Epidemiological trends in electronic cigarette exposures reported to U.S. Poison Centers

Abstract

Context. The Centers for Disease Control and Prevention (CDC) has reported an increase in electronic cigarette (e-cigarette) use in both adults and adolescents. Poison Center calls provide data on exposures pertaining to e-cigarette devices and components (including nicotine-refill cartridges), potentially identifying epidemiological trends in reported exposures over time. Objective. To characterize the trends in e-cigarette exposures reported to United States (U.S.) Poison Centers between 01 June 2010 and 30 September 2013. Methods. We obtained data from the American Association of Poison Control Centers (AAPCC) for all exposures involving e-cigarettes reported to the National Poison Data System (NPDS) by U.S. Poison Centers and described trends in exposures over time, demographics, geographical characteristics, clinical effects and outcomes, management site, and exposure route. Results. A total of 1,700 exposures were reported to Poison Centers during this time. The most frequent age groups were children 5 years or below with 717 (42.2%) exposures and adults ages 20–39 years with 466 (27.4%) exposures. Temporal trends showed an increase of 1.36 exposures per month [95% CI: 1.16–1.56] from June 2010 through December 2012, after which exposures increased by 9.60 per month [95% CI: 8.64–10.55] from January through September 2013. The majority of patients who were followed reported that they had only minor effects. Conclusions. The majority of exposures to e-cigarette devices and components occurred in children of 5 years or below due to accidental exposure. Based on the available data, the reported exposures have resulted in minimal toxicity. Calls to Poison Centers regarding these products have rapidly increased since 2010, and continued surveillance may show changes in the epidemiological trends surrounding e-cigarette exposures.

Keywords:

• E-cigarettes
• Epidemiology
• Poison Centers

Disclaimer

The American Association of Poison Control Centers (www.aapcc.org) maintains the national database of information logged by the 57 U.S. Poison Control Centers. Case records in this database are from self-reported calls; they reflect only information provided when the public or health care professionals report an actual or potential exposure to a substance (e.g., an ingestion, inhalation, or topical exposure) or request information. Exposures are not necessarily poisonings or overdoses. The AAPCC is not able to completely verify the accuracy of every report made to member centers. Additional exposures may go unreported to Poison Control Centers, and data referenced from the AAPCC should not be construed to represent the complete incidence of national exposures to any substance(s).

Acknowledgments

We would like to thank Elise Bailey and Asma Madad with the National Poison Data System for assisting and providing the data.

Declaration of interest

The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.