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Vardavas CI, Girvalaki C, Odani S, Nikitara K, de Vries I, van Riel A, van Sommeren-de Potter I, Grass JN, Grassi MC, Deim S, Balázs A, Fosztó S, Schiel H, Arif T, Eronen AK, Alonso AA, Menor JLC, Arrieta RM, Babić Ž, Turk R, Vardavas AI, Tsatsakis A. Profile of incidental exposures to e-cigarette liquids in Europe, 2018-2019. Hum Exp Toxicol 2020; 40:1045-1050. [PMID: 33272061 DOI: 10.1177/0960327120975828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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.
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Affiliation(s)
- Constantine I Vardavas
- Laboratory of Toxicology, 37778Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
| | - Charis Girvalaki
- Laboratory of Toxicology, 37778Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
| | - Satomi Odani
- Laboratory of Toxicology, 37778Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
| | - Katerina Nikitara
- Laboratory of Toxicology, 37778Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
| | - Irma de Vries
- Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antoinette van Riel
- Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Maria Caterina Grassi
- Clinical Toxicology-Poison Control Centre and Drug Dependence Unit, Policlinico Umberto I-"Sapienza University of Rome", Rome, Italy
| | - Szilvia Deim
- National Public Health Center, Department for Chemical Safety and Competent Authority, Unit for Health Toxicological Information Service and Notification, Hungary
| | - Andrea Balázs
- National Public Health Center, Department for Chemical Safety and Competent Authority, Unit for Health Toxicological Information Service and Notification, Hungary
| | - Szabolcs Fosztó
- National Public Health Center, Department for Chemical Safety and Competent Authority, Unit for Health Toxicological Information Service and Notification, Hungary
| | | | - Tara Arif
- Poisons Information Centre, Vienna, Austria
| | | | | | | | | | - Željka Babić
- Croatian Poison Control Centre at Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Rajka Turk
- Croatian Poison Control Centre at Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Alexander I Vardavas
- Laboratory of Toxicology, 37778Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, 37778Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
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