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Tran V, Mian M, Sreedharan S, Robertson R, Saha A, Tadakamadla SK, Lee K. Oral and Maxillofacial Injuries Associated With E-Cigarette Explosions: A Systematic Review and Management Guidelines Proposal. J Oral Maxillofac Surg 2023; 81:583-592. [PMID: 36806607 DOI: 10.1016/j.joms.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 02/16/2023]
Abstract
PURPOSE E-cigarettes have become increasingly popular devices used to consume nicotine in recent years. There is a growing body of evidence regarding the risk of spontaneous explosion of these devices causing burn and projectile injuries. The primary purpose of this review was to summarize all injuries to the oral and maxillofacial region secondary to explosion of e-cigarettes. The secondary purpose was to propose an initial management algorithm for such injuries based on the findings in the literature. This review also aims to test the hypothesis that e-cigarette explosive injuries to the oral region were associated with an increased risk of intubation and surgery and examine whether any other injury pattern was associated with an increased risk of intubation or surgery. METHODS A cohort study based on identifying cases in the literature was conducted to summarize injuries to the oral and maxillofacial region and examine the associations between injury types and location and management. A literature search of the major biomedical databases was conducted in September 2022 using terms such as e-cigarette, explosion, blast, trauma, and burn, among others, which yielded 922 studies. Nonclinical studies, review articles, and studies without injuries to the facial region were excluded. Study subjects were recorded for demographics, device characteristics, injury mechanism, injury location, management, and complications. Chi-squared analysis was used to determine if the predictor variables of type of injury (burn or projectile) and its associated location (ocular, facial, or intraoral for burns and facial thirds for projectile) were associated with the outcomes of intubation and surgical management. The collected data were then used as a guide to propose an initial management algorithm for these injuries. RESULTS Twenty eight studies, including 20 case reports and 8 case series met the inclusion criteria. A total of 32 explosions of e-cigarettes to 32 patients caused 105 recorded injuries to the facial region. Projectile injuries made up 73.3% (n = 77) of all facial injuries, while burn injuries made up of 26.7% (n = 28). There were 14 (43.8%) patients who suffered both projectile and burn injuries. Burn injuries mostly involved the face (64.3%, n = 18), oral cavity (25%, n = 7), and eye (10.7%, n = 7). The majority (81.8%, n = 63) of projectile injuries occurred in the lower facial third. There were 20 (62.5%) patients who suffered a bone or tooth fracture. Management of injuries involved surgery in 62.5% (n = 20) of patients, which included open reduction and internal fixation of fractures, dental extraction, bone and skin grafts, and ocular surgery. A complication rate of 44.4% (n = 8) was observed across studies that reported on follow-up. There was no statistically significant association between explosive injury to the oral region and intubation or surgical management. There was also no other statistically significant association between any other injury type and location with intubation or surgical management. CONCLUSIONS E-cigarettes are at risk for spontaneous combustion that can cause serious oral and maxillofacial injuries, particularly to the lower facial third and commonly requiring surgical management. Safety of these devices should be improved through increased user education and regulation.
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Affiliation(s)
- Vincent Tran
- Master of Philosophy Candidate, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Mustafa Mian
- Resident Medical Officer, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Subhashaan Sreedharan
- Resident Medical Officer, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Ross Robertson
- Resident Medical Officer, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Anik Saha
- Oral and Maxillofacial Registrar, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Santosh Kumar Tadakamadla
- Discipline Lead of Dentistry, Associate Professor, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Kai Lee
- Associate Professor, Consultant Oral & Maxillofacial Surgeon, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Soo J, Easwaran M, Erickson‐DiRenzo E. Impact of Electronic Cigarettes on the Upper Aerodigestive Tract: A Comprehensive Review for Otolaryngology Providers. OTO Open 2023; 7:e25. [PMID: 36998560 PMCID: PMC10046796 DOI: 10.1002/oto2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023] Open
Abstract
Objective The use and effects of electronic (e)-cigarettes (e-cigs) are particularly relevant for otolaryngology providers as tobacco plays a major role in benign and malignant diseases of the upper aerodigestive tract. This review aims to (1) summarize the recent policies regarding e-cigs and important patterns of use and (2) serve as a comprehensive resource for clinical providers on the known biologic and clinical effects of e-cigs on the upper aerodigestive tract. Data Sources PubMed/MEDLINE. Review Methods We conducted a narrative review on (1) general information on e-cig use and informative findings in the lower respiratory system and a comprehensive review on (2) the effects of e-cigs on cell and animal models and the clinical implications of these products on human health as is relevant to otolaryngology. Conclusions Although e-cigs are likely less harmful than conventional cigarettes, preliminary research on e-cigs suggest several deleterious effects including in the upper aerodigestive tract. Due to this, there has been increased interest in restricting e-cig usage, particularly among the adolescent population, and caution in recommending e-cigs to current smokers. Implications for Practice Chronic e-cig use is likely to have clinical implications. It is critical for otolaryngology providers to be aware of the rapidly changing regulations and use patterns regarding e-cigs and how e-cigs influence human health, particularly with regards to the upper aerodigestive tract, to accurately council patients regarding potential risks and benefits of use.
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Affiliation(s)
- Joanne Soo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Meena Easwaran
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Elizabeth Erickson‐DiRenzo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
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Becker TD, Rice TR. Youth vaping: a review and update on global epidemiology, physical and behavioral health risks, and clinical considerations. Eur J Pediatr 2022; 181:453-462. [PMID: 34396473 PMCID: PMC8364775 DOI: 10.1007/s00431-021-04220-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/24/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022]
Abstract
Worldwide, youth electronic cigarette use (vaping) has risen significantly over the past decade. This public health concern has spurred many high-quality studies characterizing country-specific prevalence, risk factors, physical and behavioral health complications, and optimal methods of assessment and counseling for youth vaping. Clinicians remain underexposed to this recent work, limiting translation of evidence into higher quality patient care. This review aims to provide pediatricians and other clinicians working with youth a clinically focused survey of key research findings and considerations based on recent evidence. This narrative review surveys emerging trends in EC use across different countries, reasons for youth vaping, characteristics of vaping materials that promote youth use, associations with combustible cigarette use, relation with cannabis and other illicit substances, physical and behavioral health risks associated with vaping, and methods of assessment, counseling, and intervention for problematic vaping in youth. Since vaping remains a relatively new phenomenon, long-term health consequences remain unknown.Conclusion: Youth vaping is an increasingly well-studied phenomenon with both physical and behavioral health risks. Pediatricians and other youth-focused clinicians can apply the lessons of recent research in work with youth and their families. What is Known: • Youth vaping is an increasingly prevalent public health concern. • Recent research demonstrates physical and behavioral health risks associated with vaping as well as methods for assessment, counseling, and intervention. What is New: • The current review summarizes the latest evidence in a clinically focused framework to facilitate translation of emerging knowledge to practice.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Icahn School of Medicine At Mount Sinai, One Gustave Levy Place, Box 1230, New York, NY, 10019, USA.
| | - Timothy R Rice
- Department of Psychiatry, Icahn School of Medicine At Mount Sinai, One Gustave Levy Place, Box 1230, New York, NY, 10019, USA.
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Dekhou A, Oska N, Partiali B, Johnson J, Chung MT, Folbe A. E-Cigarette Burns and Explosions: What are the Patterns of Oromaxillofacial Injury? J Oral Maxillofac Surg 2021; 79:1723-1730. [PMID: 33974919 DOI: 10.1016/j.joms.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE With the recent increase in popularity of electronic cigarette use in the United States, its harmful effects are not only limited to smoke inhalation, but also to the possibility of e-cigarette device malfunction. The purpose of this review is to characterize oromaxillofacial trauma secondary to electronic cigarette device explosion. METHODS For this systematic review, PubMed and Embase were searched in October 2019 using the following search terms: e-cigarette burns, e-cigarette injury, and e-cigarette explosions, which yielded 400 studies. Basic science research, animal studies, non-English studies, and reports of non-oromaxillofacial injuries were excluded. Study subject demographics, mechanism of trauma, injury type, treatment, and sequelae were recorded and analyzed. RESULTS Of all studies, 20 studies met inclusion criteria, including 14 case reports and 6 case series, with a total of 21 study subjects. For cases that reported sex, 100% were male (20) with a mean age of 29.5 years. Most common lacerations and/or burns involved the lips (10/21), tongue (8/21), soft palate and/or hard palate (4/21), and nose (5/21). Thirteen subjects underwent surgeries including oral-maxillofacial surgery or dental implants (7/13), bone graft repair (3/13), open reduction and internal fixation for preservation of sinus outflow tracts (2/13), foreign body removal from the cervical spine (1/13), and iridectomy (1/13). Reported complications included bone loss secondary to traumatic fracture, tinnitus and hearing loss, lip paralysis secondary to persistent edema, major depressive disorder/ post-traumatic stress disorder, persistent sinusitis, photophobia, and bilateral axillary and hand contractures. CONCLUSIONS Electronic cigarette device malfunction and explosion carries great risk for acute oromaxillofacial trauma that may be disfiguring. With the increasing popularity of electronic cigarette use, clinicians and patients should be advised regarding dangers of electronic cigarette use.
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Affiliation(s)
- Antonio Dekhou
- Oakland University William Beaumont School of Medicine, Rochester, MI.
| | | | - Benjamin Partiali
- Oakland University William Beaumont School of Medicine, Rochester, MI
| | - Jared Johnson
- Wayne State University School of Medicine, Department of Otolaryngology, Detroit, MI
| | - Michael T Chung
- Wayne State University School of Medicine, Department of Otolaryngology, Detroit, MI
| | - Adam Folbe
- William Beaumont Hospital - Royal Oak, Department of Otolaryngology, Royal Oak, MI
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Briggs K, Bell C, Breik O. What should every dental health professional know about electronic cigarettes? Aust Dent J 2021; 66:224-233. [PMID: 33428774 DOI: 10.1111/adj.12818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 01/02/2023]
Abstract
Electronic cigarettes (E-cigarettes) have become increasingly popular around the world. Currently, dental professionals' knowledge and attitudes are varied with many clinicians unclear regarding the impact of E-cigarette products on the oral and general health of their patients. With developing social and health-related challenges, advice of dental and medical associations and other regulatory bodies on E-cigarette use is changing. Growing evidence demonstrating the risks of E-cigarette usage has prompted a review of legislation in the United Kingdom (UK), United States of America (USA), Australia and Canada to include the sale and availability of E-cigarettes, particularly those containing nicotine. Further consideration within the scientific and public health community is being given to assessing demographic usage patterns particularly uptake by non-smokers and adolescents, efficacy as a cessation tool, the impact of vapour on bystanders and direct injuries via explosions as well as emerging lung injuries. This article aims to provide a summary of the most up to date evidence relating to E-cigarette use, the latest position of dental associations and the oral health implications of E-cigarettes compared to conventional smoking. The article also aims to collate this information in order to provide dental clinicians with guidance on how to advise patients, specifically in answering common questions posed regarding E-cigarette use.
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Affiliation(s)
- K Briggs
- General Dentist, Private Practice, Brisbane, Australia
| | - C Bell
- Associate Specialist Oral and Maxillofacial Surgery, Bristol University Hospitals Trust, Bristol, United Kingdom
| | - O Breik
- Oral and Maxillofacial Surgeon, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Injuries associated with electronic nicotine delivery systems: A systematic review. J Trauma Acute Care Surg 2020; 89:783-791. [PMID: 32590554 DOI: 10.1097/ta.0000000000002834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since its introduction on the market in 2007, the number of reports on injuries caused by the overheating, ignition, or explosion of electronic nicotine delivery systems (ENDSs) has increased significantly. These injuries appear to have different causes, the most important one being lithium-ion battery overheating to the point of ignition or explosion. METHODS A literature search for all relevant studies concerning ENDS-related traumatic injuries of all kinds was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol. The search started with the first introduction of ENDSs in 2007 and ended February 2020. Articles included were reports on patients who sustained flame, chemical, or traumatic injuries of the skin, soft tissue, and/or bone, related to the use of ENDSs. RESULTS This systematic review includes 180 patients from 41 case series and reports, published between 2016 and 2020. The mean age was 30.8 years (range, 17-59 years) with an overall male predominance (168 of 180 patients, 93%). In most injuries, multiple anatomical sites were affected, with the thigh/lower limb being the most commonly injured area (77%) followed by the upper limb/hand (43%). Eighty-two patients (51%) required a surgical treatment, 70 patients (43%) were managed conservatively with dressings or ointments, and 9 patients (6%) underwent enzymatic debridement. Thirty-five percent of all patients underwent skin grafting. CONCLUSION Injuries from overheating, ignition, or explosion of ENDSs are an emerging, underreported, and underresearched issue. There is a need for increased regulation of ENDSs and improved surveillance of related injuries. Both health care providers and consumers should be made aware of the risks and be advised about how to safely handle these devices. In contrast to other articles, this systematic review includes all types of injuries related to ENDS overheating, ignition, and explosion. To our knowledge, this is the most extensive systematic review performed to date. LEVEL OF EVIDENCE Review article, level III.
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Fakeh Campbell ML, Sansone A, Gonzalez LN, Schroth KRJ, Shendell DG. E-cigarette environmental and fire/life safety risks in schools reported by secondary school teachers. BMC Public Health 2020; 20:1215. [PMID: 32770976 PMCID: PMC7414759 DOI: 10.1186/s12889-020-09319-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background To identify if e-cigarette usage is an on-campus problem for secondary schools and evaluate initial school survey responses. More specifically, this survey can aid in identifying where students are seen using e-cigarettes, if smoke alarms have been newly inserted on school property, if smoke alarms have been tampered with to allow for vaping without detection; and, if any e-cigarette fires or explosions have occurred on school property. Methods This survey, disseminated to New Jersey secondary school teachers across seven sessions January–July 2019, resulted in 104 complete responses of 109 respondents. The survey was conducted after fire prevention, exit/egress, and life safety portions of “OSHA 10 Plus for General Industry” courses. Survey questions included number of times teachers observed students vaping and location where vaping in last 12 months, fire alarm installation and tampering, and fires or explosions and injuries from vaping/e-cigarette devices. Results Many (63%) respondents reported very or moderately common rates of vaping within their schools; however, three of four questions regarding school fire and smoke alarm use specifically to detect vaping had a majority of unsure/I don’t know responses. Conclusion Results suggested concerns regarding student vaping and e-cigarette use inside and outside secondary schools. Improved school detection and response are warranted. Trial registration Not applicable.
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Affiliation(s)
- Maryanne L Fakeh Campbell
- New Jersey Safe Schools Program (NJSS), Rutgers School of Public Health (SPH), 683 Hoes Lane West, 3rd Floor SPH - Suite 399, Piscataway, New Jersey, 08854, USA
| | - Andrew Sansone
- New Jersey Safe Schools Program (NJSS), Rutgers School of Public Health (SPH), 683 Hoes Lane West, 3rd Floor SPH - Suite 399, Piscataway, New Jersey, 08854, USA.,Department of Environmental and Occupational Health, Rutgers SPH, 683 Hoes Lane West, 3rd Floor SPH Building, Piscataway, New Jersey, 08854, USA
| | - Lauren N Gonzalez
- New Jersey Safe Schools Program (NJSS), Rutgers School of Public Health (SPH), 683 Hoes Lane West, 3rd Floor SPH - Suite 399, Piscataway, New Jersey, 08854, USA
| | - Kevin R J Schroth
- Department of Health Behavior, Society and Policy, Rutgers SPH, 683 Hoes Lane West, 3rd Floor SPH Building, Piscataway, New Jersey, 08854, USA.,Center for Tobacco Studies, Rutgers SPH, New Brunswick, New Jersey, 08903, USA
| | - Derek G Shendell
- New Jersey Safe Schools Program (NJSS), Rutgers School of Public Health (SPH), 683 Hoes Lane West, 3rd Floor SPH - Suite 399, Piscataway, New Jersey, 08854, USA. .,Department of Environmental and Occupational Health, Rutgers SPH, 683 Hoes Lane West, 3rd Floor SPH Building, Piscataway, New Jersey, 08854, USA. .,Environmental and Occupational Health Science Institute (EOHSI), Rutgers Biomedical and Health Sciences, 170 Frelinghuysen Road, Piscataway, New Jersey, 08854, USA.
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Perez MF, Crotty Alexander LE. Why Is Vaping Going Up in Flames? Ann Am Thorac Soc 2020; 17:545-549. [PMID: 31944819 PMCID: PMC7263393 DOI: 10.1513/annalsats.201910-802ps] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/16/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
| | - Laura E. Crotty Alexander
- Department of Medicine, University of California at San Diego, San Diego, California; and
- Department of Medicine, VA San Diego Healthcare System, San Diego, California
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Hagarty S, Luo J. E-cigarette "Vape" Device Explosion Causing C Spine Fracture. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2745. [PMID: 32440415 PMCID: PMC7209853 DOI: 10.1097/gox.0000000000002745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 02/05/2020] [Indexed: 11/25/2022]
Abstract
Electronic cigarette (e-cigarette) use has grown exponentially since its introduction to the US market in 2007.1 Sales went largely unregulated until 2016, when the Food and Drug Administration expanded tobacco laws to encompass the manufacturing, distribution, and marketing of e-cigarette products.2,3 Production safety standards are still being established. Rechargeable lithium batteries used have been reported to combust. The US Fire Administration reported 195 cases of e-cigarette explosions and fires from 2009 to 2016. The proximity of the explosions can cause serious burns and facial trauma to the user.3,4 We present a case report of a 30-year-old woman with oral soft tissue and dental injuries, C1 fracture, and left vertebral artery dissection from an e-cigarette explosion.
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Affiliation(s)
- Sarah Hagarty
- From the Department of Surgery, University of Illinois College of Medicine at Rockford, and OSF St Anthony Medical Center, Rockford, Ill
| | - Jessica Luo
- From the Department of Surgery, University of Illinois College of Medicine at Rockford, and OSF St Anthony Medical Center, Rockford, Ill
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Tzortzi A, Kapetanstrataki M, Evangelopoulou V, Behrakis P. A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2248. [PMID: 32230711 PMCID: PMC7177608 DOI: 10.3390/ijerph17072248] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 12/13/2022]
Abstract
Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016-2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.
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Affiliation(s)
- Anna Tzortzi
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
- Institute of Public Health, The American College of Greece, 17B Ipitou Street, 10557 Athens, Greece
| | - Melpo Kapetanstrataki
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
| | - Vaso Evangelopoulou
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
| | - Panagiotis Behrakis
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou Street, 10557 Athens, Greece; (V.E.); (P.B.)
- Institute of Public Health, The American College of Greece, 17B Ipitou Street, 10557 Athens, Greece
- Pulmonary Department, Athens Medical Center, Distomou 5-7, Marousi, 15125 Athens, Greece
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Makrynioti D, Zagoriti Z, Koutsojannis C, Morgan PB, Lagoumintzis G. Ocular conditions and dry eye due to traditional and new forms of smoking: A review. Cont Lens Anterior Eye 2020; 43:277-284. [PMID: 32111452 DOI: 10.1016/j.clae.2020.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/24/2020] [Accepted: 02/16/2020] [Indexed: 12/26/2022]
Abstract
Addiction to cigarette smoking has high prevalence rates recorded worldwide. Smoking has been linked to several life-threatening systemic conditions such as cancer, heart attack and stroke, in addition to a range of ocular pathologies. In recent years, electronic cigarettes (EC) have emerged as alternatives to smoking. ECs are nicotine delivery devices which produce an aerosol by heating, rather than combusting, a liquid which contains nicotine, flavours and preservatives. This review focuses on the association of traditional and new forms of smoking with dry eye disease, contact lens wear and four other common ocular diseases: cataract, age-related macular degeneration, glaucoma and Graves' ophthalmopathy. It is concluded that smoking and vaping appear as a risk factor for the aforementioned ocular conditions. An evidence-based, clear link between cigarette smoking, or EC vaping and ocular problems is yet to be discovered.
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Affiliation(s)
- Dimitra Makrynioti
- School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece.
| | - Zoi Zagoriti
- Department of Pharmacy, Laboratory of Molecular Biology and Immunology, University of Patras, University Campus, GR26504, Patras, Greece.
| | - Constantinos Koutsojannis
- Department of Physiotherapy, Laboratory of Health Physics and Computational Intelligence, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece.
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Carys Bannister Building, Dover Street, Manchester, M13 9PL, United Kingdom.
| | - George Lagoumintzis
- School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece; Department of Pharmacy, Laboratory of Molecular Biology and Immunology, University of Patras, University Campus, GR26504, Patras, Greece.
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Yang I, Sandeep S, Rodriguez J. The oral health impact of electronic cigarette use: a systematic review. Crit Rev Toxicol 2020; 50:97-127. [PMID: 32043402 DOI: 10.1080/10408444.2020.1713726] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Electronic cigarette (e-cigarette) use is becoming more prevalent and is particularly popular among adolescents and conventional smokers. While the oral health sequelae of conventional smoking are well-established, the impact of e-cigarettes on oral health is still unknown. This study aims to systematically review the available research evidence on the oral health impact of e-cigarette use.Methods: This systematic review was conducted according to PRISMA guidelines and used the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence. Three electronic databases (PubMed, Web of Science, and Embase) were systematically searched for studies including case reports. Two independent reviewers extracted data and synthesized the findings.Results: Ninety-nine articles were included in this systematic review. Analyses of the articles yielded seven categories based on symptom similarity and/or focus: mouth effects, throat effects, periodontal effects, dental effects, cytotoxic/genotoxic/oncologic effects, oral microbiome effects, and traumatic/accidental injury. The majority of mouth and throat symptoms experienced by e-cigarette users were relatively minor and temporary, with some evidence that conventional smokers who switched to e-cigarettes experienced mitigation of these symptoms. E-cigarette exposure increased the risk for deteriorating periodontal, dental and gingival health as well as changes to the oral microbiome. Extensive dental damage as a result of e-cigarette explosions were described in case reports. Components of e-cigarette vapor have known cytotoxic, genotoxic, and carcinogenic properties.Conclusions: Although switching to e-cigarettes may mitigate oral symptomatology for conventional smokers, findings from this review suggest that a wide range of oral health sequelae may be associated with e-cigarette use. Well-designed studies to investigate oral health outcomes of e-cigarette use are needed.
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Affiliation(s)
- Irene Yang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Shelly Sandeep
- Emory University Midtown Hospital, Emory University, Atlanta, GA, USA
| | - Jeannie Rodriguez
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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13
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Thermal and chemical burns caused by e-cigarette battery explosions. ANN CHIR PLAST ESTH 2020; 65:24-30. [DOI: 10.1016/j.anplas.2019.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/05/2019] [Indexed: 12/23/2022]
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Alexander LEC, Perez MF. Identifying, tracking, and treating lung injury associated with e-cigarettes or vaping. Lancet 2019; 394:2041-2043. [PMID: 31711628 DOI: 10.1016/s0140-6736(19)32730-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Laura E Crotty Alexander
- University of California San Diego, San Diego, CA 92093, USA; VA San Diego Healthcare System, San Diego, CA, USA.
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15
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Ho W, Jones CD, Widdowson D, Bahia H. Bromelain-based enzymatic debridement of e-cigarette burns: a single unit experience. J Wound Care 2019; 28:758-761. [DOI: 10.12968/jowc.2019.28.11.758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: It is widely accepted that the early debridement of burns improves outcome. There is increasing evidence that enzymatic debridement is an effective technique for removal of full-thickness and deep-dermal burns, reducing blood loss and often the need for autologous skin grafting by avoiding over excision of the burn. We aim to highlight the potential use of this form of debridement as an alternative to surgical management in patients with electronic cigarette (e-cigarette)-associated flame burn injuries. Methods: This case series presents the use of Nexobrid (MediWound Ltd, Israel), a non-surgical, bromelain-based enzymatic debridement technique, in patients with deep partial-thickness burns (range: 1–3% total body surface area), avoiding the need for autologous skin grafting. Results: Burn wounds in two patients healed within 14 days without complications or the need for further surgical intervention. Another patient required further dressings after discharge but failed to attend follow-up appointments. These results are comparable with those reported by others using conservative management of e-cigarette burns. Conclusion: The authors wish to raise awareness of the potential for a combination of thermal and chemical burns related to e-cigarette explosions. Chemical burns should be excluded by pH testing of the burn wound. From our experience, small e-cigarette-associated flame burns can be considered for management with enzymatic debridement.
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Affiliation(s)
- Weiguang Ho
- Department of Plastic Surgery, Ulster Hospital, Dundonald, BT16 1RH, Northern Ireland, UK
| | - Christopher D. Jones
- Department of Plastic Surgery, St John Hospital, Livingstone, Livingston EH54 6PP, Scotland, UK
| | - Daniel Widdowson
- Department of Plastic Surgery, St John Hospital, Livingstone, Livingston EH54 6PP, Scotland, UK
| | - Hilal Bahia
- Department of Plastic Surgery, St John Hospital, Livingstone, Livingston EH54 6PP, Scotland, UK
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16
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Nyman AL, Weaver SR, Huang J, Slovic P, Ashley DL, Eriksen MP. US Adult Smokers' Perceived Risk of Fire or Explosion-Related Injury Caused by Electronic Nicotine Delivery Systems. Public Health Rep 2019; 134:675-684. [PMID: 31600459 PMCID: PMC6831949 DOI: 10.1177/0033354919878433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Publicity on incidents of electronic nicotine delivery systems (ENDS) exploding or catching fire may influence smokers' risk perceptions and decisions about using ENDS for quitting smoking. We examined combustible cigarette smokers' perceptions of the possibility of injury from exploding ENDS and the relationship of those perceptions to ENDS use, perceived risk relative to smoking, and perceived costs and benefits of ENDS use. METHODS We used data from the 2017 Tobacco Products and Risk Perceptions Survey of a national probability sample of US adults, conducted online in August and September 2017. The analytic sample consisted of 1181 current combustible cigarette smokers aware of ENDS. RESULTS Among combustible cigarette smokers aware of ENDS, a medium/high perceived risk of injury from exploding ENDS was associated with lower odds of current ENDS use (adjusted odds ratio [aOR] = 0.50; 95% confidence interval [CI], 0.30-0.86; P = .01), perceiving ENDS to be at least as harmful as cigarettes (aOR = 3.22; 95% CI, 2.11-4.93; P < .001), and feeling that the negatives of ENDS use outweighed the positives (aOR = 3.50; 95% CI, 2.00-6.14; P < .001). CONCLUSIONS Product standards, improved product labeling, and education about how to properly use, charge, and store ENDS can help protect consumers from injury. Communication efforts should seek to fully inform combustible cigarette smokers about both the absolute health risks of ENDS, including risk of explosions, and their relative risks compared with those of cigarette smoking.
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Affiliation(s)
- Amy L. Nyman
- Tobacco Center of Regulatory Science, School of Public Health,
Georgia State University, Atlanta, GA, USA
| | - Scott R. Weaver
- Tobacco Center of Regulatory Science, School of Public Health,
Georgia State University, Atlanta, GA, USA
- Department of Population Health Sciences, School of Public Health,
Georgia State University, Atlanta, GA, USA
| | - Jidong Huang
- Tobacco Center of Regulatory Science, School of Public Health,
Georgia State University, Atlanta, GA, USA
- Department of Health Policy and Behavioral Sciences, School of
Public Health, Georgia State University, Atlanta, GA, USA
| | | | - David L. Ashley
- Tobacco Center of Regulatory Science, School of Public Health,
Georgia State University, Atlanta, GA, USA
- Department of Health Policy and Behavioral Sciences, School of
Public Health, Georgia State University, Atlanta, GA, USA
| | - Michael P. Eriksen
- Tobacco Center of Regulatory Science, School of Public Health,
Georgia State University, Atlanta, GA, USA
- Department of Health Policy and Behavioral Sciences, School of
Public Health, Georgia State University, Atlanta, GA, USA
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17
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Seitz CM, Kabir Z. Burn injuries caused by e-cigarette explosions: A systematic review of published cases. Tob Prev Cessat 2018; 4:32. [PMID: 32411858 PMCID: PMC7205087 DOI: 10.18332/tpc/94664] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/15/2018] [Accepted: 08/28/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION E-cigarettes have the potential to cause burns from batteries that explode. Although e-cigarette explosion burns have been reported by the media (e.g. local online news, blogs), there is a need for a comprehensive review of published medical case reports regarding these injuries. METHODS CINAHL and PubMed were systematically searched using common terms regarding e-cigarettes (electronic cigarette, e-cigarette, vape, vaping, electronic nicotine delivery systems) in every combination with the term ‘explosion’. Peer-reviewed articles were included if they: were written in English, described case reports of burn injuries caused by e-cigarette explosions, and were published in any year. Cases were categorized by demographics, location of the e-cigarette explosion, burned body areas, types of burns, total body surface area of burns, the need for skin grafting, and the length of hospital stay. RESULTS Thirty-one articles were included in the review and described 164 cases. Most patients (90%) were male and between 20 to 29 years old. In the majority of cases (65%), e-cigarettes exploded in pockets, compared to exploding in the face or hand. Common burned areas included the thigh, hand, genitals, and face. Burn severity was typically second-degree burns (35%) or a combination of second-degree and third-degree burns (20%). In all, 48 patients required skin grafting, with 19 reporting a median hospital stay of 5 days. CONCLUSIONS This review has several implications, including the need for regulation of batteries, education regarding battery safety, and leveraging images of the severity of e-cigarette explosion burns to discourage the use of e-cigarettes.
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Affiliation(s)
- Christopher M Seitz
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina, United States
| | - Zubair Kabir
- School of Public Health, University College Cork, Ireland
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18
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Morse J, Tittman S, Gelbard A. Oropharyngeal Injury From Spontaneous Combustion of a Lithium-ion Battery: A Case Report. Laryngoscope 2018; 129:45-48. [DOI: 10.1002/lary.27275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Justin Morse
- Department of Otolaryngology-Head and Neck Surgery; Vanderbilt University School of Medicine; Nashville Tennessee U.S.A
| | - Sarah Tittman
- Department of Otolaryngology-Head and Neck Surgery; Vanderbilt University School of Medicine; Nashville Tennessee U.S.A
| | - Alexander Gelbard
- Department of Otolaryngology-Head and Neck Surgery; Vanderbilt University School of Medicine; Nashville Tennessee U.S.A
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19
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Hickey S, Goverman J, Friedstat J, Sheridan R, Schulz J. Thermal injuries from exploding electronic cigarettes. Burns 2018; 44:1294-1301. [DOI: 10.1016/j.burns.2018.02.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/11/2017] [Accepted: 02/07/2018] [Indexed: 10/17/2022]
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20
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Satteson ES, Walker NJ, Tuohy CJ, Molnar JA. Extensive Hand Thermal and Blast Injury From Electronic Cigarette Explosion: A Case Report. Hand (N Y) 2018; 13:NP1-NP5. [PMID: 29192506 PMCID: PMC5987979 DOI: 10.1177/1558944717744333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: As the use of electronic cigarettes rises, more reports of injuries related to device explosion are surfacing. Methods: Presented here is the case of a 35-year-old man sustaining extensive thermal and blast injuries to his hand when the device exploded while he was holding it. He required multiple surgeries involving groin flap coverage, tendon transfer, and nerve grafting to optimize his postinjury function. Results: While much of his hand function has been restored, he has continued deficits in range of motion and sensation as a result of the incident. Conclusions: With increasing numbers of such injuries, hand surgeons must be aware of the blast mechanism involved so as to avoid missing deep soft tissue injury or disruption of deep structures, as demonstrated in this case.
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Affiliation(s)
- Ellen S. Satteson
- Wake Forest University School of Medicine, Winston-Salem, NC, USA,Ellen S. Satteson, Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health, Wake Forest University School of Medicine, Medical Center Boulevard, 5th Floor Janeway Tower, Winston-Salem, NC 27103, USA.
| | | | | | - Joseph A. Molnar
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
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21
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Maraqa T, Mohamed MAT, Salib M, Morris S, Mercer L, Sachwani-Daswani GR. Too Hot for Your Pocket! Burns From E-Cigarette Lithium Battery Explosions: A Case Series. J Burn Care Res 2017; 39:1043-1047. [DOI: 10.1093/jbcr/irx015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Tareq Maraqa
- Trauma Services, Hurley Medical Center/Michigan State University, College of Human Medicine, Flint
| | - Mohamed A T Mohamed
- Trauma Services, Hurley Medical Center/Michigan State University, College of Human Medicine, Flint
| | - Mina Salib
- Trauma Services, Hurley Medical Center/Michigan State University, College of Human Medicine, Flint
| | - Stephen Morris
- Trauma Services, Hurley Medical Center/Michigan State University, College of Human Medicine, Flint
| | - Leo Mercer
- Trauma Services, Hurley Medical Center/Michigan State University, College of Human Medicine, Flint
| | - Gul R Sachwani-Daswani
- Trauma Services, Hurley Medical Center/Michigan State University, College of Human Medicine, Flint
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22
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McCausland K, Maycock B, Jancey J. The messages presented in online electronic cigarette promotions and discussions: a scoping review protocol. BMJ Open 2017; 7:e018633. [PMID: 29122804 PMCID: PMC5695349 DOI: 10.1136/bmjopen-2017-018633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/13/2017] [Accepted: 10/06/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Electronic cigarettes have become increasingly popular over the last 10 years. These devices represent a new paradigm for tobacco control offering smokers an opportunity to inhale nicotine without inhaling tobacco smoke. To date there are no definite conclusions regarding the safety and long-term health effects of electronic cigarettes; however, there is evidence that they are being marketed online as a healthier alternative to traditional cigarettes. This scoping review aims to identify and describe the breadth of messages (eg, health, smoking-cessation and price related claims) presented in online electronic cigarette promotions and discussions. METHODS AND ANALYSIS A scoping review will be undertaken adhering to the methodology outlined in The Joanna Briggs Institute Manual for Scoping Reviews. Six key electronic databases will be searched to identify eligible studies. Studies must be published in English between 2007 and 2017, examine and/or analyse content captured from online electronic cigarette promotions or discussions and report results for electronic cigarettes separately to other forms of tobacco delivery. Studies will be screened initially by title and abstract, followed by full-text review. Results of the search strategy will be reported in a PRISMA flow diagram and presented in tabular form with accompanying narrative summary. ETHICS AND DISSEMINATION The methodology consists of reviewing and collecting data from publicly available studies, and therefore does not require ethics approval. Results will be published in a peer reviewed journal and be presented at national/international conferences. Additionally, findings will be disseminated via social media and online platforms. Advocacy will be key to informing policy makers of regulatory and health issues that need to be addressed. REGISTRATION DETAILS The review was registered prospectively with The Joanna Briggs Institute Systematic Reviews database.
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Affiliation(s)
- Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Science, Curtin University, Bentley, Australia
| | - Bruce Maycock
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Science, Curtin University, Bentley, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Faculty of Health Science, Curtin University, Bentley, Australia
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23
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Williams RS, Derrick J, Liebman AK, LaFleur K. Content analysis of e-cigarette products, promotions, prices and claims on Internet tobacco vendor websites, 2013-2014. Tob Control 2017; 27:e34-e40. [PMID: 29101294 DOI: 10.1136/tobaccocontrol-2017-053762] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 09/28/2017] [Accepted: 10/05/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To identify the population of Internet e-cigarette vendors (IEVs) and conduct content analysis of products sold and IEVs' promotional, claims and pricing practices. METHODS Multiple sources were used to identify IEV websites, primarily complex search algorithms scanning over 180 million websites. In 2013, 32 446 websites were manually screened, identifying 980 IEVs, with the 281 most popular selected for content analysis. This methodology yielded 31 239 websites for manual screening in 2014, identifying 3096 IEVs, with 283 selected for content analysis. RESULTS While the majority of IEVs (71.9%) were US based in 2013, this dropped to 64.3% in 2014 (p<0.01), with IEVs located in at least 38 countries, and 12% providing location indicators reflecting two or more countries, complicating jurisdictional determinations.Reflecting the retail market, IEVs are transitioning from offering disposable and 'cigalike' e-cigarettes to larger tank and "mod" systems. Flavored e-cigarettes were available from 85.9% of IEVs in 2014, with fruit and candy flavors being most popular. Most vendors (76.5%) made health claims in 2013, dropping to 43.1% in 2014. Some IEVs featured conflicting claims about whether or not e-cigarettes aid in smoking cessation. There was wide variation in pricing, with e-cigarettes available as inexpensive as one dollar, well within the affordable range for adults and teens. CONCLUSIONS The number of Internet e-cigarette vendors grew threefold from 2013 to 2014, far surpassing the number of Internet cigarette vendors (N=775) at the 2004 height of that industry. New and expanded regulations for online e-cigarette sales are needed, including restrictions on flavors and marketing claims.
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Affiliation(s)
- Rebecca S Williams
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Carrboro, North Carolina, USA.,Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Carrboro, North Carolina, USA
| | - Jason Derrick
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Carrboro, North Carolina, USA
| | - Aliza K Liebman
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin LaFleur
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Carrboro, North Carolina, USA
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24
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Serror K, Chaouat M, Legrand MM, Depret F, Haddad J, Malca N, Mimoun M, Boccara D. Burns caused by electronic vaping devices (e-cigarettes): A new classification proposal based on mechanisms. Burns 2017; 44:544-548. [PMID: 29056367 DOI: 10.1016/j.burns.2017.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/02/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
Abstract
Introduction With more than 10 million of daily users, e-cigarettes encountered a great success. But in the past few years, the number of medical reports of injuries caused by the explosion of e-cigarettes has significantly increased. This article aims at reporting our series and reviewing the literature to propose a new classification based on the mechanisms of injuries related to e-cigarettes that can guide non-specialists and specialists in the management of these patients. Method We performed a retrospective review of our institutional burn database from June 2016 to July 2017 for injuries caused by or in the context of using an e-cigarette. The patients' demographics (age, gender), burn injury mechanisms, depth, localization, surface and interventions were described. Results Ten patients suffered from burns related to the use of e-cigarettes. The burns were located at the thigh (80%) and the hand (50%) with a mean surface of 3% of TBSA. Four different mechanisms could be described: Type A: thermal burns with flames due to the phenomenon of "thermal runaway", Type B: blasts lesions secondary to the explosion, Type C: chemical alkali burns caused by spreading of the electrolyte solution and Type D: thermal burns without flames due to overheating. These different mechanisms suggest specific surgical and non-surgical management. Conclusion Management of injuries sustained from e-cigarettes' explosions should be approached from the standpoint of mechanisms. Different mechanisms could be associated and should be considered in specific management.
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Affiliation(s)
- K Serror
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France.
| | - M Chaouat
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Matthieu M Legrand
- Departement of Anesthesiology and Intensive Care Unit, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - F Depret
- Departement of Anesthesiology and Intensive Care Unit, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - J Haddad
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - N Malca
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - M Mimoun
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - D Boccara
- Department of Plastic Reconstructive Surgery, Burn Center, Hôpital Saint Louis, AP-HP 1 Avenue Claude Vellefaux, 75010 Paris, France
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25
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Thigh deep burns caused by electronic vaping devices (e-cigarettes): A new mechanism. Burns 2017; 43:1133-1135. [DOI: 10.1016/j.burns.2017.01.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 11/20/2022]
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26
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Treitl D, Solomon R, Davare DL, Sanchez R, Kiffin C. Full and Partial Thickness Burns from Spontaneous Combustion of E-Cigarette Lithium-Ion Batteries with Review of Literature. J Emerg Med 2017; 53:121-125. [DOI: 10.1016/j.jemermed.2017.03.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/17/2017] [Accepted: 03/27/2017] [Indexed: 11/26/2022]
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27
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Arnaout A, Khashaba H, Dobbs T, Dewi F, Pope-Jones S, Sack A, Estela C, Nguyen D. The Southwest UK Burns Network (SWUK) experience of electronic cigarette explosions and review of literature. Burns 2017; 43:e1-e6. [DOI: 10.1016/j.burns.2017.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 11/11/2016] [Accepted: 01/05/2017] [Indexed: 11/28/2022]
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28
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Yu MY, Su Y, Meng XJ, Luan BW, Gu GS, Sun Q, Zhao DW. Uncontacted tire explosion causing trauma to bilateral lower extremities: A case report. Chin J Traumatol 2017; 20:177-179. [PMID: 28502602 PMCID: PMC5473710 DOI: 10.1016/j.cjtee.2016.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 07/20/2016] [Accepted: 08/05/2016] [Indexed: 02/04/2023] Open
Abstract
It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus (a comminuted fracture in the right ankle joint) and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient's feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon.
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Affiliation(s)
- Ming-Yang Yu
- Department of Traumatic Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Yun Su
- Department of Traumatic Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China,Corresponding author.
| | - Xiang-Jun Meng
- Department of Ophthalmology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - Bo-Wu Luan
- Department of Discovery Biology, GenScript USA Inc., Piscataway 08854, USA
| | - Gui-Shan Gu
- Department of Orthopedics, First Hospital of Jilin University, Changchun 130021, China
| | - Qiang Sun
- Department of Traumatic Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
| | - De-Wei Zhao
- Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
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29
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Bauman ZM, Roman J, Singer M, Vercruysse GA. Canary in the coal mine—Initial reports of thermal injury secondary to electronic cigarettes. Burns 2017; 43:e38-e42. [DOI: 10.1016/j.burns.2016.09.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 09/14/2016] [Accepted: 09/26/2016] [Indexed: 10/20/2022]
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30
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Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
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Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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31
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Sheckter C, Chattopadhyay A, Paro J, Karanas Y. Burns resulting from spontaneous combustion of electronic cigarettes: a case series. BURNS & TRAUMA 2016; 4:35. [PMID: 27995151 PMCID: PMC5151131 DOI: 10.1186/s41038-016-0061-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Electronic cigarette (e-cigarette) sales have grown rapidly in recent years, coinciding with a public perception that they are a safer alternative to traditional cigarettes. However, there have been numerous media reports of fires associated with e-cigarette spontaneous combustion. CASE PRESENTATION Three severe burns caused by spontaneous combustion of e-cigarettes within a 6-month period were treated at the Santa Clara Valley Medical Center Burn Unit. Patients sustained partial and full-thickness burns. Two required hospitalization and surgical treatment. CONCLUSIONS E-cigarettes are dangerous devices and have the potential to cause significant burns. Consumers and the general public should be made aware of these life-threatening devices.
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Affiliation(s)
| | | | - John Paro
- Division of Plastic Surgery, Stanford University, Palo Alto, CA USA
| | - Yvonne Karanas
- Division of Plastic Surgery, Stanford University, Palo Alto, CA USA
- Santa Clara Valley Medical Center Regional Burn Center, 751 South Bascom Avenue, San Jose, CA 95128 USA
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Brooks JK, Kleinman JW, Brooks JB, Reynolds MA. Electronic cigarette explosion associated with extensive intraoral injuries. Dent Traumatol 2016; 33:149-152. [DOI: 10.1111/edt.12293] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 11/30/2022]
Affiliation(s)
- John K. Brooks
- Department of Oncology and Diagnostic Sciences; University of Maryland School of Dentistry; Baltimore Maryland USA
| | - Justin W. Kleinman
- Department of Periodontology; University of Maryland School of Dentistry; Baltimore Maryland USA
- Private practice; Westminster Maryland USA
| | | | - Mark A. Reynolds
- Department of Periodontology; University of Maryland School of Dentistry; Baltimore Maryland USA
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