Environmental Tobacco Smoke and Airway Obstruction in Children With Sickle Cell Anemia

Cohen, Robyn T.; Strunk, Robert C.; Field, Joshua J.; Rosen, Carol L.; Kirkham, Fenella J.; Redline, Susan; Stocks, Janet; Rodeghier, Mark; DeBaun, Michael R.

doi:10.1378/chest.12-1569

Cited by 18 publications

(23 citation statements)

References 33 publications

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“…Similarly, a retrospective study on lung function data concerning 20 000 children at the age of 6-12 years showed that smoking during pregnancy was independently associated with a lower forced expiratory volume in 1 s (FEV1) (-1--6%) [43]. Similar effects on lung function and the presence of respiratory symptoms at school age have been reported for postnatal exposure to tobacco smoke [44,45]. In a cohort study, passive smoking during the first year of life increased the risk of respiratory symptoms at 5 years of age in children born moderately preterm, with an adjusted odds ratio of 1.8 [45].…”

Section: Second-hand Smoke Exposurementioning

confidence: 66%

Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

et al. 2014

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Chronic obstructive respiratory disorders such as asthma and chronic obstructive pulmonary disease often originate early in life. In addition to a genetic predisposition, prenatal and early-life environmental exposures have a persistent impact on respiratory health. Acting during a critical phase of lung development, these factors may change lung structure and metabolism, and may induce maladaptive responses to harmful agents, which will affect the whole lifespan.Some environmental factors, such as exposure to cigarette smoke, type of childbirth and diet, may be modifiable, but it is more difficult to influence other factors, such as preterm birth and early exposure to viruses or allergens.Here, we bring together recent literature to analyse the critical aspects involved in the early stages of lung development, going back to prenatal and perinatal events, and we discuss the mechanisms by which noxious factors encountered early on may have a lifelong impact on respiratory health.We briefly comment on the need for early disease biomarkers and on the possible role of ''-omic'' technologies in identifying risk profiles predictive of chronic respiratory conditions. Such profiles could guide the ideation of effective preventive strategies and/or targeted early lifestyle or therapeutic interventions. @ERSpublications Early-life factors have a role in onset of asthma and COPD; early postnatal interventions may promote lung health http://ow.ly/BvUrx

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Section: Second-hand Smoke Exposurementioning

confidence: 66%

Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

et al. 2014

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“…These include a retrospective cohort study of 52 children with SCD that demonstrated an increased rate of hospitalizations in children with exposure by questionnaire [9], a retrospective cohort study that identified an increased risk of ACS (2.6 times) for both primary smokers and adults only exposed to secondhand smoke (exposure assessed via questionnaire) [8], a prospective cohort study that found increased respiratory symptoms and lower airway obstruction in children with SCD (exposure quantified by parental report) [22], and a retrospective cohort study that identified increased ED utilization (73% more visits for ACS) in children with SCD (parental report of secondhand smoke exposure) [23]. The aforementioned studies focused on subjective report of exposure in children's home environments and may not have sufficiently captured other places in which children are frequently exposed to tobacco smoke (such as regular childcare arrangements, the homes of close friends and relatives, or split-parent households) and likely underestimate the effect of tobacco smoke exposure.…”

Section: Discussionmentioning

confidence: 99%

Secondhand smoke is associated with more frequent hospitalizations in children with sickle cell disease

et al. 2016

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Tobacco smoke exposure has been associated with more frequent hospitalizations in children with sickle cell disease (SCD), but previous studies have not quantified the exposure by objective methods. We enrolled 50 children and young adults with SCD in a retrospective and prospective cohort study and quantified tobacco smoke exposure by objective (salivary cotinine) and survey measures. We used a multivariable negative binomial regression model to evaluate the association between salivary cotinine and hospital admissions. Forty-five percent (22/49) of participants had significant elevation of salivary cotinine ( 0.5 ng/ ml). The incidence risk ratio (IRR) for hospital admission for those with elevated cotinine was 3.7 (95% CI 1.8-8). Those exposed to secondhand smoke but not primary smokers (cotinine between 0.5 and 10 ng/ml) had a similarly increased risk of hospitalization [IRR 4.3 (95% CI 1.8-10)]. We show that an objective measure of tobacco smoke exposure, salivary cotinine, is strongly associated with the rate of hospital admissions in children and young adults with SCD. This association underscores the importance of screening for tobacco smoke exposure in people with SCD. Further investigation is warranted to determine the mechanisms of and to evaluate interventions to decrease tobacco smoke exposure.

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“…These include prophylaxis against influenza (vaccination) and pneumococcal infection (vaccination, penicillin in early childhood) [5], avoidance of exposure to cold water and weather [6], and malaria prophylaxis with bed nets and/or medications in parts of the world where it is endemic [7]. Evidence is mounting that tobacco smoke exposure (TSE), whether first-hand through primary smoking, or secondhand, is a common and important modifiable risk factor for pain [8,9,10], ACS [8,9,10,11,12], and lower airway obstruction [13,14] in children and adults with SCD. …”

Section: Introductionmentioning

confidence: 99%

“…TSE is associated with significant morbidity in children and adults with SCD, whether through secondhand exposure or through primary smoking [8,9,10,11,12,13]. TSE appears to have negative effects on pulmonary function and pulmonary exacerbations of SCD (i.e., more frequent ACS episodes) [8,9,10,11,13].…”

Section: Introductionmentioning

confidence: 99%

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Secondhand Smoke Is an Important Modifiable Risk Factor in Sickle Cell Disease: A Review of the Current Literature and Areas for Future Research

Sadreameli¹,

Kopp

Creary

et al. 2016

IJERPH

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Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy that causes significant morbidity and mortality related to chronic hemolytic anemia, vaso-occlusion, and resultant end-organ damage. Tobacco smoke exposure (TSE) through secondhand smoke exposure in people with SCD of all ages and through primary smoking in adolescents and adults is associated with significantly increased morbidity, with increased rates of emergency department visits and hospitalizations for painful vaso-occlusive crises and acute chest syndrome (ACS). Secondhand smoke is also associated with pulmonary function abnormalities in children with SCD who are already at risk for pulmonary function abnormalities on the basis of SCD. TSE is emerging as one of the few modifiable risk factors of SCD. This review discusses the current state of the evidence with respect to TSE and SCD morbidity, discusses potential mechanisms, and highlights current gaps in the evidence and future research directions.

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Environmental Tobacco Smoke and Airway Obstruction in Children With Sickle Cell Anemia

Cited by 18 publications

References 33 publications

Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

Secondhand smoke is associated with more frequent hospitalizations in children with sickle cell disease

Secondhand Smoke Is an Important Modifiable Risk Factor in Sickle Cell Disease: A Review of the Current Literature and Areas for Future Research

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