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.

参考译文：
美国心脏病协会发布报告，警示儿童暴露于能量饮料的中毒风险。 每罐500ml装“怪物”能量饮料含有160mg咖啡因，每罐250ml装红牛能量饮料含有80mg咖啡因，都超过了对于儿童的安全限制，1罐就可导致孩子中毒。

研究人员通过对2010年10月到2013年9月间美国国家毒物数据系统中有关公众和医疗保健机构因能量饮料而呼叫中毒控制中心急救的数据分析发现，5156例暴露于能量饮料的儿童中有40％是无意的；发生中度到重要后果者的42％涉及能量饮料和乙醇混合暴露，19％暴露于非酒精能量饮料。主要后果包括：57％的个例报告了心血管效应（心脏节律和传导异常），55％报告了神经系统影响（癫痫，包括癫痫发作和癫痫持续状态）。

专家指出，能量饮料不应当存在于儿童饮食成分中；任何患有潜在心脏、神经或其他系统明显疾病者，消费能量饮料都应该征得医生的同意，以确保安全。

能量饮料虽然不是毒物，但其中含有的药用级咖啡因和天然来源的额外咖啡因，可能导致心率加速和血压上升。过量的咖啡因还会导致涉及神经、消化和心血管系统等副作用。

一些能量饮料每罐或每瓶含有高达400mg的咖啡因，远高于一杯普通咖啡的100-150mg和330ml装可口可乐的含有的32mg。

每天400mg以上咖啡因就有可能导致成人中毒，12kg以下的儿童喝下每公斤体重2.5mg的咖啡因就可能中毒。每天50mg咖啡因就能导致一个6岁孩子中毒，100mg咖啡因可以引起一位12岁孩子中毒。

除咖啡因外，能量饮料中添加的其他化合物都从来没有进行过儿童安全性验证，都有可能造成不良影响。

在过去的三年中，有2000多名6岁以下儿童因为暴露于流行的功能饮料被送往医院，涉及主要毒性作用包括严重的心脏问题，比如心律失常，或神经问题，如癫痫发作和癫痫持续状态。

因此，专家呼吁，监管部门应该修改能量饮料咖啡因含量和潜在健康后果的标签，努力减少儿童接触到这类产品的机会。


原始来源：
http://www.sciencedaily.com/releases/2014/11/141116094326.htm