Non-smoking Households Research Articles

Insuffisance respiratoire aiguë révélant un carcinome bronchiolo-alvéolaire

A novel, highly selective method for the determination of nicotine, N-nitrosamines and tobacco-specific nitrosamines (TSNAs) in indoor dust samples is presented in this study. Samples were extracted by in-cell clean-up pressurized liquid extraction (PLE) that allows high extraction efficiency with moderate consumption of organic solvents. The extracts were analyzed by comprehensive gas chromatography and detected with a nitrogen chemiluminiscence detector (GC × GC-NCD) that provided enhanced selectivity and sensitivity for organic nitrogen containing compounds. Method validation showed good linearity, repeatability and reproducibility (%RSD < 8%). Recovery was higher than 80% for most target compounds and limits of detection lower than 16 ng g−1. The method was used for the determination of the nitrosamine target compounds in house dust samples from both smoking and non-smoking households. All the analytes were found in the samples, nicotine being the most abundant compound in smokers’ dust and one of the most abundant in non-smokers’ dust. To our knowledge this is the first time that volatile N-nitrosamines and TSNAs have been determined in indoor dust samples. The results demonstrate the presence of these highly carcinogenic compounds in house dust, with inherent human exposure through inhalation and/or involuntary ingestion of house dust.

Determination of nicotine and N-nitrosamines in house dust by pressurized liquid extraction and comprehensive gas chromatography—Nitrogen chemiluminiscence detection

A novel, highly selective method for the determination of nicotine, N-nitrosamines and tobacco-specific nitrosamines (TSNAs) in indoor dust samples is presented in this study. Samples were extracted by in-cell clean-up pressurized liquid extraction (PLE) that allows high extraction efficiency with moderate consumption of organic solvents. The extracts were analyzed by comprehensive gas chromatography and detected with a nitrogen chemiluminiscence detector (GC×GC-NCD) that provided enhanced selectivity and sensitivity for organic nitrogen containing compounds. Method validation showed good linearity, repeatability and reproducibility (%RSD<8%). Recovery was higher than 80% for most target compounds and limits of detection lower than 16 ng g(-1). The method was used for the determination of the nitrosamine target compounds in house dust samples from both smoking and non-smoking households. All the analytes were found in the samples, nicotine being the most abundant compound in smokers' dust and one of the most abundant in non-smokers' dust. To our knowledge this is the first time that volatile N-nitrosamines and TSNAs have been determined in indoor dust samples. The results demonstrate the presence of these highly carcinogenic compounds in house dust, with inherent human exposure through inhalation and/or involuntary ingestion of house dust.

P2-369 Correlation of household smoking with individual smoking, FYR of Macedonia, 2009

IntroductionStudies report various results on association of parental smoking with adolescent smoking initiation. This study researched smoking prevalence among students of the State University of Tetovo in comparison to household...

Household Tobacco Smoke and Admission Weight Predict Severe Bronchiolitis in Infants Independent of Deprivation: Prospective Cohort Study

ObjectivesTo examine demographic, environmental and clinical factors associated with severe bronchiolitis in infants admitted to hospital and quantify the independent effects of these factors.DesignProspective cohort study.SettingAlder Hey Children's Hospital, Liverpool, United Kingdom.Participants378 infants admitted to hospital with a diagnosis of bronchiolitis, of whom 299 (79%) were antigen positive to respiratory syncytial virus (RSV).OutcomeSeverity of disease during admission, defined as “no need for supplemental oxygen” (reference group), “any need for supplemental oxygen” and “any need for mechanical ventilation”.ResultsUnivariate analysis found male sex (p = 0.035) and tobacco smoking by a household member (p<0.001) were associated with need for both supplemental oxygen and mechanical ventilation. Premature birth, low gestation, low birth weight, low admission weight and low corrected age on admission were also associated with need for mechanical ventilation (all p≤0.002). Deprivation scores (IMD 2004) were significantly higher in households where a member smoked compared to non-smoking households (p<0.001). The odds of smoking predicted by deprivation were 7 times higher (95%CI (3.59, 14.03)), when comparing the least and most deprived quintiles of the study population. Family history of atopic disease and deprivation score were not associated with severe disease. Multivariate multinomial logistic regression which initially included all covariates, found household tobacco smoking (adjusted OR = 2.45, 95%CI (1.60, 3.74) predicted need for oxygen supplementation. Household tobacco smoking (adjusted OR = 5.49, (2.78, 10.83)) and weight (kg) on admission (adjusted OR = 0.51, (0.40, 0.65)) were both significant predictors in the final model for mechanical ventilation. The same associations and similar size of effects were found when only children with proven RSV infection were included in analysis.ConclusionsLow admission weight and householder tobacco smoking increased the risk of severe bronchiolitis in infants admitted to hospital. These effects were independent of a standard deprivation measure. NIHR Study Ref. DHCS/G121/10.

Parental home smoking policies: The protective effect of having a young child in the household

Objective To examine selected social determinants of a home smoking policy among US households with children and whether these associations vary by the presence of a smoker and children's ages. Methods In the 2006/2007 US Tobacco Use Supplement to the Current Population Survey there were 30,874 parents with 0–17-year-olds. Results 83.9% of parents reported that no one was allowed to smoke inside the home. However, a no smoking policy varied by the presence of a smoker (93.6% of non-smoking households; 55.8% of smoking households) and children's ages (87.1% of parents with any 0–5-year-olds; 82.1% with 6–17-year-olds only; 79.2% with 14–17-year-olds only). In smoking and non-smoking households, parents of 6–17-year-olds were 25%–46% less likely to have a no smoking policy than parents of younger children. Among smoking households, Hispanic and Asian parents were over twice as likely to not allow smoking inside the home as white parents, while Black parents were half as likely. Parents from more disadvantaged circumstances were less likely to have a no smoking policy. Conclusions Parents of 6–17-year-olds are less likely to have a no smoking policy than parents of younger children. Parents with children of all ages should enact a smoking policy that promotes a smoke-free home.

Parental smoking, nasal resistance and rhinitis in children

To determine whether parent-reported perennial rhinitis or objectively measured nasal resistance is more common in children from smoking families. To assess tonsillar size, nasopharyngeal airway and upper airway surgery frequency in children with smoking and non-smoking parents. Ninety-five children (age 3-6 years, median 68 months) participated in this prospective cross-sectional clinical study. History of nasal symptoms was obtained, and all underwent an ear-nose-throat examination, anterior rhinomanometry and a lateral cephalogram. Regular smoking by either parent and their child's snoring was inquired about with a parental questionnaire. We compared children with a parental smoker and children without a parental smoker in the family. Smoking in the family led to increased risk for perennial rhinitis in the children up to 2.76-fold (aOR, 95%CI 1.00-7.67), but with no difference in nasal resistance between children from smoking and non-smoking households. Neither tonsillar size, nasopharyngeal airway nor upper airway surgery was associated with parental smoking. Parental smoking is associated with symptoms of perennial rhinitis in children. The possible role of environmental tobacco smoke should be taken into account in parent counselling and in evaluation of children being treated for symptoms of rhinitis and nasal obstruction.

Ambient concentrations and personal exposure to polycyclic aromatic hydrocarbons (PAH) in an urban community with mixed sources of air pollution

Assessment of the health risks resulting from exposure to ambient polycyclic aromatic hydrocarbons (PAH) is limited by a lack of environmental exposure data among the general population. This study characterized personal exposure and ambient concentrations of PAH in the Village of Waterfront South (WFS), an urban community with many mixed sources of air toxics in Camden, New Jersey, and CopeWood/Davis Streets (CDS), an urban reference area located ∼1 mile east of WFS. A total of 54 and 53 participants were recruited from non-smoking households in WFS and CDS, respectively. In all, 24-h personal and ambient air samples were collected simultaneously in both areas on weekdays and weekends during summer and winter. The ambient PAH concentrations in WFS were either significantly higher than or comparable to those in CDS, indicating the significant impact of local sources on PAH pollution in WFS. Analysis of diagnostic ratios and correlation suggested that diesel truck traffic, municipal waste combustion and industrial combustion were the major sources in WFS. In such an area, ambient air pollution contributed significantly to personal PAH exposure, explaining 44-96% of variability in personal concentrations. This study provides valuable data for examining the impact of local ambient PAH pollution on personal exposure and therefore potential health risks associated with environmental PAH pollution.

DEARS particulate matter relationships for personal, indoor, outdoor, and central site settings for a general population

This analysis provides the initial summary of PM 2.5 mass concentrations relationships for all seasons and participants for a general population in the Detroit Exposure and Aerosol Research Study (DEARS). The summary presented highlights the utility of the new methodologies applied, in addition to summarizing the particulate matter (PM) data. Results include the requirement to adjust the exposure data for monitor wearing compliance and measured environmental tobacco smoke (ETS) levels, even though the study design specified a non-smoking household. A 40% wearing compliance acceptance level was suggested as necessary to balance minimizing exposure misclassification (from poor compliance) and having sufficient data to conduct robust statistical analyses. An ETS threshold level equivalent to adding more than 1.5 μg m −3 to the collected sample was found to be necessary to detect changes in the personal exposure factor ( F pex ). It is not completely clear why such a large threshold level was necessary. Statistically significant spatial PM 2.5 gradients were identified in three of the six DEARS neighborhoods in Wayne County. These were expected, given the number of strong, localized PM sources in the Detroit (Michigan) metro area. Some residential outdoor bias levels compared with the central site at Allen Park exceeded 15%. After adjusting for ETS biases, the outdoor contributions to the personal exposure were typically larger by factors from 1.75 to 2.2 compared with those of the non-outdoor sources. The outdoor contribution was larger in the summer than in the winter, which is consistent with the fractions of time spent outdoors in the summer vs. the winter (6.7% vs. 1.1% of the time). Mean personal PM 2.5 cloud levels for the general population DEARS cohort ranged from 1.5 to 3.8 (after ETS adjustment) and were comparable to those reported previously. The personal exposure collections indoors were typically at least 13 times greater than those contributed outdoors.

Adult Household Smoking Is Associated With Increased Child Emotional and Behavioral Problems

Although maternal smoking has been associated with child emotional and behavioral problems, to our knowledge, no study has evaluated the association between overall household smoking and such problems. To investigate whether children who live with smokers are more likely than children who do not live with smokers to have emotional or behavioral problems and to explore this association in households with nonsmoking mothers. Nationally representative data from the 2000 to 2004 medical expenditure panel surveys, involving 30,668 children aged 5 to 17 years, were used. Associations between child emotional or behavioral problems and household smoking, and child, maternal, and family characteristics were examined. SUDAAN software was used to adjust for complex sampling design. Overall score on the Columbia Impairment Scale, a 13-item parent-report measure of child emotional or behavioral functioning (range, 0-52, >or=16 indicates a child with such problems). Children in smoking versus nonsmoking households were significantly more likely to have behavioral problems (17.39% vs 9.29%, p < .001). After adjusting for all covariates, male sex, older age of child, younger age of mother, unmarried mother, maternal depression, and below average maternal physical and mental health, each were independently associated with increased likelihood of emotional and behavioral problems, as was the presence of one or more adult smokers in the household (adjusted odds ratio 1.42; 95% confidence interval: 1.26-1.60). The odds of Columbia Impairment Scale score >or=16 increased with increasing number of smokers in the household, even among children whose mothers did not smoke. Children living with smokers are at increased risk for emotional or behavioral problems, and rates of such problems increase with increasing numbers of smokers in the household, even in the absence of maternal smoking.

Preschool children and their mothers are more exposed to paternal smoking at home than school children and their mothers

Background Exposure to secondhand smoke (SHS) is a major risk to human health, and the home is the greatest single source of SHS in children. Here, the authors assessed SHS exposure of children and mothers by paternal smoking at home, and investigated how different this exposure is according to smoking location and children's age. Methods Two hundred-five families were enrolled in this study as trios of fathers, mothers, and children. Nicotine concentrations in hair were measured using liquid chromatography–tandem mass spectrometry to determine long-term exposure to SHS. Results Differences between the smoker group and nonsmoker group in nicotine levels were statistically significant in both children and their mothers. However, difference between the indoor-smoker group and outdoor-smoker group was marginally significant in children and was not significant in their mothers. In the indoor-smoker group, preschool children and their mothers had nicotine concentrations about twice as high as school children and their mothers, respectively. In the outdoor-smoker group, however, differences between two age groups in nicotine levels were significant in preschool children, but not their mothers. Conclusion These findings indicate that paternal smoking at home leads to significant exposure to SHS in their children and spouses, which is not completely prevented by smoking outside. Especially, preschool children and their mothers appear to be most at risk for SHS exposure among nonsmoking household members.

Smoking restrictions in the home and secondhand smoke exposure among primary schoolchildren before and after introduction of the Scottish smoke-free legislation

Objective:To examine change in home smoking restrictions one year after introduction of Scottish smoke-free legislation, and whether type of restriction impacts upon secondhand smoke (SHS) exposure among children.Design:Comparison of nationally...

Tobacco-Related Documentation in Pediatric Practice

The goal of this study was to evaluate tobacco-related documentation in children's medical records. A cross-sectional, consecutive sample of 4216 parents at 13 primary care practices was surveyed on demographics, health habits, and smoking status of household members. The medical records of 2085 children from a subsample of 1149 families (all households with smokers and a sample of nonsmoking households) were reviewed for tobacco-related documentation at the first visit to the practice and visits in the 14 months preceding recruitment. Relationships of documentations with visit type, household smoking status, and use of charting prompts were examined. Most children (93%) had > or =1 visit during the reviewed period (77% had a health supervision visit), 23% were aged > or =11 years, 52% were Medicaid/uninsured, and 70% lived with smokers; 30.6% of children had family tobacco use status documented at a first visit to the practice and 15.4% had prenatal tobacco use status documented. Among children with a visit in the reviewed period, 39.3% with a health supervision visit and 9.6% without had a tobacco-related notation at a visit (P < .001). Overall, 15.2% of children living with a smoker had a visit notation indicating that someone in the household smoked. In households with smokers, documentation of household tobacco use status often disagreed with parent survey. Charting prompts significantly increased rates of identification of family tobacco use history and prenatal tobacco use history. Correct identification of household smoking status was absent for most children living with smokers. Improved documentation systems may facilitate tobacco-related surveillance and counseling.

Parental Smoking Increases Exhaled Nitric Oxide in Children

Franklin PJ, Turner S, Mutch R, Stick SM. Eur Respir J. 2006;28:730–733 PURPOSE OF THE STUDY. Fraction of exhaled nitric oxide (FeNO) seems to reflect allergic airway inflammation. The authors sought to investigate the association between reported parental smoking and FeNO in young children. STUDY POPULATION. The study included 78 children (mean age: 51.3 weeks; range: 13–106 weeks) who had FeNO data and had been well for at least 2 weeks before testing. Fifty-six children lived in nonsmoking households, 14 lived with 1 smoking parent, and 8 lived with 2 smoking parents. METHODS. Children underwent pulmonary-function testing that included measures of lung volumes (forced expiratory volume [FEV] in 0.5 second) and FeNO. The effect of parental smoking on FeNO and FEV was analyzed by using unpaired t tests and analysis of variance. Dose-response relationships between the number of smoking parents and FeNO and FEV were determined by using the χ2 test. There were no significant anthropometric differences between children in smoking and nonsmoking households. RESULTS. Children who had at least 1 smoking parent had a higher FeNO compared with children who lived in nonsmoking households (41.9 vs 33.0 ppb, respectively). Within the smoking group, children who lived with 2 smoking parents had a higher FeNO compared with children who lived with 1 smoking parent (48.3 vs 38.0 ppb, respectively). The difference between these 3 groups was not significant. However, there was a significant dose-response relationship across the 3 groups. Moreover, after controlling for other factors, it was found that parental smoking significantly increased the FeNO. Age, gender, maternal atopy, and doctor-diagnosed eczema and FEV were not associated with FeNO. CONCLUSIONS. Exposure to environmental tobacco smoke was associated with increased FeNO in young children. There also was evidence of a dose-response relationship between childhood FeNO and the number of smoking parents. REVIEWER COMMENTS. The role of FeNO as a marker for airway inflammation after exposure to tobacco smoke seems ambiguous. The authors mentioned that although some studies have shown that tobacco smoke has been associated with lower FeNO in smokers, other studies have found a short-term increase in FeNO directly after smoking a cigarette. Moreover, most epidemiologic studies have not found an effect of parental smoking on FeNO in older children. The authors argued that reported parental smoking alone may not be a good indicator for exposure in older children, because they are able to remove themselves from the source, compared with younger children who are unable to move from the offending environment. Whether FeNO can prove to be a useful biomarker of allergic sensitization or airway inflammation still remains in question. In addition, even if the association between cigarette-smoke exposure and high FeNO remain after better-powered studies, further investigations are warranted to elucidate what the potential clinical ramifications are for children with high levels of exhaled nitric oxide.

Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey

Objective To measure change in adult non-smokers' exposure to secondhand smoke in public and private places after smoke-free legislation was implemented in Scotland.Design Repeat cross sectional survey.Setting Scotland.Participants Scottish adults,...

Spatial variability of particulates in homes: Implications for infant exposure

Personal monitoring of particulate matter (PM) exposure in infants is difficult. Indirect, microenvironment modelling methods are more practical. Infants spend most of their time indoors at home and the aim of this study was to investigate spatial variations in PM concentrations within homes. Three size fractions of PM - particles with an aerodynamic diameter of less than 10 microm (PM(10)), less than 2.5 microm (PM(2.5)) and total suspended particulates (TSP) - were monitored in the homes of 77 infants (0-2 years) using a multi-stage virtual impactor. In all homes PM was monitored simultaneously in the main living room at heights of 1.4 m and 0.2 m from the floor. In 26 of these homes monitoring was also conducted simultaneously in the infant's bedroom. Further, PM(10) was measured simultaneously in the living room, bedroom and child's cot in 14 homes using a real-time photometer. All homes in the study were non-smoking households. On average, there were no significant differences between concentrations of any of the different PM size fractions measured at the two heights (living room) and between living room and bedroom concentrations. However, there were only moderate correlations in concentrations between the different microenvironments and in some homes there was considerable variation between sampling sites. From the real-time measurements there seemed to be good agreement between concentrations measured in different rooms and in the cot and short-term peak concentrations at one sampling site were often mirrored at other sites. These results suggest that, although large variations in PM concentrations between rooms within homes can occur, a single monitoring station can provide a reasonable estimate of indoor concentrations.

Volatile Organic Compounds in Human Milk: Methods and Measurements

The present study was conducted to optimize methods for measurement of volatile organic compounds (VOCs) by use of headspace solid-phase microextraction (HS-SPME) and to provide a preliminary assessment of levels in human milk. MTBE (methyl tert-butyl ether), chloroform, benzene, and toluene were measured from two sources of milk: a North Carolina milk bank (n = 5) and multiple samples from three women within nonsmoking households in inner-city Baltimore, MD (n = 8). In Baltimore, indoor air VOC concentrations in the respective households were also measured by active sampling and thermal desorption gas chromatography/mass spectrometry in selective ion monitoring (GC/MS/SIM) over each of the 3 days of milk collection. By application of these optimized methods, we observed median VOC concentrations in Baltimore human milk of 0.09, 0.55, 0.12, and 0.46 ng/mL for MTBE, chloroform, benzene, and toluene, respectively. For benzene, toluene, and MTBE, milk levels trended with observed indoor air concentrations. On the basis of measured concentrations in air and milk, infant average daily dose by inhalation exceeded ingestion rates by 25-135-fold. Thus, VOC exposure from breast milk is vastly exceeded by that from indoor air in nonsmoking households. Accordingly, strategies to mitigate infant VOC exposure should focus on the indoor air inhalation pathway of exposure.

Glutathione S-Transferase M1 and P1 Genotype, Passive Smoking, and Peak Expiratory Flow in Asthma

Our purpose with this work was to assess the contribution of glutathione S-transferase gene variants to asthma susceptibility and pulmonary function in relation to tobacco smoke exposure in the home. Young individuals with asthma (age: 3-21 years; n = 504) were recruited through primary and secondary care throughout Tayside, Scotland (BREATHE Study). Spirometry was obtained on 407 individuals. Binary logistic regression and general linear modeling were used to explore phenotypic characteristics by genotype and tobacco smoke exposure status in younger children (3-12 years; n = 384) and teenagers and young adults (13-21 years; n = 120). Three- to 12-year-olds with asthma, null for the GSTM1 gene or homozygous for the GSTP1Val105 allele, were overrepresented in the group exposed to environmental tobacco smoke. No differences in lung function values could be detected in this group. In contrast, 13- to 21-year-olds with the GSTM1-null genotype or homozygous for the GSTP1Val105 allele from smoking households were more likely to have a substantially lower percentage of predicted peak expiratory flow rates than those from nonsmoking households (83% vs 98%). Three- to 12-year-olds who are null for GSTM1 or homozygous for the GSTP1Val105 allele are more susceptible to asthma associated with environmental tobacco smoke exposure than those with more intact glutathione S-transferase status. In the 13- to 21-year-olds, GSTM1-null status interacts with environmental tobacco smoke exposure to substantially reduce peak expiratory flow rate. The environmental tobacco smoke effect in GSTM1-null children with asthma could be cumulative over time, resulting in detrimental effects on peak expiratory flow rate in 13- to 21-year-olds with asthma.

Real-time measurement of short-term peaks in environmental CO concentrations in the homes of the elderly in South Wales

In order to determine whether short-term World Health Organization (WHO) guideline limits for carbon monoxide (CO) are exceeded in the home environment, a number of sensors were constructed capable of real-time measurement. These were deployed for a period of 7 days to continuously monitor CO concentrations in 44 non-smoking households using either gas, coal, electricity, liquid propane gas, or oil for heating fuel in South Wales. The mean environmental concentrations over the period monitored were less than 1 p.p.m and WHO short-term limits were not exceeded in any household. In another 20 homes containing a smoker the mean concentrations measured over a period of 2 days ranged from 0.1 to 21 p.p.m and WHO short-term limits were exceeded in one household.

Detection of Cotinine, a Nicotine Metabolite, in the Plasma of Birds Exposed to Secondhand Smoke

A commercially available enzyme-linked immunosorbent assay was used to quantitate cotinine, a nicotine metabolite, in the plasma of caged birds exposed to environmental tobacco smoke. Birds in smoking households were found to have significantly higher plasma cotinine levels (4.3–37.8 ng/ml) than control birds from nonsmoking households (0–3.6 ng/ml) (P < .001). These high levels of cotinine are similar to those reported in humans with clear evidence of clinical alteration and resultant disease from environmental tobacco smoke.

Indoor- and Outdoor-Generated Particles and Children with Asthma

In their article “Pulmonary Effects of Indoor- and Outdoor-Generated Particles in Children with Asthma,” Koenig et al. (2005) made use of their really interesting model that enables them to discern exposure from indoor- and outdoor-generated particles. They concluded that The ambient-generated component of PM2.5 [particulate matter ≤2.5 μm in aerodynamic diameter] exposure is consistently associated with increases in eNO [exhaled nitric oxide] and the indoor-generated component is less strongly associated with eNO. This finding should not lead to the assumption that particles generated indoors are in general not able to induce endogenous NO production. The authors themselves pointed out one limitation of their study: Children in the Seattle panel study spent an average of 66% of their time indoors at home and 21% indoors away from home (primarily at school) … (Koenig et al. 2005) However, contribution of indoor sources to PM exposure was only estimated on the basis of measurement data from the subjects’ residences. This could have led to uncertainties in the exposure assessment, biasing the effect estimates toward null. I also want to mention the great variability in possible indoor sources of PM. In their article, Koenig et al. (2005) provided no information on the smoking status of household members. If the 19 children under study lived in nonsmoking households, the results might be true for this setting but not for others. Finally, I suggest that time of measurement and exposure should be considered. If the children attend school in the morning, they might go home (maybe in high traffic) at noon or early afternoon for lunch. [NO] samples were collected in the afternoon or early evening at the child’s residence. Children were asked to forgo food intake for 1 hr before collection of exhaled breath. If NO production peaks several hours after exposure, it could be possible that the children’s exposure on their way home from school was the most influential one (not because of the origin of the particles but because of the study’s lag structure). It would be interesting and rather rewarding to study the short-term lag structure between PM exposure and both exhaled NO and lung function [for which Koenig et al. (2005) found an association with exposure due to sources in the residents’ homes]. I would expect an increase of exhaled NO to be a rather late reaction to inflammatory stimuli. For example Rolla et al. (2004) reported that after aspirin inhalation by subjects with aspirin-inducible asthma, NO increased significantly reaching the peak value 4 hr after bronchoconstriction.