E-cigarettes should be considered a source of volatile organic compounds (VOCs) and particulates in the indoor environment that have not been thoroughly characterized or evaluated for safety. --NIOS

Marcham, Cheri

English

Embry-Riddle Aeronautical University

Publications 10-21-2016 Electronic Cigarettes in the Indoor Environment Cheri Marcham Embry-Riddle Aeronautical University, march617@erau.edu Follow this and additional works at: https://commons.erau.edu/publication  Part of the Occupational Health and Industrial Hygiene Commons Scholarly Commons Citation Marcham, C. (2016). Electronic Cigarettes in the Indoor Environment. , (). Retrieved from https://commons.erau.edu/publication/517 This Presentation without Video is brought to you for free and open access by Scholarly Commons. It has been accepted for inclusion in Publications by an authorized administrator of Scholarly Commons. For more information, please contact commons@erau.edu. Electronic Cigarettes in the Indoor EnvironmentCheri Marcham, PhD, CIH, CSP, CHMM, FAIHAEmbry Riddle Aeronautical UniversityBoard of Certified Safety Professionalsmarch617@erau.eduAnatomy of an E-Cigarette• More than 460 different e-brands on the market.*• Over 7,700 unique e-cigarette flavors.** As of January 2014• China produces approximately 90% of the world’s e-cigarettes and 91% of US imports• Chinese manufacturers shipped more than 300 million e-cigarettes to the US and Europe in 2014• 2016 GAO import data are in dollars (includes parts, liquids, and devices) = $342,257,308.00Barboza, D. (2014, December 13). China’s e-cigarette boom lacks oversight for safety. The New York Times. Retrieved from http://www.nytimes.com/2014/12/14/business/international/chinas-e-cigarette-boom-lacks-oversight-for-safety-.html?_r=0 U.S. Government Accountability Office. (2017, April 24).  Electronic cigarettes: US Imports in 2016.  Retrieved from https://www.gao.gov/assets/690/684227.pdf Zhu, S. (2014). Four hundred and sixty brands of e-cigarettes and counting: Implications for product regulation. Tobacco Control. doi:10.1136/tobaccocontrol-2014-051670Statistics• E-cigarette sales in the U.S. were estimated at $2.2 billion in 2014.• Sales expected to grow nearly 50% per year through 2018.• In 2014, an estimated 2.5 million middle and high school students used e-cigarettes. • In 2015, this number increased to more than 3 million Statistics• There is some evidence that e-cigarette use is pro-spectively associated with increased risk of combustible tobacco use initiation during early adolescence• An estimated 16% of U.S. tenth graders have tried e-cigarettes, of whom 43% have never smoked combustible cigarettes (August, 2015)• Among high school students that were electronic nicotine delivery system (ENDS) users, 25% went on to be conventional tobacco product users, compared with 9% in the population that had never used an ENDSLeventhal, A.M., Strong, D.R., Kirkpatrick, M.G., Under, J. B., Sussman, S., Riggs, N.R., Stone, M.D.,Khoddam, R., Sarnet, J.M. & Audrain-McGovern, J. (2015). Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolesence. JAMA. doi:10.1001/jama.2015.8950Rigotti, N.A. (2015).  E-cigarette use and subsequent tobacco use by adolescents: New evidence about a potential risk of e-cigarettes.  JAMA, 314(7), 673-674. doi:10.1001/jama.2015.8382 Statistics• Propylene Glycol/ Vegetable Glycerin• Nicotine• FlavoringsPrimary Components• Used in theatrical fogo Exposure may contribute to both acute and chronic health issues, such as asthma, wheezing, chest tightness, decreased lung function, respiratory irritation, and airway obstruction**Varughese, S., Teschke, M., Brauer, Y. Chow, C. Van Netten, C. & Kennedy, S.M. (2005) Effects of theatrical smokes and fogs on respiratory health in the entertainment industry. American Journal of Industrial Medicine, 47, 411–418Propylene Glycol/Vegetable Glycerin• Pyrolysis/heating glycerin forms acrolein, formaldehyde and acetaldehyde in the vaporsGeiss, O., Bianchi, I., Barhona, F., & Barrero-Moreno, J. (2014). Characterisation of mainstream and passive vapoursemitted by selected electronic cigarettes. International Journal of Hygiene and Environmental Health, 281, 169-180Goniewicz, M.L., Knysak, J., Gawron, M., Kosmider, L., Sobczak, A. Kurek, J., Prokopowicz, A. …& N. Benowitz. (2013). Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tobacco Control. 0:1–7 doi:10.1136/tobaccocontrol-2012-050859. Lauterbach, J.H. & Laugesen, M. (2012). Comparison of toxicant levels in mainstream aerosols generated by Ruyan® electronic nicotine delivery systems (ENDS) and conventional cigarette products. Toxicologist, 126, 1Lauterbach, J.H., Laugesen, M., Ross, B.B., 2012. Suggested protocol for estimation of harmful and potentially harmful constituents in mainstream aerosols generated by elec- tronic nicotine delivery systems (ENDS).Toxicologist, 126, 1Uchiyama, S., K. Ohta, Y. Inaba, & N. Kunugita. (2013). Determination of carbonyl compounds generated from the e-cigarette using coupled silica cartridges impregnated with hydroquinone and 2,4-dinitrophenylhydrazine, followed by high-performance liquid chromatography. Analytical Sciences, 29 (12), 1219–1222Propylene Glycol/Vegetable Glycerin • A known degradation product of propylene glycol and glycerin• Found in vapor and in small amounts in some studies of some liquids• Higher airborne concentrations with higher voltage second and third generation units• Known human carcinogen Formaldehyde• Causes irritation to the nasal cavity, damage to the lining of the lungs and is thought to contribute to cardiovascular disease in cigarette smokers• Found in vapor only (formed as a result of heating process)Acrolein• Health Effectso Addictive o Teratogenico Increases heart rate, respiratory rate, blood pressure, and level of alertness• E-Cig Labeling o Some cartridges labeled as containing no nicotine did, in fact, contain detectable levels of nicotine o Concentration and delivery inconsistencies • Nicotine found in the vapor, but lower than found emitted from conventional cigarettesNicotineThe first reported child’s death from accidently ingesting e-liquid was in early December of 2014 involving a 1-year old in Fort Plain, New York. FlavoringsFood and Drug Administration. (2010). Warning letter.  Retrieved from http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm225187.htm Other AdditivesOther AdditivesGenerally Recognized as Safe (GRAS)?Diacetyl as a food additive is GRAS, but aerosolized exposures can cause bronchiolitis obliterans• Diacetyl and acetyl propionyl are GRAS but are associated with respiratory disease when inhaledo The risks associated with inhalation of acetyl propionyl may be as high as from diacetyl based on inhalation studies with rats• 159 samples purchased from 36 manufacturer and retailers in 7 countries*• Diacetyl and acetyl propionyl were found in 74.2% of the samples o Even found in samples from manufacturers who clearly stated that these chemicals were not present *Farsalinos, K. E., Kistler, K. A., Gilman, G., Voudris, V. (2015) Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins. Nicotine & Tobacco Research, 168-174, doi: 10.1093/ntr/ntu176Diacetyl and Acetyl Propionyl• No research on potential health effects of aerosolized vapor exposure• No research on pyrolization products of flavorings• Manufacturing of many flavoring sources are outside the US (China)Flavoring Concerns• Benzaldehyde was detected in cherry flavoring, but also in 75% of 145 e-cig refill liquids*• Cytotoxic and genotoxic to cell cultures• Cinnamaldehyde present in 51% of 39 refill liquids*• Highly cytotoxic• Methyl anthranilate was detected in grape flavoring• 1-hexanol was detected in apple flavoringBehar, R.Z., Luo, W., Lin, S.C., Wang, Y., Valle, J., Pankow, J.F. & Talbot, P. (2016). Distribution, quantification and toxicity of cinnamaldehyde in electronic cigarette refill fluids and aerosols. Tobacco Control. doi:10.1136/tobaccocontrol-2016-053224Flavoring Concerns• Tin• Lead• Nickel• Zinc• Copper• Chromium• Silicon fibers• NanoparticlesAdditional Potential Exposures Tobacco-Specific Nitrosamines (TSNAs) Acetic Acid BTEX Isoprene Diethylene Glycol (antifreeze)**Food and Drug Administration. (2009) FDA news release: FDA and public health experts warn about electronic cigarettes. Retrieved from  www.fda.gov/newsevents/newsroom/pressannouncements/ucm173222.htmAdditional Potential Exposures• Some TSNAs are known human carcinogens and are suspected to contribute to the cancer burden of smokers• Small amounts of TSNAs have been found in e-liquids and vapor• Residual nicotine from tobacco smoke has been shown to react with ambient nitrous acid to form TSNAs over timeo Third-hand exposure?Tobacco-Specific Nitrosamines (TSNAs)Second-Hand Exposure Concerns• Nicotine (teratogen and addictive)   • Flavorings (nut and other allergies)• Formaldehyde (carcinogen)• Acrolein (listed as a Hazardous Air Pollutant by the EPA)• Acetaldehyde (possible human carcinogen)• Fine/Ultrafine Particles• Tin, Lead, Nickel, ChromiumCloud Chasing• Contenthttps://www.youtube.com/watch?v=ZgouBVNItQAWhen Cloud Chasing Spills Over: A different kind of ‘vapor intrusion.’  Floyd (2017) showed that e-cig aerosols can spread through HVAC systems to adjacent parts of a building.   Nicotine contamination was found to be elevated on surfaces in shops adjacent to small vape shops.   Cleaning regimens in the vape shops were very aggressive (daily or twice daily) and this seem to control surface contamination adequately within the shops, but adjacent shops did not clean display cabinets as frequently, resulting in elevated nicotine contamination. Floyd, E. (2017).  When cloud chasing spills over: A different kind of ‘vapor intrusion.’ American Industrial Hygiene Conference and Exposition, Seattle, Washington, June 6, 2017.• Mouth and throat irritation• Dry cough• Nausea• Dizziness• Changes in heart rhythm• Changes in blood pressureSome Reported Health Effects• Some are single use or disposable• Lithium ion batteries• Nicotine (acute hazardous waste)o EPA: “unused (unsold, expired, or returned) nicotine-containing products, including patches, gums, lozenges, inhalers, nasal sprays, and e-cigarettes, are classified as P075 listed acute hazardous wastes when discarded.” • Some manufacturers offer recycling programs• There is at least one disposal company that is disassembling the components, recycling the batteries, metal, and plastic components that can be recycled, then disposing of the nicotine by incineration. Life Cycle IssuesWHO• The World Health Organization (WHO) has recommended that consumers be strongly advised not to use electronic nicotine delivery systems, including e-cigarettes, until they are deemed safe and effective and of acceptable quality by a competent national regulatory body. Food and Drug Administration (FDA)• August 8, 2016, the FDA regulation banning the sale of e-cigarettes to minors became effective. • Photo ID required• Retailers may not hand out free samples• No sales in vending machines• The FDA now requires manufacturers, importers, and retailers to report ingredients and place health warnings on products and advertisements• Vape shops that mix e-liquids will be regulated as a retailer and a manufacturerFood and Drug Administration (FDA)• Manufacturers must:o Stop distributing products that claim it is a modified risk tobacco producto Register their establishments and submit a list of products, including labeling and advertisementso Submit tobacco health documents by 2017o Submit ingredient listing by 2017o Submit a premarket application for “new” tobacco productsNIOSH• NIOSH Current Intelligence Bulletin 67 published  April 2, 2015 recommends that employers “establish and maintain smoke-free workplaces that protect those in workplaces from involuntary, secondhand exposures to tobacco smoke and airborne emissions from e-cigarettes and other electronic nicotine delivery systems.”(emphasis added)• ASHRAE Standard 62.1 contains requirements for ventilation of spaces that are free of environmental tobacco smoke (ETS).  • Also contains requirements for separation of an ETS-free area from any spaces containing ETS.• Addendum c to ANSI/ASHRAE Standard 62.1-2013 clarifies that the definition of ETS “includes smoke produced from the combustion of cannabis and controlled substances and the emissions produced by electronic smoking devices.” • “The existing requirements for separation of ETS-free spaces from ETS spaces remains unchanged.”ANSI/ASHRAE 62.1• ETS-free areas at positive pressure to ETS areas• Solid walls, floors, ceiling, and doors with automatic closing mechanisms to separate ETS areas from ETS-free areas• No recirculation or transfer of air from ETS area to ETS-free area• Signage for ETS areasANSI/ASHRAE 62.1Recommendation:“E-cigarettes should be considered a source of volatile organic compounds (VOCs) and particulates in the indoor environment that have not been thoroughly characterized or evaluated for safety.”**Quoted by NIOSH in the 2015 Current Intelligence Bulletin 67 “Promoting Disease and Injury Through Workplace Tobacco Policies”AIHA White Paper: Electronic Cigarettes in the Indoor EnvironmentBibliography• AIHA White Paper: Electronic Cigarettes in the Indoor Environment https://www.aiha.org/government-affairs/Documents/Electronc%20Cig%20Document_Final.pdf• NIOSH Current Intelligence Bulletin 67: Promoting Health and Preventing Disease and Injury Through Workplace Tobacco Policies (NIOSH Publication No. 2015-113) http://www.cdc.gov/niosh/docs/2015-113/pdfs/fy15_cib-67_2015-113_v3.pdf• ANSI/ASHRAE Addenda a, c, j, k, q, r, and s to ANSI/ASHRAE Standard 62.1-2013: Ventilation for Acceptable Indoor Air Qualityhttps://www.ashrae.org/File%20Library/docLib/StdsAddenda/62_1_2013_2015Supplement_20150203.pdfQUESTIONS?

Electronic Cigarettes in the Indoor Environment

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Electronic Cigarettes in the Indoor Environment

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