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Published on: May 24, 2017
E-Cigarette and Liquid Nicotine Exposures Among Young Children
Preethi Govindarajan1,2, Henry A Spiller3,4, Marcel J Casavant1,3,4
1Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Insights
Child-resistant packaging laws significantly reduced liquid nicotine exposures in young children. Despite this decrease, liquid nicotine remains a serious risk, necessitating further regulation to protect children.
Area of Science:
- Toxicology
- Public Health
- Pediatrics
Background:
- Liquid nicotine, used in electronic cigarettes, presents a significant poisoning risk to young children.
- Accidental ingestions of liquid nicotine can lead to severe health consequences.
Purpose of the Study:
- To analyze trends in liquid nicotine exposures among children under 6 years old in the U.S.
- To assess the impact of child-resistant packaging legislation on these exposures.
Main Methods:
- Analysis of liquid nicotine exposure data from the National Poison Data System (2012-2017).
- Comparison of exposure rates before and after the implementation of federal child-resistant packaging laws.
Main Results:
- Over 8,000 liquid nicotine exposures in children under 6 were reported, primarily through ingestion.
- Exposure rates peaked in 2015 and then declined, coinciding with legislative changes.
- States without prior child-resistant laws saw a significant decrease in exposures post-federal law.
Conclusions:
- Legislation mandating child-resistant packaging has contributed to a reduction in pediatric liquid nicotine exposures.
- Despite progress, liquid nicotine remains a substantial hazard for young children.
- Additional regulatory measures are recommended to enhance child safety regarding electronic cigarette products.
Objectives:
To investigate exposures to liquid nicotine (including electronic cigarette devices and liquids) among children <6 years old in the United States and evaluate the impact of legislation requiring child-resistant packaging for liquid nicotine containers.
Methods:
Liquid nicotine exposure data from the National Poison Data System for January 2012 through April 2017 were analyzed.
Results:
There were 8269 liquid nicotine exposures among children <6 years old reported to US poison control centers during the study period. Most (92.5%) children were exposed through ingestion and 83.9% were children <3 years old. Among children exposed to liquid nicotine, 35.1% were treated and released from a health care facility, and 1.4% were admitted. The annual exposure rate per 100 000 children increased by 1398.2% from 0.7 in 2012 to 10.4 in 2015, and subsequently decreased by 19.8% from 2015 to 8.3 in 2016. Among states without a preexisting law requiring child-resistant packaging for liquid nicotine containers, there was a significant decrease in the mean number of exposures during the 9 months before compared with the 9 months after the federal child-resistant packaging law went into effect, averaging 4.4 (95% confidence interval: -7.1 to -1.7) fewer exposures per state after implementation of the law.
Conclusions:
Pediatric exposures to liquid nicotine have decreased since January 2015, which may, in part, be attributable to legislation requiring child-resistant packaging and greater public awareness of risks associated with electronic cigarette products. Liquid nicotine continues to pose a serious risk for young children. Additional regulation of these products is warranted.
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