TY - JOUR
T1 - Exposure to metals among Electronic Nicotine Delivery System (ENDS) users in the PATH study
T2 - A longitudinal analysis
AU - Kaplan, Bekir
AU - Navas Acien, Ana
AU - Rule, Ana M.
AU - Hilpert, Markus
AU - Cohen, Joanna E.
N1 - Funding Information:
This research was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number U54DA036105 and the Center for Tobacco Products of the U.S. Food and Drug Administration . The content is solely the responsibility of the authors and does not necessarily represent the views of the NIH or the FDA.
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/8/15
Y1 - 2023/8/15
N2 - Background: Few studies have evaluated Electronic Nicotine Delivery Systems (ENDS) in longitudinal studies, as a potential source of metals which may have carcinogenic, neurotoxic, and cardiotoxic effects. We evaluated metal body burden by ENDS use status in a longitudinal population-based national survey. Methods: We used the Population Assessment of Tobacco and Health (PATH) Study wave 1 (2013–2014), wave 2 (2014–2015), and wave 3 (2015–2016) adult data to assess urinary concentrations of seven metals among (1) ENDS only users who never used any nonelectronic tobacco products (n = 50), (2) ENDS only users who were former users of any nonelectronic tobacco products (n = 123) and (3) Never users (n = 1501) of any tobacco product. Results: Among ENDS only users who never used any nonelectronic tobacco products (n = 50), the geometric mean ratios (GMRs) of Cd and Pb were 1.25 (95%CI: 1.09–1.42) and 1.19 (95%CI: 1.05–1.34), respectively, compared to never users after adjustment for PATH Study wave, age, sex, race/ethnicity, education, region, secondhand smoke at home and work, and cannabis and other substance use. After the same adjustment, the corresponding GMRs were 1.48 (95%CI: 1.32–1.67) and 1.43 (95%CI: 1.28–1.60) for ENDS only users who were former users of any nonelectronic tobacco products (n = 123). No difference was observed in urinary concentrations of other metals comparing ENDS users to never users of any tobacco product. Discussion: ENDS users show higher urinary levels of Cd and Pb, including lifetime exclusive ENDS users compared to never users of any tobacco product. These findings are limited by the small sample size and could be related to underreporting of past combustible tobacco use or other factors. Metals typical of ENDS such as nickel and chromium unfortunately are not available in PATH. Studies assessing metal exposure associated with long term lifetime exclusive ENDS use (≥5 years) with larger sample size are needed.
AB - Background: Few studies have evaluated Electronic Nicotine Delivery Systems (ENDS) in longitudinal studies, as a potential source of metals which may have carcinogenic, neurotoxic, and cardiotoxic effects. We evaluated metal body burden by ENDS use status in a longitudinal population-based national survey. Methods: We used the Population Assessment of Tobacco and Health (PATH) Study wave 1 (2013–2014), wave 2 (2014–2015), and wave 3 (2015–2016) adult data to assess urinary concentrations of seven metals among (1) ENDS only users who never used any nonelectronic tobacco products (n = 50), (2) ENDS only users who were former users of any nonelectronic tobacco products (n = 123) and (3) Never users (n = 1501) of any tobacco product. Results: Among ENDS only users who never used any nonelectronic tobacco products (n = 50), the geometric mean ratios (GMRs) of Cd and Pb were 1.25 (95%CI: 1.09–1.42) and 1.19 (95%CI: 1.05–1.34), respectively, compared to never users after adjustment for PATH Study wave, age, sex, race/ethnicity, education, region, secondhand smoke at home and work, and cannabis and other substance use. After the same adjustment, the corresponding GMRs were 1.48 (95%CI: 1.32–1.67) and 1.43 (95%CI: 1.28–1.60) for ENDS only users who were former users of any nonelectronic tobacco products (n = 123). No difference was observed in urinary concentrations of other metals comparing ENDS users to never users of any tobacco product. Discussion: ENDS users show higher urinary levels of Cd and Pb, including lifetime exclusive ENDS users compared to never users of any tobacco product. These findings are limited by the small sample size and could be related to underreporting of past combustible tobacco use or other factors. Metals typical of ENDS such as nickel and chromium unfortunately are not available in PATH. Studies assessing metal exposure associated with long term lifetime exclusive ENDS use (≥5 years) with larger sample size are needed.
KW - E-cigarettes
KW - Metal
KW - Urine
UR - http://www.scopus.com/inward/record.url?scp=85158818202&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85158818202&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2023.116032
DO - 10.1016/j.envres.2023.116032
M3 - Article
C2 - 37137457
AN - SCOPUS:85158818202
SN - 0013-9351
VL - 231
JO - Environmental research
JF - Environmental research
M1 - 116032
ER -