Profile of incidental exposures to e-cigarette liquids in Europe, 2018-2019.

Introduction:
This article provides a profile of e-cigarette liquid exposure incidents and their associated health outcomes across multiple European Union (EU) member states (MS) after the implementation of the EU Tobacco Products Directive (TPD). The study collected data from poison centers in eight EU MS between august 2018 and December 2019. The analysis includes incident characteristics, such as age, gender, intentionality, exposure route, management, and symptoms, and investigates associations between these exposure characteristics and the presence of symptoms.

Key Points:

* The study analyzed 223 e-cigarette liquid exposure incidents reported to poison centers in eight EU MS.
* The majority of cases were adults aged 21 years or older (61.9%), male (57.1%), and exposed unintentionally (64.7%).
* The most common route of exposure was ingestion (73.5%), and 55.2% of incidents reported the presence of any symptoms.
* The most common symptoms reported were nausea (16.6%), vomiting (11.7%), and dizziness (9.0%).
* More than half the incidents were managed at the residence or on-site (57.8%).
* age was associated with the intentionality of exposure, the exposure route, and the presence of symptoms such as dizziness, nausea, and eye conditions.
* The presence of any symptoms was 1.64 times higher among incidents managed at hospitals than those maintained at other sites.

Main Message:
The study provides a multinational profile of e-cigarette exposure incidents across eight EU MS after the implementation of the EU TPD regulations. The findings indicate that further monitoring is warranted to ensure the continued compliance with the EU TPD and assess its long-term impact on related incident characteristics. The study's limitations, such as the lack of proportionality in the numbers of incidents and the inconsistencies in the classification of clinical outcomes, should be considered when interpreting the results. Overall, the study emphasizes the importance of continued monitoring and data harmonization across EU MS to assess the long-term trends and generalizability of e-cigarette exposure incidents.

Vardavas CI, Girvalaki C, Odani S, et al. Profile of incidental exposures to e-cigarette liquids in Europe, 2018-2019. human & experimental toxicology. 2021;40(6):1045-1050. doi:10.1177/0960327120975828