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December 15th, 2014:

NY toddler dies after drinking liquid nicotine in e-cig refill

Incidents of nicotine poisoning have surged with the popularity of e-cigarettes

A toddler in New York is the latest apparent victim of a new household hazard — liquid nicotine refills for e-cigarettes. Police in Fort Plain, N.Y., said they answered a call concerning an unresponsive child. The child was taken to a local hospital and died a short time later.

Sgt. Austin Ryan of the Fort Plain police said investigators were told the child drank from a bottle containing liquid refills for e-cigarettes.

Though shocking, such accidents are becoming increasingly common. Earlier this year, it was reported that a CDC study published in the agency’s Morbidity and Mortality Weekly Report found that calls to poison control centers for nicotine ingestion by children shot up from 1 per month in September 2010 to 215 per month this past February. And, the report says, the number of calls per month involving conventional cigarettes did not show a similar increase during the same time period.

The New York General Assembly recently passed a measure requiring child-resistant containers on e-cigarette refills, which are often flavored with fruit and other sweet substances attractive to children.

The CDC report said that more than half (51.1%) of the calls to poison centers due to e-cigarettes involved young children 5 years and under, and about 42% of the poison calls involved people age 20 and older.

The analysis, which compared total monthly poison center calls involving e-cigarettes and conventional cigarettes, found the proportion of e-cigarette calls jumped from 0.3% in September 2010 to 41.7% in February 2014.

Poisoning from conventional cigarettes is generally due to young children eating them. Poisoning related to e-cigarettes involves the liquid containing nicotine used in the devices and can occur in three ways: by ingestion, inhalation or absorption through the skin or eyes.

Red flag

“This report raises another red flag about e-cigarettes — the liquid nicotine used in e-cigarettes can be hazardous,” said CDC Director Tom Frieden, M.D., M.P.H. “Use of these products is skyrocketing and these poisonings will continue. E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.”

“One teaspoon of liquid nicotine could be lethal to a child, and smaller amounts can cause severe illness, often requiring trips to the emergency department,” the American Association of Poison Control (AAPC) centers said recently.

Adults should use care to protect their skin when handling the products, and they should be out of sight and out of the reach of children, AAPC said. Additionally, those using these products should dispose of them properly to prevent exposure to pets and children from the residue or liquid left in the container.

The American Association of Poison Control Centers recommends the following steps:

Protect your skin when handling the products.

Always keep e-cigarettes and liquid nicotine locked up and out of the reach of children.

Follow the specific disposal instructions on the label.

If you think someone has been exposed to an e-cigarette or liquid nicotine, call your local poison center at 1-800-222-1222 immediately.

E-Cig Liquid Nicotine Linked To 1-Year-Old’s Death; Poison Control Centers Say FDA Should Move Forward With Regulations

E-cigarettes, with their reputation for being safer than regular cigarettes, have seen record gains in usage. Their use among middle and high school students more than tripled between 2011 and 2013, going from 79,000 to 263,000 students, according to an August study. And on Thursday, the Centers for Disease Control and Prevention (CDC) released a report showing that 10 states and the District of Columbia don’t restrict e-cig sales to minors, giving over 16 million children access to the devices and liquid nicotine. The Food and Drug Administration (FDA) has stalled passing any sort of regulations on these products, and it’s because of this that a 1-year-old toddler from upstate New York died last week.

The toddler, from Fort Plain, N.Y., died last Tuesday after ingesting liquid nicotine. It’s believed he’s the first child in the U.S. to die from the product, which is sold in bottles, separate from the e-cigarette devices. After the child was found unresponsive, he was immediately taken to a hospital where he was pronounced dead, ABC News reported. Although the nicotine is commonly used for e-cigarettes, Fort Plain police didn’t specify in a statement whether it was associated with the device.

The child’s death brings to the forefront these regulation issues, which have largely gone under the radar since the FDA first proposed new ones in August. “One teaspoon of liquid nicotine could be lethal to a child, and smaller amounts can cause severe illness, often requiring trips to the emergency department,” the American Association of Poison Control Centers said in a statement on Friday, according to ABC News. “Despite the dangers these products pose to children, there are currently no standards set in place that require child-proof packaging.”

The Association also said that rates of nicotine exposure, either through ingestion, inhalation, or absorption through skin had risen since 2011, when there were only 271 exposures. As of Nov. 30, there had already been 3,638 exposures in 2014. “They’re not that difficult to get into,” Dr. Donna Seger, director of the poison control center at Vanderbilt University Medical Center, told ABC News. With many of these bottles containing colorful, flavored nicotine, such as chocolate, berry, and cotton candy, it’s no wonder kids see them and think they’re something else. Making the issue worse is that it’s not always clear how concentrated the liquid is with nicotine — they come in strengths ranging from 6 to 24 milligrams.

Nicotine poisoning has been associated with symptoms from nausea and vomiting to more dire conditions, such as a slowed heart rate, low blood pressure, seizures, lethargy, paralysis, and coma. According to ABC News, some states have begun implementing laws requiring child-resistant packaging. New York Gov. Andrew Cuomo is expected to sign one of these bills within the next few weeks.

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