Tests reveal under-reported exposure to tobacco smoke among preemies with lung disease

http://www.eurekalert.org/pub_releases/2015-02/jhm-tru022315.php

Public Release: 23-Feb-2015
Johns Hopkins Medicine

Public health experts have long known that tobacco smoke exposure (TSE) can be harmful for children with bronchopulmonary dysplasia, a lung disease that often accompanies premature birth.

Now a small study led by Johns Hopkins Children's Center investigators using hair samples to measure nicotine levels not only affirms that TSE is common in this population, but also reveals significant exposure among children whose caregivers claim not to smoke at home. The findings are published online Feb. 2 in the journal Pediatrics.

"We found that more than one-fifth of children whose caregivers report nonsmoking households have significant exposure," says investigator Sharon McGrath-Morrow, M.D., M.B.A., professor of pediatrics and a lung specialist at Johns Hopkins Children's Center. "The hope is that our study will lead to better ways to protect this vulnerable population of children."

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However, the study reports, 22 percent of children whose caregivers said lived in nonsmoking households showed significant TSE that was similar to children who did live in smoking households, suggesting that either parents weren't correctly reporting smoking habits or that children were getting TSE elsewhere.

The investigators say some of the children may have been getting exposure in multiunit housing, where about one-half of the study participants lived. The researchers cautioned, however, that this finding was not statistically significant and may have been due to chance. But they said they observed a trend toward higher nicotine levels in patients of nonsmoking families who lived in multiunit buildings that allowed smoking when compared to those living in buildings that didn't.

Nicotine exposure had a measurable effect on the most vulnerable of these children -- the ones who required supplemental oxygen or mechanical ventilation at home. The researchers saw a six to seven-fold uptick in the risk for inpatient hospitalization and activity limitations within this group as the nicotine levels in their hair increased.

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