Abstract 14841: Energy Drink Exposures in the National Poison Data System: Epidemiology and Clinical Effects
Introduction: Energy drinks (ED) are beverages whose stimulant properties are likely linked to their caffeine content, including pharmaceutical caffeine and, in some cases, additional caffeine from natural sources, other additives and, prior to the FDA ban, ethanol. Of particular concern are exposures in children, especially those with underlying cardiac or neurological conditions.
Methods: This is a retrospective analysis of human exposures to single-substance ED formulations in the National Poison Data System of the American Association of Poison Control Centers from 10/1/10 - 9/30/13.
Results: There were 10,610 cases of ED exposure, with 5,156 being single-substance exposures with identifiable contents. Over 40% involved unintentional exposures by children < 6 years old, which was constant over the study period. There were, however, increases in unintentional ED exposures (p=0.002) and no-effect outcomes (p=0.015) over time. Outcome severity was increased with exposure to products containing caffeine from multiple sources v. pharmaceutical caffeine only (23% v. 15% “Moderate” or “Major” outcomes, p<0.001). The most prevalent organ system effects in non-ethanol-containing ED were neurologic in 20%, GI in 15% and cardiovascular in 12%. Exposures with “Major” outcomes had cardiovascular effects in 57% (including rhythm and conduction abnormalities), and neurologic effects in 55% (seizures, including status epilepticus). Ethanol as an additive was also associated with increased outcome severity v. non-ethanol-containing ED (42% v. 19% “Moderate” or “Major” outcomes, p<0.001). There has been a continued decline in reports of exposure to combination ED-ethanol products since the FDA ban.
Conclusions: ED exposures reported to poison centers demonstrate a sizable proportion of pediatric cases, some with serious cardiac and neurological effects. Demographic changes over time may be related to public and professional educational efforts. Observed clinical effects are consistent with known effects of caffeine. Regulatory action has been followed by a decrease in poison center reports of ethanol-containing ED. We recommend improved labeling of caffeine content and continued efforts to decrease pediatric exposures to these products.
Author Disclosures: S.A. Seifert: None. K.L. Arheart: None. V.I. Franco: None. A.C. Bronstein: None. S.D. Fisher: None. B.J. Warrick: None. S.M. Seifert: None. S.E. Lipshultz: None.
- © 2014 by American Heart Association, Inc.