The dangers of using e-cigarettes are well known when it comes to the potential for addiction and lung injury, but a new study is published in Journal of Surgical Research finds another cause for concern when it comes to e-cigarettes: the possibility of vaping devices exploding during use.

A study conducted by members of the Western Pediatric Surgery Research Consortium found that between January 2016 and December 2019, 15 patients from nine children’s hospitals received traumatic injuries as a result of e-cigarette explosions. Ten of them demanded hospitalization, three – in the intensive care unit.

Among the members of the Western Pediatric Research Consortium who contributed to the study were Shannon Acker, MD, an associate professor of pediatric surgery at the University of Colorado School of Medicine and a pediatric surgeon at Colorado Children’s Hospital.

We talked to Acker about the results of the study and what they mean e-cigarette users and their parents.

Q: Is this a problem you see often?

A: There were 15 patients in this study, and I think four or five of them came from Colorado Children’s Hospital. It was definitely an injury we often saw. When we think of e-cigarettes, vape and cigarette marketing problems for teenagers, it is usually due to addiction and lung injury. Whereas we, as trauma surgeons, have seen these other traumatic injuries. The goal was to teach people that e-cigarettes have other disadvantages.

Q: What in these devices causes these injuries?

A: Electronic cigarettes use a lithium-ion battery that evaporates a liquid nicotine solution. Because e-cigarettes are very popular, they are not very regulated, and batteries can be low quality and prone to explosion. An e-cigarette is like a pen with a hole at both ends, so the pressure has to go somewhere. When you press the liquid heating button, the battery explodes, and the pressure comes out directly. So if it is in your hand or near your face, it will cause injury. There was at least one child in the office with a broken jaw. It can also cause eye injuries and burns to the arm – in one child it exploded in the arm and caused not only skin burns but also radiation nerve damage. Where you keep it when the battery explodes will determine what will be injured.

Q: How often do these injuries require surgery?

A: Six of the 15 children in the series required surgery. Three of them were skin grafts due to skin burns, one of them had a broken lower jaw that needed repair, and one child had an arm injury that had to be repaired. Otherwise, the device at the time of the explosion was much closer to the mouth, so the patient broke several teeth and required both a dental examination and an examination of the airways in operating room.

Q: I am sure any such injury will have psychological effects too. Did these teenagers experience something similar when these injuries occurred?

A: We did not consider this in this study, but we know that children who receive traumatic injuries are at greater risk of requiring future mental health care, and I think these children fall into this category. If you and your friends have something exploding on your face, it will leave some lasting effect.

Q: Can you tell me how bad the situation is with vaping and how many children use these devices?

A: The most recent data we found is over 5%. middle school students and 11% off high school students have used e-cigarettes for the past 30 days and now they are the most commonly used tobacco products. Their use among school-age users has increased by 900%. That seems like a big deal to me.

Q: What was the purpose of this research and dissemination of this information?

A: Our goal of the publication was to convey to people that these e-cigarettes are harmful not only because they are addictive and because they can cause concomitant lung injury, which can be fatal, but they can also explode and cause traumatic trauma. We want to teach people and say, “These are the risks you face when using electronic cigarettesWe set out in the paper what the next steps should be, including reduction efforts electronic cigarette use, improve device safety, and educate physicians about the risk of device explosion.