Concentrations of cadmium, lead, and mercury in blood among US cigarettes, cigars, electronic cigarettes, and dual cigarette-e-cigarette users

Data from National Health and Nutrition Examination Survey for 2013-2016 were used to compare observed levels of cadmium, lead, and total mercury in blood among US residents aged >= 12 years who were users of cigars, cigarettes, cigars and cigarettes, e-cigarettes and dual users of cigarettes and e-cigarettes. Total sample size available for analysis was 1139. Adjusted geometric means (AGM) among cigarette, cigar, e-cigarette, cigarette and cigar, and cigarette-e-cigarette users were comparable for blood cadmium lead, and total mercury. Cigar only users had lower AGM than cigar and cigarette users for total mercury (0.56 vs. 0.97 mu g/L, p = 0.03). There is no evidence yet that can show concentrations of blood and urine cadmium, lead, and mercury among e-cigarette users are any different than among cigarette and/or dual users of cigarettes and e-cigarettes. (C) 2019 Elsevier Ltd. All rights reserved.