Pediatric Exposures Associated with Caffeine Energy Products Reported to United States Poison Centers, 2011-2023

Overview

Journal J Med Toxicol

Publisher Springer

Date 2025 Jan 31

PMID 39890754

Authors

Timothy R Thompson

Hannah L Hays

Sandhya Kistamgari

Natalie I Rine

Motao Zhu

Henry Xiang

Gary A Smith

Affiliations

Soon will be listed here.

Abstract

Introduction: This study investigated the characteristics and trends of pediatric exposures to caffeine energy products reported to US poison centers METHODS: National Poison Data System data for caffeine energy product single-substance exposures during 2011-2023 among individuals < 20 years old were analyzed.

Results: There were 32,482 caffeine energy product exposures reported to US poison centers with a 17.3% exposure rate increase during 2011-2023. Most exposures were among < 6-year-olds (69.6%), males (56.7%), or involved liquid formulations (57.5%). Most (80.7%) were not treated in a healthcare facility; however, 1.6% were medically admitted. Teenagers 13-19 years old were more likely to be medically admitted (OR = 12.74, 95% CI: 10.40-15.60) or have a serious medical outcome (OR = 18.83, 95% CI: 16.88-21.01) than children < 13 years old. Solid energy product formulations were more likely to be associated with a serious medical outcome (OR = 1.98, 95% CI: 1.81-2.17) or medical admission (OR = 5.23, 95% CI: 4.31-6.36) than other types of formulations. During the study period, exposure rates increased for liquid (34.5%) and powder/granules (632.9%) product formulations but decreased for solids (-51.5%). Among liquid formulation subcategories, the exposure rate for beverages increased (46.5%) and that for shots decreased (-86.1%).

Conclusions: Although most pediatric exposures to caffeine energy products reported to US poison centers were associated with no or minimal clinical effects, serious medical outcomes and medical admissions occurred. The product formulations that drove the 17% increase in the exposure rate changed during the study period. Opportunities exist to reduce the adverse effects of caffeine energy products among the pediatric population.

References

Cappelletti S, Piacentino D, Daria P, Sani G, Aromatario M . Caffeine: cognitive and physical performance enhancer or psychoactive drug?. Curr Neuropharmacol. 2015; 13(1):71-88. PMC: 4462044. DOI: 10.2174/1570159X13666141210215655. View

Rosenfeld L, Mihalov J, Carlson S, Mattia A . Regulatory status of caffeine in the United States. Nutr Rev. 2014; 72 Suppl 1:23-33. DOI: 10.1111/nure.12136. View

Miller K, Dermen K, Lucke J . Caffeinated energy drink use by U.S. adolescents aged 13-17: A national profile. Psychol Addict Behav. 2018; 32(6):647-659. PMC: 6136946. DOI: 10.1037/adb0000389. View

Beauchamp G, Johnson A, Crouch B, Valento M, Horowitz B, Hendrickson R . A Retrospective Study of Clinical Effects of Powdered Caffeine Exposures Reported to Three US Poison Control Centers. J Med Toxicol. 2016; 12(3):295-300. PMC: 4996785. DOI: 10.1007/s13181-016-0545-9. View

Seifert S, Schaechter J, Hershorin E, Lipshultz S . Health effects of energy drinks on children, adolescents, and young adults. Pediatrics. 2011; 127(3):511-28. PMC: 3065144. DOI: 10.1542/peds.2009-3592. View

Gunja N, Brown J . Energy drinks: health risks and toxicity. Med J Aust. 2012; 196(1):46-9. DOI: 10.5694/mja11.10838. View

Li P, Haas N, Dalla-Pozza R, Jakob A, Oberhoffer F, Mandilaras G . Energy Drinks and Adverse Health Events in Children and Adolescents: A Literature Review. Nutrients. 2023; 15(11). PMC: 10255861. DOI: 10.3390/nu15112537. View

Moussa M, Hansz K, Rasmussen M, Gillman C, Pollard C, Kwak E . Cardiovascular Effects of Energy Drinks in the Pediatric Population. Pediatr Emerg Care. 2020; 37(11):578-582. DOI: 10.1097/PEC.0000000000002165. View

Borron S, Watts S, Herrera J, Larson J, Baeza S, Kingston R . Energy drink exposures reported to Texas poison centers: Analysis of adverse incidents in relation to total sales, 2010-2014. Regul Toxicol Pharmacol. 2018; 97:1-14. DOI: 10.1016/j.yrtph.2018.05.008. View

10.

Oberhoffer F, Li P, Jakob A, Dalla-Pozza R, Haas N, Mandilaras G . Energy Drinks: Effects on Blood Pressure and Heart Rate in Children and Teenagers. A Randomized Trial. Front Cardiovasc Med. 2022; 9:862041. PMC: 8978997. DOI: 10.3389/fcvm.2022.862041. View

11.

Mansour B, Amarah W, Nasralla E, Elias N . Energy drinks in children and adolescents: demographic data and immediate effects. Eur J Pediatr. 2019; 178(5):649-656. DOI: 10.1007/s00431-019-03342-7. View

12.

Fletcher E, Lacey C, Aaron M, Kolasa M, Occiano A, Shah S . Randomized Controlled Trial of High-Volume Energy Drink Versus Caffeine Consumption on ECG and Hemodynamic Parameters. J Am Heart Assoc. 2017; 6(5). PMC: 5524057. DOI: 10.1161/JAHA.116.004448. View

13.

Cappelletti S, Piacentino D, Fineschi V, Frati P, Cipolloni L, Aromatario M . Caffeine-Related Deaths: Manner of Deaths and Categories at Risk. Nutrients. 2018; 10(5). PMC: 5986491. DOI: 10.3390/nu10050611. View

14.

Ajibo C, Van Griethuysen A, Visram S, Lake A . Consumption of energy drinks by children and young people: a systematic review examining evidence of physical effects and consumer attitudes. Public Health. 2024; 227:274-281. DOI: 10.1016/j.puhe.2023.08.024. View

15.

Temple J, Bernard C, Lipshultz S, Czachor J, Westphal J, Mestre M . The Safety of Ingested Caffeine: A Comprehensive Review. Front Psychiatry. 2017; 8:80. PMC: 5445139. DOI: 10.3389/fpsyt.2017.00080. View

16.

Rao N, Spiller H, Michaels N, Chounthirath T, Casavant M, Kamboj A . An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers. J Med Toxicol. 2017; 13(3):227-237. PMC: 5570731. DOI: 10.1007/s13181-017-0623-7. View

17.

Bashir D, Reed-Schrader E, Olympia R, Brady J, Rivera R, Serra T . Clinical Symptoms and Adverse Effects Associated With Energy Drink Consumption in Adolescents. Pediatr Emerg Care. 2016; 32(11):751-755. DOI: 10.1097/PEC.0000000000000703. View

18.

Hampton T . Energy Drinks Pose Worrisome Risks to Adolescents' Cardiovascular Health. Circulation. 2016; 134(14):1052-1053. DOI: 10.1161/CIRCULATIONAHA.116.025039. View

19.

Jagim A, Harty P, Tinsley G, Kerksick C, Gonzalez A, Kreider R . International society of sports nutrition position stand: energy drinks and energy shots. J Int Soc Sports Nutr. 2023; 20(1):2171314. PMC: 9987737. DOI: 10.1080/15502783.2023.2171314. View

20.

Markon A, Jones O, Punzalan C, Lurie P, Wolpert B . Caffeinated energy drinks: adverse event reports to the US Food and Drug Administration and the National Poison Data System, 2008 to 2015. Public Health Nutr. 2019; 22(14):2531-2542. PMC: 10260441. DOI: 10.1017/S1368980019001605. View