Department of Public Health, The Brody School of Medicine, East Carolina University, Greenville, NC, USA; Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, USA.
Department of Public Health, The Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Sci Total Environ. 2021 Jun 10;772:145486. doi: 10.1016/j.scitotenv.2021.145486. Epub 2021 Jan 30.
Diacetyl (CHO) is a toxicant commonly found in electronic cigarettes (e-Cigs) as a flavoring component and an enhancer of e-juices. Lung injury in current and former workers in popcorn manufacturing suggests a possible association with diacetyl inhalation exposure. Although the number of e-Cig users continues to rise steadily among the teens and adults, the potential risk of pulmonary disease has not been characterized. A systematic review of the open literature identified bronchiolitis obliterans-a pathological inflammation resulting in fibrosis of the bronchioles leading to an irreversible limitation to airflow in lungs-as the primary outcome of diacetyl exposures. Following the deterministic United States National Research Council/Environmental Protection Agency's risk assessment framework, that consists of four key steps: hazard identification, dose-response assessment, exposure assessment and risk characterization, we estimated noncarcinogenic (systemic) risks using a Hazard Quotient (HQ) approach upon exposure to diacetyl among teens and adults who use e-Cigs. Based on the NIOSH Benchmark Dose (BMD; 0.0175 mg/kg-day) and modelled Average Daily Doses (ADDs; range 0.11-5.2 mg/kg-day), we estimated 12 different HQ values-a measure of non-carcinogenic risk for diacetyl inhalation exposures-all of which were greater than 1 (range 6.2875-297.1429), suggesting a significantly higher non-carcinogenic risk from diacetyl exposures among the teens and adults who use e-Cigs. These results underscore the need to regulate e-Cigs to protect teens and adults from diacetyl exposures and risk of developing lung injuries, including bronchiolitis obliterans.
双乙酰（CHO）是一种常见的电子香烟（电子烟）调味剂和烟油增味剂，具有毒性。爆米花制作行业的现职和离职工人的肺部损伤表明，双乙酰吸入暴露可能与肺部损伤有关。尽管青少年和成年人使用电子烟的人数持续稳步上升，但肺部疾病的潜在风险尚未得到明确。对开放文献的系统综述确定了闭塞性细支气管炎，这是一种导致细支气管纤维化的病理炎症，导致肺部气流不可逆受限，是双乙酰暴露的主要后果。在遵循由美国国家研究理事会/环境保护署确定的四个关键步骤的确定性风险评估框架：危害识别、剂量-反应评估、暴露评估和风险特征描述后，我们使用危害商数（HQ）方法，估计了青少年和成年人使用电子烟时暴露于双乙酰的非致癌（全身）风险。基于 NIOSH 基准剂量（BMD；0.0175 mg/kg-day）和模拟平均日剂量（ADD；范围 0.11-5.2 mg/kg-day），我们估计了 12 个不同的 HQ 值，这是双乙酰吸入暴露的非致癌风险指标，所有这些值都大于 1（范围 6.2875-297.1429），这表明青少年和成年人使用电子烟时，双乙酰暴露的非致癌风险明显更高。这些结果强调需要对电子烟进行监管，以保护青少年和成年人免受双乙酰暴露和肺部损伤的风险，包括闭塞性细支气管炎。
