Nicotine Poisoning Research Articles

Nephroprotective and antioxidant effect of green tea (Camellia sinensis) against nicotine-induced nephrotoxicity in rats and characterization of its bioactive compounds by HPLC-DAD.

Nicotine is a potential inducer of oxidative stress, through which it can damage numerous biological molecules. Natural antioxidants that prevent or slow the progression and severity of nicotine toxicity may have a significant health impact. The purpose of this study, conducted on Wistar rats, was to evaluate the beneficial effects of green tea (Camellia sinensis) extract on nicotine treatment-induced damage on kidney. Our results showed that nicotine significantly (p < 0.01) increased serum and kidney malondialdehyde, the serum contents of urea, creatinine, and uric acid. In addition, nicotine intoxication significantly (p < 0.01) decreased the levels of vitamins E and C in serum and kidney tissue as well as the activities of superoxide dismutase, catalase, and glutathione peroxidase. Interestingly, animals that were pretreated with green tea, prior to nicotine administration, showed a significant nephroprotection, revealed by a significant reduction-induced oxidative damage for all tested markers. The nephroprotective activity of green tea is mediated, at least in part, by the antioxidant effect of its constituents.

A Case Report of Cardiac Arrest Following Intentional Ingestion of Liquid Nicotine for Electronic Cigarette

Acute nicotine poisoning by liquid nicotine for electronic cigarettes is becoming an increasing problem worldwide. On the other hand, there are no regulations regarding its concentration, container or labelling in Korea. This is the first case of a cardiac arrest after liquid nicotine ingestion that was confirmed by plasma nicotine detection in Korea. A 34-year-old male was found with a cardiac arrest at home by the emergency medical services crew, and had a return of spontaneous circulation after 27 minutes of cardio-pulmonary resuscitation. The cause of his cardiac arrest was suspected to be acute nicotine poisoning by the ingestion of liquid nicotine. Toxicology analysis of the National Forensic Service confirmed plasma nicotine, and the pharmacokinetic estimated average concentration of plasma nicotine at the time of the cardiac arrest was 29.7 mg/L, a lethal dose. He was hospitalized for further treatment, but was discharged after 20 days without any improvement. Considering the strong toxicity of nicotine, appropriate policy decisions are required for sales and distribution.

Urinary cotinine in tobacco farmers in Southern Brazil.

ABSTRACTOBJECTIVE To describe urinary cotinine levels in tobacco farmers.METHODS A cross-sectional study was conducted in 2,570 tobacco farmers. All participants that reported green tobacco sickness in the week prior to the interview plus a subsample of 492 pesticide applicators were included. We collected urinary samples and information about sociodemographic, behavioral, dietary, occupational characteristics, and pesticide poisoning during their lifetime. Stratification by sex and smoking was performed and the Wilcoxon and Kruskal-Wallis non-parametrical tests were used to analyze cotinine means.RESULTS This study included 582 individuals. There was no difference in urinary cotinine means between green tobacco sickness symptomatic and asymptomatic individuals. Among non-smokers, having picked tobacco in the previous week was associated with higher cotinine means in both genders. Cotinine levels were higher on the first day of symptoms and reduced exponentially with each day in female non-smokers. Male non-smokers had higher levels on the second day and a more gradual reduction. The cotinine level rose up to 15 cigarettes/day of consumption.CONCLUSIONS The urinary cotinine measures exposure to nicotine up to its saturation point; while green tobacco sickness, affected by tolerance, indicates nicotine poisoning. Strategies to reduce nicotine exposure in tobacco production are needed. Mechanization could be an alternative, as long as it overcame the challenge of irregular terrain and did not affect the quality of the leaf. More studies are needed to evaluate the chronic effect of nicotine exposure.

Renoprotective effect of Spirulina platensis extract against nicotine-induced oxidative stress-mediated inflammation in rats

BackgroundNicotine is an important factor in the pathogenesis of renal injury in smokers. PurposeThe purpose of the present study was to investigate the renoprotective effect of Spirulina platensis extract (SP) against chronic nicotine administration in rats. MethodsNicotine intoxication was induced with 0.5 mg/kg BW. Rats received 500 mg SP/kg BW by gastric gavage over 4 weeks. ResultsOur data revealed that nicotine induced renal dysfunction manifested by significant abnormal levels of kidney function markers (creatinine and urea) accompanied by increased levels of oxidative stress biomarker (malondialdehyde) and inflammatory markers (nitric oxide, Interleukin-6 and tumor necrosis factor-α) while antioxidant status as glutathione level and glutathione S-transferase activity were found to be decreased significantly as compared with controls. It is worthy to note that nicotine toxicity induced significant increments in the protein expression levels of nuclear factor kappa B as well as caspase-3. Histopathological observations showed tubular necrosis and congestion in the endothelial lining glomerular tuft and epithelial lining renal tubules with nicotine intoxication. Interestingly, our data demonstrated that SP supplementation significantly improved the nicotine-induced kidney dysfunction, alleviated the induced-lipid peroxidation, inflammatory, apoptotic protein markers, and boosted the enzymatic/non-enzymatic antioxidants. Moreover, it attenuated the nicotine-induced histopathological alterations of the kidney architecture. ConclusionThus, it is tempting to recommend dietary approaches with Spirulina platensis extract for smokers to minimize the deleterious effect of chronic nicotine consumption and smoke exposure-related problems towards kidney injury via the antioxidant, anti-inflammatory and antiapoptotic properties of Spirulina platensis.

Selenium nanoparticles with low-level ionizing radiation exposure ameliorate nicotine-induced inflammatory impairment in rat kidney.

Occupational exposure to low-level ionizing radiation (<1Gy) was shown to enhance cell protection via attenuating an established inflammatory process. Nicotine, a major toxic component of cigarette smoke, is responsible for smoking-mediated renal dysfunction. The present study was therefore aimed to investigate the protective impact of ginger Zingiber officinale selenium nanoparticles (SeNPs) with whole-body low-dose gamma radiation (γ-R) against nicotine-induced nephrotoxicity in male albino rats. Nicotine intoxication was induced with 0.5mg/kg BW. Rats received 0.1mg SeNPs/kg BW by gastric gavage concomitant with 0.5 Gy γ-R over 4weeks. Characterization studies showed the formation of spherical SeNPs with a size ranged from 10 to 30nm in diameter with a thin film encapsulating the nanoballs. Our data revealed that nicotine induced renal dysfunction manifested by significant abnormal levels of kidney function markers (creatinine, urea, sodium and potassium) accompanied by increased levels of malondialdehyde along with a reduction in glutathione level, glutathione peroxidase, and glutathione S-transferase activities. It is worthy to note that nicotine toxicity induced significant increments in serum inflammatory markers: tumor necrosis factor-α and vascular cell adhesion protein 1. Western blotting showed marked significant elevation in caspase-3 activities against nicotine. The mRNA gene expression of inducible cyclooxygenase-2 gene was highly increased with nicotine intoxication while that of cyclooxygenase-1 did not show any changes. Interestingly, our data demonstrated that SeNPs in synergistic interaction with γ-R are efficacious control against nicotine-induced nephrotoxicity via anti-oxidant-mediated anti-inflammatory activities. Thus, it is tempting to recommend dietary approaches with ginger SeNPs for smokers at workplaces exposed occupationally and regularly to low-level ionizing radiation.

The New Dangers of Electronic Cigarettes

Historically stable, the incidence of inadvertent exposures to nicotine products has increased in recent years. Much of this increase may be attributable to the advent of electronic cigarettes. The dramatic increase in adverse exposures to electronic cigarettes and liquid nicotine products also portends new and considerable risk of potential nicotine toxicity, given the previously inconceivable high concentrations of nicotine in these products. Furthermore, this increased risk of toxicity is borne disproportionately by young children. Inadvertent exposures to electronic cigarettes and liquid nicotine, most commonly in children less than 6 years of age and primarily via ingestion, result more often in adverse clinical health effects compared to conventional cigarettes. Vomiting is common, although severe nicotine poisoning may result in airway compromise, seizures, obtundation, and the need for critical interventions.

Green Tobacco Sickness Among Tobacco Harvesters in a Korean Village.

BackgroundGreen tobacco sickness (GTS), an occupational disease in tobacco harvesters, is a form of acute nicotine intoxication by nicotine absorption through the skin from the wet green tobacco plant. We carried out a questionnaire survey and measured cotinine concentration, the metabolic product of nicotine, to determine the prevalence, incidence, and risk factors of GTS in Korean tobacco harvesters.MethodsWe measured cotinine concentrations, and administered a questionnaire survey to tobacco harvesters in Cheongsong-gun, Gyeongsangbuk-do, Korea. We repeatedly measured urine cotinine concentration five times with a questionnaire survey.ResultsCotinine concentration at dawn was significantly higher than that at other times; it was significantly lower during the nonharvesting period than during the harvesting period. However, little change in cotinine concentration was detected in the daytime during the harvesting period. Study participants included 20 men and 20 women. The prevalence of GTS was 37.5% and was significantly higher in women than in men (55.0% vs. 20.0%, p < 0.01). GTS incidence according to number of workdays was 3.4 occurrences/100 person days.ConclusionIn this study, nicotine exposure and metabolism were experimentally determined from the time of cotinine exposure, and biological monitoring was performed in each season. In the future, this information may be valuable for medical decision-making in GTS prevention.

Skin contamination as pathway for nicotine intoxication in vapers

Growing warnings on health effects related to electronic cigarettes have met inconclusive findings at present. This study analyzed the in vitro percutaneous absorption of nicotine resulting by skin contamination with two e-liquids (refill 1 and 2) containing nicotine at 1.8%. Donor chambers of 6 Franz cells for each refill liquid were filled with 1mL of nicotine e-liquid for 24h; at selected intervals, 1.5mL of the receptor solutions were collected for nicotine concentration analysis by mean gas chromatography–mass spectrometry (LOD: 0.01μg/mL). The experiment was repeated removing the nicotine donor solution after 10min from the application and rinsing the skin surface three times with 3.0mL of milliQ water. A total of 12 cells with 24h exposure and 12 cells washed were studied. The mean concentration of nicotine in the receiving phase at the end of the experiment was 54.9±29.5 and 30.2±18.4μg/cm2 for refill 1 and 2 respectively and significantly lower in washed cells (4.7±2.4 and 3.5±1.3μg/cm2). The skin absorption of nicotine can lead to minor health illness in vapers, while caution must be paid to dermal contamination by e liquids in children. The skin cleaning significantly reduced the transdermal absorption kinetic and intradermal deposition of nicotine.

A Case Report of Successful Kidney Donation After Brain Death Following Nicotine Intoxication

Nicotine intoxication is a rare cause of death and can lead to brain death after respiratory arrest and hypoxic-ischemic encephalopathy. To our knowledge, no previous reports regarding organ donation after nicotine intoxication have been described. We present a successful case of kidney donation after brain death caused by subcutaneous nicotine overdose from liquid nicotine from an e-cigarette cartridge in an attempted suicide. Both kidneys were transplanted successfully with immediate graft function, and both recipients were discharged at postoperative day 9 with normal plasma creatinine levels. Graft function has remained excellent in follow-up. This case suggests that kidneys from a donor with fatal nicotine intoxication may be successfully used for kidney transplantation in the absence of other contraindications for donation.

Profile of clinical information in medical records of tobacco farmers in Alagoas, Brazil.

The study of the profile of medical records of tobacco growers contributes to discussions on the establishment of diagnosis and its causal correlation with work. To investigate the profile of clinical information in medical records of tobacco growers. The present was a descriptive field and documentary study, with quantitative approach, of 149medical records of farmers who visited basic health units in rural communities in the municipality of Arapiraca, Alagoas, Brazil, from 2008 to 2013. About 66% of the investigated population was female, with average age 58.6 years old (standard deviation ±16.4). The most significant clinical complaint found in the records was headache (16.71%), followed by low back pain (10.20%), dysuria or other urinary problems (8.90%) and stomachache (8.30%). Medical diagnoses included gastritis (15.1%), depression (7.1%), anxiety (7.1%), myalgia (7.1%) and arthritis/arthralgia (5.3%). Correlation between clinical complaints and work performed by tobacco growers was registered on one single medical record. The clinical profile of tobacco growers described in the medical records might be associated with their social and working conditions and related to pesticide and nicotine poisoning. However, the scarcity of information on the environmental and occupational risk context limits the establishment of a causal link. As a function of the relevance of the occupational-clinical conditions of this population of workers, improving medical records is necessary, as the temporal relationship between exposure and outcomes might account for the occurrence of the reported symptoms.

Nicotine Poisoning Trends in Georgia

Nicotine Poisoning Trends in Georgia

Potential health effects of electronic cigarettes: A systematic review of case reports.

The health risks associated with electronic cigarettes (ECs) are largely unknown. The purpose of this systematic review was to evaluate published case reports that deal with health effects attributed to EC use. An Internet search was conducted to identify case reports dealing with the effects of EC use on health. Twenty-six case reports representing 27 individuals (one study contained reports for two individuals) were published between April 2012 and January 2016, and these were grouped into categories of effect according to their health outcomes.Of the 27 individuals, 25 had negative effects subsequent to use or exposure to ECs and their refill fluids, while two reported improvement in chronic immune and gastrointestinal conditions. Three categories of negative health effects were identified: systemic effects, nicotine poisoning, and mechanical injury. Thirteen cases reported EC effects on different systems including: respiratory (6), gastrointestinal or developing intestine of an infant (3), cardiovascular (2), neurological (1), and immune (1). Twelve cases involved nicotine poisoning resulting from accidental (N = 3), misuse/abuse (N = 1), or suicidal/intentional ingestion (N = 8); four of these involved children and three resulted in adult fatalities. Two cases reported mechanical injury caused by an EC battery explosion. Most case reports show that the health of children and adults can be negatively affected by EC products and that if death does not occur, negative effects can be reversed. Data further indicate that EC use can cause negative health effects in previously healthy individuals and exacerbate pre-existing conditions.

EFFECTIVENESS OF PREVENTION OF DENTAL CARIES IN CHILDREN UNDER ADVERSE ENVIRONMENTAL FACTORS

Aim. The article deals with the main methods and techniques for the prevention of caries of temporary and permanent teeth in children of preschool and school ages, as well as the methods for evaluating and the percentage of the effectiveness caries prevention. Discussion. Reducing the amount of digestible carbohydrates for up to five times a day and a daily double-entry tooth brushing with fluoride toothpaste matched according to age of the child and the standard technique. In most cases these measures are sufficient and prove to be effective. The research on the incidence of dental caries in children has found that among children with disordered eating behavior and nicotine intoxication (passive smoking) dental caries prevalence rates are 3 times higher, and the intensity is 18 times higher than that of children with the right diet and not exposed to passive smoking. Conclusion. Thus, at the moment there is a fairly wide range of different means and methods of preventing dental caries in children of preschool and school age, but none of these guarantee the prevention of caries, but with implementation of preventive measures on the advice and under the dentist's supervision carious processes can be slowed or moved over longer periods while treatment of carious disease can be psychologically difficult for the child.

Is the E-Liquid Industry Regulating Itself? A Look at E-Liquid Internet Vendors in the United States.

The objective of this study was to assess whether the nascent, but rapidly growing e-liquid industry prohibits Internet sales to minors and employs safety measures to prevent accidental poisonings. A stratified simple random sample (n = 120) was selected from the target population (N = 1107) of US online vendors of e-liquid in July 2015. The vendors were stratified and subsequently oversampled by trade association membership and vendor popularity. Three minors aged 16 to 17, who were supervised by adult research staff, attempted to purchase e-liquid from the 120 online vendors using debit cards issued in their names. Measures included vendors' use of age verification, warning labels on e-liquid bottles, and child-resistant packaging. Statistically significant differences were observed by vendor popularity, but not by membership in a trade association. The differences by vendor popularity, however, occurred for measures that were limited to an age warning and list of ingredients. The most striking finding was the scant vendors (n = 4) who successfully prevented the sale of e-liquid to the minors. In contrast, 87.5% and 53.9% of the bottles contained child-resistant packaging and a health warning label, respectively. Irrespective of trade association membership or vendor popularity, online vendors of e-liquids are not taking the proper precautions in preventing sales to minors. The FDA's upcoming deeming rules on e-cigarette products should include explicit requirements for offline and online e-liquid vendors, particularly the use of effective age verification, warning labels, and child-resistant packaging. This study demonstrates that, in the absence of any current FDA regulation of e-liquid products, self-regulation among vendors is not effective in preventing product acquisition by minors. Lax oversight of the e-liquid industry may draw consumers to bypass current tobacco control restrictions implemented in face-to-face sales settings. As a consequence, there may be an increase in online sales to minors. Further regulation of the industry may increase the already prevalent use of child-resistant packaging, leading to fewer cases of accidental nicotine poisoning.

Accidental ingestion of E-cigarette liquid nicotine in a 15-month-old child: an infant mortality case of nicotine intoxication.

Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents.

Medicating the salaryman lifestyle: fear-based marketing of liver stimulant drugs in postwar Japan

This article studies the heretofore unexplored fear-based print marketing campaigns for postwar hangover remedies and liver drugs sold by Japan's leading drug manufacturers of the 1950s, including Chūgai, Takeda, Tanabe, Sankyō, and Yamanouchi. It reveals that these drugs were creatively and predatorily marketed to salarymen and their wives in hundreds of newspaper and magazine ads that raised the spectre of liver damage and related diseases due to overconsumption of alcohol and tobacco. It demonstrates that the makers claimed not only that their formulations could remedy liver damage, but could even serve as prophylactics that would guard against the dangers of alcohol and nicotine poisoning and enable users to drink and smoke to excess without fear. The robust copy and clever imagery appearing in the ads also illustrate the social pressures facing salarymen to drink with colleagues after work on an almost nightly basis, as well as at a series of seasonal office parties and gatherings throughout the year. This article is the first to examine how drug makers took aim at some of postwar Japan's leading causes of ill health, alcohol and tobacco abuse, as well as chemical poisonings and even morning sickness, by selling an array of ineffectual drugs based on untested and dubious claims. It charts the drug makers' increasingly outlandish ads, the slow realization that their drugs were potentially hazardous, and their swift withdrawal from the market by 1960. It argues that, amidst a rise in alcohol overconsumption and comparatively lax testing and marketing regulations, Japan's postwar pharmaceutical firms exaggerated and preyed upon consumer health concerns in hundreds of frightening and pseudoscientific ads for largely untested and potentially hazardous drugs.

Letter to the Editor Regarding the Article "Suicidal Death by Nicotine Poisoning" by Jun et al.

Letter to the Editor Regarding the Article "Suicidal Death by Nicotine Poisoning" by Jun et al.

Acute effects of chewing tobacco on coronary microcirculation and hemodynamics in habitual tobacco chewers

Background: Long-term adverse cardiovascular effects of smokeless tobacco are well established, however, the effect of chewing tobacco on coronary microcirculation and hemodynamic have not been studied. We intended to analyze the acute effect of chewing tobacco on coronary microcirculation and hemodynamics in habitual tobacco chewers with stable coronary artery disease undergoing elective percutaneous coronary intervention (PCI). Materials and Methods: We prospectively enrolled seven habitual tobacco chewers with stable coronary artery disease with single vessel disease or double vessel disease satisfying the criteria for elective PCI. Patients were instructed to keep 1 g of crushed dried tobacco leaves in the mouth after a successful PCI. Lesion in last stented vessels was evaluated for fractional flow reserve (FFR), coronary flow reserve (CFR), and index of microcirculatory resistance (IMR) post-PCI, after 15 min and 30 min of tobacco chewing along with the measurement of serum cotinine levels. Results: Oral tobacco led to high levels of cotinine in the majority of patients. There was an insignificant rise in heart rate, systolic and diastolic blood pressure following tobacco consumption. Baseline CFR (median 1.6, range 1.1–5.5) was low in tobacco chewers after PCI even after optimum FFR (0.9 ± 0.05) in the majority of patients suggesting abnormal microvascular hemodynamics (high IMR in 3 patients, overall median 14.2, range 7–36.2). However, there was no significant change in the estimated CFR or IMR values following tobacco chewing. One patient had bradycardia and hypotension which may be related to vagal reaction or acute nicotine poisoning. Conclusion: Tobacco chewers have abnormal coronary microcirculation hemodynamics even following a successful PCI. However, the coronary micocirculation and hemodynamics do not change acutely following tobacco chewing despite high serum cotinine concentrations.

Liquid nicotine used in e-cigarettes can kill children

Parents who “vape” should be aware that one swallow of the liquid nicotine used to refill their e-cigarettes can kill a child. The liquid also can be poisonous within a matter of minutes if spilled on the skin. A 1-year-old child died from liquid nicotine poisoning in December — the first

More on nicotine poisoning in infants.

More on nicotine poisoning in infants.