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More than 40 percent of reports about energy drinks to U.S. poison control centers involved children younger than 6 with some suffering serious cardiac and neurological symptoms, according to a new study presented at the American Heart Association's Scientific Sessions 2014.
This disproportionate representation of children is concerning given the number of reports of serious cardiac and neurological symptoms, said Steven Lipshultz, M.D., the study's senior author and professor and chair of pediatrics at Wayne State University and pediatrician-in-chief at Children's Hospital of Michigan in Detroit.
Researchers analyzed October 2010-September 2013 records of the American Association of Poison Control Centers' National Poison Data System, which contains information calls about energy exposures from the public and healthcare providers to 55 poison control centers in the United States. "Exposures" are defined as actual or suspected contact with any substance which has been ingested, inhaled, absorbed, applied to, or injected into the body, regardless of toxicity or clinical manifestation. Researchers found:
Of the 5,156 reported cases of energy drink exposure, 40 percent were unintentional, (i.e. unforeseen or unplanned) exposures by young children.
Moderate to major outcomes were reported in 42 percent of cases involving energy drinks that had been mixed with ethanol (alcohol) and in 19 percent of non-alcohol-containing energy drinks.
Among cases across all age groups with major outcomes, cardiovascular effects (including an abnormal heart rhythm and conduction abnormalities) were reported in 57 percent of cases, and neurologic effects (seizures, including status epilepticus) in 55 percent.
"Energy drinks have no place in pediatric diets," "And anyone with underlying cardiac, neurologic or other significant medical conditions should check with their healthcare provider to make sure it's safe to consume energy drinks."
He noted that he is not a toxicologist but was interested in the topic after treating children who became ill after consuming energy drinks.
Energy drinks may contain pharmaceutical-grade caffeine and additional caffeine from natural sources that may cause the heart to race and blood pressure to increase. Energy drinks with multiple caffeine sources were tied to a higher rate of side effects, typically involving the nervous, digestive or cardiovascular systems.
Some energy drinks contain up to 400 milligrams (mg) of caffeine per can or bottle, compared to 100-150 mg in a typical cup of coffee, Lipshultz said.
Caffeine poisoning can occur at levels higher than 400 mg a day in adults; above 100 mg a day in adolescents; and at 2.5 mg per kilogram (2.2 pounds) of body weight in children younger than 12, he said.
Researchers don't yet know whether compounds other than caffeine in the drinks contribute to the ill effects. Many of the added ingredients have never been tested for safety in children and have never been tested in combination.
In 2010, the U.S. Food and Drug Administration banned pre-packaged energy drinks that contain alcohol. Since then, calls to poison control centers about such drinks fell sharply, which supports the effectiveness of the combination ban. But some people might custom mix alcohol-energy brews, Lipshultz said.
Reports to poison control centers vastly underestimate the problem because many people who become ill from energy drinks don't call the hotlines and emergency room visits are not included.
"The reported data probably represent the tip of the iceberg," Lipshultz said.
Researchers called for improved labeling of caffeine content and potential health consequences, as well as continued efforts to decrease children's exposures to the products.
參考譯文：
美國心臟病協(xié)會發(fā)布報告，警示兒童暴露于能量飲料的中毒風險。 每罐500ml裝“怪物”能量飲料含有160mg咖啡因，每罐250ml裝紅牛能量飲料含有80mg咖啡因，都超過了對于兒童的安全限制，1罐就可導致孩子中毒。
研究人員通過對2010年10月到2013年9月間美國國家毒物數(shù)據(jù)系統(tǒng)中有關公眾和醫(yī)療保健機構因能量飲料而呼叫中毒控制中心急救的數(shù)據(jù)分析發(fā)現(xiàn)，5156例暴露于能量飲料的兒童中有40％是無意的；發(fā)生中度到重要后果者的42％涉及能量飲料和乙醇混合暴露，19％暴露于非酒精能量飲料。主要后果包括：57％的個例報告了心血管效應（心臟節(jié)律和傳導異常），55％報告了神經(jīng)系統(tǒng)影響（癲癇，包括癲癇發(fā)作和癲癇持續(xù)狀態(tài)）。
專家指出，能量飲料不應當存在于兒童飲食成分中；任何患有潛在心臟、神經(jīng)或其他系統(tǒng)明顯疾病者，消費能量飲料都應該征得醫(yī)生的同意，以確保安全。
能量飲料雖然不是毒物，但其中含有的藥用級咖啡因和天然來源的額外咖啡因，可能導致心率加速和血壓上升。過量的咖啡因還會導致涉及神經(jīng)、消化和心血管系統(tǒng)等副作用。
一些能量飲料每罐或每瓶含有高達400mg的咖啡因，遠高于一杯普通咖啡的100-150mg和330ml裝可口可樂的含有的32mg。
每天400mg以上咖啡因就有可能導致成人中毒，12kg以下的兒童喝下每公斤體重2.5mg的咖啡因就可能中毒。每天50mg咖啡因就能導致一個6歲孩子中毒，100mg咖啡因可以引起一位12歲孩子中毒。
除咖啡因外，能量飲料中添加的其他化合物都從來沒有進行過兒童安全性驗證，都有可能造成不良影響。
在過去的三年中，有2000多名6歲以下兒童因為暴露于流行的功能飲料被送往醫(yī)院，涉及主要毒性作用包括嚴重的心臟問題，比如心律失常，或神經(jīng)問題，如癲癇發(fā)作和癲癇持續(xù)狀態(tài)。
因此，專家呼吁，監(jiān)管部門應該修改能量飲料咖啡因含量和潛在健康后果的標簽，努力減少兒童接觸到這類產(chǎn)品的機會。
原始來源：
http://www.sciencedaily.com/releases/2014/11/141116094326.htm
This disproportionate representation of children is concerning given the number of reports of serious cardiac and neurological symptoms, said Steven Lipshultz, M.D., the study's senior author and professor and chair of pediatrics at Wayne State University and pediatrician-in-chief at Children's Hospital of Michigan in Detroit.
Researchers analyzed October 2010-September 2013 records of the American Association of Poison Control Centers' National Poison Data System, which contains information calls about energy exposures from the public and healthcare providers to 55 poison control centers in the United States. "Exposures" are defined as actual or suspected contact with any substance which has been ingested, inhaled, absorbed, applied to, or injected into the body, regardless of toxicity or clinical manifestation. Researchers found:
Of the 5,156 reported cases of energy drink exposure, 40 percent were unintentional, (i.e. unforeseen or unplanned) exposures by young children.
Moderate to major outcomes were reported in 42 percent of cases involving energy drinks that had been mixed with ethanol (alcohol) and in 19 percent of non-alcohol-containing energy drinks.
Among cases across all age groups with major outcomes, cardiovascular effects (including an abnormal heart rhythm and conduction abnormalities) were reported in 57 percent of cases, and neurologic effects (seizures, including status epilepticus) in 55 percent.
"Energy drinks have no place in pediatric diets," "And anyone with underlying cardiac, neurologic or other significant medical conditions should check with their healthcare provider to make sure it's safe to consume energy drinks."
He noted that he is not a toxicologist but was interested in the topic after treating children who became ill after consuming energy drinks.
Energy drinks may contain pharmaceutical-grade caffeine and additional caffeine from natural sources that may cause the heart to race and blood pressure to increase. Energy drinks with multiple caffeine sources were tied to a higher rate of side effects, typically involving the nervous, digestive or cardiovascular systems.
Some energy drinks contain up to 400 milligrams (mg) of caffeine per can or bottle, compared to 100-150 mg in a typical cup of coffee, Lipshultz said.
Caffeine poisoning can occur at levels higher than 400 mg a day in adults; above 100 mg a day in adolescents; and at 2.5 mg per kilogram (2.2 pounds) of body weight in children younger than 12, he said.
Researchers don't yet know whether compounds other than caffeine in the drinks contribute to the ill effects. Many of the added ingredients have never been tested for safety in children and have never been tested in combination.
In 2010, the U.S. Food and Drug Administration banned pre-packaged energy drinks that contain alcohol. Since then, calls to poison control centers about such drinks fell sharply, which supports the effectiveness of the combination ban. But some people might custom mix alcohol-energy brews, Lipshultz said.
Reports to poison control centers vastly underestimate the problem because many people who become ill from energy drinks don't call the hotlines and emergency room visits are not included.
"The reported data probably represent the tip of the iceberg," Lipshultz said.
Researchers called for improved labeling of caffeine content and potential health consequences, as well as continued efforts to decrease children's exposures to the products.
參考譯文：
美國心臟病協(xié)會發(fā)布報告，警示兒童暴露于能量飲料的中毒風險。 每罐500ml裝“怪物”能量飲料含有160mg咖啡因，每罐250ml裝紅牛能量飲料含有80mg咖啡因，都超過了對于兒童的安全限制，1罐就可導致孩子中毒。
研究人員通過對2010年10月到2013年9月間美國國家毒物數(shù)據(jù)系統(tǒng)中有關公眾和醫(yī)療保健機構因能量飲料而呼叫中毒控制中心急救的數(shù)據(jù)分析發(fā)現(xiàn)，5156例暴露于能量飲料的兒童中有40％是無意的；發(fā)生中度到重要后果者的42％涉及能量飲料和乙醇混合暴露，19％暴露于非酒精能量飲料。主要后果包括：57％的個例報告了心血管效應（心臟節(jié)律和傳導異常），55％報告了神經(jīng)系統(tǒng)影響（癲癇，包括癲癇發(fā)作和癲癇持續(xù)狀態(tài)）。
專家指出，能量飲料不應當存在于兒童飲食成分中；任何患有潛在心臟、神經(jīng)或其他系統(tǒng)明顯疾病者，消費能量飲料都應該征得醫(yī)生的同意，以確保安全。
能量飲料雖然不是毒物，但其中含有的藥用級咖啡因和天然來源的額外咖啡因，可能導致心率加速和血壓上升。過量的咖啡因還會導致涉及神經(jīng)、消化和心血管系統(tǒng)等副作用。
一些能量飲料每罐或每瓶含有高達400mg的咖啡因，遠高于一杯普通咖啡的100-150mg和330ml裝可口可樂的含有的32mg。
每天400mg以上咖啡因就有可能導致成人中毒，12kg以下的兒童喝下每公斤體重2.5mg的咖啡因就可能中毒。每天50mg咖啡因就能導致一個6歲孩子中毒，100mg咖啡因可以引起一位12歲孩子中毒。
除咖啡因外，能量飲料中添加的其他化合物都從來沒有進行過兒童安全性驗證，都有可能造成不良影響。
在過去的三年中，有2000多名6歲以下兒童因為暴露于流行的功能飲料被送往醫(yī)院，涉及主要毒性作用包括嚴重的心臟問題，比如心律失常，或神經(jīng)問題，如癲癇發(fā)作和癲癇持續(xù)狀態(tài)。
因此，專家呼吁，監(jiān)管部門應該修改能量飲料咖啡因含量和潛在健康后果的標簽，努力減少兒童接觸到這類產(chǎn)品的機會。
原始來源：
http://www.sciencedaily.com/releases/2014/11/141116094326.htm
