September 19, 2012

Stanton A. Glantz, PhD

e-cigarettes release toxic chemicals indoors, should be included in clean indoor air laws and policies

A study published in Indoor Air from the Fraunhofer Wilhelm-Klauditz-Institut in Germany examined secondhand emissions from several e-cigarettes in a human exposure chamber.  Each e-cigarette was puffed 6 times and data were collected for a conventional cigarette, also puffed 6 times.

While the e-cigarette produced lower levels of toxins in the air for nonsmokers to breathe than the conventional cigarette, there were still elevated levels of acetic acid, acetone, isoprene, formaldehyde and acetaldehyde, averaging around 20% of what the conventional cigarette put into the air.

Thus, while not as polluting as a conventional cigarette, the e-cigarettes are putting detectable levels of several significant carcinogens and toxins in the air. 

No one should have to breathe these chemicals, whether they come out of a conventional or e-cigarette.  No one should smoke e-cigarettes indoors that are free of other forms of tobacco smoke pollution.

Comments

Comment: 

Since 2009, e-cigs are banned in Brazil. In addition E-cigs in Brazil are considered tobacco products, it means e-cigs are not allowed in closed spaces. This paper is one more support to the Brazilian measure, specially because the carcinogenic compounds sometimes don´t obey the classic relation dose X response. 

Comment: 

Diskin, et al. conducted a study of the concentrations of the common breath metabolites ammonia, acetone, isoprene, ethanol and acetaldehyde in the breath of five subjects over a period of 30 days. “Breath samples were taken and analysed in the early morning on arrival at the laboratory.” http://hero.epa.gov/index.cfm?action=reference.details&reference_id=9895...
It is enlightening to compare their results for the three compounds that correspond to three of the six e-cigarette exhaled vapor compounds in the <em;Indoor Air </em;<em;study.</em;
<em;The Indoor Air study</em;<em; measured a concentration of 25 mcg/m3 of Acetone, which converts to 10.39 PPB. In Diskin’s study, Acetone ranged from 293-870 PPB. </em;
<em;The Indoor Air study found 10 mcg/m3 of Isoprene, which converts to 3.54 PPB. Compare to 55-171 PPB in Diskin’s study.</em;
<em;The Indoor Air study found 3 mcg/m3 of Acetaldehyde, which converts to 1.64 PPB, compared with 2-5 PPB in Diskin’s study.</em;
Therefore for these three compounds, bystanders would be in greater danger if exposed to exhaled breath of ordinary non-smoking, non-vaping citizens.
Three additional compounds were noted in the Indoor Air study. The quantities were reported as micrograms per cubic meter by the German researchers.&nbsp; OSHA Permissible Exposure Limit (PEL) are expressed as milligrams per cubic meter.&nbsp; To convert to mg/m3, divide the mcg value by 1000.
<em;2-Butanone (MEK) = 0.002 mg/m3&nbsp; (OSHA PEL = 590 mg/m3)</em;
<em;Acetic acid = 0.014 mg/m3&nbsp; (OSHA PEL = 25 mg/m3)</em;
<em;Formaldehyde&nbsp; = 0.016 mg/m3&nbsp; (OSHA PEL = 0.661 mg/m3)</em;
When all the scientific data are considered, we must conclude that bystanders are in no danger whatsoever from exhaled vapor, as the highest concentration measured represents a mere 2.4% of the OSHA PEL, and the remaining 5 compounds represent a fraction of 1% of the OSHA PEL.
&nbsp;

Comment: 

Several people have submitted responses to this post (and posted Twitter tweets), such as the comment above, pointing out the the levels of toxic chemicals e-cigarettes put into indoor air are lower than Occupational Safety and Health Administration (OSHA) Permissible Exposure Levels (PELs).
Without commenting on whether the specific exposure levels that are claimed in the comment, the problem with this argument is that&nbsp; OHSA PELs were established for <em;occupational </em;exposures for workers working in a hazardous environment (like a chemical plant) where <em;some exposure to toxins is unavoidable</em;.&nbsp;
These levels are much higher than permitted ambient exposures. (Cigarette companies made similar arguments against restrictions on use of conventional cigarettes indoors years ago.)&nbsp; The PEL is simply not an appropriate standard.
The important point is that the emissions of these toxic chemicals is not zero and there are no safe levels of exposure to carcinogens.
More important, indoor exposure to toxic e-cigarette emissions is completely avoidable by simply not allowing use of e-cigarettes indoors.&nbsp; As with conventional cigarettes, people should not be forced to breathe toxic chemicals to support someone else's nicotine addiction.

Comment: 

We have every right to ban the unregulated use of any delivery method for a toxic recreational drug that has any potential to harm others whatsoever.
Until it is conclusively proven that exposure to e-cig vapour in the concentration, duration, and frequency generated if vaping is permitted everywhere is <strong;as safe as or safer than</strong; not being exposed to it--the only acceptable standard for a non-essential such as nicotine--e-cigs must and should be banned from use in public.
There is also the risk of normalizing addiction, so e-cigs should also be banned in any public place, including outdoors, where people under the legal age for consent may be present.
We have spent enough time fighting to protect people from addiction and secondhand smoke. We do not owe it to anyone to become lab rats or sacrificial lambs in yet another scheme by a corrupt industry to enrich its coffers by hooking vulnerable people on a toxic non-essential for life through manipulative and mendacious marketing.
And while e-cigs may reduce harm for already addicted smokers, they are still considerably more harmful than not using them at all. Makers owe it to us to carefully and rigorously test their product and agree to regulation <strong;before</strong;, not after, e-cigs are unleashed on the public.
At this point, e-cigs look like just another another tobacco industry lie designed to placate people into accepting unnecessary risks that they owe no one simply so that the addicts from which it makes its money are not inconvenienced in accessing their next fix.
&nbsp;

Comment: 

It should be noted that infants and children do not work in industrial plants and the occupational standards do not take into account sensitivities of early life
exposures. The occupational standards are set in consideration of technological feasibility and cost, not just health effects.&nbsp; Neither USEPA nor CalEPA use
occupational standards for setting acceptable levels of environmental chemical exposure to the general public.
&nbsp;
Melanie Marty, Ph.D.
Adjunct Associate Professor
UC Davis

Comment: 

If it is "the right thing" to ban something because it creates a situation where carcinogens that could potentially result in tiny amounts of exposure to humans, then pretty much everything would be banned.

Comment: 

Because e-cigarettes put measurable levels of toxins into the air I am recommending that their use not be permitted indoors where use of other polluting nicotine delivery devices (conventional cigarettes) is not allowed.
They should also not be marketed or sold to children, since they are delivering an addictive drug.
They should also not be allowed to be marketed with claims that they assist in smoking cessation until there is actual good independent evidence that such claims are true.

Comment: 

&nbsp;
<strong;From:</strong;&nbsp;James Repace [mailto:[email protected]]&nbsp;
<strong;Sent:</strong;&nbsp;Friday, September 21, 2012 10:22 AM
<strong;To:</strong;&nbsp;Glantz, Stanton A
<strong;Subject:</strong;&nbsp;Re: OSHA PEL is not the appropriate standard for involuntary exposure to e-cig emissions
&nbsp;
Stan you are absolutely right. &nbsp;Further to the point OSHA PELs are designed by law to be stringent enough to avoid workers being overcome during a workshift, but explicitly do not guarantee that long term exposure will not cause health effects. &nbsp;Moreover, they are designed for a healthy workforce, not infants, the elderly, or those whose health is compromised. &nbsp;Finally, the OSH Act has an explicit cost-benefit test which unlike section 112 of the Clean Air Act, does not permit regulation of an occupational pollutant below the level that it is possible for the affected industry to economically meet. &nbsp;As an example: &nbsp;OSHA's PEL for 8-h occupational exposure to respirable dust is 5000 ug/m3, corresponding to a 1667 ug/m3 24 hr ave., while EPA's 24-h PM2.5 standard is 35 ug/m3, designed to protect sensitive groups. &nbsp;So the PEL argument is bogus. &nbsp;Furthermore, for 4-aminobiphenyl and beta naphylamine, both potent bladder carcinogens with short latency periods -- a decade or less -- there is no permissible exposure for workers. &nbsp; All three pollutants occur in secondhand smoke, although 2 of the 3 perhaps not in eCigs. &nbsp;Jim
&nbsp;
James Repace, MSc.&nbsp;Biophysicist;&nbsp;Repace&nbsp;Associates, Inc.&nbsp;Secondhand Smoke&nbsp;Consultants. &nbsp;6701&nbsp;Felicia Lane &nbsp; &nbsp;Bowie,&nbsp;MD 20720 phone 1-301-262-9131&nbsp;fax 1-301-262-3865&nbsp;email:&nbsp;<mailto:[email protected]";repace@comcast.net;;&nbsp;website:&nbsp;<http://www.repace.com/";www.repace.com;.

Comment: 

The only true places where OSHA standards would not apply would be in a private place. You really can not go anywhere where not one person is working, or it is considered their work area. If you are in an area that is not covered by some sort of standard covered by OSHA, then you are in an open area, presumably a traditional smoking allowed area. By saying that OSHA PEL is only applicable to "Hazardous work conditions" would mean that workers in those conditions should also be getting hazardous pay. This is something that can lead into Unions fighting for their employees. That being said, this topic would typically apply to restaurants, airports, malls, etc. What is the EPA or OSHA PEL for these areas as of now? I am certain that in restaurants, the exhaust from the kitchen is causing something. In airports and on the plane, the air from the ventilation system is being recycled while emissions from electronics is being distributed in the air. And in Malls, How many pollutants are flying around from the glues in most new plastics, paints, and items typically sold in Malls. Not to mention the by product from cleansing chemicals. As a smoker, I agreed with the anti smoking law indoors. I hate the Casinos in Las Vegas because of this, and I am a smoker. I prefer to go outside and smoke. However, I do not see the harm from e-cigarette exhaust. It is odorless, and taste less. &nbsp; I do however see the danger influencing children, hence, making it cool to smoke. But that should be an entirely other topic. Also, how do you get all those by-products from simple Propelyne Glycol or Vegetable Glycerine? I personally only use 100% USP Vegetable Glycerine in my e-cigarette. How does my body turn it into a toxic substance? Given this, shouldn't the area of&nbsp;focus be directed towards the e-juice industry and not the actual delivery product it's self? Just a smoker, chiming in. Please respond. I do not want to offend anybody. Just trying to get a good grip on this topic as well. I have just quit smoking thanks to my e-cig product. I think it may have just saved my life, or at the very least, given me a few more years with my children. Richard &nbsp;

Comment: 

The PEL is designed for situations (like working in an oil refinery) where some level of toxic exposure is essentially unavoidable because of the nature of&nbsp; the workplace.&nbsp; It is not an appropriate standard for the general public. Environmental standards, which are designed to protect the general public, are at <EM;much lower</em; <EM;levels</em; than occupational PELs. Also, the whole PEL methodology is widely viewed as outdated and likely to set levels that are too high <EM;even</em; for occupational settings.

Comment: 

I don't like how it makes me feel helpless, my kids, I just want the nicotine user to use it like any typical cigarette, not exposing my child in a car, though not used in my presence, when there has been vapors left behind all day even I feel the rath and have no say.&nbsp; My child is being subjected with no legal protection.&nbsp; I want this to stop, I want to have a say.&nbsp; I want power of information, I work hard to be healthy why would I relinquish my rights and safety.&nbsp; I can't wait till the leaders do their job, I am irritable to the core and my human spirit and liberty is being sucked dry.&nbsp; It really saddens me that someone can be subjected to someone else drug and have no legal&nbsp;protection. &nbsp;

Comment: 

S Glantz, while your intentions seem noble, if not a bit condescending, your stated facts in response to the study are not completely accurate, and your comments do not portray what the study found.&nbsp; For example, the levels of acetic acids, acetone, and isoprene are in levels 10,000 times lower than the average person would receive in a room heated with a central forced-air heating system, not 20% of what a cigarette would put into the air. You need to re-read the study.&nbsp;
Additionally, there is more formaldehyde absorbed into the skin by washing your hands just one time with the average restroom soap from a restaurant or other public establishment that one would receive being in a room full of e-cigarette users for an entire year.&nbsp;
While it is true that some inexpensive e-cigarettes do use some chemicals which may contain higher levels of some chemicals and perhaps carcinogens, generally speaking, the base chemical used in standard liquids for an e-cigarette are purified propylene glycol and vegetable glycerin.&nbsp; These are the same chemicals used to give asthma and pulmonary patients breathing and nebulizer treatments.&nbsp; These liquids allow the breakdown of the nicotine into the body the same as they allow a nebulizer to deliver drugs (NABA and SAIDS) to pulmonary patients.&nbsp;
Instead of continually trying to vilify those who are addicted to nicotine, let's first try congratulating them on at least dumping the horrible habit of tobacco use, which puts out 400+ additional, truly harmful chemicals to the smoker, and those around them.&nbsp; Instead of just screaming "BAN IT!" to anyone who will listen, why not try a truthful, educative approach first?&nbsp; Just don't try to educate by trumping up the facts, simply because it bruises your dislike of their habit. &nbsp;&nbsp;
&nbsp;
Dr. Peter Protero
Dr. of Pulmonology
&nbsp;

Comment: 

What I and others are calling for is not a ban on the purchase or use of e-cigarettes; we are simply saying that they should not be used indoors where bystanders are not exposed to the toxic chemicals emit.&nbsp; The fact that they emit lower levels of toxic chemicals than super-polluting conventional cigarettes is not relevant.

Comment: 

Please give Dr Peter Protero, Dr of Pulmonology's &nbsp;address as he is not listed anywhere and Has never made a scientific publication in international Repository Pubmed.. &nbsp; Is&nbsp;he a fiction &nbsp;of tobacco industry? Or simply an apologist? Shame this [erson has made sweeping comments in defence of this product, which creates &nbsp;electronic vapourisation of addictive chemicals. surely any doctor would want to promote cessation. Or is this the same school of thought that suggests arsenic for skin conditions? T Shelley MD

Comment: 

My son has his room under my room, he smokes electronic.cigarrettes an I am sure he uses marijua on tgem, but wether he uses marijuana or not, I have chronic bronchitis and Am very sensitive to smells or toxic stuff. Everytime he smokes, I taste the toxic syugf and my bronchitis reat to it . Some feel more harmful then others. Its horrible because he doesnt believe me and I am getting sivker, I am getting headaches now.

Comment: 

Proof pure nicotine is addictive? After all, don't NRT use pure nicotine?

Comment: 

The nicotine is the same and is just as addictive, whether in a cigarette, an e-cigarette, or NRT.
&nbsp;
The difference is that NRT is an FDA-approved medicine designed to help smokers ease out of the addiction, not a recreational device.

Comment: 

no matter how much lower the second-hand exposure is, there is exposure and e-cig smokers should be banned from smoking indoors in a public place, do you agree Dr. Protero? I've recently gotten into an argument with the e-cig smoker who was smoking inside the tourist boat with about 50 people in a small place including my 2 little boys. While we were trying to enjoy the glass-bottom view of the coral reef off FL Keys, I don't want my boys or myself to be smoked next to, e-cig or regular cig, do you agree with me on that? Well, the man actually cussed at me when I mentioned to the boat crew that he's smoking. Listen, I don't want to ban them from everywhere - I've been a smoker and quit 15 years ago after many tries. What I don't want them to do is to smoke in an enclosed public space - is that too much to ask? Please write to me mailto:[email protected]";dniyazov@gmail.com.

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