Acute health effects after passive e-vape among patients with COPD – an RCT exposure study

Abstract

Background: E-cigarette use is dramatically increasing and often permitted in smoke-free areas causing passive vape exposure. Little is known about potential adverse health effects of passive vape and people with respiratory diseases may be more susceptible. Our aim was to investigate local and systemic effects of short-term passive exposure to vape among patients with mild or moderate COPD.

Methods: In a randomised double-blinded crossover study non-smoking COPD patients were exposed for four hours at two different exposure conditions separated by 14 days; A) clean filtered air (particles concentration <6 µg/m3) and B) passive vaping (median: 18 µg/m3 (range: 8-333)). E-cigarette users in an adjacent chamber were vaping in situation B and vape-polluted air was passed to the exposure chamber. Health effects including FEV1/FVC, FeNO, Surfactant Protein-A (SP-A) in Particles in Exhaled Air (PExA) and plasma biomarkers were evaluated before, after, and 24 h. after exposures.

Results: 16 patients (mean age 68) participated. Exposure to passive vape did not alter FEV1/FVC or FeNO. SP-A in exhaled air was negatively affected by time and exposure to vape, and some plasma biomarkers (citrate, phospholipids and free cholesterol in very large HDL plus triglycerides in medium HDL) increased significantly after exposure to vape alone.

Conclusions: At the exposure levels in the study, SP-A in exhaled particles, citrate and some plasma biomarkers in patients with COPD were affected by passive vaping indicating inflammation and atherogene activity. We recommend that passive vape exposure should be further studied.