Electronic nicotine delivery system (ENDS) battery-related explosions and burns presenting to United States Emergency Departments, 2020-2024.

Abstract

Electronic nicotine delivery systems (ENDS) pose mechanical risks including device explosions and thermal burns due to lithium-ion battery failures. This study analyzed recent trends in ENDS explosion injuries using national surveillance data. We analyzed 2020-2024 National Electronic Injury Surveillance System (NEISS) data from emergency departments across the United States to identify emergency department visits for ENDS battery-related explosion and burn injuries. Cases were identified through systematic text mining of narrative fields using keywords related to e-cigarettes and explosion/combustion. Weighted national estimates were calculated using the NEISS sampling methodology. Between 2020 and 2024, an estimated 2043 emergency department visits (95% CI: 1326, 2760) were attributed to ENDS battery-related explosion/burn injuries based on 52 unweighted cases. Most patients were adults ages 18-44 years (72.7%) and male (80.7%). Lower extremity injuries were most common (54.1%), followed by upper extremity injuries (31.0%). More than one-quarter of cases (26.3%) required hospital admission, with an additional 3.9% transferred to other facilities. ENDS battery-related explosion injuries remain an uncommon but serious source of morbidity, with over 25% of cases requiring hospitalization. These findings emphasize the need for continued surveillance and stronger regulatory standards for ENDS to avert serious, preventable injuries among users.