Poisoning Public Health Issues: Chapter 2

Three years ago I discussed an unfounded claim by Harvard University’s Dr. Gregory Connolly that smokeless tobacco products are a major cause of poisoning among American children (here).  A recent press release from the Kentucky Regional Poison Control Center (here) has a similar ring, with the headline, “E-cigarettes cause alarming increase in calls to poison control center.”  The center based its claim on the fact that it received 39 calls in 2013, compared to nine in 2012. 

In context, the figures pack none of the headline’s punch.

At my request, the Center provided some additional information:

“24 of the 39 cases are exposures to children (less than 6 years)… Most exposures were small and did not lead to symptoms.  Those individuals that did develop symptoms were monitored at home by the [Kentucky Regional Poison Control Center] through follow-up calls.  Only two patients were recommended to go to the emergency department: 1 dermal exposure and 1 ingestion.  Both patients saw symptom resolution in less than 8 hours.”

To place the Kentucky e-cigarette poison alert in focus, I reviewed the American Association of Poison Control Centers’ latest (2012) report (read it here). 

It turns out that tobacco products accounted for only about 1.3% of the over 581,000 cases of exposure to non-pharmaceutical agents of all kinds in children less than 6 years of age in 2012. That’s 7,480 cases. Here’s a table of some of the more common exposures:

Non-pharmaceutical Exposure Cases Among Children Under 6 Years Old, 2012
Product Category	Number of Exposures
Cosmetics and personal care products	156,623
Household cleaners	106,582
Foreign bodies	77,905
Pesticides	36,056
Plants	30,690
Arts, crafts, office supplies	21,146
Deodorizers	19,153
Alcohols	11,443
Gasoline, other hydrocarbons	10,572
Food additives, spoilage	10,547
Bites, venom	8,777
Tobacco products	7,480
Essential Oils (clove, etc)	7,446
Paint, paint strippers	7,192
Adhesives, glue	5,863
Batteries	5,116
Chemicals	3,923
Fertilizers	3,054
Everything else	51,351
Total	580,919

 

Of the tobacco product exposures, cigarettes were the most common, at 53%, while smokeless products accounted for 16%.  Only 172 incidents (2%) involved e-cigarettes.

Many consumer products pose potential danger, especially to young children.  However, when put into perspective with exposures to cosmetics, household cleaners, paint and paint strippers and fertilizers, the selective reporting of poison control information about e-cigarettes is meaningless.