The American Industrial Hygiene Association® (AIHA) has described the potential exposures and health risks associated with the use of electronic cigarettes in a new report. The report reviewed current scientific information and evaluated the effects of chemicals used in e-cigarettes and emitted from them. The report indicated that although e-cigarettes may be “safer” for the user than tobacco cigarettes, they can emit airborne contaminants that may affect both the user and people nearby.

Emissions may contain nicotine

“Vaping has been promoted as a smoking cessation tool that has no smoke,” said Cheryl (Cheri) L. Marcham, PhD, CIH, CSP, CHMM, project team leader on the white paper. “However, research indicates that emissions from vaping may contain nicotine and other contaminants whose health effects have not been thoroughly studied.”

E-cigarettes are battery-powered devices that deliver vaporized nicotine and other chemicals to users. They are frequently promoted as safer than traditional cigarettes because they do not burn tobacco. However, they have been shown to emit aerosols and several organic compounds, including nicotine, acetone, acrolein, formaldehyde, and flavoring compounds.

Effects of nicotine

The vapor from electronic cigarettes that contain nicotine may cause exposure for people around the users. Exposure to even low levels of nicotine can increase heart rate, respiratory rate, and blood pressure. It can also cause birth defects, promote tumor growth, and affect brain development.

Another chemical, propylene glycol, found in theatrical smoke, is commonly used in e-cigarettes as a carrier for the nicotine and the flavorings, and to create the “vapor” that is emitted. The literature reviewed indicates that exposure to theatrical fogs may contribute to asthma and other lung problems.

Limited information is available on the health effects of exposure to aerosolized flavorings. A compound that may be safe when ingested is not automatically safe when inhaled as an aerosol, as has been seen with the use of diacetyl for buttery flavorings. Most flavorings in e-cigarettes have not been thoroughly studied for inhalation health effects.

Risk assessment

The report recommends that healthcare providers, e-cigarette companies and distributors, and the public health community understand that e-cigarettes are not emission-free, and that limited scientific information exists on their potential health risks. Risk assessment methods that look at the costs and benefits of e-cigarettes may be more useful than quantitative health risk assessments. The only group that may benefit from their use consists of people who already smoke and who want to reduce their exposure to byproducts of combustion. For other people, however, no clear benefits have been demonstrated, and there may be health risks, especially for vulnerable populations. These include children, pregnant women, and people with cardiovascular and/or lung conditions.

“While e-cigarettes may appear to provide a ‘safer’ alternative to tobacco cigarettes, these products have been shown to emit airborne contaminants that may be inhaled by both the vaper and those nearby,” said Marcham. “As a result, the project team concluded that e-cigarettes should be considered a source of organic compounds and particulates in the indoor environment until they have been thoroughly evaluated for safety.”

The white paper, which is the product of collaboration between the AIHA Indoor Environmental Quality and Risk Assessment committees, is available on AIHA.org. 

About AIHA®

Founded in 1939, the American Industrial Hygiene Association (AIHA) is the premier association of occupational and environmental health and safety professionals. AIHA’s 10,000 members play a crucial role on the front line of worker health and safety every day. Members represent a cross-section of industry, private business, labor, government and academia.