Electronic Nicotine Delivery Systems
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Electronic nicotine delivery systems (ENDS) such as e-cigarettes, e-hookahs, e-pipes and e-cigars are devices that deliver aerosolized nicotine, flavorings, and/or other chemicals into the lungs of users. Use of ENDS is sometimes referred to as “vaping.” A typical ENDS device contains three main com-ponents: a battery, a heating element, and a cartridge or tank that holds the e-liquid.1 The e-liquid is a solution that typically contains a mixture of nicotine, propylene glycol and glycerin. Additionally, e-liquid may also contain flavoring chemicals.2-4 When an ENDS user takes a puff from a device, the e-liquid is heated by the heating element and forms an aerosol that the user inhales into their lungs. A portion of the aerosol taken into the ENDS user’s lung is exhaled, which may result in exposure to bystanders in proximity to the user.5
Use of ENDS is rising among never-tobacco smokers and former or current tobacco smokers.6-9 While ENDS aerosol may differ in some ways from tobacco smoke, users of ENDS are still exposed to many different types of chemical compounds (some of which are known carcinogens), very small particles, and numerous hazardous metals.10-12 Chemicals emitted in ENDS aerosols can include carcinogens such as formaldehyde, polyaromatic hydrocarbons, and other chemicals, as well as various organic compounds that are irritating to the lung, and flavoring compounds.11,13-15 Among flavoring compounds emitted in some ENDS aerosol are 2,3-pentanedione and diacetyl, which NIOSH has linked to causing obliterative bronchiolitis, a devastating lung disease in workers.4 In addition to concerns about chemicals emitted from ENDS, there is also a risk of burns following spontaneous combustion of the lithium battery in the device.16
The potential health risks to users or bystanders exposed to secondhand smoke from ENDS is still under investigation. NIOSH issued a Current Intelligence Bulletin 67: Promoting Health and Preventing Disease and Injury Through Workplace Tobacco Policies, that recommends employers establish “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.” This recommendation covers all varieties of ENDS including e-hookahs, e-pipes, e-cigars, e-cigarettes and advanced modular ENDS.
References
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Barrington-Trimis J, Samet J, McConnell R [2015]. Flavorings in electronic cigarettes an unrecognized respiratory health hazard? J Am Med Assoc; 312: 2493- 2494.
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Allen J, Flanigan S, LeBlanc M, Vallarino J, MacNaughton P, Stewart J, Christiani D [2015]. Flavoring chemicals in e-cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a sample of 51 products, including fruit, candy, and cocktail-flavored e-cigarettes. Environ Health Perspect. E-printhttp://ehp.niehs.nih.gov/15-10185/
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Grana R, Benowitz N, Glantz S [2014]. E-Cigarettes, A scientific review. Circulation; 129:1972-1986.
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Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P [2013]. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS ONE; 8(3) e57987.
Bekki K, Uchiyama S, Ohta K, Inaba Y, Nakagome H, Kunugita N [2014]. Carbonyl compounds generated from electronic cigarettes. Int J Environ Res Publ Health; 11: 11192-11200.
Kim H, Shin H [2013]. Determination of tobacco-specific nitrosamines in replacement liquids of electronic cigarettes by liquid chromatography-tandem mass spectrometry. J Chromatog A; 1291: 48– 55.
Farsalinos K, Gillman I, Melvin M, Paolantonio A, Gardow W, Humphries K, Brown S, Poulas K, Voudris V [2015]. Nicotine levels and presence of selected tobacco-derived toxins in tobacco flavoured electronic cigarette refill liquids. Int J Environ Res Public Health; 12: 3439-3452.
Geiss O, Bianchi I, Barrero-Moreno J [2016]. Correlation of volatile carbonyl yields emitted by e-cigarettes with the temperature of the heating coil and the perceived sensorial quality of the generated vapours. Int J Hyg Environ Health; 219: 268-277.
Walsh K, Sheikh Z, Johal K, Khwaja N [2016]. Case Report: Rare case of accidental fire and burns caused by e-cigarette batteries. BMJ Case Rep; doi:10.1136/ bcr-2015-212868.
- Page last reviewed: November 16, 2016
- Page last updated: November 16, 2016
- Content source:
- National Institute for Occupational Safety and Health Respiratory Health Division (RHD)