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Injuries and poisonings from vaping products including e-cigarettes Published: ()
Vaping is the use of an electronic cigarette (e-cigarette) or other vaping device to inhale vapour produced by heating vaping liquid or 'e-juice'. Most vaping devices have a battery, mouthpiece, heating element, and a chamber to hold vaping liquid which can contain nicotine.Footnote 1 Some people also use vaping devices to consume cannabis.
Vaping has a risk of poisoning, burns and other unexpected health effects. Children have been poisoned by ingesting vaping liquid as it is often flavoured, making it more appealing; ingesting even a small amount of liquid nicotine can be serious and even life-threatening for a child.Footnote 2 There are also reports of vaping device malfunctions, such as overheating batteries causing explosions and burns. In a nationally representative sample of US hospital emergency departments, one study found 26 cases of battery-related burns from vaping devices malfunctioning, which translates to a national estimate of 1007 cases.Footnote 3
On May 23, 2018 Canada’s Tobacco and Vaping Products Act (TVPA) came into effect allowing adults to legally access vaping products with nicotine.Footnote 1 Although unregulated vaping products have been available for more than a decade,Footnote 4 their manufacture, import, sale and advertisement are now subject to the TVPA as well as the Food and Drugs Act (FDA), Canada Consumer Product Safety Act (CCPSA), and The Non-smoker’s Health Act.Footnote 1
The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning sentinel surveillance system currently operating in the emergency departments of 11 paediatric and 8 general hospitals across Canada. The numbers below are taken from an analysis of CHIRPP’s electronic database (eCHIRPP).Footnote 5
The eCHIRPP database was searched for events (or cases) related to e-cigarettes and other vaping products, which occurred on or after April 1, 2011. A detailed search was conducted of nearly 60 English and French key words in patients’ descriptions of the injury event, in combination with numerical codes. Below is a snapshot of our findings.
How many cases were there?
There were 32 reported cases of unintentional injuries or poisonings related to vaping products including e-cigarettes (6.2 cases/100,000 eCHIRPP records) between January 2013 and August 2018. No cases were reported before 2013. The frequency of cases increased over this time period from 2.0 cases to 13.0 cases/100,000 eCHIRPP records, with an annual increase of 16.6%.
Children and youth vs. adults
The age range of patients injured or poisoned from e-cigarettes and other vaping products was 0 to 49 years of age. Children and youth aged 0 to 14 years were most common at 7.1 cases/100,000 eCHIRPP records, compared to patients aged 15 to 49 at 2.8 cases/100,000 records.
Males vs. females
Overall, 62.5% of the patients injured or poisoned were male.
What types of injuries?
Seventy-eight percent (78%) of the injuries reported were poisonings from ingesting vaping liquid, and 92% of those were among children aged 4 years or younger. Among all ages, nearly two-thirds (64%) of the poisoning cases specified nicotine.
The remaining patients were burned from e-cigarettes exploding or catching fire (9%), or sustained another type of injury or had no injury detected (12%).
Where did the injuries and poisonings happen?
Most (80.6%) injuries and poisonings occurred in private residences (i.e. the patient’s own home, or someone else’s home).
What level of in-hospital treatment was needed?
More than two-thirds of patients (69%) had minor injuries or poisonings that did not require hospital admission or medical treatment, and who were therefore observed in the emergency department or received advice. Just over one-quarter (28%) of patients received medical treatment in the emergency department, and one fatality was reported.
Take Note
The results presented above should be interpreted with caution as they do not represent all vaping-related injuries and poisonings in Canada. CHIRPP is a sentinel surveillance system and collects data from select emergency departments across Canada. Teenagers older than 18 years of age, Aboriginal persons and people who live in rural areas may be under-represented in the eCHIRPP database, as most CHIRPP sites are paediatric hospitals located in major cities. Fatal injuries are also under-represented in the eCHIRPP database because the emergency department data do not capture people who died before they could be taken to hospital or those who died after being admitted via another department. Information is continuously being entered into the eCHIRPP database; therefore, some years do not yet have complete data.
More information and related material
Learn more about the health risks of vaping products including e-cigarettes.
Learn more about the Canadian Hospitals Injury Reporting and Prevention Program.