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Liquid Nicotine in E-Cigarettes Rising Cause of Poisonings: CDC

Calls to poison control centers have jumped, ingestion could be deadly for kids, experts report

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, April 3, 2014 (HealthDay News) -- The number of calls to poison control centers for nicotine poisoning from e-cigarettes has risen dramatically in recent years, U.S. health officials reported Thursday.

Calls related to poisoning from the liquid nicotine used in these devices were running at a rate of roughly one a month in 2010, but jumped to 215 in February of this year, according to the U.S. Centers for Disease Control and Prevention.

Even more troubling, more than half (51 percent) of the poison calls involved children aged 5 and younger, while 42 percent involved people aged 20 and older.

"The time has come to start thinking about what we can do to keep this from turning into an even worse public health problem," said Dr. Tim McAfee, director of the CDC's Office on Smoking and Health.

He added that many people are not aware that liquid nicotine is toxic. "We need to make sure we can avert the possibility of an unintended death from nicotine poisoning," he said.

"We have not had an unintentional poisoning death from e-cigarettes yet in the United States that we know of, but the potential is there given the amount of concentrated nicotine in these solutions -- it would not take a lot for a child death to occur," McAfee noted.

CDC director Dr. Tom Frieden noted in a news release that e-cigarettes are particularly attractive to kids because they come in candy and fruit flavors.

Dr. Vincenzo Maniaci, an emergency medicine specialist at Miami Children's Hospital, agreed that the danger to children is real.

"The concentration of nicotine in these solutions is significant and they need to be made childproof and regulated," Maniaci said. "Especially for kids under the age of 5, this amount of nicotine can be fatal."

McAfee noted that the U.S. Food and Drug Administration is planning to propose regulations for e-cigarettes. He added that he hopes these regulations will include how the product is packaged, including childproof caps and warning labels.

"These things can be hardwired into these products, rather than being left to the whim of the manufacturer," he said.

In the meantime, McAfee advised keeping these devices, and their refills, out of the reach of children.

"These should be treated with the same caution one would use for bleach. In some ways, this is more toxic than bleach," he said.

Poisoning from the liquid nicotine in e-cigarettes can happen in one of three ways: by swallowing it; inhaling it; or absorbing it through the skin or membranes in the mouth and lips or eyes, McAfee said. Once it is in a person's system, nicotine can cause nausea, vomiting or seizures.

If those symptoms are occurring, the patient will typically be told to go straight to the emergency room, said Amy Hanoian-Fontana, from the Connecticut Poison Control Center.

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