Respiratory Effects of Exposure to Metals from Electronic Cigarettes (RE-EMIT)

项目摘要 电子烟（e-cigs）的使用在年轻人和年轻人中以惊人的速度增长， 尽管在其毒性和潜在健康影响方面存在严重的知识差距。电子烟装置的工作原理是加热 化学品（电子液体）的混合物与金属线圈，以产生精细的气溶胶，这是由用户吸入。几 包括铅和镍的金属已经在电子烟气溶胶中发现并且是已知的肺毒物;然而， 关于电子烟的模式如何使用对金属的影响暴露以及这些金属暴露如何影响电子烟的模式的信息很少。 可能与肺部健康影响有关。此外，尽管FDA部分禁止调味电子烟， 香烟，一种新型的一次性电子烟（例如Puff Bar）最近已在市场上推出， 年轻人和年轻人的甜味和水果味;因此，我们想评估如何使用这些新的 器械会影响金属接触和肺功能。最近的电子烟，或vaping，产品使用相关 肺损伤（EVALI）爆发强调了研究电子烟使用如何与呼吸系统疾病相关的必要性。 结果。肺功能测定法是一种可重复的肺肺功能（PFT）检测方法， 阻碍性或限制性过程。我们假设1）市场上新的一次性电子烟（即泡芙棒）是 也是金属暴露的来源，2）电子烟用户的vaping方案影响金属暴露的程度，以及3） 有毒金属暴露可能对呼吸系统健康结果产生负面影响， 可重复的肺功能测试，如肺活量测定。因此，我们的具体目标是：1）测量金属 暴露于新的和新兴的电子烟设备，2）评估电子烟使用与肺部健康的关联 3）评估电子烟中金属的潜力，以至少部分解释所测量的 肺健康的影响。为了实现我们的目标，我们将在剩余的25项指标中增加肺部结局指标 POD电子烟用户和25名来自R01的对照参与者。我们将招募额外的25个新的电子烟用户 一次性电子烟（包括Puff Bars）和25名匹配的非使用者，以表征肺部结局 （1秒用力呼气量（FEV1）、用力肺活量（FVC）和弥散功能的减少） 一氧化碳容量（DLCO）），测量其装置气溶胶中的金属， 0个月和6个月时尿液和血液中金属的内部暴露。我们将通过尿液可替宁来验证电子烟的使用情况， 通过尿液毒理学试验确定潜在的四氢大麻酚（THC）使用。政策和研究的影响：鉴于 最近的EVALI爆发，以及新口味的一次性电子烟设备的扩散，迫切需要 了解这些设备造成的暴露。本研究将生成关键数据，以通知FDA， CIG监管旨在遏制青年和年轻成年人中日益普遍的使用，以及 规划未来的干预措施，以限制不利的接触和健康结果。

Project Summary The use of electronic cigarettes (e-cigs) has increased at an alarming rate among youth and young adults, despite critical knowledge gaps on their toxicity and potential health effects. E-cig devices work by heating a mixture of chemicals (e-liquid) with a metallic coil to generate a fine aerosol, which is inhaled by the user. Several metals, including lead and nickel, have been found in e-cig aerosols and are known lung toxicants; however, there is little information on how patterns of e-cig use impact exposure to metals and how these metal exposures may be associated with pulmonary health effects. In addition, despite the FDA's partial ban on flavored e- cigarettes, a new type of disposable e-cig (e.g. Puff Bar) has been recently introduced in the market targeting youth and young adults with sweet and fruity flavors; thus, we would like to evaluate how the use of these new devices affects exposure to metals and lung function. The recent e-cigarette, or vaping, product use-associated lung injury (EVALI) outbreak underscores the need to study how e-cig use may be associated with respiratory outcomes. Spirometry, a reproducible test of pulmonary lung function (PFT), allows assessment of early airway obstructive or restrictive processes. We hypothesize 1) new disposable e-cigs on the market (i.e. puff bars) are also a source of metal exposure, 2) e-cig user's vaping regimen affects the degree of metal exposure, and 3) that toxic metal exposure can have negative effects on respiratory health outcomes measured through reproducible pulmonary function tests, such as spirometry. Thus, our specific aims are 1) to measure metal exposure from new and emerging e-cig devices, 2) evaluate the association of e-cig use with pulmonary health measures, and 3) to assess the potential for metals from e-cigs to explain, at least in part, the measured pulmonary health effects. To achieve our goal, we will add pulmonary outcome measures to the remaining 25 POD e-cig users and 25 control participants from our R01. We will recruit an additional 25 e-cigs users of new disposable e-cigs (including Puff Bars) and 25 matched non-users to characterize pulmonary outcomes (Reductions in the forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and diffusing capacity of carbon monoxide (DLCO)), measures of metals in aerosol from their devices, and measures of internal exposure to metals in urine and blood at 0 and 6 months. We will verify e-cig use by urine cotinine and potential tetrahydrocannabinol (THC) use by urine toxicology test. Policy and research impact: In light of the recent EVALI outbreak, and the proliferation of new flavored disposable e-cig devices, there is an urgent need to understand exposures resulting from these devices. This study will generate critical data to inform FDA for e- cig regulation targeted at curbing the increasing prevalence use among youth and young adults, as well as to plan future interventions to limit adverse exposures and health outcomes.