cantly worse outcome in DUs (50,51,54), in fact, one of them found that ESCC had a worse outcome (54).…”

“…Six studies found that levels of harmful substances were higher in ESCC (37,41,48,(52)(53)(54). One study found that DUs had higher values for most substances tested, but it did not test for signi cance (51). Three studies found signi cantly higher levels of harmful biomarkers in DUs (11,55,56), and nine studies found no signi cant difference.…”

“…Sixteen (29%) of the studies had a con ict of interest (COI): two with an EC manufacturer (50,51), two had received nancial support from anonymous contributors (26, 40), and the remaining had a COI with pharmaceutical companies. One study was tobacco-industry-sponsored and found a bene cial effect of replacing ESCC with the ECs they manufactured, also in DUs (41).…”

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

“…Fourteen (27%) of the papers had a COI: two with an EC manufacturer [ 52 , 56 ], one with the tobacco industry [ 29 ], two had received financial support from anonymous contributors [ 29 , 50 ], and the remaining had a COI with pharmaceutical companies.…”