Chemical Constituents in E-Cigarette Liquids and Aerosols

Electronic cigarettes (e-cigarettes, EC) form an aerosol from the heating element and liquid-containing cartridge. The heating element aerosolizes the refill solutions (e-liquids) when the power source of e-cigarette is pressed. E-liquids consist of combinations of propylene glycol, glycerine, nicotine and flavouring ingredients. Puffing activates the battery-operated heating element in the atomizer and will produce smoke that is similar to conventional cigarette (CC). This study evaluated the chemical composition of e-liquid and aerosol samples available in Malaysia. We analyzed the volatile organic compounds in e-liquids and the aerosols samples from EC using gas chromatography mass spectrometer. Seventy-two EC e-liquids were analyzed through different flavours from more than 60 brands. Samples consisted of 32 nicotine-free (0 mg) and 40 nicotine-containing refill solutions (3 - 12 mg). Overall, 116 compounds were identified from EC e-liquids. On the other hand, 275 compounds were identified from their resultant aerosol samples. There were 42 compounds found in both e-liquids and aerosols. Seven compounds were only found in e-liquids and 38 compounds were only found in aerosols. Propylene glycol was found in all of the e-liquid and aerosol samples. Glycerin was found in 99% of the e-liquid and 100% of aerosol samples. At least 60% of the EC e-liquids and the resultant aerosol contain piperidine, butanoic acid ethyl ester and nicotine. It was also found that at least 9 out of 35 nicotine free labeled e-liquids contain nicotine. Some of these compounds were known to be detrimental to health and were detected in aerosol although they were not present in e-liquids. While some of the compounds are flavouring ingredients, it is necessary to evaluate its long-term effects on EC users.

Nicotine Content in Electronic Cigarette Refill Solutions and Its Release in Aerosols

Electronic cigarette (EC) is a device that imitates conventional cigarettes, which vaporizes a solution, with or without nicotine. This study evaluates the nicotine levels in EC refill solutions, its release in aerosols and comparison to the amount stated on the label. Seventy-two (72) different EC refill solutions were obtained from local shops in Selangor, Malaysia consisting of 40 nicotine-containing (3 - 12 mg) and 32 nicotine-free (0 mg) solutions. Aerosols were obtained by using an air tight syringe connected to an EC device to draw aerosol through an XAD-4 sorbent tube that trapped the nicotine. Nicotine in solution and aerosol samples are analyzed using gas chromatography-mass spectrometry equipment. Quantified nicotine in 40 nicotine-containing solutions ranged from 0.224 - 17.306 mg/mL. Nicotine is detected in 3 of the 32 nicotine-free solutions. Percentage of nicotine released into aerosols from refill solutions varied from 0.54% - 28.2%. Out of the 40 samples, thirty-two (32) had nicotine content that violated by more than ±10% from the value on the label. In comparing the labels, 19 samples have 0.3% - 77% higher nicotine level and 13 samples have 0.2% - 96.3% lower nicotine content. The inconsistency between the labelled and true levels of nicotine content indicates that commercial information may be misleading. The presence of nicotine in the nicotine-free refill solutions and higher nicotine content in aerosols may be addictive and may have negative health effects on users.

Formaldehyde Exposure, Health Symptoms and Risk Assessment among Hospital Workers in Malaysia

Formaldehyde is a chemical commonly used in hospitals as a tissue preservative;histopathology laboratory personnel are therefore among the workers most heavily exposed to formaldehyde. This study measured the formaldehyde exposure through ambient and personal air sampling, assessed the symptoms of poor health as well as estimating the health risk among hospital workers. We conducted a comparative cross-sectional study of both histopathology laboratory (exposed) and administration (nonexposed) workers in four hospitals in the Klang Valley, Selangor, Malaysia. Ambient and personal exposure to formaldehyde was measured using the OSHA 52 and NIOSH 2541 methods, respectively. The 8-hr time-weighted-average formaldehyde concentration was higher in exposed areas (0.25 ± 0.11 ppm) than nonexposed areas (0.08 ± 0.02 ppm). Histopathology workers were exposed to between 140% and 480% higher concentrations of formaldehyde than administration workers. Personal exposure was highest during grossing tasks (0.797 ± 0.436 ppm). A total of 67% of the exposed workers exhibited the same ten health symptoms related to formaldehyde exposure, and 57% of the nonexposed workers reported similar symptoms at their current workplace. Notably, symptoms of eye irritation, headache, drowsiness, and chest tightness were significantly more prevalent (p < 0.05;chi square and Fisher’s exact tests) among the exposed workers than the nonexposed workers. Among those with symptoms, 37% of the exposed workers, and 16% of the nonexposed workers believed that the symptoms were related to their current working environment. The noncancer effect of formaldehyde from air inhalation poses a potential risk of eye irritation among exposed workers. The cancer risk was not significant in both groups. Formaldehyde levels and symptoms of poor health were significantly higher among the exposed group. Exposure and risk could be minimised by strengthening control measures to improve indoor air quality in the workplace.