• Journal of Environmental Health Sciences
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• v.50 no.4
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• pp.302-310
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• 2024

Background: The prevalence of allergic rhinitis in South Korean adolescents is increasing. Adolescents in South Korea currently use liquid electronic cigarettes more than heated tobacco products. Objectives: The purpose of this study was to assess the association between the use of liquid electronic cigarettes and allergic rhinitis diagnoses among South Korean adolescents. Methods: This study used data from the 17th Korea Youth Risk Behavior Survey in 2021. Out of a total of 59,066 students, data from 18,869 students who had experience with liquid electronic cigarettes were used in the final analyses. Diagnoses of allergic rhinitis by medical doctors were self-reported as outcome variables. Results: For females, when comparing 'daily users' and 'current users' with 'never users', the adjusted odds ratios (ORs) for 'allergic rhinitis' were 2.20 (95% confidence interval (CI), 1.00~4.84) and 1.49 (95% CI, 1.07~2.09), respectively. For males, when comparing 'daily users' and 'current users' with 'never users', the adjusted ORs for 'allergic rhinitis' were 1.42 (95% confidence interval (CI), 0.91~2.22) and 1.41 (95% CI, 1.08~1.84), respectively. Conclusions: The use of liquid electronic cigarettes was statistically significantly associated with increased odds of allergic rhinitis, especially for females. The results of this study will provide a useful scientific basis for establishing public health policy and using the educational data related to the use of liquid electronic cigarettes in the future.

• Journal of Environmental Health Sciences
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• v.39 no.6
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• pp.483-491
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• 2013

Objectives: Electronic cigarettes are battery powered devices that convert a nicotine-containing liquid into an inhalable vapor. The device aerosolizes nicotine so that it is readily entrained into the respiratory tract, from where it enters the bloodstream. Information on the safety of E-cigarettes is required. Methods: Seventeen articles on studies analyzing toxic substances in the liquid and gas phases of electronic cigarettes were reviewed. Results: Tobacco-specific nitrosamines, bis(2-ethylhexyl) phthalate, formaldehyde and acetaldehyde, known to be carcinogenic agents in humans or animals, were detected in the liquid and gas phases. In addition, diethyl phthalate, acetone, ethanol, cresol, xylene, propylene, styrene, triethylene glycol, tetraethylene glycol, pentaethylene glycol cis-3-hexen-1-ol, methyl cinnamate and undecane were identified in the liquid and gas phases of E-cigarettes. Propylene glycol, glycerin, 1-methoxy-2-propanol, 1-hydroxy-2- propanone, acetic acid, 1-menthone, 2,3-butanediol, menthol, carvone, maple lactone, benzyl alcohol, 2-methyl-2-pentanoic acid, ethyl mantel, ethyl cinnamate, myosamine, benzoic acid, 2,3-bipyridine, cotinine, hexadecanoic acid, and 1'1-oxybis-2-propanol were detected in the vapors of E-cigarettes. Conclusion: The hazardous compounds identified in the liquid and gas phases of E-cigarettes should be controlled for the lowest concentrations in the raw materials and production procedures.

• Bulletin of the Korean Chemical Society
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• v.34 no.9
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• pp.2691-2696
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• 2013

The electronic cigarette (E-cigarette) is a battery-powered device that aerosolizes nicotine so that it is readily delivered into the respiratory tract. The analytical data regarding the substances present in E-cigarettes are very limited. The aim of this study was to measure the concentration of aldehydes-formaldehyde (FA), acetaldehyde (AA) and, acrolein (AL)-in 225 replacement liquid brands from 17 E-cigarette shops sold in the Republic of Korea by headspace solid-phase micro extraction and gas chromatography-mass spectrometry (HS-SPME GC-MS). The concentration range of FA and AA was 0.02-10.09 mg/L (mean = 2.16 mg/L, detected in 207 of 225 samples) and 0.10-15.63 mg/L (mean = 4.98 mg/L, detected in all samples), respectively. AL was not detected in any of 225 replacement liquids. FA and AA were originally present in almost all replacement liquids of electronic cigarettes.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.2
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• pp.82-85
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• 2022

Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or "e-liquid" leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were >500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.

• Clinical and Experimental Pediatrics
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• v.59 no.12
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• pp.490-493
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• 2016

Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.51-56
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• 2020

Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion: The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review. The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.172-175
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• 2018

Acute nicotine poisoning by liquid nicotine for electronic cigarettes is becoming an increasing problem worldwide. On the other hand, there are no regulations regarding its concentration, container or labelling in Korea. This is the first case of a cardiac arrest after liquid nicotine ingestion that was confirmed by plasma nicotine detection in Korea. A 34-year-old male was found with a cardiac arrest at home by the emergency medical services crew, and had a return of spontaneous circulation after 27 minutes of cardio-pulmonary resuscitation. The cause of his cardiac arrest was suspected to be acute nicotine poisoning by the ingestion of liquid nicotine. Toxicology analysis of the National Forensic Service confirmed plasma nicotine, and the pharmacokinetic estimated average concentration of plasma nicotine at the time of the cardiac arrest was 29.7 mg/L, a lethal dose. He was hospitalized for further treatment, but was discharged after 20 days without any improvement. Considering the strong toxicity of nicotine, appropriate policy decisions are required for sales and distribution.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.1
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• pp.60-64
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• 2017

Nicotine-poisoning related to the electronic cigarettes (e-cigarette) is increasing worldwide. Moreover, the American Association of Poison Control Centers has advised the public to use caution with e-cigarette devices and highly concentrated liquid nicotine after a surge in related poisonings. We report here the first case of nicotine poisoning from self-injected e-cigarette fluid in Korea. A 17-year-old male patient subcutaneously injected himself with 0.5 ml of nicotine solution for an electronic cigarette via the dorsum of his hand, after which he complained of nausea, vomiting, dizziness and dyspnea. His vital signs were within the normal range, but his mental status was drowsy. He was admitted for observation and the symptoms disappeared the following day. Sinus bradycardia with a rate of 45/min was observed on the third hospital day, but improved after 6 hours. He was discharged without complications.