Secondhand exposure to e-cigarettes emissions

1. Secondhand exposure to
e-cigarettes emissions
Esteve Fernández
efernandez@iconcologia.net
@stvfdz
In memoriam
Manel Nebot

2. Is there a
“passive exposure”
To the emissions (the
vapour) of electronic
cigarettes?

3. E-cigarettes contain lower levels of toxins than
conventional cigarettes, but do contain toxins
German Cancer Prevention Center. 2013.

4. Toxicant Range in content
in vapor from e-
cigarette samples
per 15 puffs
Range in content in
conventional cigarette in
mainstream smoke from 1
cigarette
Formaldehyde (µg) 0.2-5.61 1.6-52
Acetaldehyde (µg) 0.11-1.36 52-140
Acrolein (µg) 0.07-4.19 2.4-62
o-methylbenzaldehyde (µg) .13-.71 --
Toluene(µg) 0-0.63 8.3-70
p,m-xylene (µg) 0 - 0.2 --
NNN (ng) 0 - 0.00043 0.0005-0.19
NNK (ng) 0-0.00283 0.012-0.11
Cadmium (ng) 0 - 0.022 --
Nickel (ng) 0.011-0.029 --
Lead (ng) 0.003-0.057 --
Levels of toxicants in e-cigarette vapor compared to cigarette smoke
Adapted from: Grana, Benowitz & Glantz. Circulation. 2014.

5. Cigarettes versus e-cigarettes: passive
exposure at home
Nicotine and particulate matter emissions
from e-cigarettes in a private car

6. Cigarettes versus e-cigarettes: passive
exposure at home
Montse Ballbè, Jose M. Martínez-Sánchez, Xisca Sureda,
Marcela Fu, Raúl Pérez-Ortuño, José A. Pascual,
Esteve Saltó, Esteve Fernández
Tobacco Control Unit
Institut Català d’Oncologia

7. Methods
54 non-smokers volunteers
• 25 living with conventional cigarette smokers
• 5 living with e-cigarettes smokers
• 24 living in smoke-fgree homes (and exposed anywhere)
Objective
To characterize the passive exposure to e-cigs emissions
among non-smokers living with e-cigarettes users at home.

8. Methods
Environmnetal markers of exposure in air
Airborne nicotine (µg/m3)
Cotinina en saliva
Cotinina en orina
GC/MS

9. Methods
Environmnetal markers of exposure in air
Particulate matter: PM2,5 (µg/m3)
Cotinina en saliva
Cotinina en orina
Air nicotine (µg/m3)
30.0025.0020.0015.0010.005.000.00
PM2.5(µg/m3)
1000.00
800.00
600.00
400.00
200.00
0.00
r=0,8
Fu et al. Environ Res. 2014.

10. Methods
Personal biomarkers of exposure
Cotinine in saliva and in urine (ng/ml)
Cotinina en saliva
Cotinina en orina

11. 0.01
0.11
1.61
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
1.60
1.80
2.00
Smokefree E-cigarettes Cigarettes
Concentrationinµg/m3
Median concentration of airborne nicotine
(µg/m3) taken during one week period
Results. Environmental markers: nicotine in air

12. Real-time PM2.5 concentrations (µg/m3) in an
e-cigarettes user’s home, in a conventional cigarettes
user’s home, and in two smoke-free homes.
Results. Environmental markers: particulate matter

13. n
Salivary cotinine
(ng/ml)
Urinary cotinine
(ng/ml)
Smoke-free homes 24 0.05 (0.05; 0.13) 0.43 (0.26; 0.96)
Exposed to e-cigarettes 5 0.24 (0.15; 0.31) 2.10 (0.57; 2.70)
Exposed to conventional
cigarettes
25 0.32 (0.23; 0.63) 2.06 (0.81; 3.71)
Median and interquartil range of cotinine in saliva and urine
taken at the end of one week period.
Results. Personal biomarkers: cotinine

14. n
Salivary cotinine
(ng/ml)
Urinary cotinine
(ng/ml)
Smoke-free homes 24 0.05 (0.05; 0.13) 0.43 (0.26; 0.96)
Exposed to e-cigarettes 5 0.24 (0.15; 0.31) 2.10 (0.57; 2.70)
Exposed to conventional
cigarettes
25 0.32 (0.23; 0.63) 2.06 (0.81; 3.71)
Median and interquartil range of salivary and urine
cotinine taken at the end of one week period.

15. Conclusions
These environmentalmarkers objectively show the
presence of small particulate matter and nicotine in the
homes of e-cigarettes users.
The personal biomarkers objectively show that non-
smokers who live with e-cigarette users are passively
exposed to the exhaled vapour from e-cigarettes and
incorporate and metabolize nicotine from them.

16. Nicotine and particulate matter emissions
from e-cigarettes in a private car
Esteve Fernández, Marcela Fu, Montse Ballbè,
Jose M. Martínez-Sánchez, Anna Riccobene, Xisca
Sureda, Glòria Muñoz, David Cordero, Esteve Saltó
Tobacco Control Unit
Institut Català d’Oncologia

17. Methods
Design: 3 experimental situations (5 measurements each)
Exp. A (Ø): control measurements (without smokers)
Exp. B (Ecig): e-cigarette measurements
Exp. C (Cig): tobacco cigarette measurements
Objective
To analyze the particulate matter and nicotine emissions
from e-cigarettes in cars.

18. Methods
Medium sized car
VW Touran, driver + 2 passengers (1 smoker + 2 researchers)
Phase Conditions Time
1 outdoor control measurement 15 min
2 in-car measurement in movement 30 min
semiopen window
3 in-car measurement in movement 15 min
open windows
4 in-car measurement stopped 30 min
closed windows

20. Electronic cigarette with nicotine (2.75 mg)
Phase 2 in-car measurement in movement
Phase 4 in-car measurement stopped

21. Conventional cigarette (2 cigs)
Phase 2 in-car measurement inmovement
Phase 4 in-car measurement stopped

22. Measurements
Environmental exposure markers
PM2.5, PM1 and airborne nicotine (µg/m3)

24. Experiment B: electronic cigarette
Phase 1 Phase 2 Phase 3 Phase 4

25. Experiment B: electronic cigarette
Phase 2

26. Experiment B: electronic cigarette
Phase 4

27. Experiment C: conventional cigarette
Phase 1 Phase 2 Phase 3 Phase 4

28. Experiment C: conventional cigarette
Phase 2

29. Control
(n=5)
Electronic
cigarettes
(n=5)
Conventional
cigarettes
(n=5)
PM1.0 (µg/m3) 2.6 (1.6; 4.9) 15.1 (13.0; 24.7) 4125.2
PM2.5 (µg/m3) 3.6 (2.1; 7.3) 22.9 (19.0; 44.5) 5158.4
Airborne nicotine (µg/m3) 0.01 (0.01; 0.01) 1.0 (0.4; 2.0) 162.4
Median (and interquartile range) of particulate matter (PM1.0 &
PM2.5) and airborne nicotine in a series of controlled experiments
during 30-minutes periods in a stopped car with closed windows.

30. Conclusions
The environmental markers objectively show the
emissions to the environment of PMs and nicotine
In a small, closed space, such a car, the use of an e-
cigarette (with a nicotine charge equivalent to 2
traditional cigarettes) during a short period of time
produces PM above the WHO limits.

31. Exhaled vapor from
electronic cigarettes
pollutes the air with fine
particles and nicotine
Is there a “passive exposure” to the emissions
(the vapor) of electronic cigarettes?
People exposed to exhaled vapor
from electronic cigarettes incorporate
and metabolize nicotine.

32. Secondhand exposure to
e-cigarettes emissions
Esteve Fernández
efernandez@iconcologia.net
@stvfdz
In memoriam
Manel Nebot