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Merianos AL, Jacobs W, Olaniyan AC, Smith ML, Mahabee‐Gittens EM. Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1202-1213. [PMID: 35989183 PMCID: PMC9669117 DOI: 10.1111/josh.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Tobacco smoke exposure (TSE), defined as secondhand smoke (SHS) and thirdhand smoke (THS), is associated with negative health consequences. This study's objective was to assess the associations between home TSE status and school engagement, school success, and afterschool activity participation among school-aged children. METHODS We conducted a secondary analysis of 2018-2019 National Survey of Children's Health cross-sectional data. Children ages 6-11 years (N = 17,466) were categorized into home TSE groups: no home TSE; THS exposure only; and SHS and THS exposure. Weighted logistic and Poisson regression models were built. RESULTS Compared to children with no home TSE, children with home THS exposure only and SHS and THS exposure were at decreased odds of being engaged in school (AOR = 0.69, 95%CI = 0.57, 0.83; AOR = 0.63, 95%CI = 0.41, 0.97, respectively), and at increased odds of having ≥1 school-to-home contact about child problems in school (AOR = 1.83, 95%CI = 1.50, 2.23; AOR = 1.58, 95%CI = 1.05, 2.37, respectively). Children with THS exposure only were at increased odds of missing ≥1 school day (AOR = 1.43, 95%CI = 1.13, 1.81). Children with THS exposure only (ARR = 0.90, 95%CI = 0.83, 0.96) and SHS and THS exposure (ARR = 0.74, 95%CI = 0.61, 0.89) were at reduced likelihood of participating in a higher number of afterschool activities. CONCLUSIONS Children exposed to home tobacco smoke are at unique risk for poorer school engagement and success.
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Affiliation(s)
- Ashley L. Merianos
- University of Cincinnati, School of Human ServicesPO Box 210068CincinnatiOH45221‐0068
| | - Wura Jacobs
- Department of KinesiologyCalifornia State University Stanislaus, One University CircleTurlockCA95382
| | - Afolakemi C. Olaniyan
- University of Cincinnati, School of Human ServicesPO Box 210068CincinnatiOH45221‐0068
| | - Matthew Lee Smith
- School of Public Health, Texas A&M University212 Adriance Lab RoadCollege StationTX77843
| | - E. Melinda Mahabee‐Gittens
- Cincinnati Children's Hospital Medical Center, Division of Emergency MedicineCollege of Medicine, University of Cincinnati3333 Burnet Avenue, MLC 2008, 3333 Burnet AvenueCincinnatiOH45229
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Zhang T, Wu Y, Guo Y, Yan B, Wei J, Zhang H, Meng X, Zhang C, Sun H, Huang L. Risk of illness-related school absenteeism for elementary students with exposure to PM 2.5 and O 3. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 842:156824. [PMID: 35738367 DOI: 10.1016/j.scitotenv.2022.156824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
Air pollution addresses short-term health effects on morbidity, especially for children. Assessing the impacts of air pollution on elementary students is critical for developing preparedness response strategies for this sensitive group. In the 2016-17 academic year, up to 687,748 groups of illness-related absence records and the information on whether the absentee had gone to a hospital or not were collected from 2564 elementary schools across Jiangsu Province China. We explored the associations between air pollution and illness-related records using a time-stratified case-crossover analysis with distributed lag non-linear design. An increase of 10 μg/m3 in the current-day concentration of PM2.5 and O3 was positively associated with illness-related absenteeism overall. The excess risk of absenteeism was 4.52 % (95%CI 4.37-4.67 %) for PM2.5 and 0.25 % (95%CI 0.01-0.36 %) for O3. The risk associated with O3 was boosted for the frequent absentees who tended to have basic diseases or were more vulnerable to infectious diseases. Students in 43.1 % illness-related absenteeism, mainly due to highly infectious diseases, only received home nursing without going to a hospital. The increase in the number of illness cases associated with PM2.5 and O3 estimated based on the illness-related absence data was 41.5 % and 18.6 % higher than that evaluated based on hospital visit records. Such underestimations persisted in sensitivity analyses and persisted in subgroups classified by gender or grade. Together, the performance of illness-related absence records far outweighed that of hospital visit data regarding the thorough evaluation of air pollution-related illness cases for elementary students. Improvement in air quality and home health care education are warranted as well for the health benefits of children.
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Affiliation(s)
- Ting Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
| | - Yangyang Wu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Beizhan Yan
- Lamont-Doherty Earth Observatory of Columbia University, 61 Rt. 9W., Palisades, NY 10964, United States
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, 20740, USA
| | - Hongliang Zhang
- Department of Environmental Science and Engineering, Fudan University, Shanghai 200438, China
| | - Xia Meng
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Can Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
| | - Hong Sun
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, Nanjing 210009, China.
| | - Lei Huang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, 163 Xianlin Avenue, Qixia, Nanjing, 210023, China
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Srivastava P, Trinh TA. The effect of parental smoking on children's cognitive and non-cognitive skills. ECONOMICS AND HUMAN BIOLOGY 2021; 41:100978. [PMID: 33610090 DOI: 10.1016/j.ehb.2021.100978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/03/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Economic research emphasises the importance of cognitive and non-cognitive skills in children for long-term labour market, health and social outcomes. In contrast to previous studies that focus on the effects of maternal smoking during pregnancy, we contribute to the literature by examining whether parental current smoking impacts on children's cognitive and non-cognitive development. We exploit data from the Longitudinal Study of Australian Children and address potential endogeneity and self-selectivity bias using robust estimation methods. Overall, we find evidence that parental smoking results in worse development outcomes in children. Specifically, our fixed-effects estimates indicate that children living with parents who are smokers exhibit lower cognitive outcomes ranging between 0.09 and 0.17 standard deviation, while the impacts on non-cognitive outcomes range between 0.06 and 0.80 standard deviation. We also provide insights on some of the mechanisms of transmission. Our findings suggest that campaigns, programs and policies that reduce tobacco consumption may have positive externalities in terms of improving children's cognitive and non-cognitive development, and long-term labour market outcomes.
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Affiliation(s)
- Preety Srivastava
- School of Economics, Finance and Marketing, RMIT University, Melbourne, VIC, 3000, Australia.
| | - Trong-Anh Trinh
- School of Economics, Finance and Marketing, RMIT University, Melbourne, VIC, 3000, Australia.
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de Paiva LG, Dalmolin GDL, Dos Santos WM. Absenteeism-disease in health care workers in a hospital context in southern Brazil. Rev Bras Med Trab 2021; 18:399-406. [PMID: 33688321 PMCID: PMC7934176 DOI: 10.47626/1679-4435-2020-521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Absenteeism is a pervasive and growing worldwide problem. In hospital settings, it is often associated with a fast-paced environment, shift work and high occupational demands. Absenteeism in hospitals can also be attributed to poor working conditions and the high emotional burden associated with daily exposure to illness and death. These conditions often lead to sickness absence. Objectives: To assess sickness absence among health care workers in hospital settings. Methods: A cross sectional study was conducted using the data and medical records of health care workers in a hospital in Rio Grande do Sul, Brazil. The data covered the period of September 2014 to December 2018. Results: The sample consisted of 559 workers, 233 of whom were absent for at least 1 day in the year. Sickness absence was most common among women (79%) and nursing technicians (45.5%). The mean duration of absence was 5.53 days (standard deviation: 20.42), and the sickness absence rate was 2.01%. The most common reasons for sickness absence were injury, poisoning and other consequences of external causes (20.19%), followed by mental and behavioral disorders (17.90%) and diseases of the musculoskeletal system and connective tissue (11.69%). Conclusions: Greater awareness of the factors associated with sickness absence in hospital settings can contribute to the planning of occupational health initiatives targeting the most vulnerable workers.
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Affiliation(s)
- Larissa Garcia de Paiva
- Programa de Pós-graduação em Enfermagem, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Graziele de Lima Dalmolin
- Programa de Pós-graduação em Enfermagem, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Wendel Mombaque Dos Santos
- Serviço de Saúde Ocupacional e Segurança do Trabalhador, Hospital Universitário de Santa Maria, Empresa Brasileira de Serviços Hospitalares, Santa Maria, RS, Brazil
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Hamzeh B, Farnia V, Moradinazar M, Pasdar Y, Shakiba E, Najafi F, Alikhani M. Pattern of cigarette smoking: intensity, cessation, and age of beginning: evidence from a cohort study in West of Iran. Subst Abuse Treat Prev Policy 2020; 15:83. [PMID: 33109215 PMCID: PMC7590452 DOI: 10.1186/s13011-020-00324-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking is a social epidemic and one of the main risk factors for premature deaths and disabilities worldwide. In the present study, we investigated the Pattern of Cigarette Smoking: intensity, cessation, and age of the beginning. METHODS Data collected from the recruitment phase of Ravansar (a Kurd region in western Iran) Non-Communicable Disease (RaNCD) cohort study was analyzed by using Chi-square test, univariate and multivariate logistic regressions, Poisson regression, and linear regression. RESULTS Totally 10,035 individuals (47.42% males) participated in the study. Mean age was lower for males (47.45 yr) than for females (48.36 yr). Prevalence of smoking was 20% (36.4% of males and 5.23% of females). Compared to female participants, males showed a 7-fold higher prevalence of smoking and started smoking about 4 years earlier. Being married, having a lower BMI, living in rural areas, and being exposed to secondhand smoke (SHS) were predictors of higher smoking prevalence rates. Furthermore, current exposure to SHS, higher smoking intensity, later smoking initiation, male gender, younger age, lower education, and lower BMI were related to lower likelihood of stopping smoking. Heavy smokers began to smoke about 4 years earlier than casual smokers did. Finally, being divorced/ widow/ widower/ single and childhood exposure to SHS were found to increase the likelihood of becoming a smoker. CONCLUSIONS Based on present research results, health programs specific to smoking cessation should take socio-demographic factors, smoking history, and current smoking behavior into account.
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Affiliation(s)
- Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Nutritional Sciences Department, School of Public Health Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebrahim Shakiba
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Nabi-Burza E, Winickoff JP, Drehmer JE, Gorzkowski JA, Klein JD, Levy DE, Ossip DJ, Regan S, Rigotti NA, Hipple Walters B. Innovations in parental smoking cessation assistance delivered in the child healthcare setting. Transl Behav Med 2020; 10:1039-1052. [PMID: 31157864 PMCID: PMC7543078 DOI: 10.1093/tbm/ibz070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Addressing parental smoking in the child healthcare setting improves the health of all family members. Innovative approaches, such as mobilizing technology-based platforms, may streamline screening and motivate acceptance of behavioral health services to treat tobacco use and dependence. The obective of this study was to describe innovations added to the CEASE intervention and to track 2 year post-intervention implementation data on families who were screened for tobacco use. Child healthcare practices in five states (IN, NC, OH, TN, and VA) used an electronic tablet screener to identify tobacco use within families and deliver tobacco cessation assistance to smokers. Motivational/educational videos on cessation were displayed via the screener to enhance its utility. Five CEASE intervention practices screened 50,111 family members for tobacco use and identified 6,885 families with children exposed to tobacco smoke. The mean number of screeners per practice per month was 417; the mean number of households with smokers identified per month was 57. Of 2,764 smokers who were at visits and consented, 57% indicated that they wanted a prescription to reduce or quit smoking; 94% of these were given preprinted prescriptions. Of 41% who requested connection to the quitline, 93% were given enrollment forms. Electronic screening was used to routinely identify tobacco users, leading to increased potential for offering cessation assistance to all household members who smoke. Improved delivery of smoking cessation services to families may be achieved by integrating technological innovations into routine pediatric practice. CLINICAL TRIALS REGISTRATION: Trial Number NCT01882348.
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Affiliation(s)
- Emara Nabi-Burza
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
| | - Jonathan P Winickoff
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL, USA
| | - Jeremy E Drehmer
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
| | - Julie A Gorzkowski
- American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL, USA
| | - Jonathan D Klein
- American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL, USA
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Douglas E Levy
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Mongan Institute Health Policy Center, Boston, MA, USA
| | - Deborah J Ossip
- University of Rochester Medical Center, Department of Public Health Sciences, Rochester, NY, USA
| | - Susan Regan
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
| | - Nancy A Rigotti
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Bethany Hipple Walters
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
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Perelman J, Leão T, Kunst AE. Smoking and school absenteeism among 15- to 16-year-old adolescents: a cross-section analysis on 36 European countries. Eur J Public Health 2020; 29:778-784. [PMID: 31168621 PMCID: PMC6660109 DOI: 10.1093/eurpub/ckz110] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Schools have a crucial role to play in preventing youth smoking. However, the well-known long-term health consequences of youth smoking may be insufficient to convince education stakeholders to devote efforts to implement school-based programmes. However, if youth smoking were to have short-term consequences, this evidence could prompt education stakeholders’ action. In this article, we investigate the link between smoking and school absenteeism. Methods We used data from the 2011 wave of the European School Survey Project on Alcohol and Other Drugs, on adolescents aged 15–16. We applied logistic models to assess the risk of more than 3 missed school days, by cause, as function of smoking intensity, adjusting for age, sex, socioeconomic status, academic performance, parental involvement and other risk behaviours (alcohol and cannabis consumption). Consistency was assessed by replicating the analyses for each sex and age group and further adjusting for depression and self-esteem. Results Smoking more than five cigarettes per day was significantly linked to school absenteeism, with a 55% excess risk of missing more than 3 school days per month due to illness (OR = 1.55, 95% CI 1.46–1.64), and a more than two times excess risk due to skipping (OR = 2.29; 95% CI 2.16–2.43). These findings were consistent across age and sex groups. Conclusion We observed an association between smoking intensity and absenteeism among youth in Europe. This implies that, to the extent that this association is causal, school tobacco control policies may reduce the short-term consequences of smoking on adolescents’ education and health.
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Affiliation(s)
- Julian Perelman
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Teresa Leão
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Choi K, Chen-Sankey JC, Merianos AL, McGruder C, Yerger V. Secondhand Smoke Exposure and Subsequent Academic Performance Among U.S. Youth. Am J Prev Med 2020; 58:776-782. [PMID: 32147368 PMCID: PMC7246157 DOI: 10.1016/j.amepre.2019.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Previous research shows the associations between secondhand smoke exposure and health consequences among youth, but less is known about its effect on academic performance. This study examines a dose-response relationship between secondhand smoke exposure and subsequent academic performance among U.S. youth. METHODS Data were from a nationally representative sample of youth non-tobacco users (aged 12-16 years) in Wave 2 (2014-2015) who completed Wave 3 (2015-2016) of the Population Assessment of Tobacco and Health Study (n=9,020). Past-7-day number of hours exposed to secondhand smoke at Wave 2 and academic performance at Wave 3 (1=Mostly As to 9=Mostly Fs) were assessed. Weighted multivariable linear regression models were used to examine the association between hours of self-reported secondhand smoke exposure at Wave 2 and academic performance at Wave 3 (1=Mostly Fs, 9=Mostly As), adjusting for covariates including sociodemographics, prior academic performance, internalizing and externalizing problems, and substance use problems. Analyses were conducted in 2019. RESULTS More than 30% of U.S. youth non-tobacco users were exposed to secondhand smoke in the past 7 days. Compared with unexposed youth at Wave 2, those who were exposed for 1-9 hours had poorer academic performance at Wave 3 (adjusted regression coefficient= -0.11, 95% CI= -0.18, -0.04), and those who were exposed for ≥10 hours at Wave 2 had even poorer academic performance (adjusted regression coefficient = -0.31, 95% CI= -0.45, -0.18). CONCLUSIONS A dose-response relationship was observed between secondhand smoke exposure and academic performance among U.S. youth. Reducing youth secondhand smoke exposure may promote academic performance and subsequent educational attainment.
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Affiliation(s)
- Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
| | - Julia Cen Chen-Sankey
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, Ohio
| | - Carol McGruder
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
| | - Valerie Yerger
- African American Tobacco Control Leadership Council, San Francisco, California
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Alagiyawanna AMAAP, Veerasingam EQ, Townsend N. Prevalence and correlates of exposure to second hand smoke (SHS) among 14 to 15 year old schoolchildren in a medical officer of health area in Sri Lanka. BMC Public Health 2018; 18:1240. [PMID: 30404593 PMCID: PMC6222988 DOI: 10.1186/s12889-018-6148-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite reports that Southeast Asia has one of the highest prevalence for childhood exposure to second hand smoke (SHS), there are limited data on SHS exposure among schoolchildren in individual countries in the region, including Sri Lanka. This study aimed to determine the prevalence and correlates of SHS among schoolchildren in a Medical Officer of Health (MOH) region in the country. METHODS We conducted a cross-sectional study, sampling from nice schools in one MOH region following a two-stage cluster sample design and probability proportionate to size sampling techniques. Data were obtained through a self-completed anonymous questionnaire on socio-demographic and health behaviour risk factors. We achieved an 89.5% response rate, corresponding to a total of 311 students in the final sample. RESULTS The prevalence of exposure to SHS during the previous week was 17.6% at home and 25.7% in enclosed public places. There were no significant differences in exposure to SHS between sexes. Univariable analysis found that the presence of smokers at home and mother's unemployment status were significantly associated with a higher risk of exposure to SHS at home. These variables remained significant in multivariable analysis. Non-Sinhalese ethnicity and presence of smokers at home were significantly associated with exposure to SHS in public places, in both uni- and multivariable analysis. Unemployment status of mother was also found to be a significant determinant of exposure to SHS in public places in multivariable analysis. CONCLUSION Despite numerous antismoking activities and strong antismoking legislation, the prevalence of SHS exposure among schoolchildren is higher in enclosed public places than homes. The implementation and enforcement of antismoking legislation is imperative to tackle this and should be supported by the provision of education for schoolchildren and their families on the health risks of SHS. The high-risk groups identified here could be prioritised for preventive programmes.
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Affiliation(s)
- A M A A P Alagiyawanna
- Health Promotion Bureau, Ministry of Health, Nutrition and Indigenous Medicine, No 02, Kynsey Road, Colombo, 08, Sri Lanka.
| | | | - Nick Townsend
- Department for Health, University of Bath, Bath, BA2 7AY, UK
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Putri PD, Susanto AD, Hudoyo A, Nurwidya F, Taufik FF, Andarini S, Antariksa B. Correlation between Domestic Cigarette Smoke Exposure and Respiratory Complaints, Hospitalization and School Absence due to Respiratory Complains in the Indonesian Elementary School-Aged Children. Int J Appl Basic Med Res 2018; 8:244-248. [PMID: 30598912 PMCID: PMC6259296 DOI: 10.4103/ijabmr.ijabmr_344_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Over 43 million Indonesian children who are exposed to cigarette smoke are at risk of having health hazard and morbidities. Aims: The aim of this study is to identify the correlation between cigarette smoke exposure and respiratory complaints, hospitalization, as well as school absence due to respiratory complaints in elementary school-aged Indonesian children. Materials and Methods: A cross-sectional study was conducted in nonsmoking elementary school-aged children. Participants were categorized into the exposed and unexposed groups based on the report of their parents. Questionnaire-retrieved data were analyzed to identify the correlation between cigarette smoke exposure and respiratory complaints, hospitalization, as well as school absence due to respiratory complaints in elementary school-aged children. Results: A total of 128 study participants of nonsmoking children aged 6–12 years (mean 9.8 ± standard deviation 1.6 years) were categorized into 64 children exposed and 64 children unexposed to domestic cigarette smoking. There was a significant correlation between smoking exposure and cough episodes as well as upper respiratory infection in children within the past 12 months. A cough episode of ≥3 times/year was found more prevalent in exposed children compared to the unexposed children (26.6% vs. 9.4%; P < 0.05). Cough ≥3 times/year was found in 50% of children exposed to cigarette smoke of a smoker with a smoking habit of >10 cigarettes/day. There was a correlation between cigarette smoke exposure and hospitalization frequency of ≥1 time(s)/year due to respiratory complaints in children (P < 0.05). Conclusion: Cigarette smoke exposure is correlated with complaints of cough, upper respiratory tract infection, and hospitalization due to respiratory complaints in children.
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Affiliation(s)
- Priska Duana Putri
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Agus Dwi Susanto
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Achmad Hudoyo
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Fariz Nurwidya
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Feni Fitriani Taufik
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Sita Andarini
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
| | - Budhi Antariksa
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia
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Conger D, Schwartz AE, Stiefel L. Immigrant and Native-Born Differences in School Stability and Special Education: Evidence from New York City. INTERNATIONAL MIGRATION REVIEW 2018. [DOI: 10.1111/j.1747-7379.2007.00073.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Using the literature on achievement differences as a framework and motivation, along with data on New York City students, we examine nativity differences in students' rates of attendance, school mobility, school system exit, and special education participation. The results indicate that, holding demographic and school characteristics constant, foreign-born have higher attendance rates and lower rates of participation in special education than native-born. Among first graders, immigrants are also more likely to transfer schools and exit the school system between years than native-born, yet the patterns are different among older students. We also identify large variation according to birth region.
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Affiliation(s)
| | - Amy Ellen Schwartz
- Steinhardt School of Education and Robert F. Wagner Graduate School of Public Service, New York University
| | - Leanna Stiefel
- Robert F. Wagner Graduate School of Public Service, New York University
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Affiliation(s)
- Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Kalyva E, Eiser C, Papathanasiou A. Health-Related Quality of Life of Children with Asthma: Self and Parental Perceptions. Int J Behav Med 2017; 23:730-737. [PMID: 27033504 DOI: 10.1007/s12529-016-9558-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to explore whether age, gender, asthma severity, asthma duration, and exposure to parental smoking were associated with levels of asthma-specific health-related quality of life (HRQoL) among Greek children with asthma and to identify any differences between self- and proxy ratings of asthma-specific HRQoL. METHOD One hundred and seventy-three (173) children with asthma (8-12 years old) and their parents completed the Pediatric Quality of Life Asthma Module self- and proxy measures. RESULTS Asthma severity, age, and asthma duration explained almost half of the variance in asthma-specific HRQoL scores according to self- and proxy reports. Older male children with more severe asthma who were diagnosed for a longer period of time and had at least one smoking parent reported lower asthma-specific HRQoL according to self- and proxy reports. Although children and their parents seemed to agree in their views of asthma-specific HRQoL, there were significant differences in ratings of specific parameters of asthma-specific HRQoL. CONCLUSION This study identifies the factors that account for a significant variance in asthma-specific HRQoL scores according to self- and proxy reports and is among the first to record the effect of parental smoking on children's and parents' perceptions of asthma-specific HRQoL.
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Affiliation(s)
- Efrosini Kalyva
- City College, Department of Psychology, The International Faculty of the University of Sheffield, 24 Proxenou Koromila Street, 546 22, Thessaloniki, Greece.
| | - Christine Eiser
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Aikaterini Papathanasiou
- City College, Department of Psychology, The International Faculty of the University of Sheffield, 24 Proxenou Koromila Street, 546 22, Thessaloniki, Greece
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Hsu J, Qin X, Beavers SF, Mirabelli MC. Asthma-Related School Absenteeism, Morbidity, and Modifiable Factors. Am J Prev Med 2016; 51:23-32. [PMID: 26873793 PMCID: PMC4914465 DOI: 10.1016/j.amepre.2015.12.012] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/30/2015] [Accepted: 12/04/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Asthma is a leading cause of chronic disease-related school absenteeism. Few data exist on how information on absenteeism might be used to identify children for interventions to improve asthma control. This study investigated how asthma-related absenteeism was associated with asthma control, exacerbations, and associated modifiable risk factors using a sample of children from 35 states and the District of Columbia. METHODS The Behavioral Risk Factor Surveillance System Child Asthma Call-back Survey is a random-digit dial survey designed to assess the health and experiences of children aged 0-17 years with asthma. During 2014-2015, multivariate analyses were conducted using 2006-2010 data to compare children with and without asthma-related absenteeism with respect to clinical, environmental, and financial measures. These analyses controlled for sociodemographic and clinical characteristics. RESULTS Compared with children without asthma-related absenteeism, children who missed any school because of asthma were more likely to have not well controlled or very poorly controlled asthma (prevalence ratio=1.50; 95% CI=1.34, 1.69) and visit an emergency department or urgent care center for asthma (prevalence ratio=3.27; 95% CI=2.44, 4.38). Mold in the home and cost as a barrier to asthma-related health care were also significantly associated with asthma-related absenteeism. CONCLUSIONS Missing any school because of asthma is associated with suboptimal asthma control, urgent or emergent asthma-related healthcare utilization, mold in the home, and financial barriers to asthma-related health care. Further understanding of asthma-related absenteeism could establish how to most effectively use absenteeism information as a health status indicator.
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Affiliation(s)
- Joy Hsu
- Epidemic Intelligence Service, Office of Public Health Scientific Services, CDC, Atlanta, Georgia;.
| | - Xiaoting Qin
- Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC, Atlanta, Georgia
| | - Suzanne F Beavers
- Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC, Atlanta, Georgia
| | - Maria C Mirabelli
- Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, CDC, Atlanta, Georgia
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15
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Lee K, Hahn EJ, Riker CA, Hoehne A, White A, Greenwell D, Thompson D. Secondhand Smoke Exposure in a Rural High School. J Sch Nurs 2016; 23:222-8. [PMID: 17676970 DOI: 10.1177/10598405070230040701] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although federal law requires all public schools to be smoke free, lack of compliance with the smoke-free policy is commonly reported. The aims of this study were to describe the indoor fine-particle (PM2.5) air pollution in a rural high school and surrounding public venues. This cross-sectional, nonexperimental study was conducted in Monroe County, Kentucky (population of 11,756). Fine-particle concentrations were measured in the high school and 5 public venues using spectrometers. Because of illegal student smoking, PM2.5 concentrations were 19 times higher in the boys’ student restroom than the National Ambient Air Quality Standard for outdoor air (670 vs. 35 μg/m3). The staff restrooms adjacent to the student restroom where staff did not smoke also showed high PM2.5 levels. Average indoor air pollution in the public venues was 158 μg/m3. Strict enforcement of smoke-free school policy and cessation resources are needed to reduce secondhand smoke exposure. Collaborative school-community campaigns involving parents, students, mass media, and community organizations may be effective in reducing the harm caused by tobacco. Implications for school nurses are discussed.
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Affiliation(s)
- Kiyoung Lee
- Department of Preventive Medicine and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY, USA
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16
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Swindle TM, Shapley K, Kyzer A, Cheerla R, Whiteside-Mansell L. Familial Risk in Low-Income Children With Chronic Illness Exposed to Passive Smoke. Clin Pediatr (Phila) 2015; 54:840-6. [PMID: 26063757 DOI: 10.1177/0009922815589927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study highlights the family characteristics of a child living in a state of triple risk: chronically ill, exposed to passive smoke, and residing in a low-income household. METHODS Head Start families were divided into 4 groups based on passive smoke exposure and child chronic illness status. Analyses of covariance controlling for parent education, parent employment, marital status, and residence were conducted to identify group differences in the Family Map risk areas. RESULTS Families of chronically ill, passive smoke-exposed children demonstrated the highest levels of risks across a range of areas including: meeting basic needs, family conflict, parenting stress, and parental depression and anxiety. CONCLUSIONS Children living in poverty with a chronic illness who are exposed to smoke are likely to face many challenges in addition to their illness. Healthcare professionals can identify family risks and provide targeted educate and support to potentially reduce risk factors for children.
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Affiliation(s)
- Taren M Swindle
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Kathy Shapley
- University of Arkansas at Little Rock, Little Rock, AR, USA
| | - Angie Kyzer
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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17
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Semple S. Employment, smoking, and health: the role of the hygienist. ANNALS OF OCCUPATIONAL HYGIENE 2015; 59:529-33. [PMID: 25925743 DOI: 10.1093/annhyg/mev030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Indexed: 12/30/2022]
Abstract
The association between smoking and poverty is well established but the relationship between smoking and employment is less clear. Those in work are less likely to smoke, with recent data from Scotland suggesting the unemployed are nearly 2.5 times more likely to smoke than those in employment. This commentary looks at emerging evidence that work may have a positive role in reducing smoking prevalence. Occupational hygienists are uniquely placed to provide health-based information and risk communication that may help workers and those seeking employment to become smoke-free. The public health benefits of such intervention are likely to be substantial and are entirely in keeping with the health protection aims of the discipline of Occupational Hygiene.
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Affiliation(s)
- Sean Semple
- Respiratory Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZG, Scotland
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18
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Alberg AJ, Korte JE. Invited commentary: Parental smoking as a risk factor for adult tobacco use: can maternal smoking during pregnancy be distinguished from the social environmental influence during childhood? Am J Epidemiol 2014; 179:1418-21. [PMID: 24761006 DOI: 10.1093/aje/kwu079] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Parental smoking is known to have prenatal health effects on developing fetuses, and postnatal exposure to secondhand smoke causes adverse health effects during childhood and beyond. Further, there is solid evidence that parental smoking during childhood is a potent risk factor for smoking in offspring. In this issue of the Journal, Rydell et al. (Am J Epidemiol. 2014;179(12):1409-1417) add to a growing body of evidence showing that maternal smoking during pregnancy is statistically associated with the long-term risk of tobacco use in offspring. The data revealed a strong signal between maternal smoking during pregnancy and tobacco use in young adulthood, an association that was largely concentrated in snus use but not cigarette smoking. This new study adds to a growing body of epidemiologic evidence that consistently points toward maternal smoking during pregnancy being associated with an increased risk of offspring tobacco use in later life. There is also evidence from animal models indicating that fetal exposure to maternal nicotine use in utero can have a durable impact on the neural pathways that affect lifetime sensitivity to nicotine. This is an important research topic that continues to yield a consistent signal despite an array of inferential challenges.
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Harrington KF, Haven KM, Nuño VL, Magruder T, Bailey WC, Gerald LB. Parent report and electronic medical record agreement on asthma education provided and children's tobacco smoke exposure. J Asthma 2013; 50:968-74. [PMID: 23883356 DOI: 10.3109/02770903.2013.828303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the concordance between parent report and electronic medical record documentation of asthma health education provided during a single clinic visit and second-hand tobacco smoke exposure among children with asthma. METHODS Parents of children with asthma were recruited from two types of clinics using different electronic medical record systems: asthma-specialty or general pediatric health department clinics. After their child's outpatient visit, parents were interviewed by trained study staff. Interview data were compared to electronic medical records for agreement in five categories of asthma health education and for the child's environmental tobacco smoke exposure. Kappa statistics were used to identify strength of agreement. Chi square and t-tests were used to examine differences between clinic types. RESULTS Of 255 parents participating in the study 90.6% were African American and 96.1% were female. Agreement was poor across all clinics but was higher within the asthma specialty clinics than the health department clinics for smoke exposure (κ = 0.410 versus 0.205), asthma diagnosis/disease process (κ = 0.213 versus -0.016) and devices reviewed (κ = 0.253 versus -0.089) with parents generally reporting more education provided. For the 203 children with complete medical records, 40.5% did not have any documentation regarding smoking exposure in the home and 85.2% did not have any documentation regarding exposure elsewhere. CONCLUSIONS We found low concordance between the parent's report and the electronic medical record for smoke exposure and asthma education provided. Un- or under-documented smoke exposure and health education have the potential to affect continuity of care for pediatric patients with asthma.
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Affiliation(s)
- Kathleen F Harrington
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama , Birmingham, AL , USA
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20
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Stosić L, Milutinović S, Lazarević K, Blagojević L, Tadić L. Household environmental tobacco smoke and respiratory diseases among children in Nis (Serbia). Cent Eur J Public Health 2012; 20:29-32. [PMID: 22571013 DOI: 10.21101/cejph.a3730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors investigated the relationship between household environmental tobacco smoke (ETS) exposure and prevalence of respiratory symptoms and diseases as well as absenteeism related to respiratory illness in schoolchildren. The study sample consisted of 1,074 children aged 7-11 years from three primary schools in Nis (Serbia). ETS exposure was associated with wheezing (OR-1.48; 1.09-2.01), bronchitis (OR-1.66; 1.23-2.23), headache (OR-1.45; 1.08-1.95), and fatigue (OR-1.38; 1.02-1.85) in exposed children. The other risk factors with possible influences weren't assessed. There was no statistically significant difference in the number of physicians' visits as well as in absenteeism from school due to illness in children exposed to ETS in comparison to non exposed children. The tobacco smoke effect on children is an essential and urgent problem with life lasting negative health effects which are preventable.
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21
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Zacharasiewicz A, Horak F, Fazekas T, Riedler J. Tabakrauchexposition von Kindern und Jugendlichen. Monatsschr Kinderheilkd 2012. [DOI: 10.1007/s00112-011-2572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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22
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Abstract
OBJECTIVE Involuntary tobacco smoke exposure causes substantial morbidity in children. We hypothesized that children exposed to tobacco smoke in the home would have increased school absenteeism with associated costs due to lost caregiver wages/time. METHODS We analyzed data on health and absenteeism among schoolchildren aged 6 to 11 years identified in the 2005 National Health Interview Survey (NHIS). We used multivariate models to assess the relationships between adult-reported household smoking and child health and school absenteeism. Analyses were adjusted for children's and parents' demographic and socioeconomic characteristics. The value of lost caregiver time was estimated by using self-reported employment and earnings data in the NHIS and publicly available time-use data. RESULTS Children living with 1 or ≥ 2 adults who smoked in the home had 1.06 (95% confidence interval [CI]: 0.54-1.55) and 1.54 (95% CI: 0.95-2.12) more days absent from school per year, respectively, than children living with 0 smokers in the home. Living with ≥ 2 adults who smoked in the home was associated with increased reports of having ≥ 3 ear infections in the previous 12 months (adjusted odds ratio [aOR]: 2.65 [95% CI: 1.36-5.16]) and having a chest cold in the 2 weeks before interview (aOR: 1.77 [95% CI: 1.03-3.03]) but not with having vomiting/diarrhea in the previous 2 weeks (aOR: 0.93 [95% CI: 0.45-1.89]). Caregivers' time tending children absent from school was valued at $227 million per year. CONCLUSIONS Tobacco smoke exposure has significant consequences for children and families above and beyond child morbidity, including academic disadvantage and financial burden.
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Affiliation(s)
- Douglas E. Levy
- Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts; ,Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts; ,Departments of Medicine and
| | - Jonathan P. Winickoff
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts; ,Pediatrics, Harvard Medical School, Boston, Massachusetts; ,MGH Center for Child and Adolescent Health Policy, General Pediatrics Division, MassGeneral Hospital for Children, Boston, Massachusetts; and ,American Academy of Pediatrics, Julius B. Richmond Center, Elk Grove Village, Illinois
| | - Nancy A. Rigotti
- Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts; ,Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts; ,Departments of Medicine and
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23
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Castro SM, Chakraborty K, Guerrero-Plata A. Cigarette smoke suppresses TLR-7 stimulation in response to virus infection in plasmacytoid dendritic cells. Toxicol In Vitro 2011; 25:1106-13. [PMID: 21435390 DOI: 10.1016/j.tiv.2011.03.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 02/28/2011] [Accepted: 03/17/2011] [Indexed: 12/16/2022]
Abstract
Exposure to environmental tobacco smoke (ETS) is associated with an increase in the frequency and severity of respiratory infections, including bronchiolitis, a clinical syndrome of infancy caused by viruses such as respiratory syncytial virus (RSV). The mechanisms by which ETS increases the risk of viral respiratory infections are largely unknown. A major effector integrating early antiviral and immunostimulatory activities is interferon-α (IFN-α), which is highly produced by plasmacytoid dendritic cells (pDC). In this work, we determined the effect of cigarette smoke extract (CSE) on human pDC immunity in response to a respiratory viral infection. We found that CSE inhibited RSV-induced IFN-α in pDC as well as the release of IL-1β, IL-10 and CXCL10. However, the production of additional cytokines and chemokines such as IL-6, TNF-α, CCL2, CCL3, CCL5 and CXCL8 was not altered. Quantitative RT-PCR analysis indicated that CSE decreased the expression of toll-like receptor (TLR)-7 and interferon regulatory factor (IRF)-7 in RSV-infected pDC. Furthermore, determination of IRF-7 phosphorylation by flow cytometry showed that CSE prevented IRF-7 activation. These data provide evidence that cigarette smoke suppresses key pDC functions upon viral infection by a mechanism that involves downregulation of TLR7 expression and decreased activation of IRF-7.
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Affiliation(s)
- Shawn M Castro
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
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24
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Shendell DG, Alexander MS, Sanders DL, Jewett A, Yang J. Assessing the potential influence of asthma on student attendance/absence in public elementary schools. J Asthma 2010; 47:465-72. [PMID: 20528603 DOI: 10.3109/02770901003734298] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Student health, well-being, and productivity are determined in part by attending school daily. Increased annual average daily attendance (ADA) increases public funding for school district-based enrichment programs. Asthma is reported as the number 1 cause of American school absenteeism due to chronic illness; however, only limited, estimated national data exist. Accurate, precise ways to assess potential disparities in disease-driven absence do not yet exist. The authors summarize part of their community-based participatory research (CBPR), namely planning then testing a set of matching field sheet (data collection) and computer-based spreadsheets (database) based on previous school-based research to track attendance and reasons for absence. METHODS The CBPR process occurred mid-2005 to mid-2008, with final activities in DeKalb County, Georgia, August-December 2007 (fall semester) for this portion. The authors tracked absence, with an ability to examine data overall and at classroom, grade, and school levels by gender, race/ethnicity, and doctor-diagnosed asthma as reported to schools on student emergency cards. RESULTS The authors characterized their study sample, consisting of 914 4th-5th grade children (overall, 9.2% of children with asthma) from seven randomly selected, consenting participating schools (n = 21 classrooms per grade, 2 to 4 classrooms per grade per school). Six schools used paper versions of tools while one school used electronic versions. The authors presented attendance results in various aggregated manners. Absence was higher (ADA lower) among 4th grade asthmatic students compared to the entire classroom. CONCLUSIONS This study can inform future interdisciplinary school-based research combining health and student academic productivity, adult work performance outcomes, and other measures.
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Affiliation(s)
- Derek G Shendell
- Department of Environmental and Occupational Health Sciences, University of Medicine and Dentistry of New Jersey School of Public Health, Piscataway, New Jersey 08854, USA.
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25
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Yolton K, Xu Y, Khoury J, Succop P, Lanphear B, Beebe DW, Owens J. Associations between secondhand smoke exposure and sleep patterns in children. Pediatrics 2010; 125:e261-8. [PMID: 20083521 PMCID: PMC4900537 DOI: 10.1542/peds.2009-0690] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The objective of this study was to investigate the relationship between exposure to secondhand smoke (SHS) and child sleep patterns among a group of children with asthma who were exposed regularly to tobacco smoke at home. METHODS We studied 219 children who were enrolled in an asthma intervention trial and were exposed regularly to SHS. Serum cotinine levels were used to measure exposure to tobacco smoke, and sleep patterns were assessed through parent reports using the Children's Sleep Habits Questionnaire. Covariates in adjusted analyses included gender, age, race, maternal marital status, education, and income, prenatal tobacco exposure, maternal depression, Home Observation for Measurement of the Environment total score, household density, asthma severity, and use of asthma medications. RESULTS Exposure to SHS was associated with sleep problems, including longer sleep-onset delay (P = .004), sleep-disordered breathing (P = .02), parasomnias (P = .002), daytime sleepiness (P = .022), and overall sleep disturbance (P = .0002). CONCLUSIONS We conclude that exposure to SHS is associated with increased sleep problems among children with asthma.
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Affiliation(s)
- Kimberly Yolton
- Cincinnati Children's Hospital Medical Center, Division of General and Community Pediatrics, 3333 Burnet Ave, ML 7035, Cincinnati, OH 45229-3039, USA.
| | - Yingying Xu
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati, Ohio
| | - Jane Khoury
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati, Ohio
| | - Paul Succop
- University of Cincinnati, Department of Environmental Health, Cincinnati, Ohio
| | - Bruce Lanphear
- Simon Frasier University and British Columbia Children's Hospital, British Columbia, Vancouver
| | - Dean W. Beebe
- Cincinnati Children's Hospital Medical Center, Department of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio
| | - Judith Owens
- Brown University, Department of Pediatrics, Providence, Rhode Island
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Household environmental tobacco smoke and risks of asthma, wheeze and bronchitic symptoms among children in Taiwan. Respir Res 2010; 11:11. [PMID: 20113468 PMCID: PMC2828425 DOI: 10.1186/1465-9921-11-11] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 01/29/2010] [Indexed: 01/27/2023] Open
Abstract
Background Although studies show that maternal smoking during pregnancy increases the risks of respiratory outcomes in childhood, evidence concerning the effects of household environmental tobacco smoke (ETS) exposure remains inconsistent. Methods We conducted a population-based study comprised of 5,019 seventh and eighth-grade children in 14 Taiwanese communities. Questionnaire responses by parents were used to ascertain children's exposure and disease status. Logistic regression models were fitted to estimate the effects of ETS exposures on the prevalence of asthma, wheeze, and bronchitic symptoms. Results The lifetime prevalence of wheeze was 11.6% and physician-diagnosed asthma was 7.5% in our population. After adjustment for potential confounders, in utero exposure showed the strongest effect on all respiratory outcomes. Current household ETS exposure was significantly associated with increased prevalence of active asthma, ever wheeze, wheeze with nighttime awakening, and bronchitis. Maternal smoking was associated with the increased prevalence of a wide range of wheeze subcategories, serious asthma, and chronic cough, but paternal smoking had no significant effects. Although maternal smoking alone and paternal smoking alone were not independently associated with respiratory outcomes, joint exposure appeared to increase the effects. Furthermore, joint exposure to parental smoking showed a significant effect on early-onset asthma (OR, 2.01; 95% CI, 1.00-4.02), but did not show a significant effect on late-onset asthma (OR, 1.17; 95% CI, 0.36-3.87). Conclusion We concluded that prenatal and household ETS exposure had significant adverse effects on respiratory health in Taiwanese children.
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27
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Song DJ. Environmental tobacco smoke and childhood asthma. KOREAN JOURNAL OF PEDIATRICS 2010. [DOI: 10.3345/kjp.2010.53.2.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Dae Jin Song
- Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
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28
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Best D. From the American Academy of Pediatrics: Technical report--Secondhand and prenatal tobacco smoke exposure. Pediatrics 2009; 124:e1017-44. [PMID: 19841110 DOI: 10.1542/peds.2009-2120] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Secondhand tobacco smoke (SHS) exposure of children and their families causes significant morbidity and mortality. In their personal and professional roles, pediatricians have many opportunities to advocate for elimination of SHS exposure of children, to counsel tobacco users to quit, and to counsel children never to start. This report discusses the harms of tobacco use and SHS exposure, the extent and costs of tobacco use and SHS exposure, and the evidence that supports counseling and other clinical interventions in the cycle of tobacco use. Recommendations for future research, policy, and clinical practice change are discussed. To improve understanding and provide support for these activities, the harms of SHS exposure are discussed, effective ways to eliminate or reduce SHS exposure are presented, and policies that support a smoke-free environment are outlined.
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Abstract
Diabetes mellitus is the most common endocrine disease in childhood and adolescence. Type 1 diabetes accounts for over 90% of diabetes in children. During the past decades, epidemiological studies have clearly shown a worldwide increase in the incidence of both type 1 and type 2 diabetes in many countries. The worldwide incidence of diabetes and especially the diabetes-related complications highlight the relevant economic burden of this disease. In fact, its costs affect health services, national productivity as well as individuals and families. Hospital in-patient costs for the treatment of complications are the largest single contributor to direct healthcare costs. Anyway, many of these complications and, therefore, their costs, as well as most of the indirect costs, are partially or completely preventable. In fact, intensive therapy, directed at controlling blood glucose, blood pressure and lipid levels, has been shown to be cost effective in that, although initial costs are high, longer term costs decrease as a result of delayed or prevented complications. From this point of view, technological advances have provided new therapeutic options to achieve metabolic control as close to normal as possible in children and adolescents with diabetes. In fact, the relevant technological devices that have been adopted till now, if adequately utilized, should allow patients to achieve intensive management with improved metabolic control, quality of life as well as reduced mortality and morbidity. However, new technologies are not a panacea, and the benefit they provide can be completely achieved only if adequately and especially individually determined. Furthermore, it is inevitable that new modalities of treatment for people with diabetes will be considered critically by healthcare planners and providers in the prevailing global environment of increasing costs of medical care and pressure for rational allocation of resources. Therefore, new technologically derived devices and therapeutic opportunity for diabetes should be rationally utilized in order to offer real advantages and reduce the relevant worldwide cost of diabetes.
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Affiliation(s)
- Cosimo Giannini
- Department of Pediatrics, University of Chieti, I - 66100 Chieti, Italy
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30
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Wenten M, Li YF, Lin PC, Gauderman WJ, Berhane K, Avol E, Gilliland FD. In utero smoke exposure, glutathione S-transferase P1 haplotypes, and respiratory illness-related absence among schoolchildren. Pediatrics 2009; 123:1344-51. [PMID: 19403501 DOI: 10.1542/peds.2008-1892] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The GSTP1 Ile105Val variant and secondhand tobacco smoke exposure have been independently associated with acute respiratory illness; however, susceptibility to in utero and secondhand tobacco smoke has yet to be examined in relation to variation across the GSTP1 locus. OBJECTIVE The purpose of this work was to determine whether variation across the GSTP1 locus is associated with respiratory illness-related school absences and to determine whether this relationship varies by in utero and secondhand tobacco smoke exposure. METHODS Tobacco smoke exposure status, incident respiratory-related school absence records, and DNA samples was ascertained for 1132 Hispanic and non-Hispanic white elementary school children as part of the Children's Health Study. RESULTS Four GSTP1 single-nucleotide polymorphisms were selected that accounted for 93% of the variation across the locus. Individual single-nucleotide polymorphism analyses showed a protective effect for the minor alleles in single-nucleotide polymorphisms 1 (rs6591255), 3 (GSTP1 Ile105Val: rs1695), and 4 (rs749174) for respiratory illness. The haplotype, which includes a minor allele for single-nucleotide polymorphisms 1, 3, and 4 (h1011), was associated with a decreased risk of respiratory illness. The protective effect of GSTP1 variants was lost among individuals exposed to in utero and secondhand tobacco smoke. CONCLUSIONS A common GSTP1 haplotype, which includes the functional Ile105Val polymorphism, was associated with respiratory-related school absences. The protection afforded by this haplotype was lost in children exposed to involuntary tobacco smoke. The paradigm of loss of genetic protection among those exposed to tobacco smoke has clinical and public health implications that warrant broader consideration in research and practice.
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Affiliation(s)
- Madé Wenten
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
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Abstract
RATIONALE Emerging evidence suggests that exposure to environmental tobacco smoke (ETS) may be linked with behavior problems in childhood, but previous research has relied primarily on parent report of exposure, and results are inconclusive. OBJECTIVES To investigate the relationship between exposure to ETS and child behavior problems among children with asthma. METHODS The sample included 220 children who were enrolled in an asthma intervention trial and regularly exposed to ETS at home. Serum cotinine was used to measure exposure to tobacco smoke, and behavior problems were assessed by parent report on the Behavior Assessment System for Children. Covariates in adjusted analyses included: sex, age, race, asthma severity, asthma medication, maternal education, prenatal tobacco exposure, maternal depression, and Home Observation for Measurement of the Environment score. RESULTS Child behavior problems increased with increasing exposure to ETS. A stratified analysis of boys and girls separately indicated higher exposure among girls, but behavior problems were statistically significantly associated with exposure only in boys. Increasing behavior problems included externalizing behavior problems (beta= 2.23, p =.02) such as hyperactivity and aggression, internalizing behavior problems (beta= 2.19, p= .01) such as depression, and behavior symptoms (beta= 2.55, p= .01). CONCLUSIONS Among children with asthma, exposure to ETS is related to increased child behavior problems among boys.
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Gerald LB, Gerald JK, Gibson L, Patel K, Zhang S, McClure LA. Changes in environmental tobacco smoke exposure and asthma morbidity among urban school children. Chest 2008; 135:911-916. [PMID: 19017893 DOI: 10.1378/chest.08-1869] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure is associated with poor asthma outcomes in children. However, little is known about natural changes in ETS exposure over time in children with asthma and how these changes may affect health-care utilization. This article documents the relationship between changes in ETS exposure and childhood asthma morbidity among children enrolled in a clinical trial of supervised asthma therapy. METHODS Data for this analysis come from a large randomized clinical trial of supervised asthma therapy in which 290 children with persistent asthma were randomized to receive either usual care or supervised asthma therapy. No smoking cessation counseling or ETS exposure education was provided to caregivers; however, children were given 20 min of asthma education, which incorporated discussion of the avoidance of asthma triggers, including ETS. Asthma morbidity and ETS exposure data were collected from caregivers via telephone interviews at baseline and at the 1-year follow-up. RESULTS At baseline, 28% of caregivers reported ETS exposure in the home and 19% reported exposure outside of the primary household only. Among children whose ETS exposure decreased from baseline, fewer hospitalizations (p = 0.034) and emergency department (ED) visits (p < or = 0.001) were reported in the 12 months prior to the second interview compared to the 12 months prior to the first interview. Additionally, these children were 48% less likely (p = 0.042) to experience an episode of poor asthma control (EPAC). CONCLUSIONS This is the first study to demonstrate an association between ETS exposure reduction and fewer EPACs, respiratory-related ED visits, and hospitalizations. These findings emphasize the importance of ETS exposure reduction as a mechanism to improve asthma control and morbidity. Potential policy implications include supporting ETS reductions and smoking cessation interventions for parents and caregivers of children with asthma. Research to identify the most cost-effective strategy is warranted.
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Affiliation(s)
- Lynn B Gerald
- Health System Information Services, School of Public Health, University of Alabama at Birmingham, Birmingham, AL; Critical Care Medicine, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
| | - Joe K Gerald
- Lung Health Center, School of Medicine, Department of Medicine, Division of Pulmonary, Allergy
| | - Linda Gibson
- Lung Health Center, School of Medicine, Department of Medicine, Division of Pulmonary, Allergy; Critical Care Medicine, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Karna Patel
- Lung Health Center, School of Medicine, Department of Medicine, Division of Pulmonary, Allergy
| | - Sijian Zhang
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Leslie A McClure
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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Suárez López de Vergara RG, Galván Fernández C, Oliva Hernández C, Doménech Martínez E, Dorta Delgado JM, Dorta Suárez M. [Lung function and exposure to tobacco smoke among adolescents]. An Pediatr (Barc) 2008; 67:559-66. [PMID: 18053521 DOI: 10.1016/s1695-4033(07)70804-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To study lung function in adolescents in relation to smoking (active and passive smokers) and to investigate the repercussion on spirometric parameters. PATIENTS AND METHOD We studied 301 healthy adolescents with no history of bronchial asthma or colds in the month prior to the study. A questionnaire on tobacco exposure was administered and spirometry (Datospir-92) was performed. RESULTS There were 165 boys (54.5%) and 136 girls (45.5%) aged between 14 and 20 years old (16.40+/-1.32). A total of 27.2% were non-smokers and were not exposed to tobacco smoke (NS), 31.3% were passive smokers, with household exposure of 10 cigarettes per day during at least the previous year (PS), and 41.5% were current smokers who had been smoking>or=10 cigarettes/day for at least 1 year (CS). Significant differences were found between age and smoking habits (p=0.0001) and between smoking habits and female sex (girls CS: 33.9% vs boys CS: 21.8 %) (p=0.007). A significant association was found between smoking (NS, PS and CS) and spirometric parameters (ANOVA): forced vital capacity (FVC) (p=0.001), forced expiratory volume in 1 second (FEV1) (p=0.0001), FEV1/FVC (p=0.004), peak expiratory flow (PEF) (p=0.0001), midexpiratory flow at 25% of forced vital capacity (MEF25%) (p=0.01), MEF50% (p=0.0001) and MEF25-75% (p=0.0001); CS in relation to NS was as follows: FEV1, PEF, MEF50%, MEF25-50% (p=0.0001) and FVC, FEV1/FVC, MEF25% (p=0.01); CS in relation to PS: FEV1/ FVC (p=0.02), PEF (p=0.004), MEF50% and MEF25-75% (p=0.003), PS in relation to NS: FVC and FEV1 (p=0.02). Significant differences in FVC, FEV1 and MEF25-75% were found in female CS in comparison with boys. CONCLUSIONS The CS group showed a significant decrease in spirometric parameters in relation to the NS group. The airway was affected sooner in the female group of smokers than in the male group, even though the intensity and time of exposure were the same in both groups.
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Abstract
The effects of tobacco smoke exposure on the respiratory health of school-aged children relate to persisting effects of exposure to tobacco smoke during pregnancy and early infancy, passive exposure to environmental tobacco smoke in the home and elsewhere, and active smoking during later childhood. Much of the current evidence comes from cross-sectional and longitudinal observational studies and suggests that, for asthma and pulmonary function outcomes, the strongest associations are with smoke exposure in pregnancy and early childhood, although independent effects of later exposure are reported. Exposure in later childhood to environmental tobacco smoke is associated with increased respiratory symptoms, although for some of these, the effect appears to diminish with increasing age of the child. There is currently a paucity of evidence on the long-term adverse respiratory consequences of active smoking by children and adolescents, but such evidence there is suggests that these may be substantial.
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Abstract
Involuntary exposure to environmental tobacco smoke (ETS) is a serious and entirely preventable public health hazard. It has become clear that ETS adversely affects the health of all who breathe its toxins. Independent of active smoking, ETS exposure is a modifiable risk factor for chronic obstructive pulmonary disease. The expanding body of research presented in this article provides evidence that the damaging consequences of ETS reach far beyond the lungs. Having been determined the third leading cause of preventable death in this country, this is a problem that must be addressed aggressively.
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Affiliation(s)
- Jane Z Reardon
- Department of Medicine, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA.
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Thomson NC. The role of environmental tobacco smoke in the origins and progression of asthma. Curr Allergy Asthma Rep 2007; 7:303-9. [PMID: 17547853 DOI: 10.1007/s11882-007-0045-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Exposure to environmental tobacco smoke (ETS) is a major source of indoor air pollution and causes adverse effects on the respiratory health of individuals with asthma. At least one third of children and adults with asthma are exposed to ETS on a regular basis. There is convincing evidence for a causal relationship between exposure to ETS and development of asthma in children and in nonsmoking adults. Exposure to ETS also worsens asthma control in children and nonsmoking adults who have established asthma. The mechanism by which ETS causes these harmful effects is not established but may involve genetic predisposition, impairment of lung development, and altered lung inflammatory responses. Workplace smoking restrictions and reduced smoking in the home may lower the prevalence of asthma, improve asthma control, and reduce the use of medical services in both children and adults who are exposed to ETS.
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Affiliation(s)
- Neil C Thomson
- Department of Respiratory Medicine, Division of Immunology, Infection and Inflammation, Western Infirmary and University of Glasgow, Glasgow G11 6NT, UK.
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Lee YL, Lee YC, Guo YL. Associations of glutathione S-transferase P1, M1, and environmental tobacco smoke with wheezing illness in school children. Allergy 2007; 62:641-7. [PMID: 17508968 DOI: 10.1111/j.1398-9995.2007.01380.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Polymorphisms at the glutathione S-transferase (GST) were associated with asthma-related phenotypes. We hypothesized that the GSTP1 and GSTM1 genotypes could modify the effects of household environmental tobacco smoke (ETS) on childhood wheezing illness. METHODS We conducted a case-control study comprised of 216 lifetime wheezing children and 185 nonwheezing controls, all of whom were selected from 2524 fourth- to ninth-grade school children in southern Taiwan. RESULTS Homozygous GSTP1 Ile-105 was significantly associated with current wheezing (OR = 1.78, 95% CI 1.04-3.12), but insignificantly associated with ever wheezing (OR = 1.26, 95% CI 0.82-1.94). The risks of ever or current wheezing on GSTM1 null genotype were positive but not statistically significant. Although household ETS exposure was not associated with wheezing illness, after excluding subjects having in utero ETS or active smoking habits, the adverse effects of household ETS exposure differed significantly by GSTP1-105 genotypes. In children without any ETS exposure at home, GSTP1 Ile-105 homozygosity was significantly related to increased risks for both ever wheezing (OR = 2.29, 95% CI 1.17-4.49) and current wheezing (OR = 4.86, 95% CI 1.86-12.70). In children with household ETS exposure, the risks of wheezing illness did not increase for those carrying two GSTP1 Ile-105 alleles. Children carrying any GSTP1 Val-105 allele were at a significantly greater risk of both ever and current wheezing when exposed to ETS, with a clear dose-response relationship to the number of smokers at home. CONCLUSION Household ETS exposure is a modifiable cause of wheezing illness in a genetically susceptible subpopulation.
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Affiliation(s)
- Y-L Lee
- Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Thomson G, Wilson N, Howden-Chapman P. Population level policy options for increasing the prevalence of smokefree homes. J Epidemiol Community Health 2006; 60:298-304. [PMID: 16537345 PMCID: PMC2577370 DOI: 10.1136/jech.2005.038091] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To identify and evaluate the options for population level government policies to increase the prevalence of homes free of secondhand smoke. METHODS The literature was searched for population level policy options and evidence on them. Three criteria were used to evaluate the policy options: effectiveness, the reductions on inequalities in secondhand smoke exposure, and cost effectiveness. The setting was four developed, English speaking jurisdictions: Britain, USA, Australia, and New Zealand. RESULTS Evidence from all four countries shows some association between relatively comprehensive tobacco control programmes and lower prevalence levels of smoking in homes. The evidence of the effect of such programmes on inequalities in smokefree home prevalence is limited. No published evidence was found of the cost effectiveness of the programmes in achieving changes in smokefree homes. Within comprehensive programmes, there is some indirect evidence that some mass media campaigns could increase the prevalence of smokefree homes. Structural options that have potential to support smokefree homes include smokefree places legislation, and laws for the protection of children. CONCLUSION The available evidence to date suggests that comprehensive tobacco control programmes (to reduce the prevalence of smoking in the total population) are likely to be the most effective and sustainable option for increasing the prevalence of smokefree homes.
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Affiliation(s)
- George Thomson
- Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, New Zealand.
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Milton B, Holland P, Whitehead M. The social and economic consequences of childhood-onset Type 1 diabetes mellitus across the lifecourse: a systematic review. Diabet Med 2006; 23:821-9. [PMID: 16911617 DOI: 10.1111/j.1464-5491.2006.01796.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The incidence of childhood-onset (Type 1) diabetes is high, and increasing, particularly among the very young. The aim of this review was to determine the longer-term social consequences of having diabetes as a child and to determine whether adverse consequences are more severe for disadvantaged children. METHODS Results from published and unpublished studies were synthesized narratively to examine the impact of diabetes on education, employment and income in adulthood. The question of whether the impact differed for different social groups was also examined. RESULTS Case-control studies found that children with diabetes missed more school than healthy children. Most studies of attainment found no differences between children with diabetes and non-diabetic control subjects or the local population, although poor metabolic control, early-onset, longer illness duration and serious hypoglycaemic events were associated with underachievement. People with childhood-onset diabetes may experience disadvantage in employment, and have a lower income in adulthood, although diabetic complications appear to be the most important determinant of social consequences in later life. CONCLUSIONS Many children with diabetes--especially late-onset--perform equally well at school despite increased rates of absence, but it is not yet clear whether specific subgroups are at greater risk of educational underperformance. People with childhood-onset diabetes, however, do appear to experience some disadvantage in adult employment. Qualitative research and cohort studies are needed to fill key gaps in the existing evidence base. Future research must also examine the impact of diabetes-related risk factors on socio-economic consequences.
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Affiliation(s)
- B Milton
- Division of Public Health, University of Liverpool, Liverpool, UK.
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Kimmel CA, Collman GW, Fields N, Eskenazi B. Lessons learned for the National Children's Study from the National Institute of Environmental Health Sciences/U.S. Environmental Protection Agency Centers for Children's Environmental Health and Disease Prevention Research. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:1414-8. [PMID: 16203257 PMCID: PMC1281290 DOI: 10.1289/ehp.7669] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This mini-monograph was developed to highlight the experiences of the National Institute of Environmental Health Sciences (NIEHS)/U.S. Environmental Protection Agency (EPA) Centers for Children's Environmental Health and Disease Prevention Research, focusing particularly on several areas of interest for the National Children's Study. These include general methodologic issues for conducting longitudinal birth cohort studies and community-based participatory research and for measuring air pollution exposures, pesticide exposures, asthma, and neurobehavioral toxicity. Rather than a detailed description of the studies in each of the centers, this series of articles is intended to provide information on the practicalities of conducting such intensive studies and the lessons learned. This explication of lessons learned provides an outstanding opportunity for the planners of the National Children's Study to draw on past experiences that provide information on what has and has not worked when studying diverse multiracial and multiethnic groups of children with unique urban and rural exposures. The Children's Centers have addressed and overcome many hurdles in their efforts to understand the link between environmental exposures and health outcomes as well as interactions between exposures and a variety of social and cultural factors. Some of the major lessons learned include the critical importance of long-term studies for assessing the full range of developmental consequences of environmental exposures, recognition of the unique challenges presented at different life stages for both outcome and exposure measurement, and the importance of ethical issues that must be dealt with in a changing medical and legal environment. It is hoped that these articles will be of value to others who are embarking on studies of children's environmental health.
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Affiliation(s)
- Carole A Kimmel
- National Children's Study Interagency Coordinating Committee, National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC, USA
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Wenten M, Berhane K, Rappaport EB, Avol E, Tsai WW, Gauderman WJ, McConnell R, Dubeau L, Gilliland FD. TNF-308 modifies the effect of second-hand smoke on respiratory illness-related school absences. Am J Respir Crit Care Med 2005; 172:1563-8. [PMID: 16166621 PMCID: PMC2718456 DOI: 10.1164/rccm.200503-490oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Exposure to second-hand smoke (SHS) has been associated with increased risk of respiratory illness in children including respiratory illness-related school absences. The role of genetic susceptibility in risk for adverse effects from SHS has not been extensively investigated in children. OBJECTIVE To determine whether the tumor necrosis factor (TNF) G-308A genotype influences the risk for respiratory illness-related school absences associated with SHS exposure. METHODS Incident school absences were collected, using an active surveillance system, between January and June 1996, as part of the Air Pollution and Absence Study, a prospective cohort study nested in the Children's Health Study. Buccal cells and absence reports were collected on 1,351 students from 27 elementary schools in California. MEASUREMENTS AND MAIN RESULTS Illness-related school absences were classified as nonrespiratory and respiratory illness-related, which were further categorized into upper or lower respiratory illness-related absences based on symptoms. The effect of SHS exposure on respiratory illness-related absences differed by TNF genotype (p interaction, 0.02). In children possessing at least one copy of the TNF-308 A variant, exposure to two or more household smokers was associated with a twofold risk of a school absence due to respiratory illness (relative risk, 2.13; 95% confidence interval, 1.34, 3.40) and a fourfold risk of lower respiratory illness-related school absence (relative risk, 4.15; 95% confidence interval, 2.57, 6.71) compared with unexposed children homozygous for the common TNF-308 G allele. CONCLUSIONS These results indicate that a subgroup of genetically susceptible children are at substantially greater risk of respiratory illness if exposed to SHS.
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Affiliation(s)
- Madé Wenten
- Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of USC, 1540 Alcazar Street, Los Angeles, CA 90033, USA
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Chang MJ, Walker K, McDaniel RL, Connell CT. Impaction collection and slurry sampling for the determination of arsenic, cadmium, and lead in sidestream cigarette smoke by inductively coupled plasma-mass spectrometry. ACTA ACUST UNITED AC 2005; 7:1349-54. [PMID: 16307095 DOI: 10.1039/b509048b] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The slurry sampling technique has been applied for the determination of arsenic, cadmium and lead in sidestream cigarette smoke condensate (SS CSC) by inductively coupled plasma mass spectrometry (ICP-MS). The smoke collection system consists of a "fishtail" chimney in conjunction with an impaction trap and a mixed cellulose ester (MCE) backup filter for the SS CSC collection. The smoke condensates, collected at three different regions of the system (i.e. the inner wall of the chimney, the impaction trap and the MCE filter), were individually prepared and analyzed and showed that about 70 and 20% of Cd and Pb, respectively, were trapped by the impaction trap and the MCE filter with less than 5% trapped by the chimney. In contrast, about 60% of As was trapped by the impactor and a relatively high percentage of As, about 30%, was deposited onto the inner wall of the chimney. The uneven distribution of trace metals at each collection stage strongly suggested that the composition of smoke aerosol and the associated physical form of the analytes may be different. The yields of As, Cd and Pb for the sidestream cigarette smoke of the 1R4F reference cigarette were 29.5 +/- 2.4, 421 +/- 6.6 and 46.4 +/- 0.9 ng cigarette(-1)(n= 3) respectively, when the cigarette was smoked according to the smoking regime: 45 mL puff volume of 2-s puff duration at an interval of 30 s with 50% ventilation holes covered. The analytical results for the slurry sampling technique were also compared with other sample preparation techniques and show good agreement.
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Affiliation(s)
- Michael J Chang
- Philip Morris USA, Research Center, 4201 Commerce Road, Richmond, VA 23234, USA.
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Dhala A, Pinsker K, Prezant DJ. Respiratory health consequences of environmental tobacco smoke. Med Clin North Am 2004; 88:1535-52, xi. [PMID: 15464112 DOI: 10.1016/j.mcna.2004.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Over the last several decades there has been a growing interest in examining the health consequences of environmental tobacco smoke (ETS). As a result of a wide body of research, ETS is now considered an unacceptable and entirely preventable public health hazard, and public policy increasingly discourages the presence of tobacco smoke in the public domain. This article provides an overview of the composition of ETS and the major diseases and disorders strongly linked to ETS, emphasizing the effects of ETS on pulmonary function, asthma, and lung cancer.
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Affiliation(s)
- Atiya Dhala
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Shenkin JD, Broffitt B, Levy SM, Warren JJ. The association between environmental tobacco smoke and primary tooth caries. J Public Health Dent 2004; 64:184-6. [PMID: 15341143 DOI: 10.1111/j.1752-7325.2004.tb02750.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Environmental tobacco smoke (ETS) has been associated with a number of negative health outcomes for exposed children. The goal of this study was to assess the association between ETS and dental caries in a pediatric population. METHODS This study included 637 Iowa Fluoride Study children whose parents provided socioeconomic information, completed at least three questionnaires during the first year of life, and had a primary dentition exam at age 4-7 years. Households reporting in all questionnaires that someone smoked in the home were categorized as regularly smoking homes. Socioeconomic status (SES) was divided into three groups (low, middle, and high) based on family income and mother's education. Children were classified as having caries if any of the primary teeth had fillings or cavitated lesions at the primary dentition exam. RESULTS Overall, children residing in regularly smoking homes had a higher prevalence of caries. For the middle SES group and overall, the children from smoking homes had a significantly higher prevalence of caries compared to nonregular/nonsmoking homes (52% vs 24%, P=.05 and 44% vs 25%, P=.002, respectively). After adjusting for age, SES, toothbrushing frequency, total ingested fluoride, and combined intake of soda pop and powdered drink beverages, the relationship of smoking and caries still remained significant (odds ratio [OR]=3.38; P=.001). CONCLUSIONS Environmental tobacco smoke was associated with an increased risk of caries among children.
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Powers CA, Zapka JG, Bognar B, Dube C, Hyder Ferry L, Ferguson KJ, O'donnell JF, Rigotti N, Conley Thomson C, White M, Wilkerson L, Geller AC, McIntosh S. Evaluation of current tobacco curriculum at 12 US medical schools. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2004; 19:212-219. [PMID: 15725638 DOI: 10.1207/s15430154jce1904_7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Training medical students in tobacco prevention and treatment skills is critical if we are to have competent physicians prepared to address the grave levels of morbidity and mortality associated with tobacco use. Tobacco Prevention and Cessation Education at US Medical Schools (PACE), a National Cancer Institute funded project, was launched to assess and improve curriculum content and teaching at 12 US medical schools. METHODS The 2003 survey was completed by faculty and administrators. The survey was divided into four main sections: tobacco content and skills, curricular evaluation, faculty perceptions of barriers and promoters, and educational vision. RESULTS Thirty-six percent of all medical school courses had some tobacco-related content. Five schools provided a total of between 4 and 8 hours of teaching, 5 schools provided 10-13 hours, and 2 schools provided 17 and 18 hours of teaching. Of the 12 schools, 8 had fewer hours devoted to tobacco teaching in the clerkships than during the 1st-year courses. Only 2 schools noted any tobacco content for Obstetrics/Gynecology clerkships, and only 4 schools provided teaching in the pediatric setting (range 5-201 minutes). CONCLUSION In comparison to earlier studies, it appears that more tobacco content is now integrated into medical school courses. More improvement is necessary, however, particularly in tobacco use prevention. Institutions need to examine the role of faculty in prioritizing tobacco information and promoting a culture that builds competency in tobacco control and treatment.
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