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Zhang Y, Zhang XJ, Yuan N, Wang YM, Ip P, Chen LJ, Tham CC, Pang CP, Yam JC. Secondhand smoke exposure and ocular health: A systematic review. Surv Ophthalmol 2023; 68:1166-1207. [PMID: 37479063 DOI: 10.1016/j.survophthal.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
The toxicology of secondhand smoke (SHS), along with the harm of its exposure to human health, has been generally acknowledged; however, specific evidence is lacking on the association between SHS exposure and ocular health. In this systematic review (PROSPERO registration number: CRD42022247992), we included 55 original articles published by 12 May 2023, which dealt with SHS exposure and ocular disorders, such as eye irritation, conjunctivitis, dry eye diseases, uveitis, myopia, astigmatism, contact lens discomfort, age-related macular degeneration, glaucoma, and thyroid eye disease that addressed the ocular neurovascular structures of the macular, retinal nerve fiber layer, choroid, and corneal biomechanical parameters. We found compelling correlational evidence for eye irritation, conjunctivitis, and dry eye symptoms-supporting that SHS exposure was positively associated with inflammatory and allergic changes in the eyes. Yet, evidence about the associations between SHS exposure and other ocular disorders, structures, and parameters is still limited or controversial. Given the limitations of existing literature, more investigations with high quality and rigorous design are warranted to elucidate the potentially harmful effects of SHS exposure on ocular health.
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Affiliation(s)
- Youjuan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China
| | - Nan Yuan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Kunming Bright Eye Hospital, Kunming, China
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Neurobiology, Interdisciplinary Center for Neurosciences (IZN), Heidelberg University, Heidelberg, Germany
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Arfaeinia H, Ghaemi M, Jahantigh A, Soleimani F, Hashemi H. Secondhand and thirdhand smoke: a review on chemical contents, exposure routes, and protective strategies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-28128-1. [PMID: 37306877 DOI: 10.1007/s11356-023-28128-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Abstract
Secondhand smoke (SHS: a mixture of sidestream and mainstream smoke) and thirdhand smoke (THS: made up of the pollutants that settle indoors after smoking in closed environments) are a significant public health concern. SHS and THS contain various chemicals which can be released into the air or settle on surfaces. At present, the hazards of SHS and THS are not as well documented. In this review, we describe the chemical contents of THS and SHS, exposure routes, vulnerable groups, health effects, and protective strategies. The literature search was conducted for published papers on September 2022 in Scopus, Web of Science, PubMed, and Google Scholar databases. This review could provide a comprehensive understanding of the chemical contents of THS and SHS, exposure routes, vulnerable groups, health effects, protective strategies, and future researches on environmental tobacco smoke.
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Affiliation(s)
- Hossein Arfaeinia
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Ghaemi
- Iranian National Institute for Oceanography and Atmospheric Science, No. 3, Etemadzadeh St., Fatemi Ave, Tehran, 1411813389, Iran
| | - Anis Jahantigh
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farshid Soleimani
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Hassan Hashemi
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Matt GE, Greiner L, Record RA, Wipfli H, Long J, Dodder NG, Hoh E, Lopez Galvez N, Novotny TE, Quintana PJE, Destaillats H, Tang X, Snijders AM, Mao JH, Hang B, Schick S, Jacob P, Talbot P, Mahabee-Gittens EM, Merianos AL, Northrup TF, Gundel L, Benowitz NL. Policy-relevant differences between secondhand and thirdhand smoke: strengthening protections from involuntary exposure to tobacco smoke pollutants. Tob Control 2023:tc-2023-057971. [PMID: 37263783 DOI: 10.1136/tc-2023-057971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
Starting in the 1970s, individuals, businesses and the public have increasingly benefited from policies prohibiting smoking indoors, saving thousands of lives and billions of dollars in healthcare expenditures. Smokefree policies to protect against secondhand smoke exposure, however, do not fully protect the public from the persistent and toxic chemical residues from tobacco smoke (also known as thirdhand smoke) that linger in indoor environments for years after smoking stops. Nor do these policies address the economic costs that individuals, businesses and the public bear in their attempts to remediate this toxic residue. We discuss policy-relevant differences between secondhand smoke and thirdhand smoke exposure: persistent pollutant reservoirs, pollutant transport, routes of exposure, the time gap between initial cause and effect, and remediation and disposal. We examine four policy considerations to better protect the public from involuntary exposure to tobacco smoke pollutants from all sources. We call for (a) redefining smokefree as free of tobacco smoke pollutants from secondhand and thirdhand smoke; (b) eliminating exemptions to comprehensive smoking bans; (c) identifying indoor environments with significant thirdhand smoke reservoirs; and (d) remediating thirdhand smoke. We use the case of California as an example of how secondhand smoke-protective laws may be strengthened to encompass thirdhand smoke protections. The health risks and economic costs of thirdhand smoke require that smokefree policies, environmental protections, real estate and rental disclosure policies, tenant protections, and consumer protection laws be strengthened to ensure that the public is fully protected from and informed about the risks of thirdhand smoke exposure.
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Affiliation(s)
- Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Lydia Greiner
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Rachael A Record
- School of Communication, San Diego State University, San Diego, CA, USA
| | - Heather Wipfli
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jamie Long
- Public Health Law Center, Mitchell Hamline School of Law, University of Minnesota, St Paul, MN, USA
| | - Nathan G Dodder
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA, USA
| | | | - Thomas E Novotny
- School of Public Health, San Diego State University, San Diego, CA, USA
| | | | - Hugo Destaillats
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Xiaochen Tang
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Antoine M Snijders
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jian-Hua Mao
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Bo Hang
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Suzaynn Schick
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Peyton Jacob
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Prue Talbot
- Department of Molecular, Cell, and Systems Biology, University of California Riverside, Riverside, CA, USA
| | - E Melinda Mahabee-Gittens
- Department of Pediatrics, Division of Emergency Medicine Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Thomas F Northrup
- Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Lara Gundel
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Neal L Benowitz
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
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Díez-Izquierdo A, Lidón-Moyano C, Martínez-Sánchez JM. Tobacco smoke is not limited to second hand smoke. EBioMedicine 2022; 87:104412. [PMID: 36525721 PMCID: PMC9772542 DOI: 10.1016/j.ebiom.2022.104412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Ana Díez-Izquierdo
- Pediatric Allergy and Pulmonology Section, Department of Pediatrics, Hospital Universitari Vall d'Hebron, Barcelona, Spain,Group of Evaluation of Health Determinants and Health Policies, Faculty of Medicine and Health Science, Universitat Internacional de Catalunya (UIC-Barcelona), Sant Cugat del Vallès, Spain,Corresponding author. Pediatric Allergy and Pulmonology Section, Department of Pediatrics, Hospital Universitari Vall d’Hebrón, Pg.Vall d’Hebrón 119-129, 08035, Barcelona, Spain.
| | - Cristina Lidón-Moyano
- Group of Evaluation of Health Determinants and Health Policies, Faculty of Medicine and Health Science, Universitat Internacional de Catalunya (UIC-Barcelona), Sant Cugat del Vallès, Spain
| | - José María Martínez-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Faculty of Medicine and Health Science, Universitat Internacional de Catalunya (UIC-Barcelona), Sant Cugat del Vallès, Spain
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Northrup TF, Stotts AL, Suchting R, Khan AM, Klawans MR, Green C, Hoh E, Hovell MF, Matt GE, Quintana PJE. Handwashing Results in Incomplete Nicotine Removal from Fingers of Individuals who Smoke: A Randomized Controlled Experiment. Am J Perinatol 2022; 39:1634-1642. [PMID: 34634832 DOI: 10.1055/s-0041-1736287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Tobacco residue, also known as third-hand smoke (THS), contains toxicants and lingers in dust and on surfaces and clothes. THS also remains on hands of individuals who smoke, with potential transfer to infants during visitation while infants are hospitalized in neonatal intensive care units (NICUs), raising concerns (e.g., hindered respiratory development) for vulnerable infants. Previously unexplored, this study tested handwashing (HW) and sanitization efficacy for finger-nicotine removal in a sample of adults who smoked and were visiting infants in an NICU. STUDY DESIGN A cross-sectional sample was recruited to complete an interview, carbon monoxide breath samples, and three nicotine wipes of separate fingers (thumb, index, and middle). Eligible participants (n = 14) reported current smoking (verified with breath samples) and were randomly assigned to 30 seconds of HW (n = 7) or alcohol-based sanitization (n = 7), with the order of finger wipes both counterbalanced and randomly assigned. After randomization, the first finger was wiped for nicotine. Participants then washed or sanitized their hands and finger two was wiped 5 minutes later. An interview assessing tobacco/nicotine use and exposure was then administered, followed by a second breath sample and the final finger wipe (40-60 minutes after washing/sanitizing). RESULTS Generalized linear mixed models found that HW was more effective than sanitizer for nicotine removal but failed to completely remove nicotine. CONCLUSIONS Without proper protections (e.g., wearing gloves and gowns), NICU visitors who smoke may inadvertently expose infants to THS. Research on cleaning protocols are needed to protect vulnerable medical populations from THS and associated risks. KEY POINTS · NICU infants may be exposed to THS via visitors.. · THS is not eliminated by HW or sanitizing.. · THS removal protections for NICU infants are needed..
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Angela L Stotts
- Department of Family and Community Medicine, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, Texas
| | - Amir M Khan
- Department of Pediatrics, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Michelle R Klawans
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Charles Green
- Department of Pediatrics, Center for Clinical Research and Evidence-Based Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Eunha Hoh
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, California
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, California
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, California
| | - Penelope J E Quintana
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, California
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Jaiswal S, Jalbert I, Schmid K, Tein N, Wang S, Golebiowski B. Smoke and the eyes: A review of the harmful effects of wildfire smoke and air pollution on the ocular surface. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 309:119732. [PMID: 35839974 DOI: 10.1016/j.envpol.2022.119732] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/16/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Wildfires are occurring worldwide with greater frequency and intensity. Wildfires, as well as other sources of air pollution including environmental tobacco smoke, household biomass combustion, agricultural burning, and vehicular emissions, release large amounts of toxic substances into the atmosphere. The ocular surface is constantly exposed to the ambient air and is hence vulnerable to damage from air pollutants. This review describes the detrimental effects of wildfire smoke and air pollution on the ocular surface and resultant signs and symptoms. The latest relevant evidence is synthesised and critically evaluated. A mechanism for the pathophysiology of ocular surface damage will be proposed considering the existing literature on respiratory effects of air pollution. Current strategies to reduce human exposure to air pollutants are discussed and specific possible approaches to protect the ocular surface and manage air pollution induced ocular surface damage are suggested. Further avenues of research are suggested to understand how acute and chronic air pollution exposure affects the ocular surface including the short and long-term implications.
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Affiliation(s)
- Sukanya Jaiswal
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | | | - Katrina Schmid
- School of Optometry and Vision Science, Queensland University of Technology, Australia
| | - Natasha Tein
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | - Sarah Wang
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Park MB, Sim B. Evaluation of Thirdhand Smoke Exposure after Short Visits to Public Facilities (Noraebang and Internet Cafés): A Prospective Cohort Study. TOXICS 2022; 10:toxics10060307. [PMID: 35736915 PMCID: PMC9227155 DOI: 10.3390/toxics10060307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/20/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
We aimed to evaluate the degree of thirdhand smoke (THS) caused by short-term exposure to smoking-related substances. To this end, we evaluated the change in concentration of a smoking-related urine biomarker in volunteers before and after visiting public spaces where there is likely THS exposure. We hypothesized that a visit to such public spaces would result in an increase in such biomarkers. Participants visited one of the predetermined facilities (noraebang, PC café) and revisited the same facility after 24 h, spending around 2 h per visit. We selected creatinine-corrected urine cotinine (CUC) as a biomarker to evaluate THS. In addition, we collected nicotine-derived nitrosamine ketone (NNK) from surface dust at each site with cotton swabs (diameter of 2.5 cm). We examined whether CUC concentration significantly changed across three time points (baseline, first visit, and second visit) via repeated-measures analysis of variance (RM-ANOVA). Moreover, we analyzed the interaction to determine whether cigarette smell affects the CUC concentration. Finally, CUC and dust NNK were analyzed with Pearson’s correlation. The CUC concentration did not increase from baseline to the first visit, but increased from the baseline to the second visit (Diff = Ln [0.565] ng/mg, P < 0.01). Further, the CUC concentration increased from the first to the second visit (Diff = Ln [0.393] ng/mg, p < 0.01). In the case of the interaction effect, there were statistically significant differences in CUC concentration depending on the smell of smoke in the facility (Diff = Ln [0.325], F value = 4.438, p value = 0.041). The change in CUC concentration from baseline to the second visit (r = 0.562, p < 0.001) and from the first to the second visit (r = 0.544, p < 0.001) were correlated with NNK concentration. We evaluated whether a short stay in a facility with smoke-related substances that adhere to the surrounding environment would expose individuals to THS even if they do not smell or are directly exposed to cigarette smoke. We confirmed that even two relatively short stays (approximately 2 h each) in a facility in which people had previously smoked can lead to THS exposure.
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Affiliation(s)
- Myung-Bae Park
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon 35345, Korea;
| | - Boram Sim
- HIRA Research Institute, Health Insurance Review and Assessment Service (HIRA), Wonju 26465, Korea
- Correspondence:
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Northrup TF, Stotts AL, Suchting R, Khan AM, Green C, Klawans MR, Quintana PJE, Hoh E, Hovell MF, Matt GE. Thirdhand Smoke Contamination and Infant Nicotine Exposure in a Neonatal Intensive Care Unit: An Observational Study. Nicotine Tob Res 2021; 23:373-382. [PMID: 32866238 DOI: 10.1093/ntr/ntaa167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/26/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Thirdhand smoke (THS) is ultrafine particulate matter and residue resulting from tobacco combustion, with implications for health-related harm (eg, impaired wound healing), particularly among hospitalized infants. Project aims were to characterize nicotine (THS proxy) transported on neonatal intensive care unit (NICU) visitors and deposited on bedside furniture, as well as infant exposure. METHODS Cross-sectional data were collected from participants in a metropolitan NICU. Participants completed a survey and carbon monoxide breath sample, and 41.9% (n = 88) of participants (n = 210) were randomly selected for finger-nicotine wipes during a study phase when all bedside visitors were screened for nicotine use and finger-nicotine levels. During an overlapping study phase, 80 mother-infant dyads consented to bedside furniture-nicotine wipes and an infant urine sample (for cotinine analyses). RESULTS Most nonstaff visitors' fingers had nicotine above the limit of quantification (>LOQ; 61.9%). Almost all bedside furniture surfaces (93.8%) and infant cotinine measures (93.6%) had values >LOQ, regardless of household nicotine use. Participants who reported using (or lived with others who used) nicotine had greater furniture-nicotine contamination (Mdn = 0.6 [interquartile range, IQR = 0.2-1.6] µg/m2) and higher infant cotinine (Mdn = 0.09 [IQR = 0.04-0.25] ng/mL) compared to participants who reported no household-member nicotine use (Mdn = 0.5 [IQR = 0.2-0.7] µg/m2; Mdn = 0.04 [IQR = 0.03-0.07] ng/mL, respectively). Bayesian univariate regressions supported hypotheses that increased nicotine use/exposure correlated with greater nicotine contamination (on fingers/furniture) and infant THS exposure. CONCLUSIONS Potential furniture-contamination pathways and infant-exposure routes (eg, dermal) during NICU hospitalization were identified, despite hospital prohibitions on tobacco/nicotine use. This work highlights the surreptitious spread of nicotine and potential THS-related health risks to vulnerable infants during critical stages of development. IMPLICATIONS THS contamination is underexplored in medical settings. Infants who were cared for in the NICU are vulnerable to health risks from THS exposure. This study demonstrated that 62% of nonstaff NICU visitors transport nicotine on their fingers to the NICU. Over 90% of NICU (bedside) furniture was contaminated with nicotine, regardless of visitors' reported household-member nicotine use or nonuse. Over 90% of infants had detectable levels of urinary cotinine during NICU hospitalizations. Results justify further research to better protect infants from unintended THS exposure while hospitalized.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX
| | - Angela L Stotts
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX.,Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, TX
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, TX
| | - Amir M Khan
- Department of Pediatrics, UTHealth, McGovern Medical School, Houston, TX
| | - Charles Green
- Department of Pediatrics, UTHealth, McGovern Medical School, Houston, TX.,Center for Clinical Research and Evidence-Based Medicine, UTHealth, McGovern Medical School, Houston, TX
| | - Michelle R Klawans
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX
| | | | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, San Diego, CA
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA
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Pozuelos GL, Jacob P, Schick SF, Omaiye EE, Talbot P. Adhesion and Removal of Thirdhand Smoke from Indoor Fabrics: A Method for Rapid Assessment and Identification of Chemical Repositories. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3592. [PMID: 33808392 PMCID: PMC8037229 DOI: 10.3390/ijerph18073592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 01/23/2023]
Abstract
Thirdhand smoke (THS) is an environmental contaminant that may cause adverse health effects in smokers and nonsmokers. Currently, time-consuming analytical methods are necessary to assess chemicals in THS repositories, like upholstered furniture and clothing. Our goal was to develop a rapid, accessible method that can be used to measure THS contamination in common household fabrics and to evaluate remediation. Cotton, terry cloth, polyester, and wool were exposed to THS for various times in a controlled laboratory environment and then extracted in various media at room temperature or 60 °C to develop an autofluorescent method to quantify THS. Concentrations of nicotine and related alkaloids in the extracts were determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and high-performance liquid chromatography (HPLC). The autofluorescence of extracts was proportional to the time and amount of THS exposure received by cotton and terry cloth. Extracts of polyester and wool did not show autofluorescence unless heat was applied during extraction. Nicotine, nicotine alkaloids, and TSNA concentrations were higher in THS extracts from cotton and terry cloth than extracts of polyester and wool carpet, in agreement with the autofluorescence data. For fabrics spiked with 10 mg of nicotine, extraction efficiency was much higher from terry cloth (7 mg) than polyester (0.11 mg). In high relative humidity, nicotine recovery from both cotton and polyester was 80% (~8 mg). Our results provide a simple, rapid method to assess THS contaminants in household fabrics and further show that THS extraction is influenced by fabric type, heat, and humidity. Thus, remediation of THS environments may need to vary depending on the fabric reservoirs being treated. Understanding the dynamics of THS in fabrics can help set up appropriate remediation policies to protect humans from exposure.
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Affiliation(s)
- Giovanna L. Pozuelos
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA 92521, USA; (G.L.P.); (E.E.O.)
| | - Peyton Jacob
- Department of Medicine, Division of Cardiology, Clinical Pharmacology Program, University of California San Francisco, San Francisco, CA 94110, USA;
| | - Suzaynn F. Schick
- Department of Medicine, Division of Occupational and Environmental Medicine, University of California San Francisco, San Francisco, CA 94110, USA;
| | - Esther E. Omaiye
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA 92521, USA; (G.L.P.); (E.E.O.)
| | - Prue Talbot
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA 92521, USA; (G.L.P.); (E.E.O.)
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10
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Oh SS, Park S, You YA, Jee Y, Ansari A, Kim SM, Lee G, Kim YJ. Prenatal Exposure to Alcohol, Tobacco, and Coffee: Associated Congenital Complications and Adverse Birth Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3140. [PMID: 33803679 PMCID: PMC8003057 DOI: 10.3390/ijerph18063140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 12/11/2022]
Abstract
A few studies to date have examined the association between prenatal exposure to alcohol, tobacco, and coffee, and congenital complications/adverse birth outcomes among South Korean populations. Thus, this study analyzed the data of 1675 Korean women with birth experience within the last 3 years for pregnancy-related health and nutritional behaviors and relative outcomes. During their pregnancies, 11.58% of the study population consumed alcohol at least once, 1.43% drank throughout all three trimesters, 1.13% smoked, 25.43% were exposed to secondhand smoking, and 28.18% consumed 3 coffees or more every day. Prenatal alcohol exposure was associated with 11.24 times increased risk of birth defects/disabilities [Odds Ratio (OR): 11.24, 95% Confidence Interval (CI) 1.07-117.86] and 10.66 times increased risk of inherited metabolic diseases (OR: 10.66, 95% CI: 1.08-104.82). Prenatal secondhand smoke exposure (OR: 1.62, 95% CI: 1.01-2.62) and coffee consumption (OR: 1.92, 95% CI: 1.22-3.03) was associated with increased risk of low birth weight. Such results were in alignment with that of previous studies and confirmed that prenatal alcohol, tobacco, and coffee exposure can have detrimental neonatal and maternal consequences.
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Affiliation(s)
- Sarah Soyeon Oh
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Department of Obstetrics & Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Sunwha Park
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Department of Obstetrics & Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Young-Ah You
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Medical Research Institute, College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
| | - Yongho Jee
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
| | - AbuZar Ansari
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Medical Research Institute, College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
| | - Soo Min Kim
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Korea
| | - Gain Lee
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Korea
| | - Young Ju Kim
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Department of Obstetrics & Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Korea
- Medical Research Institute, College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Korea
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Ngo CQ, Vu GV, Phan PT, Chu HT, Doan LPT, Duong AT, Vuong QH, Ho MT, Nguyen MH, Nguyen HKT, Phan HT, Ha GH, Vu GT, Pham KTH, Tran TH, Tran BX, Latkin CA, Ho CSH, Ho RCM. Passive Smoking Exposure and Perceived Health Status in Children Seeking Pediatric Care Services at a Vietnamese Tertiary Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041188. [PMID: 32069825 PMCID: PMC7068483 DOI: 10.3390/ijerph17041188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 01/27/2023]
Abstract
Understanding the predictors of health conditions and exposure to secondhand smoke among children is necessary to determine the severity of the issues and identify effective solutions. Despite the significant prevalence in smoking and child exposure to secondhand smoke, there have been only a few studies focusing on this area in Vietnam, and thus the current study aims to fill in this gap. The questionnaires of 435 children aged between 0 and 6 and their caregivers, who agreed to participate in the research, were collected at the Pediatric Department of Bach Mai hospital, Hanoi, in 2016. Multivariable logistic regression was employed to identify factors associated with perceived health status and exposure to secondhand smoke among children in the last 24 h and the last 7 days from the date of the survey. Our study found that 43% of the respondents had smokers in the family, and 46.4% of children were exposed to passive smoking in the last 7 days. Urban children were most frequently exposed to passive smoking at home and in public, whereas in the rural area, the home and relatives’ houses were the most common places for exposure. Compared to children whose caregivers were farmers, children of non-government workers were more likely to be exposed to passive smoking in the last 7 days. Moreover, children in a family having smoking rules and no smokers were less likely to be exposed to passive smoking in the last 24 h and 7 days than those living in a family allowing smoking and having smokers. In conclusion, our study shows that the government needs to implement better public smoking monitoring and encourage caregivers to implement smoke-free households or smoking rules in their houses.
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Affiliation(s)
- Chau Quy Ngo
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam; (C.Q.N.); (G.V.V.); (P.T.P.)
- Respiratory Center, Bach Mai Hospital, Hanoi 10000, Vietnam; (H.T.C.); (L.P.T.D.); (A.T.D.)
| | - Giap Van Vu
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam; (C.Q.N.); (G.V.V.); (P.T.P.)
- Respiratory Center, Bach Mai Hospital, Hanoi 10000, Vietnam; (H.T.C.); (L.P.T.D.); (A.T.D.)
| | - Phuong Thu Phan
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam; (C.Q.N.); (G.V.V.); (P.T.P.)
- Respiratory Center, Bach Mai Hospital, Hanoi 10000, Vietnam; (H.T.C.); (L.P.T.D.); (A.T.D.)
| | - Hanh Thi Chu
- Respiratory Center, Bach Mai Hospital, Hanoi 10000, Vietnam; (H.T.C.); (L.P.T.D.); (A.T.D.)
| | - Lan Phuong Thi Doan
- Respiratory Center, Bach Mai Hospital, Hanoi 10000, Vietnam; (H.T.C.); (L.P.T.D.); (A.T.D.)
| | - Anh Tu Duong
- Respiratory Center, Bach Mai Hospital, Hanoi 10000, Vietnam; (H.T.C.); (L.P.T.D.); (A.T.D.)
| | - Quan-Hoang Vuong
- Centre for Interdisciplinary Social Research, Phenikaa University, Yen Nghia, Ha Dong, Hanoi 100803, Vietnam; (Q.-H.V.); (M.-T.H.)
- Faculty of Economics and Finance, Phenikaa University, Yen Nghia, Ha Dong, Hanoi 100803, Vietnam
| | - Manh-Tung Ho
- Centre for Interdisciplinary Social Research, Phenikaa University, Yen Nghia, Ha Dong, Hanoi 100803, Vietnam; (Q.-H.V.); (M.-T.H.)
- Faculty of Economics and Finance, Phenikaa University, Yen Nghia, Ha Dong, Hanoi 100803, Vietnam
| | - Minh-Hoang Nguyen
- Graduate School of Asia Pacific Studies, Ritsumeikan Asia Pacific University, Beppu, Oita 874-8577, Japan (H.-K.T.N.)
| | - Hong-Kong T. Nguyen
- Graduate School of Asia Pacific Studies, Ritsumeikan Asia Pacific University, Beppu, Oita 874-8577, Japan (H.-K.T.N.)
- Vuong & Associates Co., Hanoi 100000, Vietnam
| | - Hai Thanh Phan
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
- Correspondence: ; Tel.: +84-869-548-561
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam;
| | - Kiet Tuan Huy Pham
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (K.T.H.P.); (B.X.T.)
| | - Tung Hoang Tran
- Institute of Orthopaedic and Trauma Surgery, Vietnam-Germany Hospital, Hanoi 100000, Vietnam;
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (K.T.H.P.); (B.X.T.)
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Roger C. M. Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam;
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
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Liang HJ, Wu MJ, Jerng JS, Yang CH. Reinforcement of Tobacco Control and Reduction in Medical Utilization for Asthma in Taiwan: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3950. [PMID: 31627282 PMCID: PMC6844081 DOI: 10.3390/ijerph16203950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/26/2019] [Accepted: 10/15/2019] [Indexed: 11/21/2022]
Abstract
Environmental air quality can affect asthma control and the development of overt asthmatic manifestations. In this population-based study, we investigated the effect of reinforcing a smoking ban in Taiwan through the enactment of the Tobacco Hazards and Prevention Act (THPA) on healthcare utilization rate by asthmatics. Analysis was performed based on data relevant to non-hospitalized asthmatic patients with insurance claims between 2005 and 2013 from the National Health Insurance Research Database of Taiwan, reported data on Asian dust storms, and penalty rates for violations of the tobacco ban. Poisson regression showed that the risk for outpatient visits for asthma was lower after enactment of the THPA (RR = 0.98, 95% CI = 0.98-0.99), with a yearly trend of a reduced risk (RR = 0.99, 95% CI = 0.99-1.00), also lower in geographic regions with medium (RR = 0.79, 95% CI = 0.79-0.80) and high (RR = 0.91, 95% CI = 0.91-0.92) penalty rates. Subgroup analysis showed that asthma visit rates were reduced in both male and female groups after the enactment of the THPA. The risk of an asthma ER visit was increased after the enactment of the amended THPA (RR = 1.07, 95% CI = 1.05-1.09), although the yearly trend was not significant (RR = 1.00, 95% CI = 1.00-1.00). The risk of emergency room visits for asthma was significantly reduced in regions with medium (RR = 0.68, 95% CI = 0.68-0.69) and high (RR = 0.75, 95% CI = 0.74-0.76) penalty rates. Subgroup analysis showed that the visit rates were similar in both male and female groups. The effectiveness of reinforcing the smoking ban warrants further policies aimed at further reducing passive smoking.
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Affiliation(s)
- Huang-Ju Liang
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 108, Taiwan.
- Center for Quality Management, National Taiwan University Hospital, Taipei 100, Taiwan.
| | - Ming-Jiuan Wu
- Department of Business and Management, Ming Chi University of Technology, New Taipei City 243, Taiwan.
| | - Jih-Shuin Jerng
- Center for Quality Management, National Taiwan University Hospital, Taipei 100, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
| | - Chiang-Hsing Yang
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 108, Taiwan.
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Affiliation(s)
- Jason E Lang
- Duke University, School of Medicine, Division of Allergy, Immunology and Pulmonary Medicine, Durham, United States.
| | - Monica Tang
- Duke University, School of Medicine, Division of Allergy, Immunology and Pulmonary Medicine, Durham, United States
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14
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Smoking: it's still a big problem in children with asthma. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2019.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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15
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Leung LT, Ho SY, Wang MP, Lam TH. Secondhand Smoke From Multiple Sources, Thirdhand Smoke and Respiratory Symptoms in Hong Kong Adolescents. Nicotine Tob Res 2019; 20:192-198. [PMID: 27807126 DOI: 10.1093/ntr/ntw302] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/01/2016] [Indexed: 12/28/2022]
Abstract
Introduction Reports on involuntary tobacco smoke exposure in children have focused mostly on secondhand smoke (SHS) from smoking inside the home. We studied the separate and combined prevalence of SHS exposure from multiple sources and thirdhand smoke (THS) and the associations with respiratory symptoms in Hong Kong adolescents. Methods In 2010-2011, 61 810 Secondary 1 (US Grade 7) to seven students reported their smoking status, respiratory symptoms, and exposure to four sources of tobacco smoke in the past 7 days. Weighted prevalence of exposure was calculated. Associations with respiratory symptoms were analyzed in 50 762 never smokers using logistic regression. Results Tobacco smoke exposure at home was 23.2% considering SHS exposure from inside the home, but increased to 33.2% including SHS from neighbors and 36.2% further including THS. Including SHS outside home (55.3%), 63.3% of adolescents were exposed to SHS anywhere or THS at home. In never smokers, SHS from each source and THS at home were linearly associated with respiratory symptoms. Exposure to more sources yielded stronger associations with respiratory symptoms (p for trend<.001). The adjusted odds ratios (95% CI) were 1.04 (0.97-1.11), 1.12 (1.03-1.22), 1.40 (1.26-1.56) and 1.99 (1.74-2.28) for 1, 2, 3, and 4 sources, respectively. Conclusions Although Hong Kong's smoking prevalence is among the lowest in the developed world, over 60% of its adolescents were involuntarily exposed to tobacco smoke from one or more sources with a linear association with respiratory symptoms in never smokers. More stringent policies are needed to protect adolescents from tobacco smoke. Implications In a high-density urban setting, involuntary exposure to tobacco smoke in adolescents can be much higher than the smoking prevalence of the general population, especially if SHS exposure from multiple sources and THS are also considered. Such exposures have important health implications as demonstrated by their linear associations with respiratory symptoms. Tobacco control measures effective in reducing smoking prevalence may have little effect in reducing adolescent exposure to tobacco smoke, especially in the private home, in which other public health strategies are urgently needed.
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Affiliation(s)
- Lok Tung Leung
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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16
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Northrup TF, Stotts AL, Suchting R, Khan AM, Green C, Quintana PJE, Hoh E, Hovell MF, Matt GE. Medical staff contributions to thirdhand smoke contamination in a neonatal intensive care unit. Tob Induc Dis 2019; 17:37. [PMID: 31516480 PMCID: PMC6662774 DOI: 10.18332/tid/106116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Non-smoking policies are strictly enforced in neonatal intensive care units (NICUs), which may still become contaminated by thirdhand smoke (THS), posing potential health risks to medically fragile infants. Study aims were to explore contamination routes by characterizing nicotine levels (THS proxy) found on the fingers of NICU medical staff and to assess finger-nicotine correlates. METHODS NICU medical staff were surveyed regarding smoking and electronic nicotine devices (ENDS) use/exposure, and household characteristics. Approximately 35% of staff were randomly selected for a finger-nicotine wipe. Three separate quantile regressions modeled percentiles associated with: presence of any finger nicotine, finger-nicotine levels above the median field blank level (i.e. 0.377 ng/wipe), and finger-nicotine levels two times the median blank. RESULTS The final sample size was 246 (n=260 approached; n=14 refusals). Over three-quarters (78.5%) reported some exposure to tobacco smoke or ENDS vapor/aerosols. After field-blank adjustments, the median nicotine level (ng/finger wipe) was 0.232 (IQR: 0.021–0.681) and 78.3% of medical staff had measurable finger-nicotine levels. Both being near smoking in friends’/family members’ homes and finger-surface area were related to elevated finger-nicotine levels (p<0.05) in the median blank model. CONCLUSIONS Almost four in five NICU staff had measurable finger nicotine, with finger surface area and frequency of reported exposure to tobacco smoke in friends’/family members’ homes emerging as important correlates. Future research will determine the impact of THS on NICU infants. Medical personnel working in a NICU should be cognizant of secondhand smoke and THS, particularly inside friends’/family members’ homes, to reduce potential NICU contamination and infant exposures.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Angela L Stotts
- Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States.,Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Amir M Khan
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Charles Green
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States.,Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, United States
| | - Penelope J E Quintana
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, United States
| | - Eunha Hoh
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, United States
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, San Diego, United States
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, United States
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Public Facility Utility and Third-Hand Smoking Exposure without First and Second-Hand Smoking According to Urinary Cotinine Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050855. [PMID: 30857230 PMCID: PMC6427616 DOI: 10.3390/ijerph16050855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 01/09/2023]
Abstract
Third-hand smoke (THS) causes pathological changes in the liver, lungs, and skin. THS exposure can be ubiquitous, chronic, and unconscious. However, little is known about THS exposure in public facilities and its susceptible population. This paper aimed to identify which public facilities and socio-demographic groups were especially vulnerable to THS. Data from 1360 adults obtained from Korean National Environmental Health Survey I (2009–2011) were analyzed. To study the sole effect of THS, we restricted the study population to those participants who had never smoked and who had no exposure to second-hand smoke. The assessed variables included the type and frequency of public transportation, frequency of use of 12 different public facilities, and 8 socio-demographic factors. Urinary cotinine was used as a biomarker. T-tests and analysis of variance were used for univariate analyses, while generalized linear regression was used for multivariate analysis. Frequent use of public transportation, bars, internet cafés, and participants with low levels of education, divorced or bereaved, living in multi-unit houses, and with smokers within the family were associated with significantly high urinary cotinine levels. These findings indicate that the frequent use of public transportation, certain public facilities and certain socio-demographic factors can result in high THS exposure.
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Díez-Izquierdo A, Cassanello-Peñarroya P, Lidón-Moyano C, Matilla-Santander N, Balaguer A, Martínez-Sánchez JM. Update on thirdhand smoke: A comprehensive systematic review. ENVIRONMENTAL RESEARCH 2018; 167:341-371. [PMID: 30096604 DOI: 10.1016/j.envres.2018.07.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The objective of this study is to perform a comprehensive review of the literature about thirdhand smoke (THS). METHODS Systematic review of all aspects of THS. Standard methodological procedures were used to search the following databases through April 2018: MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science (WOS) in Indo-European languages. To identify published grey literature, the first 200 hits from Google Scholar™ were evaluated. Clinical trial databases, conference proceedings, and reference lists from the identified articles were also searched. Two unblinded review authors independently assessed trials for inclusion in the review. These same reviewers also extracted study data in accordance with PRISMA guidelines. The study protocol was registered with PROSPERO (CRD42018083619). RESULTS Sixty-eight articles were included in this systematic review. Of these, 28 analyzed the concentration of nicotine as a component of THS (the most commonly-used method to measure THS in those studies was chromatography, followed by the mass spectrometry), 21 evaluated the exposure and impact of THS on health (11 studies analyzed the effect of THS in cells [human and animal], 4 in animals, 1 in adults, and 5 in children), 16 investigated the beliefs, behaviours, and policies related to THS, and 3 evaluated other aspects such as THS in e-cigarettes or hookahs. In these 68 studies, THS was determined by measuring the following components: nicotine (30 studies), nitrosamines (17 studies) and cotinine (15 studies). The findings from most of these studies suggest a potential health impact of THS exposure (i.e.: cytotoxicity, metabolic alterations in metabolism, in glycemia; or cell structure; alterations in liver, lung, skin and behaviour in mice), and low awareness about the risks of THS among the general population. CONCLUSIONS Numerous specific biomarkers of THS were evaluated, with the most common being nicotine, nitrosamines, and cotinine. The most common method of preparing THS dust samples were cotton wipes, while chromatography, used alone or coupled with mass spectrometry, was the most common analytical technique. We have tried to establish common bases after reviewing all the current literature of the THS although, there is great heterogeneity between the studies and we have not always succeeded. The studies in this review demonstrate the harmful effects of THS on health in cells, in animal models, and in people including children. However, in people, the long-term effects remain unknown and more research is needed. These studies show that knowledge about THS and its potential harmful effects are poorly understood among the general population. For this reason, THS should receive greater emphasis in education and awareness policies.
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Affiliation(s)
- Ana Díez-Izquierdo
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Pia Cassanello-Peñarroya
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Lidón-Moyano
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Nuria Matilla-Santander
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Albert Balaguer
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M Martínez-Sánchez
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
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Díez-Izquierdo A, Cassanello P, Cartanyà A, Matilla-Santander N, Balaguer Santamaria A, Martinez-Sanchez JM. Knowledge and attitudes toward thirdhand smoke among parents with children under 3 years in Spain. Pediatr Res 2018; 84:645-649. [PMID: 30194415 DOI: 10.1038/s41390-018-0153-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/31/2018] [Accepted: 08/08/2018] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The knowledge and beliefs about what is thirdhand smoke (THS) are limited. Our objective is to characterize the knowledge and beliefs about THS in parents of children under 3 years old in Spain. METHODS A cross-sectional study (n = 1406 parents) was conducted online in 2017. We collected information about the knowledge of THS given later, written information with the definition of THS, and asking about beliefs of the effects of THS on children's health. RESULTS A total of 27% of the respondents had heard about THS. We only found significant differences among smoking status, being the smokers who declare higher knowledge about THS. A total of 86% of the respondents believed that THS is harmful to their children with statistically significant differences according to educational level, higher among parents with a university degree (ORa = 2.6), and according to the previous knowledge on THS (ORa = 2.1). CONCLUSIONS This is the first study in Europe to describe the knowledge and belief of THS. Around 3 out of 10 parents have heard about THS and more than 8 out of 10 parents believed that THS is harmful to their children. Currently, they were not aware of THS but after providing brief information about it, most of them agreed that THS exposure is harmful to their children.
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Affiliation(s)
- Ana Díez-Izquierdo
- Pediatrics Department, Hospital Universitari General de Catalunya (HUGC), Sant Cugat del Vallès, Spain
| | - Pia Cassanello
- Pediatrics Department, Hospital Universitari General de Catalunya (HUGC), Sant Cugat del Vallès, Spain
| | - Aurea Cartanyà
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya (UIC-Barcelona), Sant Cugat del Vallès, Spain
| | - Núria Matilla-Santander
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya (UIC-Barcelona), Sant Cugat del Vallès, Spain
| | - Albert Balaguer Santamaria
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya (UIC-Barcelona), Sant Cugat del Vallès, Spain
| | - Jose M Martinez-Sanchez
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya (UIC-Barcelona), Sant Cugat del Vallès, Spain.
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AlOtaibi E, AlAteeq M. Knowledge and practice of parents and guardians about childhood asthma at King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia. Risk Manag Healthc Policy 2018; 11:67-75. [PMID: 29713207 PMCID: PMC5907886 DOI: 10.2147/rmhp.s143829] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Family management of asthmatic children is affected by several factors, primarily the parent’s knowledge and attitude toward asthma. Objective The aim of this study was to explore the knowledge and practice of parents and guardians about asthma in their children. Methods Two hundred and thirty-one self-administered questionnaires were distributed to parents and guardians attending, with their children, general pediatric and pediatric pulmonology outpatient clinics at King Abdullah Specialist Children’s Hospital, King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia, during the period from August 2016 to March 2017. Results Most of the participants (79.6%) have moderate knowledge. The mean of total knowledge was found to be higher among mothers compared with other groups (p=0.019). Most participants (88.3%) reported providing asthma treatment regularly and 61.9% visited the clinic regularly. Almost half of the participants have misconceptions about asthma medications. During acute asthma attacks, more than half of the participants (54.5%) massaged their child’s chest or back, and 52.4% provided the child homemade or herbal remedies. Conclusion This study revealed a moderate level of knowledge about asthma among the parents and guardians of asthmatic children, but poor knowledge about asthma medications. For better control of asthma, more effort is needed to educate caregivers and to enhance their awareness about asthma and highlight the misconceptions about asthma medications at both hospital level and community level.
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Affiliation(s)
- Eman AlOtaibi
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Department of Family Medicine and Primary Health Care, Riyadh, Saudi Arabia
| | - Mohammed AlAteeq
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Department of Family Medicine and Primary Health Care, Riyadh, Saudi Arabia
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Figueiró LR, Linden R, Ziulkoski AL, Dantas DCM. Cellular effects of thirdhand tobacco smoke from smokers’ homes. Toxicol Mech Methods 2017; 28:243-251. [DOI: 10.1080/15376516.2017.1411411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | - Rafael Linden
- Toxicology Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, Brazil
| | - Ana Luiza Ziulkoski
- Cytotoxicity Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, Brazil
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Delgado-Rendon A, Boley Cruz T, Soto D, Baezconde-Garbanati L, Unger JB. Second and Thirdhand Smoke Exposure, Attitudes and Protective Practices: Results from a Survey of Hispanic Residents in Multi-unit Housing. J Immigr Minor Health 2017; 19:1148-1155. [PMID: 28074306 PMCID: PMC7453492 DOI: 10.1007/s10903-016-0540-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Secondhand and third hand smoke (SHS, THS) exposure is prevalent in multi-unit housing (MUH). Minorities and low-income MUH residents are disproportionally exposed to SHS and THS compared to other populations. This study describes the characteristics, attitudes, knowledge, and behaviors related to SHS, THS and marijuana smoke exposure (MSHS) of a sample of Hispanic tenants in randomly selected MUH units in eastern metro Los Angeles (n = 402). Although most participants (97%) banned smoking inside their homes, 80% reported infiltration of SHS inside their apartments within the last year. Most (85%) favored a complete ban on smoking in apartment buildings. Twenty-eight percent did not know that marijuana (MSHS) smoke exposure is also harmful to their health. Knowledge scores were higher among Spanish-speakers (p < 0.05). Given the interpersonal barriers to advocating for change, widespread policy and communication interventions are also necessary to protect Hispanic MUH residents' rights to clean air in their living space.
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Affiliation(s)
- Angelica Delgado-Rendon
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Daniel Soto
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Lourdes Baezconde-Garbanati
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
| | - Jennifer B. Unger
- Department of Preventive Medicine, Keck School of Medicine, Institute for Prevention Research, University of Southern California, 2001N. Soto Ave., Los Angeles, CA 90034, USA
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Yilmaz O, Turkeli A, Onur E, Bilge S, Yuksel H. Secondhand tobacco smoke and severity in wheezing children: Nasal oxidant stress and inflammation. J Asthma 2017; 55:477-482. [PMID: 28881145 DOI: 10.1080/02770903.2017.1350970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Prenatal and postnatal smoke exposures are associated with many lung diseases in children due to impaired lung function, increased inflammation, and oxidative stress. We aimed to determine the influence of secondhand tobacco smoke exposure on the levels of nasal glutathione, IL-8, IL-17, MMP-9, and TIMP-1, as well as serum surfactant protein-D (SP-D) in wheezy children. METHODS We enrolled 150 children with recurrent wheezing and recorded wheezing characteristics at enrollment. We measured the levels of serum cotinine, SP-D, nasal glutathione, IL-8, IL-17, MMP-9, and TIMP-1. Serum cotinine levels between 3 and 12 ng/mL, and above 12 ng/mL were defined as lower and higher level secondhand tobacco smoke exposure, respectively. The ANOVA test, Pearson's correlation analysis and multivariate analysis with a linear regression test were used for the statistical analysis. RESULTS Ninety-one children had been exposed to lower level secondhand tobacco smoke, while 24 children were exposed to higher level secondhand tobacco smoke. Thirty-five children were not exposed to cigarette smoke. Wheezing symptom scores were higher in exposed children (p = 0.03). Levels of other biomarkers showed no significant difference. CONCLUSIONS Secondhand tobacco smoke exposure is associated with more severe respiratory symptoms in wheezing children. However, levels of nasal or serum inflammatory markers fail to explain this association, either because of different mechanical factors in the process or due to low levels of the biomarkers especially in nasal secretions.
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Affiliation(s)
- Ozge Yilmaz
- a Department of Pediatric Allergy and Pulmonology , Celal Bayar University Medical Faculty , Manisa , Turkey
| | - Ahmet Turkeli
- a Department of Pediatric Allergy and Pulmonology , Celal Bayar University Medical Faculty , Manisa , Turkey
| | - Ece Onur
- b Department of Biochemistry , Celal Bayar University Medical Faculty , Manisa , Turkey
| | - Sema Bilge
- b Department of Biochemistry , Celal Bayar University Medical Faculty , Manisa , Turkey
| | - Hasan Yuksel
- a Department of Pediatric Allergy and Pulmonology , Celal Bayar University Medical Faculty , Manisa , Turkey
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Figueiró LR, Ziulkoski AL, Dantas DCM. Thirdhand smoke: when the danger is more than you can see or smell. CAD SAUDE PUBLICA 2016; 32:e00032216. [PMID: 27925021 DOI: 10.1590/0102-311x00032216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/24/2016] [Indexed: 11/21/2022] Open
Abstract
Recent discussion has focused on another form of exposure to tobacco - thirdhand smoke (THS) - consisting of residual pollutants from cigarette smoke that remain in environments. The main concern with THS is based on the presence and persistence of many toxic compounds, some specific nitrosamines from tobacco that have carcinogenic activity. Little is known about THS, and few people are aware of its existence and potential health repercussions, thus highlighting the need to shed light on the subject and incorporate it into the public health debate, as was done with passive smoking several years ago. THS is a form of passive smoking, together with secondary or involuntary exposure to cigarette smoke. Recentemente, passou a ser discutida mais uma forma de exposição ao tabaco - thirdhand smoke (THS) - que consiste nos poluentes residuais da fumaça de cigarro que permanecem nos ambientes. A principal preocupação com o THS é embasada na presença e longa persistência de muitos compostos tóxicos, algumas nitrosaminas específicas do tabaco que têm atividade carcinogênica. Além de se saber pouco sobre o THS, poucos sabem de sua existência e preocupante repercussão na saúde. Coloca-se em destaque a necessidade de trazê-lo à luz e incluí-lo nas discussões, assim como foi feito com o tabagismo passivo alguns anos atrás, até mesmo porque o THS se caracteriza como uma forma de tabagismo passivo junto à exposição secundária ou involuntária da fumaça de cigarro.
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Figueiró LR, Dantas DCM, Linden R, Ziulkoski AL. Thirdhand tobacco smoke: procedures to evaluate cytotoxicity in cell cultures. Toxicol Mech Methods 2016; 26:355-61. [PMID: 27268319 DOI: 10.1080/15376516.2016.1188190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The risks associated to tobacco smoking are not ceased with smoke extinction. Many toxic compounds remain in the environment after the cigarette is extinguished and accumulated in the air or on surfaces. However, little is known about the risks of this exposure. The aim of this study was to evaluate procedures to collect thirdhand smoke (THS) and prepare the samples to perform three in vitro toxicity tests. Cellulose papers and cotton wipes were used to impregnate with nicotine solution and smoke cigarette in a chamber or in smoker's home. Samples were immersed in methanol or Dulbecco's modified Eagle's medium (DMEM) to expose Hep-2 cells. MTT, neutral red uptake (NRU) and trypan blue assays were performed. The concentration of nicotine in DMEM extract of THS in paper and cotton was similar to those in methanol extract (p > 0.05). Alterations in the mitochondrial and lysosomal functions were found in both paper and cotton samples; however, the cytotoxic effect was not always observed. There was a decrease of 21-31% in MTT assay and 38-56% in NRU assay (p < 0.003). There was a dose-response relationship between the amount of cigarettes and lysosomal viability; the correlation was higher for cotton samples (r = -0.843, p < 0.001). As a dose-response relationship was found only in NRU assay, this test may be a more suitable choice rather than the MTT assay. Paper and wipe sampling can be reliable markers of tobacco smoke contamination. Moreover, these materials, if properly prepared, can be used as substrate providers to perform cellular assays.
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Affiliation(s)
- Luciana Rizzieri Figueiró
- a Graduate Program in Pathology , Federal University of Health Sciences of Porto Alegre (UFCSPA) , Porto Alegre , RS , Brazil
| | | | - Rafael Linden
- c Toxicology Laboratory , Institute of Health Sciences, Feevale University , Novo Hamburgo , RS , Brazil
| | - Ana Luiza Ziulkoski
- d Cytotoxicity Laboratory , Institute of Health Sciences, Feevale University , Novo Hamburgo , RS , Brazil
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Northrup TF, Jacob P, Benowitz NL, Hoh E, Quintana PJ, Hovell MF, Matt GE, Stotts AL. Thirdhand Smoke: State of the Science and a Call for Policy Expansion. Public Health Rep 2016; 131:233-8. [PMID: 26957657 PMCID: PMC4765971 DOI: 10.1177/003335491613100206] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Thomas F. Northrup
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Family and Community Medicine, Houston, TX
| | - Peyton Jacob
- University of California San Francisco, Departments of Medicine and Psychiatry, San Francisco, CA
- San Francisco General Hospital Medical Center, Division of Clinical Pharmacology, San Francisco, CA
| | - Neal L. Benowitz
- University of California San Francisco, Departments of Medicine and Bioengineering & Therapeutic Sciences, San Francisco, CA
| | - Eunha Hoh
- San Diego State University, Graduate School of Public Health, Division of Environmental Health, San Diego, CA
| | - Penelope J.E. Quintana
- San Diego State University, Graduate School of Public Health, Division of Environmental Health, San Diego, CA
| | - Melbourne F. Hovell
- San Diego State University, Graduate School of Public Health, Center for Behavioral Epidemiology and Community Health, San Diego, CA
| | - Georg E. Matt
- San Diego State University, Department of Psychology, San Diego, CA
| | - Angela L. Stotts
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Family and Community Medicine, Houston, TX
- UTHealth McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX
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Northrup TF, Khan AM, Jacob P, Benowitz NL, Hoh E, Hovell MF, Matt GE, Stotts AL. Thirdhand smoke contamination in hospital settings: assessing exposure risk for vulnerable paediatric patients. Tob Control 2015; 25:619-623. [PMID: 26635031 DOI: 10.1136/tobaccocontrol-2015-052506] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/07/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Tobacco has regained the status of the world's number two killer behind heart/vascular disease. Thirdhand smoke (THS) residue and particles from secondhand smoke (SHS) are suspected health hazards (eg, DNA damage) that are likely to contribute to morbidity and mortality, especially in vulnerable children. THS is easily transported and deposited indoors, where it persists and exposes individuals for months, creating potential health consequences in seemingly nicotine-free environments, particularly for vulnerable patients. We collected THS data to estimate infant exposure in the neonatal ICU (NICU) after visits from household smokers. Infant exposure to nicotine, potentially from THS, was assessed via assays of infant urine. METHODS Participants were mothers who smoked and had an infant in the NICU (N=5). Participants provided surface nicotine samples from their fingers, infants' crib/incubator and hospital-provided furniture. Infant urine was analysed for cotinine, cotinine's major metabolite: trans-3'-hydroxycotinine (3HC) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a metabolite of the nicotine-derived and tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). RESULTS Incubators/cribs and other furniture had detectable surface nicotine. Detectable levels of cotinine, 3HC and NNAL were found in the infants' urine. DISCUSSION THS appears to be ubiquitous, even in closely guarded healthcare settings. Future research will address potential health consequences and THS-reduction policies. Ultimately, hospital policies and interventions to reduce THS transport and exposure may prove necessary, especially for immunocompromised children.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth) Medical School, Houston, Texas, USA
| | - Amir M Khan
- Department of Pediatrics, UTHealth Medical School; Medical Director Level III NICU, Children's Memorial Hermann Hospital, Houston, Texas, USA
| | - Peyton Jacob
- Departments of Medicine and Psychiatry, University of California San Francisco; Division of Clinical Pharmacology, San Francisco General Hospital Medical Center, San Francisco, California, USA
| | - Neal L Benowitz
- Departments of Medicine and Bioengineering & Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA
| | - Eunha Hoh
- Division of Environmental Health, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Angela L Stotts
- Department of Family and Community Medicine, Department of Psychiatry and Behavioral Sciences, UTHealth Medical School, Houston, Texas, USA
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Xu B, Chen M, Yao M, Ji X, Mao Z, Tang W, Qiao S, Schick SF, Mao JH, Hang B, Xia Y. Metabolomics reveals metabolic changes in male reproductive cells exposed to thirdhand smoke. Sci Rep 2015; 5:15512. [PMID: 26489853 PMCID: PMC4614949 DOI: 10.1038/srep15512] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 09/24/2015] [Indexed: 11/09/2022] Open
Abstract
Thirdhand smoke (THS) is a new term for the toxins in cigarette smoke that linger in the environment long after the cigarettes are extinguished. The effects of THS exposure on male reproduction have not yet been studied. In this study, metabolic changes in male germ cell lines (GC-2 and TM-4) were analyzed after THS treatment for 24 h. THS-loaded chromatography paper samples were generated in a laboratory chamber system and extracted in DMEM. At a paper: DMEM ratio of 50 μg/ml, cell viability in both cell lines was normal, as measured by the MTT assay and markers of cytotoxicity, cell cycle, apoptosis and ROS production were normal as measured by quantitative immunofluorescence. Metabolomic analysis was performed on methanol extracts of GC-2 and TM-4 cells. Glutathione metabolism in GC-2 cells, and nucleic acid and ammonia metabolism in TM-4 cells, was changed significantly by THS treatment. RT-PCR analyses of mRNA for enzyme genes Gss and Ggt in GC-2 cells, and TK, SMS and Glna in TM-4 cells reinforced these findings, showing changes in the levels of enzymes involved in the relevant pathways. In conclusion, exposure to THS at very low concentrations caused distinct metabolic changes in two different types of male reproductive cell lines.
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Affiliation(s)
- Bo Xu
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Minjian Chen
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Mengmeng Yao
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xiaoli Ji
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhilei Mao
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Wei Tang
- Department of Endocrinology, Jiangsu Province Official Hospital, Nanjing Medical University, Nanjing 210024, China
| | - Shanlei Qiao
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Suzaynn F. Schick
- Department of Medicine, Division of Occupational and Environmental Medicine, University of California, San Francisco, CA 94143, USA
| | - Jian-Hua Mao
- Department of Cancer & DNA Damage Responses, Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Bo Hang
- Department of Cancer & DNA Damage Responses, Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
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Northrup TF, Matt GE, Hovell MF, Khan AM, Stotts AL. Thirdhand Smoke in the Homes of Medically Fragile Children: Assessing the Impact of Indoor Smoking Levels and Smoking Bans. Nicotine Tob Res 2015; 18:1290-8. [PMID: 26315474 DOI: 10.1093/ntr/ntv174] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 08/05/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Thirdhand smoke (THS) residue results from secondhand smoke, and is emerging as a distinct public health hazard, particularly for medically fragile pediatric patients living with smokers. THS is difficult to remove and readily reacts with other pollutants to form carcinogens and ultrafine particles. This study investigated THS found in homes of high-risk infants admitted to a neonatal intensive care unit and their association with characteristics (eg, number of household smokers) hypothesized to influence THS. METHODS Baseline data from 141 hospitalized infants' homes were analyzed, along with follow-up data (n = 22) to explore household smoking characteristics and THS changes in response to indoor smoking ban policies. RESULTS Households with an indoor ban, in which not more than 10 cigarettes/d were smoked, had the lowest levels of THS contamination compared to homes with no ban (P < .001) and compared to homes with an indoor ban in which greater numbers of cigarettes were smoked (P < .001). Importantly, homes with an indoor ban in which at least 11 cigarettes/d were smoked were not different from homes without a ban. The follow-up sample of 22 homes provided initial evidence indicating that, unless a ban was implemented, THS levels in homes continued to increase over time. CONCLUSIONS Preliminary longitudinal data suggest that THS may continue to accumulate in homes over time and household smoking bans may be protective. However, for homes with high occupant smoking levels, banning indoor smoking may not be fully adequate to protect children from THS. Unless smoking is reduced and bans are implemented, medically fragile children will be exposed to the dangers of THS.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, University of Texas Medical School at Houston, Houston, TX;
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA
| | - Melbourne F Hovell
- School of Public Health, Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA
| | - Amir M Khan
- Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX
| | - Angela L Stotts
- Department of Family and Community Medicine, University of Texas Medical School at Houston, Houston, TX; Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston, Houston, TX
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O'Brien E, Spiess PC, Habibovic A, Hristova M, Bauer RA, Randall MJ, Poynter ME, van der Vliet A. Inhalation of the reactive aldehyde acrolein promotes antigen sensitization to ovalbumin and enhances neutrophilic inflammation. J Immunotoxicol 2015; 13:191-7. [PMID: 25875327 DOI: 10.3109/1547691x.2015.1033571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acrolein (ACR), an α,β-unsaturated aldehyde and a major component of tobacco smoke, is a highly reactive electrophilic respiratory irritant implicated in asthma pathogenesis and severity. However, few studies have directly investigated the influence of ACR exposure on allergen sensitization and pulmonary inflammation. The present study was designed to examine the impact of ACR inhalation on allergic sensitization to the inhaled antigen ovalbumin (OVA), as well as pulmonary inflammation during subsequent OVA challenge. Adult male C57BL/6 mice were exposed to inhaled OVA (1%, 30 min/day, 4 days/week) and/or ACR (5 ppm, 4 h/day, 4 days/week) over 2 weeks and subsequently challenged with aerosolized OVA (1%, 30 min/day) over three consecutive days. Serum anti-OVA IgG1 levels were increased significantly in animals exposed to both OVA and ACR, compared to animals exposed to either OVA or ACR alone. In addition, differential cell counts and histological analysis revealed an increase in BAL neutrophils in animals exposed to both OVA and ACR. However, exposure to both OVA and ACR did not influence mRNA expression of the cytokines il5, il10, il13 or tnfa, but significantly increased mRNA expression of ccl20. Moreover, ACR exposure enhanced lung mRNA levels of il17f and tgfb1, suggesting development of enhanced inhalation tolerance to OVA. Overall, the findings indicate that ACR inhalation can promote airway-mediated sensitization to otherwise innocuous inhaled antigens, such as OVA, but also enhances immune tolerance, thereby favoring neutrophilic airway inflammation.
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Affiliation(s)
| | | | | | | | | | | | - Matthew E Poynter
- b Department of Medicine , College of Medicine, University of Vermont , Burlington , VT , USA
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Kalliola S, Pelkonen AS, Malmberg LP, Sarna S, Hämäläinen M, Mononen I, Mäkelä MJ. Maternal smoking affects lung function and airway inflammation in young children with multiple-trigger wheeze. J Allergy Clin Immunol 2013; 131:730-5. [PMID: 23380219 DOI: 10.1016/j.jaci.2013.01.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 01/11/2013] [Accepted: 01/11/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Exposure to tobacco smoke is a well-known risk factor for childhood asthma and reduced lung function, but the effect on airway inflammation in preschool-aged children is unclear. OBJECTIVE To examine the effect of parental smoking on lung function and fractional concentration of exhaled nitric oxide (Feno) in relation to both parental reports and children's urine cotinine concentrations in preschool-aged children with multiple-trigger wheeze. METHODS A total of 105 3- to 7-year-old children with multiple-trigger wheeze and lung function abnormalities were recruited. Lung function was assessed by impulse oscillometry, and Feno measurements were performed. Exposure to tobacco smoke was determined by parental reports and measurement of children's urinary cotinine concentrations. RESULTS Forty-three percent of the children were exposed to environmental tobacco smoke according to parental reports. The Feno level was significantly higher in children with a smoking mother (n = 27) than in children with a nonsmoking mother (23.4 vs 12.5 ppb, P = .006). The Feno level expressed as z score and the cotinine level correlated significantly (P = .03). Respiratory resistance at 5 Hz was higher in children exposed to maternal smoking than in others (0.99 vs 0.88 kPas/L, P = .005). Urinary cotinine concentrations reflected well parental reports on their daily smoking and increased relative to the number of cigarettes smoked in the family (P < .01). Atopy was found in 75% of the children, but it was not associated with the Feno value (P = .65). CONCLUSION Maternal smoking was associated with increased Feno value and poorer lung function in steroid-naive preschool children with multiple-trigger wheeze. Larger controlled trials are needed to generalize the results.
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Affiliation(s)
- Satu Kalliola
- Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland.
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Woodgate RL, Kreklewetz CM. Youth's narratives about family members smoking: parenting the parent- it's not fair! BMC Public Health 2012; 12:965. [PMID: 23140551 PMCID: PMC3503740 DOI: 10.1186/1471-2458-12-965] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 11/06/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Successful cancer prevention policies and programming for youth must be based on a solid understanding of youth's conceptualization of cancer and cancer prevention. Accordingly, a qualitative study examining youth's perspectives of cancer and its prevention was undertaken. Not surprisingly, smoking (i.e., tobacco cigarette smoking) was one of the dominant lines of discourse in the youth's narratives. This paper reports findings of how youth conceptualize smoking with attention to their perspectives on parental and family-related smoking issues and experiences. METHODS Seventy-five Canadian youth ranging in age from 11-19 years participated in the study. Six of the 75 youth had a history of smoking and 29 had parents with a history of smoking. Youth were involved in traditional ethnographic methods of interviewing and photovoice. Data analysis involved multiple levels of analysis congruent with ethnography. RESULTS Youth's perspectives of parents and other family members' cigarette smoking around them was salient as represented by the theme: It's not fair. Youth struggled to make sense of why parents would smoke around their children and perceived their smoking as an unjust act. The theme was supported by four subthemes: 1) parenting the parent about the dangers of smoking; 2) the good/bad parent; 3) distancing family relationships; and 4) the prisoner. Instead of being talked to about smoking it was more common for youth to share stories of talking to their parents about the dangers of smoking. Parents who did not smoke were seen by youth as the good parent, as opposed to the bad parent who smoked. Smoking was an agent that altered relationships with parents and other family members. Youth who lived in homes where they were exposed to cigarette smoke felt like a trapped prisoner. CONCLUSIONS Further research is needed to investigate youth's perceptions about parental cigarette smoking as well as possible linkages between youth exposed to second hand smoke in their home environment and emotional and lifestyle-related health difficulties. Results emphasize the relational impact of smoking when developing anti-tobacco and cancer prevention campaigns. Recognizing the potential toll that second-hand smoke can have on youth's emotional well-being, health care professionals are encouraged to give youth positive messages in coping with their parents' smoking behaviour.
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Affiliation(s)
- Roberta L Woodgate
- Faculty of Nursing, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada
| | - Christine M Kreklewetz
- Faculty of Nursing, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada
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