Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers: a retrospective data analysis
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Biomedical Research Foundation of the Academy of Athens (BRFAAA), Athens, Greece
Institute of Public Health, American College of Greece, Athens, Greece
Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
Poisoning Information Center, Estonian Health Board, Tallinn, Estonia
Dutch Poisons Information Center, University Medical Center Utrecht, Utrech, The Netherlands
Swedish Poisons Information Center, Stockholm, Sweden
National Toxicological Information Center, University Hospital Bratislava, Bratislava, Slovakia
Institute for Medical Research an Occupational Health, Poison Control Center, Zagreb, Croatia
Poison Information Bureau, Health emergency situations center of the Ministry of health, Vilnius, Lithuania
National Institute Of Medical Emergency, Lisboa, Portugal
Poisons Information Center, Vienna, Austria
National Public Health Center, National Directorate of Chemical Safety, Health Toxicological Information Service, Budapest, Hungary
National Poisons Information Center, Beaumont Hospital, Dublin, Ireland
Laboratory of Toxicology, Medical School, University of Crete, Heraklion, Greece
Submission date: 2017-04-24
Acceptance date: 2017-07-25
Publication date: 2017-08-16
Corresponding author
Constantine I. Vardavas   

Biomedical Research Foundation of the Academy of Athens (BRFAAA), Athens, Greece
Tob. Induc. Dis. 2017;15(August):36
The use of e-cigarettes has increased during the past few years. Exposure to e-cigarette liquids, whether intentional or accidental, may lead to adverse events our aim was to assess factors associated with e-cigarette exposures across European Union Member States (EU MS).

A retrospective analysis of exposures associated with e-cigarettes reported to national poison centers was performed covering incidents from 2012 to March 2015 from 10 EU MS. De-identified and anonymous raw data was acquired.

In total, 277 incidents were reported. Unintentional exposure was the most frequently cited type of exposure (71.3%), while e-cigarette refill vials were responsible for the majority of the reported incidents (87.3%). Two-thirds of all exposures (67.5%) occurred as ingestion of e-liquids, which was more frequent among children (≤ 5 years, 6–18 years) compared to adults (87.0% vs. 59.3% vs. 57.6%, p < 0.001 respectively), exposure via the respiratory (5.4% vs. 22.2% vs. 22.2%, p < 0.001) were more frequent among paediatric patients while ocular routes (2.2% vs. 3.7% vs. 11.4%, p = 0.021) were more frequent among adults. Logistic regression analyses indicated that paediatric incidents (≤ 5 years) were more likely to be through ingestion (adjusted Odds Ratio [aOR] = 4.36, 95% Confidence Interval [C.I.]: 1.87–10.18), but less likely to have a reported clinical effect (aOR = 0.41, 95% C.I.: 0.21–0.82).

Our study highlighted parameters related to e-cigarette exposure incidents in 10 EU MS, the results of which indicate that consideration should be given to the design features which may mitigate risks, thereby protecting users, non-users and especially children.

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