A numerical investigation of the potential effects of e-cigarette smoking on local tissue dosimetry and the deterioration of indoor air quality

Quantification of Flavors, Volatile Organic Compounds, Tobacco Markers, and Tobacco-Specific Nitrosamines in Heated Tobacco Products and Their Mainstream Aerosol

As an alternative to cigarettes, the sales of heated tobacco products (HTPs) have increased in the Japanese market. This may contribute to improving a smoker's health because the levels of most toxic compounds─such as tobacco-specific nitrosamines (TSNAs) and volatile organic compounds (VOCs)─in the mainstream of HTPs are lower than those in cigarettes. However, the risks associated with the flavors that provide attractive tastes to HTPs remain unknown. We demonstrated that compared with cigarettes, HTPs reduce the health risks associated with VOCs and TSNAs while achieving comparable nicotine and flavor levels. The VOC and TSNA concentrations in the mainstream aerosol of HTPs were 0.0039 (benzene)-0.53 (acetaldehyde) times lower than those in cigarettes. Using HTPs may still pose adverse noncarcinogenic and carcinogenic effects on human health, as indicated by hazard quotients >1 for acrolein and acetaldehyde, margins of exposure <100 for (R)-(+)-limonene, and cancer risks >1.0 × 10-6 for acetaldehyde. Additionally, the exhalation of mainstream aerosol may increase the indoor acrolein concentration to 0.069 μg m-3, exceeding the reference concentration for acrolein (0.02 μg m-3). Therefore, reducing acrolein concentrations is an effective measure for improving the safety of HTP use.

Higher Reactive Oxygen Species and cellular aging in oral mucosal cells of young smokers: a comparative analytical study

Background

Cigarette smoke contains chemical components that cause excessive production of Reactive Oxygen Species (ROS), altering cell physiology and affecting key pathways. This leads to hyperinflammation, DNA damage, and cellular aging, which may cause oral and pulmonary pathologies. Our study aims to investigate the impact of smoking on ROS levels and cellular aging in oral mucosal cells. We compared Reactive oxygen Species and cellular aging between smokers and non-smokers. Secondarily, we also compared the results between young and old smokers.

Methods

Oral swabs were taken from 50 smokers and 50 nonsmokers using a cytology brush. We quantified the reactive oxygen species (ROS) by using oxidized 2'7' dichlorodihydrofluorescein-diacetate (DCFH-DA) dye. To assess cellular aging, mRNA levels of the CYR61 gene-a cellular aging marker, were compared through RT-PCR.

Results

It was found that smokers had a higher percentage of ROS in comparison to non-smokers (p value < 0.001). Additionally, there was an over-expression of the CYR61 gene in smokers as compared to non-smokers (p value = 0.001). Furthermore, when comparing ROS and cellular aging between young smokers and old smokers, it was noted that there was a significantly higher percentage of ROS and up-regulation of mRNA levels of CYR61 gene in young smokers in comparison to old smokers (p value 0.001 and <0.0001 respectively).

Conclusion

It has been observed that smokers have a higher amount of ROS production and cellular aging in their oral mucosal cells. In young smokers, ROS and cellular aging were found to be higher compared to older smokers. This is quite concerning and could be a major factor leading to oral pathologies in smokers.

The use of the model organism Caenorhabditis elegans in the investigation of the adverse effects of electronic cigarettes

The use of tobacco products is one of the most preventable risk factors for mortality from a variety of diseases, including cardiovascular, infectious, respiratory, and neoplastic conditions. The use of electronic cigarettes (ECIGs), also known as electronic nicotine delivery devices, has increased significantly in recent years. Nicotine, propylene glycol, and / or glycerine, water, alcohol, flavorings, and other substances are among the many chemicals found in ECIGs that are vaporized and inhaled. A review of the existing literature shows that research dedicated to ECIGs is a rapidly developing and growing field of study. The rationale for the use of ECIGs is that they represent a safer alternative to traditional tobacco products. However, vaping safety profiles are still under development, as this is a relatively recent phenomenon. Various model organisms can be employed to examine the cellular processes that may be altered by exposure to the electronic liquids utilized for vaping. For example, the translucent multicellular eukaryote Caenorhabditis elegans is widely used as a model organism to explain a broad range of biological processes, including aging, stress response, development, and many others. Due to its short lifespan and easy use, C. elegans is an ideal model organism for studying chronic exposure to drugs and environmental toxicology. This review presents a summary of the most recent findings on the impact of electronic cigarettes on the physiological health of this nematode. Preliminary observations made in C. elegans can provide insight into the consequences of exposure to fundamental cellular physiology, which can then be used for future research in humans and mammalian models.

Subject-Specific Multi-Scale Modeling of the Fate of Inhaled Aerosols

Determining the fate of inhaled aerosols in the respiratory system is essential in assessing the potential toxicity of inhaled airborne materials, responses to airborne pathogens, or in improving inhaled drug delivery. The availability of high-resolution clinical lung imaging and advances in the reconstruction of lung airways from CT images have led to the development of subject-specific in-silico 3D models of aerosol dosimetry, often referred to as computational fluid-particle-dynamics (CFPD) models. As CFPD models require extensive computing resources, they are typically confined to the upper and large airways. These models can be combined with lower-dimensional models to form multiscale models that predict the transport and deposition of inhaled aerosols in the entire respiratory tract. Understanding where aerosols deposit is only the first of potentially several key events necessary to predict an outcome, being a detrimental health effect or a therapeutic response. To that end, multiscale approaches that combine CFPD with physiologically-based pharmacokinetics (PBPK) models have been developed to evaluate the absorption, distribution, metabolism, and excretion (ADME) of toxic or medicinal chemicals in one or more compartments of the human body. CFPD models can also be combined with host cell dynamics (HCD) models to assess regional immune system responses. This paper reviews the state of the art of these different multiscale approaches and discusses the potential role of personalized or subject-specific modeling in respiratory health.

In silico identification of viral loads in cough-generated droplets - Seamless integrated analysis of CFPD-HCD-EWF

BACKGROUND AND OBJECTIVE

Respiratory diseases caused by respiratory viruses have significantly threatened public health worldwide. This study presents a comprehensive approach to predict viral dynamics and the generation of stripped droplets within the mucus layer of the respiratory tract during coughing using a larynx-trachea-bifurcation (LTB) model.

METHODS

This study integrates computational fluid-particle dynamics (CFPD), host-cell dynamics (HCD), and the Eulerian wall film (EWF) model to propose a potential means for seamless integrated analysis. The verified CFPD-HCD coupling model based on a 3D-shell model was used to characterize the severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2) dynamics in the LTB mucus layer, whereas the EWF model was employed to account for the interfacial fluid to explore the generation mechanism and trace the origin site of droplets exhaled during a coughing event of an infected host.

RESULTS

The results obtained using CFPD delineated the preferential deposition sites for droplets in the laryngeal and tracheal regions. Thus, the analysis of the HCD model showed that the viral load increased rapidly in the laryngeal region during the peak of infection, whereas there was a growth delay in the tracheal region (up to day 8 after infection). After two weeks of infection, the high viral load gradually migrated towards the glottic region. Interestingly, the EWF model demonstrated a high concentration of exhaled droplets originating from the larynx. The coupling technique indicated a concurrent high viral load in the mucus layer and site of origin of the exhaled droplets.

CONCLUSIONS

This interdisciplinary research underscores the seamless analysis from initial exposure to virus-laden droplets, the dynamics of viral infection in the LTB mucus layer, and the re-emission from the coughing activities of an infected host. Our efforts aimed to address the complex challenges at the intersection of viral dynamics and respiratory health, which can contribute to a more detailed understanding and targeted prevention of respiratory diseases.

A revision of the multiple-path particle dosimetry model focusing on tobacco product aerosol dynamics

To assess the health impact of inhaled aerosols, it is necessary to understand aerosol dynamics and the associated dosimetry in the human respiratory tract. Although several studies have measured or simulated the dosimetry of aerosol constituents, the respiratory tract focus areas have been limited. In particular, the aerosols generated from tobacco products are complex composites and simulating their dynamics in the respiratory tract is challenging. To assess the dosimetry of the aerosol constituents of tobacco products, we developed a revised version of the Multiple-Path Particle Dosimetry (MPPD) model, which employs (1) new geometry based on CT-scanned human respiratory tract data, (2) convective mixing in the oral cavity and deep lung, and (3) constituent partitioning between the tissue and air, and clearance. The sensitivity analysis was conducted using aerosols composed of four major constituents of electronic cigarette (EC) aerosols to investigate the parameters that have a significant impact on the results. In addition, the revised model was run with 4 and 10 constituents in ECs and conventional cigarettes (CCs), respectively. Sensitivity analysis revealed that the new modeling and the physicochemical properties of constituents had a considerable impact on the simulated aerosol concentration and dosimetry. The simulations could be carried out within 3 min even when 10 constituents of CC aerosols were analyzed simultaneously. The revised model based on MPPD is an efficient and easy-to-use tool for understanding the aerosol dynamics of CC and EC constituents and their effect on the human body.

Preliminary study on the E-liquid and aerosol on the neurobehavior of C. elegans

E-cigarettes, also known as electronic nicotine delivery systems (ENDS), are mainly used among adolescents and young adults. Similar to traditional cigarettes, different concentrations of nicotine are also added to E-cigarette's liquid (E-liquid), but due to the supplementation of chemicals such as propylene glycol (PG), vegetable glycerin (VG) and flavors, it is difficult to determine the risk after using E-cigarettes. And given to the specificity of the aerosol particle composition and atomization process of E-cigarettes, it is necessary to assess the neurotoxic effects of long-term E-cigarettes use. In this study, two commercial nicotine-containing (5%) and nicotine-free E-liquids were diluted to investigate the neurobehavioral changes and addictive tendencies of developing C. elegans after sub-chronic exposure to E-liquid. The results showed that sub-chronic exposure of E-liquid could lead to impaired growth and development of nematodes, abnormal general neuromotor behavior and advanced learning and memory behavior, and nicotine-containing E-liquid could also lead to increased addiction tendency of nematodes. Although the damage effect of nicotine free E-liquid is smaller than that of the nicotine-containing group, its toxic effect cannot be ignored. Further analysis of the neurotoxicity mechanism found that redox imbalance-mediated mitochondrial stress and aging may be important causes of E-liquid-induced biological damage. The biosafety of e-cigarette aerosols was also included in the assessment. The study found that the heated atomization process did not alter the E-liquid components, and E-cigarette aerosols still have the effect of interfering with the growth and development of nematodes and neurobehavior, and its addictive nature is also of concern. This study can provide new ideas for future studies on the neurotoxic effects and safety assessment of the E-cigarettes, and provide theoretical reference for the study on the injury mechanism of E-cigarettes.

Explore the Dosimetric Relationship between the Intake of Chemical Contaminants and Their Occurrence in Blood and Urine

The dosimetric relationship between the human intake dose of a chemical contaminant (an "external dose") and its concentrations in bodily fluids such as blood and urine (related to an "internal dose"), often characterized by a dose-to-concentration ratio, has critical applications in exposure science, toxicology, and risk assessment, especially in the "new approach methods" era. However, there is a lack of a mechanistic, systematic understanding of how such a dosimetric relationship depends on fundamental chemical properties, such as partition coefficients and biotransformation half-lives. Here, we investigate this issue using a well-evaluated toxicokinetic model, which links external and internal doses by quantifying the absorption and elimination of chemicals. Results are visualized in a series of chemical partitioning space plots, whereby a chemical's dose-to-concentration ratio can be approximately predicted based on its partitioning between air, water, and octanol phases. Our results indicate that when taken in equal doses, chemicals with low volatility and moderate to high hydrophobicity exhibit the highest concentrations in the blood, and chemicals undergoing significant biotransformation tend to exhibit lower concentrations in comparison to their counterparts undergoing negligible biotransformation but possessing similar partitioning properties. Chemicals with high hydrophilicity have the highest concentrations in urine. Such revealed property dependence is similar for both adults and children and for individuals with normal body weights and with obesity. Overall, insights gained from this study are important in predicting blood and urinary concentrations from exposure information and in determining the exposure rate that produces the blood or urinary concentrations observed in biomonitoring studies.

Effect of transient breathing cycle on the deposition of micro and nanoparticles on respiratory walls

BACKGROUND AND OBJECTIVE

From various perspectives (e.g. inhalation exposure and drug delivery), it is important to provide insights into the behavior of inhaled particles in the human respiratory system. Although most of the experimental and numerical studies have relied on an assumption of steady inhalation, the transient breathing profile is a key factor in particle deposition in the respiratory tract. In this study, particle transportation and deposition were predicted in a realistic human airway model during a breathing cycle and the effects of steady-state and transient flows on the deposition fraction were observed using computational fluid dynamics.

METHODS

Two transient breathing cycles with different respiratory durations were considered to evaluate the effects of respiration duration on particle transport and deposition characteristics. Two types of steady breathing conditions with corresponding steady-state respiratory volumes were reproduced. The Lagrangian discrete phase model approach was used to investigate particle transportation and deposition under transient breathing conditions. Additionally, the Eulerian approach was used to analyze the transport of nanoparticles in the gas phase. A total of >50,000 monodispersed particles with aerodynamic diameters ranging between 2 nm and 10 μm were selected for comprehensive deposition predictions for particle sizes ranging from the nano- to microscale.

RESULTS

The predicted results were compared with the experimental data. The particle deposition fraction in the nasal cavity and tracheal regions showed differences between the steady and transient simulations. In addition, particle analysis under steady inhalation conditions cannot accurately predict particle transportation and deposition in the lower airway. Furthermore, the breathing cycle had a significant effect on the deposition fraction of the particles and the behavior of the inhaled particles.

CONCLUSIONS

Transient simulation mimicking the breathing cycle was observed to be an important factor in accurately predicting the transportation and deposition of particles in the respiratory tract.

Exposure to secondhand aerosol from electronic cigarettes at homes: A real-life study in four European countries

Electronic cigarette (e-cigarette) use emits potentially hazardous compounds and deteriorates indoor air quality. Home is a place where e-cigarettes may frequently be used amid its increasing prohibition in public places. This study assessed the real-life scenario of bystanders' exposure to secondhand e-cigarette aerosol (SHA) at home. A one-week observational study was conducted within the TackSHS project in four countries (Greece, Italy, Spain, and the United Kingdom) in 2019 including: 1) homes of e-cigarette users living together with a non-user/non-smoker; and 2) control homes with no smokers nor e-cigarette users. Indoor airborne nicotine, PM2.5, and PM1.0 concentrations were measured as environmental markers of SHA. Biomarkers, including nicotine and its metabolites, tobacco-specific nitrosamines, propanediol, glycerol, and metals were measured in participants' saliva and urine samples. E-cigarette use characteristics, such as e-cigarette refill liquid's nicotine concentration, e-cigarette type, place of e-cigarette use at home, and frequency of ventilation, were also collected. A total of 29 e-cigarette users' homes and 21 control homes were included. The results showed that the seven-day concentrations of airborne nicotine were quantifiable in 21 (72.4 %) out of 29 e-cigarette users' homes; overall, they were quite low (geometric mean: 0.01 μg/m3; 95 % CI: 0.01-0.02 μg/m3) and were all below the limit of quantification in control homes. Seven-day concentrations of PM2.5 and PM1.0 in e-cigarette and control homes were similar. Airborne nicotine and PM concentrations did not differ according to different e-cigarette use characteristics. Non-users residing with e-cigarette users had low but significantly higher levels of cotinine, 3'-OH-cotinine and 1,2-propanediol in saliva, and cobalt in urine than non-users living in control homes. In conclusion, e-cigarette use at home created bystanders' exposure to SHA regardless of the e-cigarette use characteristics. Further studies are warranted to assess the implications of SHA exposure for smoke-free policy.

Prediction of exhaled carbon dioxide concentration using a computer-simulated person that included alveolar gas exchange

Accurate prediction of inhaled CO₂ concentration and alveolar gas exchange efficiency would improve the prediction of CO₂ concentrations around the human body, which is essential for advanced ventilation design in buildings. We therefore, developed a computer-simulated person (CSP) that included a computational fluid dynamics approach. The CSP simulates metabolic heat production at the skin surface and carbon dioxide (CO₂ ) gas exchange at the alveoli during the transient breathing cycle. This makes it possible to predict the CO₂ distribution around the human body. The numerical model of the CO₂ gas exchange mechanism includes both the upper and lower airways and makes it possible to calculate the alveolar CO₂ partial pressure; this improves the prediction accuracy. We used the CSP to predict emission rates of metabolically generated CO₂ exhaled by a person and assumed that the tidal volume will be unconsciously reduced as a result of exposure to poor indoor air quality. A reduction in tidal volume resulted in a decrease in CO₂ emission rates of the same magnitude as was observed in our published experimental data. We also observed that the predicted inhaled CO₂ concentration depended on the flow pattern around the human body, as would be expected.

Breathing zone and exhaled air re-inhalation rate under transient conditions assessed with a computer-simulated person

The breathing zone of an individual indoors is usually defined as a finite region steadily formed in front of a face. Assuming the steady formation of the breathing zone, we propose a procedure for quantitatively identifying a breathing zone formed in front of a human face in the transient condition. This assumption is reasonable considering that the ventilation time scale of human respiration is sufficiently short compared to the ventilation time scale of a room. We used steady-state computational fluid dynamics (CFD) and a computationally simulated person (CSP). We present the probabilistic size of the breathing zone for various postures and breathing conditions. By analyzing unsteady inhalation and exhalation airflow characteristics via a CSP with a respiratory system, we also estimated the direct re-inhalation rate of the exhaled air. The results can be used for developing methods to control the long-term and low-contaminant concentration exposures.

Secondary indoor air pollution and passive smoking associated with cannabis smoking using electric cigarette device-demonstrative in silico study

With electronic (e)-liquids containing cannabis components easily available, many anecdotal examples of cannabis vaping using electronic cigarette devices have been reported. For electronic cigarette cannabis vaping, there are potential risks of secondary indoor air pollution from vapers. However, quantitative and accurate prediction of the inhalation and dermal exposure of a passive smoker in the same room is difficult to achieve due to the ethical constraints on subject experiments. The numerical method, i.e., in silico method, is a powerful tool to complement these experiments with real humans. In this study, we adopted a computer-simulated person that has been validated from multiple perspectives for prediction accuracy. We then conducted an in silico study to elucidate secondary indoor air pollution and passive smoking associated with cannabis vaping using an electronic cigarette device in an indoor environment. The aerosols exhaled by a cannabis vaper were confirmed to be a secondary emission source in an indoor environment; non-smokers were exposed to these aerosols via respiratory and dermal pathways. Tetrahydrocannabinol was used as a model chemical compound for the exposure study. Its uptake by the non-smoker through inhalation and dermal exposure under a worst-case scenario was estimated to be 5.9% and 2.6% of the exhaled quantity from an e-cigarette cannabis user, respectively.

How can we best mitigate unintended passive smoking in an indoor environment? As marijuana tends to be legalized in more countries, there is an increasing number of cases of vaping cannabis using e-cigarette devices. E-cigarette vaping is presumed to cause relatively low levels of indoor air pollution due to the absence of a direct combustion process. In this study, we developed a numerical simulation model to quantitatively predict the impact of first- and second-hand cannabis vaping in an indoor environment. The study was conducted in response to vulnerable residents who are concerned regarding the deterioration of indoor air quality and informs policymakers of the potential risk of second-hand cannabis vaping exposure.

Editorial – Preface to the Special Issue on Numerical Techniques Meet with OR

This special issue of the Foundations of Computing and Decision Sciences, titled ”Numerical Techniques Meet with OR”, is devoted to the numerical techniques and their applications in real-world phenomena. The special issue and its editorial present numerical algorithms as they meet with different research topics such as, e.g., from operational research, supply chain management, geometrical structures and Covid-19 effects on financial applications. Besides, the special issue covers instructional information about numerical techniques which are useful for OR research problems and real-world applications on such issues.

An update on controversies in e-cigarettes

E-cigarettes are electronic nicotine delivery systems (ENDS) which mimic tobacco smoking without the combustion of tobacco. These devices have been misleadingly marketed as "less harmful" alternatives to conventional smoking tobacco products. The e-liquid in e-cigarettes include nicotine, a humectant and other additives including flavourings, colourants, or adulterants such as bacterial and fungal products. In this review, we discuss the contrasting views of the tobacco lobby and most professional societies. We describe the epidemiology of the use of these devices, with a widespread and significant rise in youth e-cigarette use seen in both the USA and Europe. We also describe what is known about the toxicity and mechanisms of EVALI (e-cigarette or vaping associated lung injury). This characterised by respiratory failure with an intense inflammatory response. The presentations are diverse and clinicians should consider vaping as a possible cause of any unusual respiratory illness in patients who have a history of vaping or other use of e-cigarette-related products. Second hand exposure to e-cigarettes is also harmful through respiration and transdermal absorption. E-cigarettes have a worse acute toxicity than tobacco and their long-term toxicity is unknown, and we advocate for the immediate, most vigorous anti-vaping legislation possible.

Influence of wind and relative humidity on the social distancing effectiveness to prevent COVID-19 airborne transmission: A numerical study

It has been confirmed that the coronavirus disease 2019 (COVID-19) can transmit through droplets created when an infected human coughs or sneezes. Accordingly, 1.83-m (6-feet) social distancing is advised to reduce the spread of the disease among humans. This is based on the assumption that no air circulation exists around people. However, it is not well investigated whether the ambient wind and relative humidity (RH) will cause SARS-CoV-2 laden droplets to transport farther in the air, and make the current social distancing policy insufficient. To provide evidence and insight into the "social distancing" guidelines, a validated computational fluid-particle dynamics (CFPD) model was employed to simulate the transient transport, condensation/evaporation, and deposition of SARS-CoV-2 laden droplets emitted by coughs, with different environmental wind velocities and RHs. Initial droplet diameters range from 2 to 2000 μm, and the wind velocities range from 0 to 16 km/h, representing different wind forces from calm air to moderate breeze. The comparison between a steady-state wind and a gust with a constant frequency has also been performed. Ambient RHs are 40% and 99.5%. The distances between the two virtual humans are 1.83 m and 3.05 m (6 feet and 10 feet). The facial covering effect on reducing the airborne transmission of the cough droplets has also been evaluated. Numerical results indicate that the ambient wind will enhance the complexity of the secondary flows with recirculation between the two virtual humans. Microdroplets follow the airflow streamlines well and deposit on both human bodies and head regions, even with the 3.05-m (10-feet) separation distance. The rest of the microdroplets can transport in the air farther than 3.05 m (10 feet) due to wind convection, causing a potential health risk to nearby people. High RH will increase the droplet sizes due to the hygroscopic growth effect, which increases the deposition fractions on both humans and the ground. With the complex environmental wind and RH conditions, the 6-feet social distancing policy may not be sufficient to protect the inter-person aerosol transmission, since the suspending micro-droplets were influenced by convection effects and can transport from the human coughs/sneezes to the other human in less than 5 seconds. Due to the complex real-world environmental ventilation conditions, a social distance longer than 1.83 m (6 feet) needs to be considered. Wearing masks should also be recommended for both infected and healthy humans to reduce the airborne cough droplet numbers.

Comparative Indoor Pollution from Glo, Iqos, and Juul, Using Traditional Combustion Cigarettes as Benchmark: Evidence from the Randomized SUR-VAPES AIR Trial

Modified risk products (MRP) such as electronic vaping cigarettes (EVC) and heat-not-burn cigarettes (HNBC) are appealing alternatives to combustion cigarettes. Limited between- and within-device comparative data are available on MRP. We aimed at comparing indoor particulate matter (PM) emissions measured in a randomized trial enforcing standardized smoking sessions, testing different devices and flavors of MRP, using traditional combustion cigarettes (TCC) as benchmark. Overall, MRP yielded significantly lower levels of indoor PM in comparison to TCC (with median PM levels during smoking for MRP < 100 μg/m3, and for TCC > 1000 μg/m3). Despite this, significant differences among MRP were found, with Iqos appearing associated with a significantly lower burden of emissions for all the monitored fractions of PM, including total PM (all p < 0.05). Precisely, during use, PM ≤1 µm (PM1) emissions were 28 (16; 28) μg/m3 for Glo, 25 (15; 57) μg/m3 for Iqos, and 73 (15; 559) μg/m3 for Juul (p < 0.001 for Glo vs. Iqos, p < 0.001 for Glo vs. Juul, and p = 0.045 for Iqos vs. Juul). Exploratory within-MRP analyses suggested significant differences between flavors, favoring, for instance, Ultramarine for Glo, Bronze for Iqos, and Mango for Juul, even if results varied substantially according to individual smoker. In conclusion, leading MRP have significantly less intense and persistent effects on indoor pollution in comparison to TCC. Yet, when focusing solely on MRP, between-product and between-flavor differences appear, with quantitative estimates suggesting lower polluting effects with Iqos. These results, if confirmed externally, could be used to individualize product and flavor choice to minimize the untoward effects of EVC and HNBC on indoor pollution.