IWK Regional Poison Centre received 34 calls related to concentrated nicotine last year, up from one in 2013
http://www.cbc.ca/news/canada/new-brunswick/nicotine-poison-e-cigarette-increase-new-brunswick-1.4141007
The number of poisoning incidents related to the concentrated nicotine cartridges used for electronic cigarettes is increasing, according to the clinical leader of a poison control centre in the Maritimes.
“It’s definitely on the rise as they become more available to the public,” said Laurie Mosher, of the IWK’s Regional Poison Centre in Halifax, which takes calls from health-care professionals in New Brunswick and from citizens in Nova Scotia and P.E.I.
The first call Mosher tracked was in 2013. In 2014, the number jumped to 14, then 21 in 2015, and 34 in 2016, she said.
The incidents involve people of all ages, but children were involved in 12 of last year’s calls, or 35 per cent, said Mosher. That’s up from three calls, or 21 per cent, in 2014.
“As a product becomes more available and more people are using it, and especially people with small children or teenagers in the house, it is likely to go up,” she said.
On Monday, a nine-year-old girl in Fredericton was taken to hospital after drinking an e-cigarette fluid called Unicorn Milk and suffering nausea, chest cramps and dizziness.
The Grade 5 student, who was diagnosed with nicotine poisoning, discovered the vial of concentrated nicotine with her friends on their school playground at École des Bâtisseurs. They all tasted drops from the fluid, which is used for electronic vaping of cigarettes.
The girl’s mother, Lea L’Hoir, said the children were tempted to try the strawberry-flavoured fluid because it smelled good, and its container was decorated with a brightly coloured image of a unicorn.
National total not tracked
The number of such incidents across Canada is unclear. There is no central data collection centre for poisonings, said Mosher.
There are five poison centres across the country that serve all of the provinces, except New Brunswick and Newfoundland, which are covered by 811 and Tele-Care.
New Brunswick’s 811 line has received only one call regarding liquid nicotine poisoning in the past two years, according to the Department of Health.
The call was in November 2016, said department spokesperson Geneviève Mallet-Chiasson.
Mosher worries the numbers will continue to grow. “I think it definitely has potential for concern. So I don’t think we’re making too much of it.”
Even small amounts problematic
The symptoms experienced depend on exposure, said Mosher, who is also a registered nurse. Just a drop or two can lead to nausea or vomiting. It can also be very irritating if the substance gets into the eyes, she said.
“Larger amounts can cause tremors, seizures, and then it can also go the other way and they can have drowsiness,” said Mosher.
“So certainly if a child ingested a mouthful it could be very toxic. We haven’t had any severe toxicity as of now in our centre, but there certainly is potential for that,” she said.
“It could be life-threatening, depending on how much they got a hold of.”
Label guidelines needed
Mosher contends part of the problem is a lack of labelling guidelines for the cartridges.
Health Canada doesn’t regulate the labelling of vape products, but the sale of the products to people 18 or under is banned.
Mosher said the nicotine comes in different concentrations and the labels are not clear. For example, a label might indicate 16 mg, but there’s a big difference between 16 mg per mL and 16 mg in the entire cartridge.
In addition, the packaging is appealing to young children and the flavours appeal to teenagers.
The lack of warning symbols and lack of child-resistant packaging is very concerning, said Mosher.
“I would treat it like any other poisonous product, it should be kept out of reach of children, it should be regulated,” she said. “And it should not be appealing to young children.”
Call for tougher regulations
Earlier this week, the Canadian Cancer Society called on the federal government to move quickly on tougher regulations surrounding the labelling of vaping products.
A federal bill that would regulate the manufacture, sale and labelling of vaping products awaits approval in the Senate.
The bill would also give Health Canada the regulatory authority to enforce policies on childproof caps and to restrict certain flavours that critics say are aimed at a younger market.
The Centres for Disease Control and Prevention in the U.S. reported in 2014 that the number of calls to poison centres involving e-cigarette liquids rose from one per month in September 2010 to 215 per month in February 2014. Almost 52 per cent of the calls involved children under the age of five.
The first four months of this year, poison centres in the U.S. reported 795 calls about exposure to the liquids.
If a child accidentally ingests the fluid, Mosher recommends calling a poison centre or 911.