Meng Qingyu, Schwander Stephan, Son Yeongkwon, Rivas Cesar, Delveno Cristine, Graber Judith, Giovenco Daniel, Bruen Uma, Mathew Rose, Robson Mark
School of Public Health, Rutgers University, Piscataway, NJ, USA.
Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA.
Hum Ecol Risk Assess. 2016;22(2):558-579. doi: 10.1080/10807039.2015.1100064. Epub 2016 Jan 6.
Electronic cigarettes, battery-powered nicotine delivery devices, have been increasingly used in the past decade. However, human health risks associated with E-vapor inhalation have not been fully characterized.
This critical review aims at revisiting the building blocks of human health risk assessment, summarizing the state of the science, and identifying major knowledge gaps in exposure assessment and toxicity assessment.
A qualitative research synthesis was conducted based on scientific findings reported to date in peer-reviewed publications and our own preliminary experimental results.
There are a limited number of studies across all lines of evidence on E-vapor exposure and the health impacts of E-vapor inhalation. E-cigarette may be as efficient as traditional cigarettes in nicotine delivery, especially for experienced users, and studies suggest lower emissions of air toxics from E-cigarette vapor and lower second- and third-hand vapor exposures. But some toxic emissions may surpass those of traditional cigarettes, especially under high voltage vaping conditions. Experimentally, E-vapor/E-liquid exposures reduce cell viability and promote pro-inflammatory cytokine release. User vulnerability to concomitant environmental agent exposures, such as viruses and bacteria, may potentially be increased.
While evidence to date suggests that e-cigarettes release fewer toxins and carcinogens and compared to cigarettes, E-vapor is not safe and might adversely affect human immune functions. Major knowledge gaps hinder risk quantification and effective regulation of E-cigarette products including: 1) lack of long-term exposure studies; 2) lack of understanding of biological mechanisms associated with exposure; and 3) lack of integration of exposure and toxicity assessments.,. Better data are needed to inform human health risk assessments and to better understand the public health impact of E-vapor exposures.
电子烟是一种由电池供电的尼古丁输送装置，在过去十年中使用日益广泛。然而，与吸入电子烟烟雾相关的人类健康风险尚未得到充分描述。
本综述旨在回顾人类健康风险评估的基础，总结科学现状，并确定暴露评估和毒性评估中的主要知识空白。
基于同行评审出版物中迄今报道的科学发现以及我们自己的初步实验结果进行了定性研究综合分析。
关于电子烟暴露及其对健康影响的所有证据方面的研究数量有限。电子烟在尼古丁输送方面可能与传统香烟一样有效，尤其是对于有经验的使用者，并且研究表明电子烟烟雾中的空气毒物排放量较低，二手和三手烟雾暴露也较少。但一些有毒排放物可能超过传统香烟，特别是在高电压雾化条件下。在实验中，电子烟烟雾/电子烟液暴露会降低细胞活力并促进促炎细胞因子释放。使用者对诸如病毒和细菌等伴随环境因素暴露的易感性可能会增加。
虽然迄今为止的证据表明电子烟释放的毒素和致癌物比香烟少，但电子烟并不安全，可能会对人类免疫功能产生不利影响。主要知识空白阻碍了对电子烟产品的风险量化和有效监管，包括：1）缺乏长期暴露研究；2）对与暴露相关的生物学机制缺乏了解；3）暴露评估和毒性评估缺乏整合。需要更好的数据来为人类健康风险评估提供信息，并更好地了解电子烟暴露对公众健康的影响。
