Posted: 5/31/2017
Parkland Burn Center officials offer words of caution
Electronic cigarettes (e-cigarettes) have been available for sale in the U.S. since 2007. Since then the battery-powered device that simulates tobacco smoking by producing heated vapor, which resembles smoke, have grown in popularity. But with sales of the devices skyrocketing to more than $1.5 billion in 2014, incidents of e-cigarette fires and explosions are on the increase.
In 2014, the U.S. Fire Administration (USFA) published an alert that identified 25 separate e-cigarette fires and explosions dating to 2009 that were reported in the media. The study indicated that the shape and construction of e-cigarettes can make them more likely than other products with lithium-ion batteries to behave like “flaming rockets” when a battery fails.
At Parkland Memorial Hospital, home to the regional burn center, five patients have been admitted with burns related to e-cigarettes since 2015.
“For several years e-cigarettes were not regulated by the federal government, therefore the manufacture of e-cigarettes were not subject to enforceable industry-wide product standards that would ensure their safety for consumers,” said Stephanie Campbell, RN, Parkland’s Burn Program Manager. “In 2016, the FDA extended its regulatory authority over vaporizers and issued the first set of regulations. Although we haven’t treated a large number of patients with burns from e-cigarettes we, like other burn centers across the country, see it as a growing problem that needs to be addressed.”
E-cigarette fires and explosions listed in a National Fire Protection Association (NFPA) database shows 15 separate incidents recorded in 2015. According to the NFPA, incidents identified through media accounts probably do not reflect the complete e-cigarette fire and explosion experience. “However, there do not currently appear to exist alternative reporting systems that systematically capture e-cigarette events,” the NFPA noted.
Of the 15 e-cigarette incidents reported in 2015, 13 were described as explosions and two as ignitions. Five incidents resulted in fires, three of which occurred while users were in the act of smoking and two while batteries were being charged. Twelve incidents resulted in injuries requiring medical treatment.
“More than 2.4 million Americans are using e-cigarettes and the number is growing rapidly,” Campbell said. “At a recent meeting of the American Burn Association, representatives of burn centers from coast to coast reported seeing multiple patients with burn injuries related to e-cigarette explosions. Many of these patients have sustained serious injuries, requiring skin grafting and rehabilitation.”
One of the key things that people can do to protect themselves when using e-cigarettes is to follow the manufacturer’s guidelines and do not use after-market power sources to recharge the lithium-ion batteries, Campbell said. Do not carry e-cigarette devices or batteries in your pocket, especially if you have multiple batteries. Do not let your batteries come into contact with metal objects such as keys or coins.
Another concern is coming to light where e-cigarettes are concerned. A technique generating higher levels of toxic emissions is being tried out by teens, according to Sarah Shafer, MD, a toxicologist with the North Texas Poison Center (NTPC) at Parkland. The technique, called “dripping,” generates higher heating coil temperatures than conventional use of e-cigarettes – and this is a safety concern.
“Higher temperatures lead to greater emissions of a class of harmful chemicals known as volatile aldehydes, including formaldehyde and acrolein. Both are known to cause cancer in humans,” Dr. Shafer said. “Emerging data is also showing that e-cigarettes contain many other chemicals like propylene glycol and glycerine, and a lot of flavor chemicals.”
Since ingredients are not regulated, users do not know what chemicals they are inhaling, Dr. Shafer said. The substances could be volatile, she added, and when heated at high temperatures could produce high levels of carcinogenic compounds, not to mention a risk for burns.
Along with burns, there is a risk for toxic exposures related to e-cigarettes. From 2009 to the present in Texas, most cases occurred at home (95.2 percent) and consist of unintentional exposures (91.4 percent). Most were ingestion exposures (81.4 percent) and in children under 6 years old (69 percent).
According to data provided by the NTPC, there were only three reported cases of exposure to toxic substances in e-cigarettes in Texas in 2009 and by 2014 there were almost 400 reported exposures. There are about 300 reported exposures per year since 2014 in Texas.
Established in 1962, the Parkland Burn Center is the second largest civilian burn center in the nation, providing care to more than 2,200 patients annually. Serving North Texas and surrounding areas, this comprehensive burn center is one of only 62 verified burn centers in North America and the only one in North Texas, and provides all services from emergency treatment to intensive care to rehabilitation and outpatient follow-up care.
For more information on services available at Parkland, please visit www.parklandhospital.com