Assessing and Reducing Worker Exposure to Exhaled E-cigarette Aerosols in Vape Shops
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Assessing and Reducing Worker Exposure to Exhaled E-cigarette Aerosols in Vape Shops


The electronic cigarette (e-cig) has become a popular alternative nicotine delivery device that continues to grow in use and revenues. E-cigs are largely sold in vape shops, retail establishments dedicated to selling vape products. Customer sampling of e-liquids and social vaping permitted in vape shops make them sites of secondhand exposure to e-cig aerosols, which may pose potential occupational risk to vape shop workers. Pollutants emitted from e-cig use include ultrafine particles, nicotine, metals, and aldehydes, which have been previously found to induce oxidative stress responses, cause cytotoxicity in humans and animals, and increase risk of cardiovascular events. Although there is growing literature studying the health effects of mainstream e-cig aerosol inhalation, studies about health risks from secondhand exposure, particularly in workplaces, are limited. This study assessed exhaled e-cig aerosols as a potential occupational exposure among vape shop workers, and tested potential air mitigation strategies to reduce vape shop worker exposure to exhaled e-cig aerosols. First, sixty-seven vape shops were randomly surveyed and fine and ultrafine particles measured in six representative shops. Simultaneous measurements were also taken at increasing distances away from a vaping area to assess the mixing and spatial profiles of particle levels inside the shops. During vaping activity, real-time indoor particle number concentration (PNC) and gravimetric-corrected PM2.5 mass concentration across the six vape shops varied from 1.3�104 to 4.8�105 particles/cm3 and from 15.5 to 37,500 μg/m3, respectively, and could rise up to 10,000 times above background for PM2.5 and 100 times above background for PNC�. Exhaled e-cig particles persisted in the air, traveling and mixing in the shops. PM�2.5� decayed faster than PNC over distances greater than 1.5 m from a vaping source. To explore employee exposure to e-cig aerosols in vape shops and potential associated effects as a result of exposure, urinary cotinine as a metabolic marker for nicotine exposure and select urinary oxidative stress, systemic inflammation, and metal exposure response markers were measured in thirty vape shop workers, fifteen vaping and fifteen non-vaping, at the start and end of a work shift on two days, which were either the first and last days of a consecutive workday period or two separate days if a subject had a nonconsecutive workday schedule. Elevated oxidative stress, inflammation, and metal toxicity/reactive oxygen species response markers observed within a work shift were much stronger among vaping workers, whose e-cig aerosol dosage is compounded with their own e-cig use during a work shift. However, increasing cotinine, and a corresponding upward trend in a lipid peroxidation marker (8-isoprostane) between the first and last work shifts were observed in non-vaping workers with a consecutive workday schedule, indicating that these increases in nicotine exposure and oxidative stress effect may be attributable to workplace exposure to exhaled e-cig aerosols. This is further suggested with the significant association observed between cotinine and 8-isoprostane in the non-vaping group varied by vape shop, suggesting that worksite characteristics, which could include vaping activity during the shift, may induce oxidative stress. With workplace exposure to nicotine, likely from exhaled e-cig aerosols in the vape shop, a possible contributor to oxidative stress in non-vaping workers, air mitigation strategies may then be needed to reduce exposure. Effectiveness of two air mitigation strategies (enhanced ventilation at the ASHRAE-recommended ventilation rate for beauty and nail salons and high-rate portable filtration) were tested in six vape shops for particle and nicotine air concentration reduction over business hours. From baseline, mean PNC levels were reduced by an average 40% after enhanced ventilation and 61% after portable filtration across the studied shops, and mean PM�2.5 levels reduced by 47% and 26%, respectively. During high vaping density in the shop, average PNC and PM2.5 concentrations were lower by 36% and 19%, respectively, during enhanced ventilation than during baseline. During portable filtration, average PNC and PM2.5 levels stayed low at varying vaping densities compared to baseline and enhanced ventilation, suggesting filtration to have a different mechanism (i.e. removal of particles) of indoor pollutant control than dilution or exhausting indoor air. From baseline, mean time-weighted average air nicotine concentrations were reduced by an average 46% after enhanced ventilation and 9% after portable filtration, suggesting enhanced ventilation may be more effective in reducing gas-phase nicotine.

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