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

Hum Exp Toxicol. 2021 Jun;40(6):1045-1050. doi: 10.1177/0960327120975828. Epub 2020 Dec 4.

Abstract

Background: Following the implementation of the European Union Tobacco Product Directive (EU TPD) regulations on e-cigarette products in 2016, we assessed the current profile of e-cigarette liquid exposure incidents and their associated health outcomes.

Methods: De-identified data were received from poison centers in eight EU Member States (Sweden, the Netherlands, Italy, Hungary Austria, Finland, Spain and Croatia) reporting on e-cigarette liquid exposure incidents between August 2018 to December 2019. Descriptive analysis was conducted to present incident characteristics and health outcomes. Chi-square tests and multivariable logistic regression analysis were used to test associations.

Results: Of the 223 e-liquid exposure incidents recorded by poison centers in multiple EU MS, 64.7% of the cases were unintentional exposures, ranging from 48.4% among adults aged ≥19 years to 100.0% among children aged 0-5 years (p < 0.05). The most frequent route of exposure was ingestion (73.5%) while55.2% experienced any clinical symptoms, including nausea (16.6%), vomiting (11.1%), and dizziness (9.0%). 57.8% of the cases were treated at the residence or on-site.

Conclusion: Further monitoring is warranted, using uniform reporting requirements, to ensure the continued compliance to the EU TPD and assess its long-term impact on related incident characteristics.

Keywords: Europe; Poisoning; e-cigarettes; e-liquid; poison centers.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Europe / epidemiology
  • Female
  • Forecasting
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Nicotine / toxicity*
  • Poison Control Centers / statistics & numerical data*
  • Vaping / epidemiology*
  • Vaping / trends*
  • Young Adult

Substances

  • Nicotine