Impact of Environmental Tobacco Smoke on Children With Sickle Cell Disease

West, Daniel C.; Romano, Patrick S.; Azari, Rahman; Rudominer, Andrea; Holman, Mark; Sandhu, Surdip

doi:10.1001/archpedi.157.12.1197

Cited by 24 publications

(29 citation statements)

References 24 publications

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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%

“…While studies such as the Cooperative Study of Sickle Cell Disease and Dallas Newborn Cohort have identified risk factors for SCD complications and death including steady-state hemoglobin concentration and percentage of fetal hemoglobin and early reticulocytosis or dactylitis [1][2][3] the clinical course of the disease varies greatly among individuals with the same hemoglobin genotype, even among twins and siblings [4]. It is likely that both genetic modifiers and environmental factors such as wind speed, humidity, change in temperature [5][6][7], and exposure to firsthand or secondhand tobacco smoke [8][9][10] influence clinical outcomes and complications in SCD, but little is known about the extent or mechanisms of these relationships. Secondhand smoke exposure is of particular interest, as it has been associated with adverse outcomes among children with other chronic diseases that affect the lungs, such as asthma, bronchopulmonary dysplasia, and cystic fibrosis; furthermore, because secondhand smoke is a modifiable exposure, avoidance may decrease the severity of SCD [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…Vascular occlusion occurs with the polymerization of hemoglobin S, resulting in the production of misshapen red blood cells that adhere abnormally to vascular endothelium. 76 Other complications include chronic anemia, stroke, splenic and renal dysfunction, and serious infections. Among children with SCD, the primary causes of morbidity are bacterial infections and stroke.…”

Section: Illness-and Treatment-related Complicationsmentioning

confidence: 99%

Smoking Rates and the State of Smoking Interventions for Children and Adolescents With Chronic Illness

Tyc

Throckmorton-Belzer

2006

Pediatrics

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Engaging in smoking is particularly risky for children and adolescents with chronic illness whose health status is already compromised because of disease- and treatment-related complications. Yet, some of these youngsters smoke at rates at least comparable to those of their healthy peers. To date, few randomized smoking-prevention and cessation trials have been conducted in children with chronic medical problems. In this review we report on the smoking rates among youngsters with chronic illness, identify specific disease- and treatment-related complications that can be exacerbated by smoking, examine risk factors associated with tobacco use among medically compromised youngsters, and review smoking interventions that have been conducted to date with pediatric populations in the health care setting. The following chronic illnesses are included in this review: asthma, cystic fibrosis, cancer, sickle cell disease, juvenile-onset diabetes, and juvenile rheumatoid arthritis. Objectives for a tobacco-control agenda and recommendations for future tobacco studies in chronically ill pediatric populations are provided. Finally, tobacco counseling strategies are suggested for clinicians who treat these youngsters in their practices.

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“…Environmental Protection Agency, 1992), as well as reduced lung function, heart disease, and cancer later in life (California Environmental Protection Agency, 1997;DiFranza & Lew, 1996;Iscan, Uyanik, Vurgun, Ece, & Yigitoglu, 1996). Recent studies have found positive associations between ETS exposure and children's respiratory symptoms following surgery (Drongowski et al, 2003), dental caries (Aligne, Moss, Auinger, & Weitzman, 2003), lower plasma vitamin C concentration (Preston, Rodriguez, Rivera, & Sahai, 2003), nocturnal asthma symptoms (Morkjaroenpong et al, 2002), atopic eczema (Kramer et al, 2004), and inpatient sickle cell crises (West et al, 2003). Children's ETS exposure results in several million episodes of illness, thousands of deaths, almost US$1 billion in excess medical care expenditures, and over US$4.5 billion in loss-of-life costs per year (Adams & Young, 1999;Aligne & Stoddard, 1997).…”

Section: Introductionmentioning

confidence: 99%

Behavioral counseling for reducing children's ETS exposure: Implementation in community clinics

Zakarian

Hovell

Sandweiss

et al. 2004

Nicotine & Tobacco Research

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The present randomized controlled trial tested the effectiveness of a behavioral counseling program for reducing children's exposure to environmental tobacco smoke (ETS). Counseling was delivered by clinic staff as part of well-child health care services in a community clinic setting. A total of 150 mothers with children aged 4 years or younger were recruited. Parent-reported and children's urinary cotinine measures of ETS exposure were obtained at baseline, 3 months, 6 months (post-test), and 12 months (follow-up). Saliva samples were obtained from mothers who reported quitting smoking, for objective verification by thiocyanate analysis. After baseline, mothers were randomly assigned to a measures-only control condition or an intervention consisting of seven behavioral counseling sessions over 6 months. Counseling included behavioral contracting, self-monitoring, problem solving, and positive reinforcement. Results indicated acceptable test-retest reliability and validity of measures. Parent-reported measures indicated that, in both groups, children's exposure to their mothers' tobacco smoke in the home and to all tobacco smoke declined steeply from baseline to 6 months post-test, and remained essentially level during follow-up. Mothers' smoking rates followed the same pattern. Children's urinary cotinine concentrations did not show significant change over time in either group. Findings on the fidelity of treatment implementation suggest that the structure and funding of the community clinic health care system and associated staff turnover and training issues resulted in participants receiving a less efficacious intervention than in our past efficacy trials. Implications for future effectiveness trials are discussed.

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Impact of Environmental Tobacco Smoke on Children With Sickle Cell Disease

Cited by 24 publications

References 24 publications

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

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

Smoking Rates and the State of Smoking Interventions for Children and Adolescents With Chronic Illness

Behavioral counseling for reducing children's ETS exposure: Implementation in community clinics

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