Reports of children consuming poisonous liquid from e-cigarettes rose sharply in Minnesota last year, prompting health officials to warn that the state may be facing a new public health hazard.
Only one child was hospitalized as a result of consuming the nicotine-laced liquid, but the total number of cases — 50 — was a tenfold increase over 2012, the Minnesota Department of Health said Tuesday.
"We really want parents to know that this liquid nicotine can pose a fatal risk and that they should store it out of the reach of children," said Dr. Ed Ehlinger, state health commissioner.
The increase tracks the growing popularity of e-cigarettes, battery-powered cartridges that heat up flavored liquid and produce an inhaled nicotine vapor. Many e-cigarette users, or "vapers,'' use them as a lower-nicotine alternative to cigarettes, or as a bridge to quitting cigarettes altogether. One in five smokers had tried e-cigarettes in 2011, twice as many as a year earlier, according to the U.S. Centers for Disease Control and Prevention.
Of the 50 cases reported by Minnesota Poison Control, 14 resulted in trips to hospital emergency rooms and one required treatment in intensive care. The cases involved children and teens up to age 19, but the majority — 36 — involved children age 3 or younger.
"We think of concentrated nicotine as a very serious poison, equivalent to dangerous prescription drugs," said Stacey Bangh, clinical supervisor of the poison center, which is located at Hennepin County Medical Center.
The report on poisoning cases also comes amid a legislative debate over whether to expand the Minnesota Clean Indoor Air Act to apply to e-cigarettes, meaning they couldn't be used in workplaces, bars and other public indoor spaces.
Such a change, however, would not do anything to protect children from the small vials that contain e-cigarette liquid. Matt Black, president of the Minnesota Vapers advocacy group, said that risk would be better addressed by a requirement that all such vials be sold with childproof caps.
"I take the same precautions with my liquids as I did with my cigarettes," said Black, whose daughter is 13. "[Keep] them up on high shelves if you have small kids, or hidden if you have older kids."
Most e-cigarette vials already have safety caps, but they are not required by state or federal law. Ehlinger said he would support efforts to increase child-resistant packaging.
Jesse Ly of Anoka has taken the precaution of locking his e-cigarette materials in a toolbox to keep them away from his 6-month-old boy.
"My kid likes pirates," said Ly, 20, who works in an e-cigarette shop. "Pirates are known for finding 'hidden treasure.' I don't want him to just stumble upon anything like that — be it alcohol, e-liquid, or anything like that."
One concern is the packaging of e-cig liquid vials, which often have pictures of chocolate or various fruits to reflect their flavors.
"I suppose seeing a big old jug of Clorox is different, as opposed to a bottle with a strawberry or a piece of chocolate on it," said Ben Wilkins, an e-cigarette user from Jordan, whose fiancée has children who are 10 and 8 years old.
Wilkins keeps his vaping materials out of sight and tells the boys that the e-cigarette vials are just like the pill bottles in the medicine cabinet with the "bad icky face" on them.
Children's Hospital in St. Paul has seen a handful of children in the emergency room suspected of ingesting e-cigarette liquid, according to Dr. Rob Sicoli, the ER's co-director.
But Children's still sees more cases of "the toddler that eats a cigarette butt or two," Sicoli said.
Emergency personnel commonly use liquid charcoal to soak up nicotine in the stomach of a toddler who swallows cigarettes, Sicoli said, but it might not be as effective for children swallowing e-cigarette juice because the stomach absorbs liquid much more quickly.
Paul Allen said his 12- and 9-year-old boys wouldn't have much trouble with safety caps — "given they open grandma's medication for her" — so he stashes his e-cigarette materials in an old humidor in his home office in Burnsville.
Allen said he believes the bigger deterrent for the boys is seeing how he has struggled with smoking cigarettes and how vaping is what he needed to shake the habit.
"I do talk with them openly and honestly about addiction," he said, "and about things you just don't want any part of."
Jeremy Olson • 612-673-7744