Computational modeling method to estimate secondhand exposure potential from exhalations during e-vapor product use under various real-world scenarios

Intern Emerg Med. 2022 Oct;17(7):2005-2016. doi: 10.1007/s11739-022-03061-2. Epub 2022 Sep 1.


Potential secondhand exposure of exhaled constituents from e-vapor product (EVP) use is a public health concern. We present a computational modeling method to predict air levels of exhaled constituents from EVP use. We measured select constituent levels in exhaled breath from adult e-vapor product users, then used a validated computational model to predict constituent levels under three scenarios (car, office, and restaurant) to estimate likely secondhand exposure to non-users. The model was based on physical/thermodynamic interactions between air, vapor, and particulate phase of the aerosol. Input variables included space setting, ventilation rate, total aerosol amount exhaled, and aerosol composition. Exhaled breath samples were analyzed after the use of four different e-liquids in a cartridge-based EVP. Nicotine, propylene glycol, glycerin, menthol, formaldehyde, acetaldehyde, and acrolein levels were measured and reported based on a linear mixed model for analysis of covariance. The ranges of nicotine, propylene glycol, glycerin, and formaldehyde in exhaled breath were 89.44-195.70 µg, 1199.7-3354.5 µg, 5366.8-6484.7 µg, and 0.25-0.34 µg, respectively. Acetaldehyde and acrolein were below detectable limits; thus, no estimated exposure to non-EVP users is reported. The model predicted that nicotine and formaldehyde exposure to non-users was substantially lower during EVPs use compared to cigarettes. The model also predicted that exposure to propylene glycol, glycerin, nicotine and formaldehyde among non-users was below permissible exposure limits.

Keywords: Bystanders; Computational model predictions; E-cigarettes; E-vapor; ENDS; Formaldehyde; Nicotine; Nonusers; Real-world scenarios; Secondhand exposure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaldehyde / analysis
  • Acrolein / analysis
  • Adult
  • Aerosols
  • Air Pollution, Indoor* / analysis
  • Computer Simulation
  • Electronic Nicotine Delivery Systems*
  • Exhalation
  • Formaldehyde / analysis
  • Glycerol / analysis
  • Humans
  • Menthol / analysis
  • Nicotine / analysis
  • Propylene Glycol / analysis


  • Aerosols
  • Menthol
  • Formaldehyde
  • Propylene Glycol
  • Nicotine
  • Acrolein
  • Acetaldehyde
  • Glycerol