ENVIRONMENTAL
TOBACCO SMOKE A RISK FOR PEDIATRIC ASTHMA
Mona El
Ganzoury, Karima Abd El Khalik
Ain Shams
University Pediatric Dept., Cairo, Egypt
The effect of parentral smoking on the
well being of infants and children is an important public health concern.
50 passively smoking children of which at least one of their parents was a
chronic smoker were include in the present study. Their aged ranged between
5-15 years. Exposure to cigarette smoke was recognized from the personal
history and was confirmed by measurement of urinary cotinine (the major
metabolite of nicotine in urine). To asses bronchial hyperactivity (BHR)
metacholine (MCH) challenge test was done by the use of dosimeter.
Pulmonary function tests were performed before and after MCH challenge
test. Challenge test was stopped when there was a reduction in the forced
expiratory volume in one second (FEV1) by 20% from the baseline, or when
the maximum concentration of MCH was reached (25mg/ml). In the present
study non of our patient had clinical evidence of although non of our
patient had clinical evidence of asthma, 34 out of 50 patients were found
to have BHR (68%). Fourteen children out of those 34 did not perform
challenge test as they had basal BHR, 20 children showed positive MCH challenge
at different concentrations. There was a significant relation between BHR,
20 of children showed positive MCH challenge at different concentrations.
There was a significant relation between BHR and number of smoked
cigarettes (P< 0.001). Also there was a relation between mean FEV1
reduction as well as (CD) of MCH and number of smoked cigarettes by the
parents (P< 0.05 and P < 0.0001). The duration of exposure to tobacco
smokes was found to be of great significance in influencing children lung
function. The longer the duration of exposure, influencing the more
severely was the affected child`s lung functions. There was a significant
relation (P <0.05) between the mean percent of FEV1 reduction and
duration of exposure. There was a significant relation between CD of
Metacholine and duration of exposure as well (P<0.001). In conclusion:
the present study demonstrated that passively smoking children had
subclinical hyperreactivity with various grades, and some of them may turn
to be asthmatics. Pulmonary functions of the passive smokers depend on
multifactors in particular, number of smoked cigarettes and duration of
exposure to tobacco smoke. Health education programmes to explain the
hazardous effect of smoke to both active and passive smokers are highly recommended.
We also recommended routine examination of passive smokers by MCH challenge
test at regular intervals to detect asthmatic patients as early as
possible.