title: Energy drinks: health risks and toxicity.
abstract: OBJECTIVE
  To describe the epidemiology and toxicity of caffeinated energy drink exposures in Australia.
  
  
  METHODS
  Retrospective observational study analysing data from calls regarding energy drink exposures recorded in the database of an Australian poisons information centre over 7 years to 2010.
  
  
  METHODS
  Type of exposure; co-ingestants; symptoms reported; and reported hospitalisations.
  
  
  RESULTS
  Callers reported 297 exposures to energy drinks, which showed an increasing annual trend from 12 in 2004 to 65 in 2010. Median age for the 217 subjects with recreational exposure was 17 years (interquartile ratio [IQR], 15-21; range, 11-60) and 57% were male. One hundred recreational users co-ingested other substances, predominantly alcohol (50) or other caffeinated products (44). The number of energy drinks consumed in one session varied greatly (median, 5 units; IQR, 3-8; range, 1-80). Most subjects who reported recreational use reported experiencing symptoms (87%). The most common symptoms were palpitations, agitation, tremor and gastrointestinal upset. Twenty-one subjects had signs of serious cardiac or neurological toxicity, including hallucinations, seizures, arrhythmias or cardiac ischaemia. At least 128 subjects (57 with no co-ingestants) required hospitalisation.
  
  
  CONCLUSIONS
  Reports of caffeine toxicity from energy drink consumption are increasing, particularly among adolescents, warranting review and regulation of the labelling and sale of these drinks. Educating adolescents and increasing the community's awareness of the hazards from energy drinks is of paramount importance.
authors.affiliation: NSW Poisons Information Centre, The Children's Hospital at Westmead, Sydney, NSW. naren.gunja@sydney.edu.au
authors.forename: Naren
authors.initials: N
authors.lastname: Gunja
authors.forename: Jared A
authors.initials: JA
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D020958:Australian Capital Territory / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002648:Child; D061215:Energy Drinks / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013648:Tasmania / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants