Poisoning exposure cases involving e-cigarettes and e-liquid in the United States, 2010-2018.

Introduction:
This text provides an analysis of poisoning exposure cases involving e-cigarettes and e-liquids reported to poison control centers in the US between 2010 and 2018. The study aims to describe trends and characteristics of these cases, with a focus on the quantity of e-liquid and nicotine involved in exposures stratified by medical outcomes.

Key Points:

* The annual number of e-cigarette exposure cases increased greatly between 2010 and 2014, reaching a peak of 3742 in 2014, and then decreasing each year between 2015 and 2017. however, between 2017 and 2018, the overall number of e-cigarette exposure cases increased by 25.0% (from 2320 to 2901).
* approximately two-thirds (64.8%) of all cases were in children under age 5, and 14.7% were in children aged 5–17 years or young adults aged 18--24 years.
* a small proportion of cases developed life-threatening symptoms (0.1%).
* Cases with more serious medical outcomes tended to be exposed to a higher e-liquid or nicotine quantity.
* The study analyzed e-liquid and nicotine quantity data for cases with substance quantity unit of mL (n = 64) and mg (n = 18) separately.
* The study found that the largest one-year increase in absolute number of e-cigarette exposure cases among children younger than five years old in 2017--2018 and the largest one-year percentage increase in e-cigarette exposure cases was among adolescents and young adults in 2017--2018.
* The study was determined as exempt by the US Food and Drug administration (FDa) Institutional Review Board for human Subject Protection because data were previously collected and did not contain personally identifiable information.

Main Message:
The study highlights the importance of ongoing surveillance of e-cigarette exposure cases, particularly in light of the rapid changes in the occurrence of poisoning exposure cases involving e-cigarettes and the development of new tobacco products with high nicotine levels. The study's findings suggest that continuous monitoring of these poisoning exposure cases may inform efforts aimed at preventing e-cigarette poisoning exposures, particularly among children and adolescents who are disproportionately affected by these exposures.

Wang B, Liu S, Persoskie a. Poisoning exposure cases involving e-cigarettes and e-liquid in the United States, 2010-2018. Clinical toxicology (Philadelphia, Pa). 2020;58(6):488-494. doi:10.1080/15563650.2019.1661426