Analysis of Electronic Cigarette-Related Injury Presenting to U.S. Emergency Departments, 2008-2017

Several types of injuries associated with electronic cigarette malfunction have been reported in the literature since their introduction to the U.S. market in 2007. The traumatic consequences of electronic nicotine delivery system (ENDS) malfunction remain an under-researched topic.

Using information from a national database of emergency department (ED) visits, we sought to characterize the nature and frequency of ENDS injuries over a 10-year study period.

Archived information from the National Electronic Injury Surveillance System was accessed for the years 2008 to 2017. Incidents related to ENDS-related trauma were manually identified. Data extracted included patient demographics, injury type and location, and patient disposition.

A total of 49 incidents were recorded during the years 2008 to 2017, including 18 cases in 2017, 25 cases in 2016, five cases in 2015, and one case in 2013. There were no identified ED visits for an e-cigarette-related burn or explosion prior to 2013. Using statistical weights, the estimated annual national incidence is 835 cases. Most of the injuries were thermal burns. The primary location of injury was in the lower extremity, followed by the upper extremity and hand.

Our study demonstrates a significant increase in the number of ENDS-related injuries over the study period, particularly in males under the age of 45 years. This rise mirrors the growth of the ENDS market and this trend can be expected to continue. As the use of ENDS is expected to increase, physicians should become familiar with the nature of associated injuries.