Environmental tobacco smoke exposure is associated with negative effects on the respiratory health of children of all ages, according to an article in the January issue of the Archives of Pediatrics & Adolescent Medicine, a member of the JAMA family of journals. David M. Mannino, M.D., from the National Center for Environmental Health in Atlanta and colleagues studied data from 5,400 U.S. children aged four to sixteen years who participated in the Third National Health and Nutrition Examination Survey from 1988 to 1994 to determine the relationship between prenatal and postnatal environmental tobacco smoke exposure and the respiratory health of children. To quantify the amount of environmental tobacco smoke exposure, the researchers analyzed the children's blood levels of cotinine, a biomarker of nicotine, thus avoiding dependence on parental reporting of exposure, which has been the basis of most of the previous research into environmental tobacco smoke and its effect on children.
The researchers found the strongest effects of environmental tobacco smoke in the youngest children, with exposure associated with an increased risk for ever and current asthma and wheezing. Among older children, significant associations were found between environmental tobacco smoke exposure and increased school absence and low lung function. They also found that recent environmental tobacco smoke exposures are important even among children without prenatal smoke exposure. Because the study found children of all ages exposed to environmental tobacco smoke had potentially related negative health effects, the authors suggest: "Environmental tobacco smoke exposure is potentially preventable by restricting or eliminating smoking in the home and in public places that children visit."
According to background information cited in the study, environmental tobacco smoke exposure, which can begin before birth and can continue through childhood, is an important and preventable cause of illness among children.
(Arch Pediatr Adolesc Med. 2001; 155:36-41)
Editor's Note: To contact David M. Mannino, M.D., call Gail Hayes at 404-639-3286.
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