A recent study published in the journal Environmental Research has found that the liquids used in e-cigarettes can contain highly toxic metals that potentially cause cancer.

Researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore analyzed the liquids found in five brands of electronic cigarettes and found them to contain such heavy metals as cadmium, chromium, lead, manganese and nickel. When inhaled, the metals become toxic.

The liquids tested were all used in first-generation e-cigarettes, which resemble actual cigarettes. In the design of these types of e-cigarettes, there is a liquid cartridge located next to a heating coil that, when heated, causes the liquid to become a vapor that users inhale. The study identified the heating coil as the primary source of the metals, but also noted that some of the metals may have come from the e-cigarette components or the manufacturing process.

The five brands selected for testing constituted 71% of the total market share in 2015 in the U.S. Researchers found varying concentrations of the toxic metals among the different brands. In one brand, they found a high concentration of all five metals. In another brand, they found a very high concentration of nickel, the most serious carcinogen.

“It was striking, the varying degrees to which the metals were present in the liquid,” said lead researcher Ana Maria Rule. “This suggests that the FDA should consider regulating the quality control of e-cigarette devices along with the ingredients found in e-cigarette liquids.”

The FDA currently requires e-cigarette manufacturers to provide an ingredient list and information about any potentially harmful elements, including cadmium, chromium, lead and nickel — four of the five toxic metals found in the e-cigarette liquids tested. The FDA has studied but has not implemented any regulations for the labeling of e-cigarettes.

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