Use of social media to establish vapers puffing behaviour: Findings and implications for laboratory evaluation of e-cigarette emissions.

The recent growth in e-cigarette use has presented many challenges to Public Health research, including understanding the potential for e-cigarettes to generate toxic aerosol constituents during use. Recent research has established that the way e-cigarettes are puffed influences the magnitude of emissions from these devices, with puff duration the dominant driving force. Standardised puffing machine methods are being developed to harmonise testing approaches across laboratories, but critical to their success is the degree with which they accurately reflect vapers real-world puffing behaviours (topography). Relatively limited data is available examining the way vapers puff, with significant inconsistencies between studies. Here we report the creation and analysis of a large database of public-domain vaping videos to establish e-cigarettes puffing behaviour in near natural settings. Over 300 videos containing 1200 puffing events from 252 vapers were obtained from social media sources, divided approximately equally amongst cigalike, Ego and Advanced Personal Vapouriser ("APV", also referred to as "boxmod") types of e-cigarettes. Analysis showed that similar mean puff durations were found for all three categories of vaping devices. This includes direct-to-lung as well as mouth-to-lung puffing behaviours. A 3 s puff duration, as used in the recently published ISO puffing standard ISO 20,768:2018, appears appropriate for average behaviours. However, the wide diversity of puffing durations observed amongst vapers means it may be challenging to identify a simple yet comprehensively representative single machine-puffing regimen for laboratory studies. A puff duration of around 5.6 s appears to represent 95th percentile puffing behaviours amongst vapers and may be an appropriate choice for scientists and regulators seeking an additional more intense puffing regime. A range of new behavioural patterns have been identified whose impact on aerosol exposure need to be considered. Public-domain video records of vapers provides valuable and accessible insights into real-world use behaviours. It is freely available, and constantly updated with new material, and therefore provides a valuable resource for scientists seeking to understand real-world vaping behaviours.

An approach to allergy risk assessments for e-liquid ingredients.

Many flavours and fragrances are known allergens. Their selection and inclusion levels in e-liquids must therefore be guided by toxicological principles, taking into account the exposure pattern and inhalation route of exposure. For contact sensitisation, a general, agreed quantitative risk assessment approach to prevent dermal sensitisation exists. Here we propose exposure parameters and safety factors to apply this approach to e-liquid ingredients. Additionally, as a risk management approach for pre-sensitised individuals, we derive a threshold of 0.1% for indicating the presence of a contact sensitiser in e-liquid. Risk assessment for respiratory sensitisation is not well established. Occupational exposure limits that protect against respiratory allergy are generally very low. Cocoa shell extract is used as a case study to discuss the issues. A tolerable exposure level is derived and estimates of consumer exposure are presented, leading to the practical risk management approach of excluding respiratory sensitisers as e-liquid ingredients. Related to this, if natural extracts are used as flavourings in e-liquids, we recommend only protein-free versions are used. Additionally, we recommend the presence of any potential food allergens should be noted on the product information.

Meeting report: risk assessment of tamiflu use under pandemic conditions.

On 3 October 2007, 40 participants with diverse expertise attended the workshop Tamiflu and the Environment: Implications of Use under Pandemic Conditions to assess the potential human health impact and environmental hazards associated with use of Tamiflu during an influenza pandemic. Based on the identification and risk-ranking of knowledge gaps, the consensus was that oseltamivir ethylester-phosphate (OE-P) and oseltamivir carboxylate (OC) were unlikely to pose an ecotoxicologic hazard to freshwater organisms. OC in river water might hasten the generation of OC-resistance in wildfowl, but this possibility seems less likely than the potential disruption that could be posed by OC and other pharmaceuticals to the operation of sewage treatment plants. The work-group members agreed on the following research priorities: a) available data on the ecotoxicology of OE-P and OC should be published; b) risk should be assessed for OC-contaminated river water generating OC-resistant viruses in wildfowl; c) sewage treatment plant functioning due to microbial inhibition by neuraminidase inhibitors and other antimicrobials used during a pandemic should be investigated; and d) realistic worst-case exposure scenarios should be developed. Additional modeling would be useful to identify localized areas within river catchments that might be prone to high pharmaceutical concentrations in sewage treatment plant effluent. Ongoing seasonal use of Tamiflu in Japan offers opportunities for researchers to assess how much OC enters and persists in the aquatic environment.

Development, validation and application of a device to measure e-cigarette users' puffing topography.

With the rapidly rising popularity and substantial evolution of electronic cigarettes (e-cigarettes) in the past 5-6 years, how these devices are used by vapers and consumers' exposure to aerosol emissions need to be understood. We used puffing topography to measure directly product use. We adapted a cigarette puffing topography device for use with e-cigarettes. We performed validation using air and e-cigarette aerosol under multiple regimes. Consumer puffing topography was measured for 60 vapers provided with rechargeable "cig-a-like" or larger button-activated e-cigarettes, to use ad-libitum in two sessions. Under all regimes, air puff volumes were within 1 mL of the target and aerosol volumes within 5 mL for all device types, serving to validate the device. Vapers' mean puff durations (2.0 s and 2.2 s) were similar with both types of e-cigarette, but mean puff volumes (52.2 mL and 83.0 mL) and mean inter-puff intervals (23.2 s and 29.3 s) differed significantly. The differing data show that product characteristics influence puffing topography and, therefore, the results obtained from a given e-cigarette might not read across to other products. Understanding the factors that affect puffing topography will be important for standardising testing protocols for e-cigarette emissions.