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Serious Burns Caused By E-Cigarette Explosions

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Many family members have e-cigarettes inside their homes, pockets and purses. As more adults try to quit smoking traditional cigarettes, the use of electronic smoking devices (e-cigarettes) is rapidly increasing.  Several recent studies show that not only are adults experimenting with e-cigarettes, but also teens and preteens are attracted to the candy-flavored gadgets through peer pressure, advertising and celebrity endorsements.

One aspect of e-cigarette use that hasn’t gotten a lot of attention, until now, is that these devices can un-expectantly explode causing severe burns to the face and other areas of the body.

According to a research letter published in the New England Journal of Medicine, electronic-cigarette devices are randomly exploding, burning and injuring people near them when they detonate.

The University of Washington Regional Burn Center in Seattle has treated 22 people for burns and other injuries caused by exploding e-cigarettes since October 2015, lead author Elisha Brownson, M.D., a burn/critical care surgical fellow at the hospital, told HealthDay.

The lithium-ion batteries used in e-cigarettes, Brownson said, cause the explosions. These rechargeable batteries charge a heating coil that brings liquid nicotine and flavorings to the boiling point inside the device, creating an inhalable vapor. Batteries in some of the devices are overheating, causing a fire or an explosion, she said.

The first Seattle case Brownson treated was a man in his 20s using an e-cigarette while driving. The device exploded in his mouth, blowing out several front teeth. She said she has since treated a variety of burns and blast injuries caused by e-cigarettes, including patients with flame burns covering 10 to 15 percent of their total body surface.

"We see a lot of patients who have burns on their thigh and their hands. That's when the device has exploded in their pocket, and they're using their hands to get the device out and away from them," Brownson said. "There also have been a lot of injuries to the hands and face when people have had explosions as they've been using them. Patients tell us they had no idea this could happen. They've had little to no warning that the device is going to explode."

The flame-burn injuries have required extensive wound care and skin grafting, and exposure to the alkali chemicals released from the battery explosion has caused chemical skin burns requiring wound care.

Why do these devices explode? NBC News put the question to Venkat Viswanathan, an assistant professor of mechanical engineering at Carnegie Mellon University in March of 2016.

“The electrolyte inside the battery is basically the equivalent of gasoline, so when these batteries short out, there's a surge of heat that causes this flammable electrolyte to combust and explode."

Well-made lithium-ion cells have a very small risk of failure. But the cheaper cells "have a much greater chance of having a manufacturing defect," which increases the likelihood for failure, Viswanathan said.

The risk goes up if the cells are overcharged or charged too quickly. This can happen if the e-cig comes with a poorly designed charger or the user switches chargers. Well-made lithium-ion batters have fail-safe mechanisms to prevent these problems. Poorly made ones do not. Just because a charger plugs into that e-cig doesn't mean you should use it.

E-cigarettes remain largely unregulated. Until recently, the Food and Drug Administration (FDA) had made little headway in the regulation of e-cigarettes. However, the FDA has recently extended regulatory authority to cover all tobacco products, including e-cigarettes, although the prospects for battery regulation remain unclear. While these explosions were previously thought to be isolated events, the injuries among our 15 patients add to growing evidence that e-cigarettes are a public safety concern that demands increased regulation as well as design changes to improve safety. In the meantime, both e-cigarette users and health care providers need to be aware of the risk of explosion associated with e-cigarettes, the paper’s researchers noted.

Story sources: http://www.physiciansbriefing.com/Article.asp?AID=715566

Herb Weisbaum, http://www.nbcnews.com/business/consumer/what-s-causing-some-e-cigarette-batteries-explode-n533516

http://www.nejm.org/doi/full/10.1056/NEJMc1608478

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