Body burden of toxic metals and rare earth elements in non-smokers, cigarette smokers and electronic cigarette users

Badea, Mihaela; Luzardo, Octavio P.; González-Antuña, Ana; Zumbado, Manuel; Rogozea, Liliana; Floroian, Laura; Alexandrescu, Dana; Moga, Marius; Găman, Laura; Rădoi, Mariana; Boada, Luís D.; Henríquez-Hernández, Luis Alberto

doi:10.1016/j.envres.2018.06.007

Cited by 97 publications

(58 citation statements)

References 35 publications

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“…The search strategy retrieved a total of 728 individual studies by search A, including 118 duplicates and 320 studies by search B, including 112 duplicates ( Figure 1). After abstract and full text review, a total of 24 individual studies met the inclusion criteria, including 3 studies identified through hand search (Badea et al 2018;Goniewicz et al 2018;Jain 2018). Of the 21 studies not counting the 3 found through manual search, 14 were identified both by search A and search B, 17 were identified by search A, and 18 were identified by search B.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Aherrera et al (2017) recruited 64 daily e-cigarette users from Maryland in the United States (5 users of cig-a-like devices and 59 users of mod devices), including 50 sole e-cigarette users who had never smoked before or had quit smoking at least 3 months prior and 14 dual users (users of both e-cigarettes and cigarettes) who smoked traditional cigarettes at least weekly. Badea et al (2018) recruited 34 e-cigarette users (device type not reported) who were former smokers, 58 nonsmokers, and 58 conventional smokers from Brasov, Romania. All e-cigarette participants in this study were sole e-cigarette users (dual users of e-cigarettes and traditional cigarettes were excluded from the study).…”

Section: Metal/metalloid Levels In Biosamples Of E-cigarette Usersmentioning

confidence: 99%

“…Among studies reporting metal/metalloid levels in serum (n = 2) (Badea et al 2018;Jain 2018), most metals/metalloids (Ag, As, Ba, Be, Cd, Co, Fe, Hg, Mn, Mo, Ni, Pb, Pd, Sb, Sn, Sr, Th, Tl, U, and V) were reported in only one study. Both studies reported Cu, Se, and Zn in the serum of e-cigarette users.…”

Section: Metal/metalloid Levels In Biosamples Of E-cigarette Usersmentioning

confidence: 99%

“…Device design, e-liquid composition, and operation preferences can affect the metal/metalloid levels that e-cigarettes deliver to users (Williams et al 2019b;Zhao et al 2019). To demonstrate internal exposure to toxic metals associated with e-cigarette use, metal/metalloid levels have not only been measured in e-liquids and aerosols but also in human biosamples such as urine (Aherrera et al 2017;Goniewicz et al 2018;Jain 2018), saliva (Aherrera et al 2017), serum (Badea et al 2018;Jain 2018), and blood (Jain 2018) collected from e-cigarette users.…”

Section: Introductionmentioning

confidence: 99%

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

Zhao

Aravindakshan

Hilpert

et al. 2020

Environ Health Perspect

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BACKGROUND: Electronic cigarettes (e-cigarettes) have become popular, in part because they are perceived as a safer alternative to tobacco cigarettes. An increasing number of studies, however, have found toxic metals/metalloids in e-cigarette emissions. OBJECTIVE: We summarized the evidence on metal/metalloid levels in e-cigarette liquid (e-liquid), aerosols, and biosamples of e-cigarette users across e-cigarette device systems to evaluate metal/metalloid exposure levels for e-cigarette users and the potential implications on health outcomes. METHODS: We searched PubMed/TOXLINE, Embase ® , and Web of Science for studies on metals/metalloids in e-liquid, e-cigarette aerosols, and biosamples of e-cigarette users. For metal/metalloid levels in e-liquid and aerosol samples, we collected the mean and standard deviation (SD) if these values were reported, derived mean and SD by using automated software to infer them if data were reported in a figure, or calculated the overall mean (mean ± SD) if data were reported only for separate groups. Metal/metalloid levels in e-liquids and aerosols were converted and reported in micrograms per kilogram and nanograms per puff, respectively, for easy comparison. RESULTS: We identified 24 studies on metals/metalloids in e-liquid, e-cigarette aerosols, and human biosamples of e-cigarette users. Metal/metalloid levels, including aluminum, antimony, arsenic, cadmium, cobalt, chromium, copper, iron, lead, manganese, nickel, selenium, tin, and zinc, were present in e-cigarette samples in the studies reviewed. Twelve studies reported metal/metalloid levels in e-liquids (bottles, cartridges, open wick, and tank), 12 studies reported metal/metalloid levels in e-cigarette aerosols (from cig-a-like and tank devices), and 4 studies reported metal/metalloid levels in human biosamples (urine, saliva, serum, and blood) of e-cigarette users. Metal/metalloid levels showed substantial heterogeneity depending on sample type, source of e-liquid, and device type. Metal/metalloid levels in e-liquid from cartridges or tank/open wicks were higher than those from bottles, possibly due to coil contact. Most metal/metalloid levels found in biosamples of e-cigarette users were similar or higher than levels found in biosamples of conventional cigarette users, and even higher than those found in biosamples of cigar users. CONCLUSION: E-cigarettes are a potential source of exposure to metals/metalloids. Differences in collection methods and puffing regimes likely contribute to the variability in metal/metalloid levels across studies, making comparison across studies difficult. Standardized protocols for the quantification of metal/metalloid levels from e-cigarette samples are needed. https://doi.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Metal/metalloid Levels In Biosamples Of E-cigarette Usersmentioning

confidence: 99%

Section: Metal/metalloid Levels In Biosamples Of E-cigarette Usersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Zhao

Aravindakshan

Hilpert

et al. 2020

Environ Health Perspect

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“…Samples were acid-digested as described (Badea et al 2018). Venous blood samples were allowed to thaw at room temperature.…”

Section: Analysis Of Venous Bll By Icp-msmentioning

confidence: 99%

Suitability of anodic stripping voltammetry for routine analysis of venous blood from raptors

González¹,

Camacho²,

Tiburón³

et al. 2019

Enviro Toxic and Chemistry

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Lead (Pb) poisoning is a significant threat faced by raptors. Hence, rapid Pb diagnosis has become a priority during the admission of raptors in wildlife recovery centers, and bench‐top analyzers, such as LeadCare II ®, are routinely employed for this purpose. However, this device has been designed for conducting analyses of human blood Pb levels (BLLs), and the validity of this methodology for whole blood from raptors has, to date, rarely been assessed. In addition, a recent recall by the US Food and Drug Administration has recommended discontinuing the use of this analyzer for human venous blood because it may underestimate the BLL. We evaluated the precision of BLL measurements taken with LeadCare II by comparing them with those obtained with inductively coupled plasma mass spectrometry (ICP‐MS). Our sample contained venous blood from 105 raptors belonging to 4 species. The results showed a good correlation between the 2 techniques (Spearman's r = 0.927, p < 0.0001). The mean BLL with ICP‐MS was 19.6 μg/dL; it was found to be 18.7 μg/dL with LeadCare II. A Bland‐Altman analysis indicated that the bias between the mean differences was only 0.5 μg/dL, but it had a high standard deviation of bias (5.7 μg/dL) and 95% limits of agreement from –10.75 to 11.74 μg/dL. The present results indicated that LeadCare II has an overall sensitivity of 71.8% and a positive predictive value of 76.3%. The specificity of LeadCare II for detecting animals with low BLL (<3.4 μg/dL) was 96.4%, and the negative predictive value (the probability that a value below the limit of detection of LeadCare II has a true correspondence with the actual value) was 100%. The present results indicated that, although LeadCare II might be imperfect in the estimation of BLLs in raptors, it performs reasonably well and might be employed in the clinical setting to assess patients potentially suffering from Pb poisoning. Environ Toxicol Chem 2019;38:737–747. © 2018 SETAC

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Association Between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017

et al. 2019

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IMPORTANCE The prevalence of the use of electronic cigarettes (e-cigarettes) in the United States has grown rapidly since their introduction to the market more than a decade ago. While several studies have demonstrated an association between combustible cigarette smoking and depression, the association between e-cigarette use and depression has not been thoroughly studied. OBJECTIVE To examine the association between e-cigarette use and depression in a nationallyrepresentative sample of the adult population in the United States. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of the Behavioral Risk FactorSurveillance System database, 2016 to 2017. The Behavioral Risk Factor Surveillance System is the largest national telephone-based survey of randomly sampled adults in the United States. A total of 892 394 participants with information on e-cigarette use and depression were included. Data analysis was conducted in May 2019.EXPOSURES Electronic cigarette use status defined by self-report as never, former, or current use. MAIN OUTCOMES AND MEASURES Self-reported history of a clinical diagnosis of depression. RESULTSOf the 892 394 participants (414 326 [29.0%] aged Ն60 years; 502 448 [51.3%] women), there were 28 736 (4.4%) current e-cigarette users, of whom 13 071 (62.1%) were aged between 18 and 39 years. Compared with never e-cigarette users, current e-cigarette users were more likely to be single, male, younger than 40 years, and current combustible cigarette smokers (single, 120 797 [24.3%] vs 10 517 [48.4%]; men, 318 970 [46.6%] vs 14 962 [60.1%]; aged 18-39 years, 129 085 [32.2%] vs 13 071 [62.1%]; current combustible cigarette use, 217 895 [7.9%] vs 8823 [51.8%]). In multivariable adjusted models, former e-cigarette users had 1.60-fold (95% CI, 1.54-1.67) higher odds of reporting a history of clinical diagnosis of depression than never users, whereas current e-cigarette users had 2.10 (95% CI, 1.98-2.23) times higher odds. Additionally, higher odds of reporting depression were observed with increased frequency of use among current e-cigarette users compared with never users (daily use: odds ratio, 2.39; 95% CI, 2.19-2.61; occasional use: odds ratio, 1.96; 95% CI, 1.82-2.10). Similar results were seen in subgroup analyses by sex, race/ethnicity, smoking status, and student status. CONCLUSIONS AND RELEVANCEThis study found a significant cross-sectional association between e-cigarette use and depression, which highlights the need for prospective studies analyzing the longitudinal risk of depression with e-cigarette use. If confirmed by other study designs, the potential mental health consequences may have regulatory implications for novel tobacco products.

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Body burden of toxic metals and rare earth elements in non-smokers, cigarette smokers and electronic cigarette users

Cited by 97 publications

References 35 publications

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

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

Suitability of anodic stripping voltammetry for routine analysis of venous blood from raptors

Association Between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017

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