AusVapeSafety: a prospective observational study of vape exposures and outcomes to an Australian Poisons Information Centre.

INTRODUCTION

Escalating vape use, regulatory changes and product innovation prompt monitoring of risks and harms from vapes in Australia. We reviewed annual vape exposures and piloted a surveillance system to describe risks for vape exposures, and outcomes.

METHODS

We performed a prospective observational study of all vape-related exposures in New South Wales notified to the New South Wales Poisons Information Centre. In 2022, additional questions were asked to callers and follow-up calls were made to non-health practitioner callers to complete details of the exposure and outcomes. Hospital and ambulance records were reviewed to complete data capture. We describe demographics, circumstances, product details and clinical effects in 2022, and annual vape exposures 2016-2024, inclusive.

RESULTS

We were consulted on 255 vape exposures in 2022. Most calls were from members of the public (90%) about toddlers (64%). Vape devices were commonly implicated (86%) and the most frequent route of exposure was inhalation (73%). Most exposures resulted in mild (67%) or no effects (28%), with more significant outcomes including decreased level of consciousness (n = 11), chest pain (n = 9) and seizures (n = 4). An adult developed severe poisoning after unintentionally drinking nicotine liquid in place of cough syrup. Annual cases increased from 2018 to 2022, followed by a numerical decrease.

DISCUSSION: We successfully incorporated additional questions and enhanced patient follow-up into routine clinical care allowing us to systematically identify factors contributing to unintentional vape exposures and outcomes. This informs public health and regulatory responses. Regulatory restrictions introduced in late 2021 may have contributed to the decrease in cases in 2024.

CONCLUSIONS

Unintentional vape exposures are relatively common, especially by young children reflecting easy accessibility to devices used by caregivers. Child safety features were rarely present. While serious poisonings were uncommon in our series, vape exposures pose a potential for severe adverse effects.