Abstract
Secondhand smoke exposure (SHSe) has multiple adverse effects on lung function and growth, nutrition, and immune function in children; it is increasingly being recognized as an important modifier of disease severity for children with chronic diseases such as cystic fibrosis (CF). This review examines what is known regarding the prevalence of SHSe in CF, with the majority of reviewed studies utilizing parental-reporting of SHSe without an objective biomarker of exposure. A wide range of SHSe is reported in children with CF, but under-reporting is common in studies involving both reported and measured SHSe. Additionally, the impact of SHSe on respiratory and nutritional health is discussed, with potential decreases in long-term lung function, linear growth, and weight gain noted in CF children with SHSe. Immunologic function in children with CF and SHSe remains unknown. The impact of SHSe on cystic fibrosis transmembrane conductance regulator (CFTR) function is also examined, as reduced CFTR function may be a pathophysiologic consequence of SHSe in CF and could modulate therapeutic interventions. Finally, potential interventions for ongoing SHSe are delineated along with recommended future areas of study.
Highlights
Cystic fibrosis (CF) is a systemic disorder caused by genetic mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) channel that results in dysfunctional chloride ion transport
Abstracts were reviewed for relevance and selected manuscripts were reviewed in full if they contained objective and/or subjective measurement of Secondhand smoke exposure (SHSe) along with clinical data related to CF outcomes
Cotinine is the major metabolite of nicotine and can be measured in biological fluids such as blood, urine, hair, and saliva [12]
Summary
Cystic fibrosis (CF) is a systemic disorder caused by genetic mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) channel that results in dysfunctional chloride ion transport. One important environmental modifier in other chronic lung disorders is secondhand smoke exposure (SHSe) [2,3]. Despite ongoing initiatives to limit tobacco smoking, children’s SHSe remains prevalent globally, with recent global surveys reporting up to 79% of children exposed in some countries [5]. The CF Foundation recommends that all patients with CF avoid SHSe, but in 2014, 23% of individuals with CF reported monthly or more frequent SHSe [6]. Cigarette smoke is composed of over 5000 chemicals, which can be directly carcinogenic or combine to provide detrimental health risks in children [8]. We will summarize the current literature regarding SHSe in children with CF, with the goal of identifying knowledge gaps to be addressed in future research efforts
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More From: International Journal of Environmental Research and Public Health
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