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CARMA HANSON: Attention, parents: E-cigs present poisoning danger

GRAND FORKS — E-cigarettes have been in the media a great deal lately, as several bills made their way through the Legislature related to the use of e-cigarettes by minors and the sale of these products.

Safe Kids Grand Forks provided testimony on these bills, not so much from an anti-smoking or youth smoking perspective but rather from a poisoning perspective.

E-cigarettes are fairly new on the market, and the poison dangers associated with them have been emerging, but the education associated with these risks has not been made widely available.

Safe Kids Grand Forks hopes to change that by getting the word out to the public about these poisoning risks so that our local emergency rooms don't need to fill up with actual cases before we alert the public.

E-cigarettes that are marketed without a therapeutic claim by the product manufacturer are currently not regulated by the Food and Drug Administration. These products are sold with solutions that come in many flavors, including some such as watermelon, gummy bear, chocolate mint, cotton candy, Skittleberry and Blue Razz.

Not only do the flavors smell good in the bottles, but also the vapor from them is sweet flavored as well. They often are kept in a storage case that is similar to a pencil case and is decorated in what could be a pattern appealing to a child.

The colors of the dispensing device also are "fun" for children, as they are sold in styles such as Hello Kitty and other cartoon characters. These attributes make them very appealing to young children.

Besides these features, the charging cord is similar to that of a cell phone and most likely is used in places with an outlet that's easily accessible.

Currently, the liquid used in these devices is sold in a small to medium-sized bottle with an eye-dropper top. This cover is easy to open and seldom child-resistant, like the FDA requires for regulated medications.

The liquid syrup contains nicotine in various levels, based on the amount of smoking that the user is accustomed to doing.

But the bottom line is this: there can be enough nicotine in as little as a teaspoon of the liquid to kill or seriously poison a young child.

This substance can enter the body by being inhaled (smoked), ingested (swallowed) or even absorbed through the skin.

In other words, if a child were to spill the liquid on his or her clothing and not report it, the nicotine could be absorbed in the skin while the youngster plays or sleeps, causing nicotine poisoning or even death.

Safe Kids Grand Forks is concerned about the potential for e-cigarettes to cause acute nicotine toxicity. In order for nicotine toxicity to become an issue with traditional cigarettes, a child would need to eat several cigarettes from the package. This is highly unlikely due to their distaste and the texture of the tobacco.

Overdose of nicotine can cause nausea, vomiting, heart problems, seizures and even death if taken in large-enough doses — and those doses are easy to reach in the liquid form.

Recently, a young child from upstate New York was the first confirmed death from liquid nicotine.

When reviewing the potential danger of these products to cause a poisoning, consider the information from poison control centers. The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014, according to a Centers for Disease Control study. The number of calls per month involving conventional cigarettes did not show a similar increase during the same time period.

And more than half — 51.1 percent — of the calls to poison centers due to e-cigarettes involved children under age 5.

Remember: One teaspoon of liquid nicotine could be lethal to a child, and smaller amounts can cause severe illness, often requiring trips to the emergency room. Last month, the North Dakota Legislature passed a bill requiring child-resistant packaging for liquid nicotine containers, but we still have a need to educate parents and users of these products of the poisoning dangers associated with them.

For specific questions, please contact Safe Kids Grand Forks at Altru Health System. And please remember to treat e-cigarettes like other poisonous products and put them "UP and OUT of sight and OUT of reach."