The Devastating Effect of Secondhand Smoking Exposure in Pediatric Intensive Care Admissions

Abstract

Background: The aim of this study was to evaluate the effect of secondhand parental smoking in pediatric intensive care unit patients. Methods: This cross sectional prospective survey study was conducted as a questionnaire regarding the smoking habits of all parents of hospitalized patients in our pediatric intensive care unit between September 2014 and January 2015. We studied the prevalence and potential effects of secondhand parental smoking on the diagnosis, severity of disease, duration of hospitalization and length of stay on mechanical ventilation. Results: A total of 125 female and 178 male were included in the study. The median age was 53 (min:1 - max: 216) months. Indications of hospitalizations were intoxication (16.5%), neurological disorders (14.9%), malignancy (12.9%), congenital heart diseases (11.2%), genetic syndromes (9.9%), trauma (9.6%), shock (%7.3), arrhythmia (6.3%), renal failure (5%), diabetes (2.6%), burns (2.6%) and metabolic diseases (%1.3). A total of 42.2% of patients were on invasive, 5.3% were on non-invasive mechanical ventilation. Mothers, fathers and guests smoking rates were 40.6%; 75.2% and 58.4% respectively. The rate of illiterate fathers and mothers were higher in secondhand parental smoking group compared with non-exposure group (6% vs 4%, p=0.004, 10.7% vs 5.7%, p=0.21, respectively). The secondhand parental smoking rate was 76.9% whereas the smoking prevalence in Turkey was determined to be 30.5% for the whole population reflecting an increased velocity of PICU admissions . The secondhand parental smoking rate of children diagnosed as malignancy was 16.4% compared with non-exposed group (1.4%) which was statistically significant (p<0.05). There was no significant difference in secondhand parental smoking rate was of children diagnosed as intoxication, trauma, burns and others. The mean length of stay in MV and Pediatric Risk of Mortality (PRISM) score were 5.8 days ± 6.3 and 11.6 ± 8 respectively.. The PRISM score was statistically significant in secondhand parental smoking exposed children compared with non-exposed ones ( 12.2 ± 7.9 vs 9.6 ± 7.8 ; p= 0.007). The length of stay in pediatric intensive care unit (PICU) and duration of mechanical ventilation were longer in children secondhand smoking exposure (p<0.05). Conclusion: Secondhand smoking is related with increased velocity of PICU admissions, severity of disease, increased diagnosis of malignancies, prolonged duration of mechanical ventilation and PICU stay. Besides, secondhand exposed patients are more likely to have low parental education level.