Liquid Nicotine Poisoning Exposures Among Children Decreasing, But Still Pose Serious Health Risk: Study

While the overall number of young children poisoned by e-cigarette liquid has decreased in recent years, the prevalence of problems remains high and children continue to face serious health risks, indicate the findings of a new study. 

In findings published in the April issue of the journal Pediatrics, researchers from The Research Institute at Nationwide Children’s Hospital warn that liquid nicotine poisoning exposure continues to pose a risk for small children nationwide.

Researchers examined liquid nicotine exposures in the U.S. among children under six. They used data from the National Poison Data System spanning January 2012 through April 2017.

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During that time 8,269 liquid nicotine exposures among children under six were reported to U.S. poison control centers. That averages to nearly 130 calls per month, or four poisoning calls every day.

The data indicates the annual exposure rate to liquid nicotine, or liquid from e-cigarette devices, increased by 1400% from 2012 to 2015. This echoes the findings of a study from 2016, indicating exposures among children under six increased by 1500% from 2013 to 2015.

Poisoning rates did decrease from 2015 to 2016, but only by 20%. This indicates the rate of exposure for young children still remains high, despite the moderate decrease.The majority of children who were poisoned, or about 93%, swallowed the liquid. The findings indicate 84% of those children were under the age of three.

More than 35% of children who were exposed to e-cigarette liquid required treatment from a health care facility, but were released after treatment. Roughly 1.5% of children who were exposed were admitted to the hospital for serious complications.

These findings indicate the decreases overall in exposures since January 2015 may, in part, be because of legislation requiring child resistant packaging and greater public awareness to the risk of ingesting liquid nicotine.

The data indicated after laws requiring child-resistant packaging for liquid nicotine containers went into effect in states where there were no pre-existing laws, there was a significant decrease in the average number of exposures to children during the nine months after the law went into effect.

The child-proof packaging laws may have resulted in 4.4 fewer exposures, on average.

Research indicates that children who ingest e-cigarette liquid are five times more likely to be admitted to the hospital. They are also 2.6 times more likely to experience serious medical outcomes, compared to children exposed to traditional cigarettes.

Nicotine is very toxic to children, even in small amounts. It can cause serious side effects, including coma, seizures, and in some cases, death. Children are able to ingest higher levels of nicotine during exposure to e-cigarette liquid, compared to traditional cigarettes. Thus, the devices pose a greater risk to children.

Researchers warn it is important for parents and caregivers who use e-cigarettes to store the devices and the liquid in a locked place out of reach and sight of children.

“Liquid nicotine continues to pose a serious risk for young children,” the study authors wrote. “Additional regulation of these products is warranted.”

Other steps could be taken to ensure children’s safety, they noted: such as adding flow restrictors to bottles, reducing the amount and concentration of liquid nicotine in each package, and calling on the FDA to limit the colors and flavors of the liquid.


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