Wednesday, May 2, 2018

Poison Control Centers' Data Puts E-Cigarette Exposure Risk in Perspective

The journal Pediatrics recently reported that “there were more than 8,200 calls to US poison centers regarding exposures to liquid nicotine and e-cigarettes among children younger than 6 years of age from January 2012 through April 2017, averaging 129 calls each month or more than 4 a day.” (here) As I previously noted (here), annual exposures (which were 1,548 according to the Pediatrics article) should be considered in appropriate perspective. 

While the journal article acknowledged that e-cigarette exposures “decreased by about 20% from 2015 to 2016,” its senior author called for additional regulation.  If children’s exposure to products should guide regulatory priorities, the following chart from the American Association of Poison Control Centers (2016 report available here) may be instructive.

Non-Pharmaceutical Exposures Reported To Poison Control Centers in the U.S., 2016

Product CategoryNumber Among Children Under 6 YearsNumber Among All AgesDeaths Per 100,000 Exposures*

Cosmetics, personal care products136,004180,0653
Household cleaners111,445179,82813
Foreign bodies65,86490,6671
Arts, crafts, office supplies20,09627,3190
Essential oils (clove, etc.)13,26418,9970
Chewing tobacco1,2201,357--
Foods, additives, spoilage10,83933,9099
Gasoline, other hydrocarbons8,82127,80776
Bites, venom6,70846,98915
Paint, strippers6,60112,2380
Adhesives, glue4,6929,6220
Fumes, vapors3,67331,337214


* All Ages

Of the half million exposures among children under 6 years of age recorded by poison control centers in 2016, 45.8% involved cosmetics, personal care products or household cleaners, while e-cigarettes accounted for just 0.4%. 

Looking at product-related deaths per 100,000 exposures, rates were highest for fumes and vapors (which included carbon monoxide) and for alcohols, but there were no deaths recorded for tobacco exposures, including e-cigarettes.

Public health generally and children’s health in particular may benefit from regulatory reform that is keyed to demonstrated risk exposure.


Bill Tarling said...

What they also tend to leave out of media reports is that if you read the CDC Logs up to 2014, you can see the calls were mostly inquiries such as [paraphrased from actual call] "I was in a packed auditorium that was really hot, and I saw a guy with a vape pen in his pocket. Later that night I started feeling sick. Was I poisoned from it?"

I have a copy of the old logs, and it wasn't filled with emergency poising calls -- rather, it was misconceptions and inquiries about whether most of the callers were poisoned due to proximity.

Bill Godshall said...

Thanks for exposing these facts.

After FDA unlawfully banned e-cigs in 2009 and held a press conference that lied about SE and NJOY vapor products and demonized the companies (in an attempt to influence the federal judges in the DC District who were adjudicating the lawsuit filed by SE and NJOY against FDA), the FDA issued a poison center alert encouraging parents and healthcare professionals to report any youth exposures with an e-cig.

Most of the calls to PCCs for youth exposures to e-cigs were cases involving one or two inhalations from an e-cig, and some calls reported that a youth simply touched an e-cig (which PCCs also classify as an "exposure").