RESEARCH PAPER
Potential harmful health effects of inhaling nicotine-free shisha-pen vapor: a chemical risk assessment of the main components propylene glycol and glycerol
 
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National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
CORRESPONDING AUTHOR
Anne S. Kienhuis   

National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands
Publish date: 2015-06-22
 
Tobacco Induced Diseases 2015;13(June):15
KEYWORDS
ABSTRACT
Background:
A shisha-pen is an electronic cigarette variant that is advertised to mimic the taste of a water pipe, or shisha. The aim of this study was to assess the potential harmful health effects caused by inhaling the vapor of a nicotine-free shisha-pen.

Methods:
Gas chromatography analysis was performed to determine the major components in shisha-pen vapor. Risk assessment was performed using puff volumes of e-cigarettes and “normal” cigarettes and a 1-puff scenario (one-time exposure). The concentrations that reached the airways and lungs after using a shisha-pen were calculated and compared to data from published toxicity studies.

Results:
The main components in shisha-pen vapor are propylene glycol and glycerol (54%/46%). One puff (50 to 70 mL) results in exposure of propylene glycol and glycerol of 430 to 603 mg/m3 and 348 to 495 mg/m3, respectively. These exposure concentrations were higher than the points of departure for airway irritation based on a human study (propylene glycol, mean concentration of 309 mg/m3) and a rat study (glycerol, no-observed adverse effect level of 165 mg/m3).

Conclusions:
Already after one puff of the shisha-pen, the concentrations of propylene glycol and glycerol are sufficiently high to potentially cause irritation of the airways. New products such as the shisha-pen should be detected and risks should be assessed to inform regulatory actions aimed at limiting potential harm that may be caused to consumers and protecting young people to take up smoking.

 
REFERENCES (19)
1.
Cheah NP, Chong NW, Tan J, Morsed FA, Yee SK. Electronic nicotine delivery systems: regulatory and safety challenges: Singapore perspective. Tob Control. 2012. doi:10.1136/tobaccocontrol-2012-050483.
 
2.
Gelderlander. 8-jarigen roken nepsigaretten op schoolplein. De Gelderlander. 2013.
 
3.
Bos P, Hernandez L, Mennes W, Kienhuis A, Talhout R. Risk assessment of tobacco additives and smoke components. National Institute for Public Health and the Environment (RIVM). 2012. Contract No.: 340031001.
 
4.
Soeteman-Hernandez LG, Bos PM, Talhout R. Tobacco smoke-related health effects induced by 1,3-butadiene and strategies for risk reduction. Toxicol Sci. 2013;136(2):566–80. doi:10.1093/toxsci/kft194.
 
5.
Djordjevic MV, Stellman SD, Zang E. Doses of nicotine and lung carcinogens delivered to cigarette smokers. J Natl Cancer Inst. 2000;92(2):106–11.
 
6.
Goniewicz ML, Kuma T, Gawron M, Knysak J, Kosmider L. Nicotine levels in electronic cigarettes. Nicotine Tob Res. 2013;15(1):158–66. doi:10.1093/ntr/nts103.
 
7.
Bos PMJ, Hernandez LG, Mennes WC, Kienhuis AS, Talhout R. Risk assessment of tobacco additives and smoke components. RIVM letter rapport 340031001/2012. 2012. http://www.rivm.nl/en/Library/....
 
8.
Etter JF. Electronic cigarettes: a survey of users. BMC Public Health. 2010;10:231. doi:10.1186/1471-2458-10-231.
 
9.
Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction. 2011;106(11):2017–28. doi:10.1111/j.1360-0443.2011.03505.x.
 
10.
RIVM. Tobacco additives: information for professionals, National Institute for Public Health and the Environment (RIVM). 2012.
 
11.
FDA. GRAS Substances (SCOGS) Database. 2013. http://www.fda.gov/Food/Ingred.... 2013.
 
12.
ATSDR. Toxicological profile for propylene glycol: US Department of Health and Human Services. Public Health Service, Agency for Toxic Substances and Disease Registry (ATSDR). 1997.
 
13.
Renne RA, Wehner AP, Greenspan BJ, Deford HS, Ragan HA, Westerberg RB, et al. 2-Week and 13-week inhalation studies of aerosolized glycerol in rats. Inhal Toxicol. 1992;4(2):95–111. doi:10.3109/08958379209145307.
 
14.
Suber RL, Deskin R, Nikiforov I, Fouillet X, Coggins CR. Subchronic nose-only inhalation study of propylene glycol in Sprague–Dawley rats. Food Chem Toxicol: Intl J Pub Br Ind Bio Res Assoc. 1989;27(9):573–83.
 
15.
Wieslander G, Norback D, Lindgren T. Experimental exposure to propylene glycol mist in aviation emergency training: acute ocular and respiratory effects. Occup Environ Med. 2001;58(10):649–55.
 
16.
Health-Council-of-The-Netherlands. Health Council of the Netherlands. Propylene glycol (1,2-Propanediol); Health-based recommended occupational exposure limit. The Hague: Health Council of the Netherlands publication no. 2007/02osh. 2007. http://www.gezondheidsraad.nl/....
 
17.
HCN. The Health Council of the Netherlands. Propylene glycol (1,2-Propanediol); Health-baded recommended occupational exposure limit. 2007. http://www.gezondheidsraad.nl/....
 
18.
ToxNet. Toxicology Data Network on Propylene Glycol. 2013; http://toxnet.nlm.nih.gov/cgi-....
 
19.
Renne R. 2-Week and 13-week inhalation studies of aerosolized glycerol in rats. Inhal Toxicol. 1992;4:95–111.
 
 
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