Passive exposure to e-cigarette emissions: irritation symptoms, severity and duration
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Hellenic Cancer Society, George D. Behrakis Research Lab, Greece
American College of Greece, Institute of Public Health, Greece
National and Kapodistrian University of Athens, Athens, Greece
WHO Collaborating Center for Tobacco Control, Institut Català d’Oncologia - Institut d'Investigació Biomèdica de Bellvitge (ICO-IDIBELL), Spain
Universitat de Barcelona, Epidemiology and Public Health, Spain
Academy of Athens, Biomedical Research Foundation (BRFAA), Greece
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A257
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The current study, part of the EU H2020 funded TackSHS project, aimed to test the hypothesis that passive exposure to e-cigarette emissions provokes systemic symptoms and to determine their severity and timing.

30 nonsmokers, 18-35 years old, BMI< 30, with no significant medical history, no medications, normal physical examination and spirometry, were passively exposed in a 35m3 room, during a 30-minute Control (no passive smoking) and Experimental (standardized e-cigarette smoking by a human smoker) session.
PM2.5 concentrations were 0.027 mg/m3 and 3.3 mg/m3 during the Control and Experimental sessions, respectively. Participants completed an irritation questionnaire, grading symptom severity at T0 (pre-exposure), T15 (midway), T30 (exposure endpoint) and T60 (30-minute post-exposure) in both sessions.
The questionnaire showed internal consistency (Cronbach's α>0.70). Scores 1-5 were generated for the environmental, ocular, nasal, airway and general complaints by adding symptoms per system. Analysis was performed using Wilcoxon-signed rank sum test and Spearman correlation (p< 0.05).

The most frequent and intense symptoms reported were mild eye burning, nasal and airway dryness.
Ocular irritation score gradually increased from T0 reaching a significant increase by T30 (p=0.034). Nasal score increased significantly from T0 to T15 (p=0.008) and remained significantly higher at T30. Airway irritation score increased significantly from T0 to T15 (p=0.004) and furthermore from T15 to T30 (p=0.018). All symptoms returned to T0 scores by T60 (p>0.05).
The increased scores for ocular, nasal and airway complaints were positively correlated with increased environmental scores at T15 and T30. General complaint scores showed a tendency to increase at T30 that was positively correlated with increased environmental scores at T30.

Short-term exposure of nonsmokers to e-cigarette emissions resulted in mild ocular, nasal and airway symptoms that persisted up to 30 minutes and were positively correlated with environmental indices. Further research is needed to investigate long-term health implications.

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