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

Smoking is considered an important source for inorganic elements, most of them toxic for human health. During the last years, there has been a significant increase in the use of e-cigarettes, although the role of them as source of inorganic elements has not been well established. A cross-sectional study including a total of 150 subjects from Brasov (Romania), divided into three groups (non-smokers, cigarette smokers and electronic cigarettes smokers) were recruited to disclose the role of smoking on the human exposure to inorganic elements. Concentration of 42 elements, including trace elements, elements in the ATSDR's priority pollutant list and rare earth elements (REE) were measured by ICP-MS in the blood serum of participants. Cigarette smokers showed the highest levels of copper, molybdenum, zinc, antimony, and strontium. Electronic cigarette (e-cigarette) users presented the highest concentrations of selenium, silver, and vanadium. Beryllium, europium and lanthanides were detected more frequently among e-cigarette users (20.6%, 23.5%, and 14.7%) than in cigarette smokers (1.7%, 19.0%, and 12.1%, respectively); and the number of detected REE was also higher among e-cigarette users (11.8% of them showed more than 10 different elements). Serum levels of cerium and erbium increased as the duration of the use of e-cigarettes was longer. We have found that smoking is mainly a source of heavy metals while the use of e-cigarettes is a potential source of REE. However, these elements were detected at low concentrations.