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A recently approved funding proposal through NC TraCS and NYU to characterize carcinogenic biomarkers found in the urine of young adult e-cigarette users will soon be underway.

The proposal, put together by UNC Urologist Dr. Marc Bjurlin, Dr. Ilona Jaspers (UNC Gillings School of Global Public Health), and Dr. Terry Gordon (NYU School of Medicine), hopes to not only better understand the types of bladder cancer-causing biomarkers in e-cigarette user urine, but also strengthen the foundation for future e-cigarette research and regulations.


The health consequences of e-cigarette use reach beyond the neurological or the pulmonary effects and can include damage to the urinary bladder. It is already well known that inhalation during cigarette smoking brings some of the cancer-causing chemicals in cigarettes out of the lungs and into the blood. These carcinogens are then filtered by the kidneys and deposited into the urine. As urine is held in the bladder, the carcinogens in the fluid may damage the cells on the bladder wall, increasing the risk of cancer.

Specifically to e-cigarettes, biomarkers of toxic and carcinogenic compounds have been observed in the urine of e-cigarettes users 1,2 and exposure to these could also lead to the development of bladder cancer like observed in cigarette smokers. This may be especially true for those who have had an early introduction to e-cigarettes and chronic exposure like so many teens and young adults have in recent years.

A Multidisciplinary, Collaborative Approach

To address the health issues mentioned above, Drs. Bjurlin, Gordon, and Jaspers will analyze the urine of young adult e-cigarette users for any known urinary bladder carcinogen biomarkers and compare these findings against both cigarette users and non-users.

Their multidisciplinary teams will work in collaboration with the Center for Alternative Tobacco Product Studies (an affiliate of NYU), the UNC Department of Urology, the UNC Center for Environmental Medicine, Asthma and Lung Biology, and the Biomarkers Mass Spectrometry sub-core of the UNC Center for Environmental Health and Susceptibility.

Impact and Broader Applicability

Based on the results of this pilot analysis there exists the potential for more widespread implications including, but not limited to, regulatory guidance of e-cigarette use, educational materials for e-cigarettes users on the potential risks for bladder cancer (especially for young adults), and even inform health care providers on how to better counsel patients.

Regardless, the researchers hope that this pilot analysis will lay the foundation for additional funding through the National Cancer Institute to further characterize the health implications of e-cigarettes use.

About the Primary Investigators

Marc Bjurlin, DO, MSc, FACOS

Dr. Bjurlin is a Physician and Researcher within the UNC School of Medicine and UNC Lineberger Comprehensive Cancer Center. His clinical practice is focused on urologic oncology—in particular, the treatment of bladder, prostate, testis, and kidney cancer. In addition to patient care, Dr. Bjurlin participates in research focused on employing advanced surgical procedures including the use of robotic surgery to maximize the quality of life for people with urologic malignancies.

Marc Bjurlin, DO, MSc,

Terry Gordon, Ph.D.

Dr. Gordon’s research program at the NYU School of Medicine employs both human and animal models to study susceptibility factors—including genetics, age, and gender—underlying the adverse pulmonary and cardiac effects of environmental and occupational air pollutants.

Terry Gordon, Ph.D.

Ilona Jaspers, Ph.D.

Dr. Jaspers is a professor at the UNC Gillings School of Global Public Health who specializes in the effects of ambient air pollutants on respiratory immune disfunction. Jaspers has established several human in vitro and clinical in vivo models to determine the adverse health effects induced by pollutant exposures.

Ilona Jaspers, Ph.D.


  1. Rubinstein ML, Delucchi K, Benowitz NL, Ramo DE. Adolescent Exposure to Toxic Volatile Organic Chemicals From E-Cigarettes. Pediatrics. 2018;141(4).
  2. Goniewicz ML, Smith DM, Edwards KC, et al. Comparison of Nicotine and Toxicant Exposure in Users of Electronic Cigarettes and Combustible Cigarettes. JAMA Netw Open. 2018;1(8):e185937.