Burn Injuries Related to E-Cigarettes Reported to Poison Control Centers in the United States, 2010-2019

Abstract

Background: United States (U.S.) national data indicate that 2,035 individuals with burn injuries from e-cigarette explosions presented to U.S. hospital emergency departments (EDs) in 2015-2017. This national estimate is valuable for understanding the burden of burn injuries from e-cigarette explosions among individuals who presented to EDs. However, little is known about individuals who experienced e-cigarette-related burns but may not present to EDs or health care facilities.Findings: We analyzed data from the National Poison Data System (NPDS) to describe frequency and characteristics of e-cigarette-related burn cases in the U.S. in 2010-2019. NPDS contains information collected during telephone calls to poison control centers (PCCs) across the U.S., including e-cigarette-related burns and other unintended events. During 2010-2019, 19,306 exposure cases involving e-cigarettes were documented in NPDS. Of those, 69 were burn cases. The number of burn cases increased from one in 2011 to a peak of 26 in 2016, then decreased to three in 2019. The majority of the burn cases occurred among young adults aged 18-24 years (29.0%; n=20) and adults aged 25 years or older (43.5%; n=30); 14.4% occurred among individuals ≤ 17 years old. Of the 69 burn cases, 5.8% (n=4) were admitted to a hospital; 65.2% (n=45) were treated and released; 15.9 % (n=11) were not referred to a health care facility (HCF); 4.4% (n=3) refused referral or did not arrive at an HCF; and 8.7% (n=6) were lost to follow-up or left the HCF against medical advice. Nearly one-third (30.4%; n=21) of the cases had a minor effect (symptoms resolved quickly), 47.8% (n=33) had a moderate effect (symptoms were more pronounced and prolonged than in minor cases, but not life-threatening), and 2.9% (n=2) had a major effect (life-threatening symptoms).Conclusions: Approximately one-fifth of e-cigarette-related burn cases reported to PCCs were not referred to or did not arrive at an HCF. Some burn cases had serious medical outcomes. The burn cases mostly affected young adults and adults aged 25 years or older. The number of burn cases in NPDS represents a small portion of e-cigarette-related burn cases but it can serve as a complementary data source to traditional injury surveillance systems.

Preclinical atherosclerosis and cardiovascular events: Do we have a consensus about the role of preclinical atherosclerosis in the prediction of cardiovascular events?

“…In the CAPTURE cohort, the PlGF was shown to be an independent predictor of death or myocardial infarction [115]. PlGF is also an independent biomarker of adverse outcomes in patients with suspected acute coronary syndrome regardless of the troponin levels [116].…”

A Review of Electronic Cigarettes and Liquid Nicotine Poisoning Exposure Cases in the United States

“…The burn injury incident was reported to be highest in the adults with the mean age of 25 years or older, followed by the young adults and children. Ecigarette related burns were from leaking e-liquids, battery failures, battery overheating, custom device modification by the e-cigarette users, incompatible or poorly designed devices, the types and quality of batteries or chargers, and the lack of quality control by suppliers (17,59). The injuries related to ecigarette-related burns included thermal and chemical burns, with blast injuries to the face, hands, chest, shoulders and thigh or groin (17,59).…”

“…Ecigarette related burns were from leaking e-liquids, battery failures, battery overheating, custom device modification by the e-cigarette users, incompatible or poorly designed devices, the types and quality of batteries or chargers, and the lack of quality control by suppliers (17,59). The injuries related to ecigarette-related burns included thermal and chemical burns, with blast injuries to the face, hands, chest, shoulders and thigh or groin (17,59). E-liquid is identified as a safety hazard, and the FDA has issued a guidance about its compliance policy for reporting vape battery fire or explosion to the FDA and limiting the safety modifications to batteryoperated tobacco and other marketed products to address the potential e-cigarette battery-related injury in the users (60).…”