The question on our lips: how safe is vaping?

Dr Kelly Burrowes likes to keep busy but one hobby might have to go on the backburner.

Kelly has an online business she runs in her spare time in the evenings, while by day she’s a senior research fellow at the Auckland Bioengineering Institute (ABI).

Kelly started her business during Covid-19. She sells products such as a fitness tracker worn as a necklace or bracelet, a device that measures how much breastmilk you’re feeding your baby, pelvic floor devices and environmentally friendly menstrual products.

“I’m reading a lot about women’s health and learning about running a business. I love learning. I also like making my own clothes and my own skincare products. I like creating things and understanding how things work.

“Like many academics, I’m always on fixed-term contracts and I’d thought ‘well, what if I don’t get a new contract? I needed a plan B, so the online business was my plan B.”

Kelly had begun the business before she knew she’d been awarded a Marsden Grant to develop her important research into e-cigarettes. Work began on the Marsden Grant research on 1 March.

“So it looks like my hobby will now be just an hour in the evening,” she laughs.

She is also the mother of an eight-year-old and six-year-old twins. She and her husband, who is from the UK, returned to New Zealand from England when Kelly was expecting the twins. She had been working at Oxford University in computational research for around a decade.

Kelly’s focus since 2001 is bioengineering research centred on creating patient-based computational models of the respiratory system. While a lot of that focuses on diseases such as lung cancer and chronic obstructive pulmonary disease, in recent years she has been interested in smoking cessation and the impact of vaping on the lungs.

The Marsden Grant aims to answer questions around any health impacts of vaping compared to smoking regular cigarettes. Kelly will develop a framework that integrates various data, including analysing what goes into electronic cigarette aerosols, where the aerosol travels to in the body and its effect on cells and organs. This will be done using state-of-the-art imaging techniques.

The research runs for three years and the $900,000 funding means Kelly has been able to employ two masters students, and is trying to get two PhD students.

She has one PhD student already who can do the work, but the student can’t get into New Zealand due to Covid-19 border restrictions.

“It’s so hard to find PhD students now because a lot of them would previously come from overseas.”

The students need to be in New Zealand because the research involves experimental work. The study will also involve a postdoctoral researcher for one year.

There are three associate investigators involved, Professor Merryn Tawhai, deputy director of the ABI, Dr Vinod Suresh, senior lecturer in engineering science at the ABI, and Professor Chris Bullen from the School of Population Health.

“The Marsden allows us to gather research about e-cigarettes and tie it all together. My expertise is in computational modelling, although for my undergraduate degree I studied chemical and materials engineering. But I always wanted to get into some sort of biological health research, and that’s where I have ended up.

“The first part of our research is chemical analysis – looking at what’s in e-cigarette aerosol and measuring the size of the particles or droplets in the vapour. Then we’ll use our computer models to simulate where those particles go, in a realistic-looking lung. And then with Vinod, we’ll be doing some cell experiments exposing lung cells that we grow in the lab to those e-cigarette aerosols and we’ll look at how they change after they’ve been exposed.”

The third area will involve magnetic resonance imaging (MRI).

“We will look at the lung before and after a person uses their vape, so we can measure the regional air flow, blood flow and tissue density.

“In the tissue of smokers who don’t have health issues, density is known to be a bit higher – thought to be because of increased inflammation. So this research will see if there are similar things going on in vapers’ lungs.”

Kelly says research often looks at just one aspect – chemicals, cells or how the lung works as a whole.

“At ABI we’re good at modelling so the goal is to use our models to bring all these measurements together, right from the cell level up.”

The Marsden project wants to establish relative harm – how e-cigarettes compare to regular cigarettes – but also look at any harm created in people who have never smoked.

“Many people think, or have thought, that e-cigarettes are pretty safe, but that’s not known yet,” says Kelly.

She also has a personal stake in knowing. Her husband is a former smoker who has tried a number of quit methods and now vapes.

“He was in the Royal Air Force and smoking was a common habit. I said, ‘I can’t be with someone who’s a smoker!’ He gave up, using gum and patches, but now is vaping. Hopefully one day he can stop. It’s a battle for a lot of people so this research is important for society.”

It stands to reason that at least some harm must come from vaping.

“My hypothesis is that vaping causes inflammation,” says Kelly. “Anything you breathe into your lungs that’s not just clean air is going to create some inflammatory response, because that’s your body’s normal response to any sort of foreign body.

“If you have repeated inflammation, that’s when you start to get problems and there are changes to how the cells are working. I just want to establish if that’s the case with vaping and what happens to the lungs.”

She says there are many different types of e-cigarette and liquid used in them, so the researchers will choose typical devices.

“We’re going to start with those open-tank type devices, mostly because they create a big cloud of aerosol. We need to be able to collect the aerosol for our analysis.”

Kelly says this research, like all at the ABI, aims to have a real impact on society.

For example, she’s working on another project, with Merryn and others, to develop a new device to measure airflow in patients who are ventilated, crucial research in these Covid-19 times.

“It’s an electrical device to measure airflow in the lungs in these patients. It will be useful for patients to see how the lungs are performing when they’re ventilated.

“There’s a very fine balance between not enough airflow and too much while a person is on a ventilator. If you inflate too much, that stretches the lungs and damages them. That’s why there is quite a high mortality rate for patients after being ventilated.”

Kelly has recently been appointed chair of Women in HealthTech, a network to support women and diversity in the medtech sector. It is a collaboration of Medical Technology Association NZ, NZ Health IT and CMDT/MedTech CoRE.

She believes a contributing factor to her own path into science came from having attended a girls’ school.

“I did three sciences and two maths in my last year of school. There’s literature to show that girls give up maths and physics because those classes are male dominated.

"I often wonder if I would have ended up doing the same thing if I’d been in a co-ed school.”

Denise Montgomery