Article

Children and Secondhand Smoke: Clear Evidence for Action

aAAP Tobacco Consortium and AAP Julius B. Richmond Center of Excellence, Elk Grove Village, Illinois
PEDIATRICS (Impact Factor: 5.47). 12/2011; 129(1):170-1. DOI: 10.1542/peds.2011-3190
Source: PubMed
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    • "Of all deaths attributable to second-hand tobacco smoke, 31% occur among children(WHO 2009).Second hand smoking significantly contributes to morbidity including bronchitis, middle ear disease, impaired endothelial function and acute respiratory illness and asthma illness. Children as a group have shown the strongest evidence of harm attributable to SHS(Singh and Lal 2011, White et al 2012, Sims et al 2012, Lin et al 2010, Moritsugu 2007, Tanski and Wilson2012).Second-hand tobacco smoke is present in virtually all public places where smoking is permitted, and there is no safe level of exposure. With the widespread establishment of smoke-free workplaces and public venues, the home is becoming the predominant source of exposure to second-hand smoke (SHS) among children in the household. "

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    ABSTRACT: Polycyclic aromatic hydrocarbons (PAHs) are generated during pyrolysis of organic material. Exposure to these ubiquitous environmental contaminants is a public health problem in cities with high industrial activity and vehicular traffic as well as in rural areas due to biomass combustion. An estimate of 90% of rural populations in developing countries uses biomass as energy source, where PAH exposure can be extremely high by means of their main exposure biomarker, 1-hydroxipyrene (1-OHP) in urine. Critical scenarios in children have shown PAH levels as high as 17 µmol 1-OHP/mol creatinine. Another disturbing PAH source for children is indoor exposure to smoke from smoking parents. PAHs are human carcinogen compounds and infant populations are most vulnerable to their toxicity, highlighting the risk at which they are exposed. The genotoxic properties of PAHs are mediated by their metabolism generating reactive metabolites that interact with DNA. Several biomarkers of DNA damage such as increased frequencies of chromosomal aberrations and micronucleus, and hemoglobin and DNA adducts have been reported in children and newborns exposed to airborne pollutants. Furthermore, epidemiological studies have found increased risk of leukemia and nervous system tumors in children with high exposure to environmental pollution and research has suggested that cancer susceptibility is higher if the exposure to carcinogenic compounds occurs during fetal and childhood periods. To date, there are no PAH exposure limits to protect general population´s health, and unfortunately, in most developing countries there are no strict regulations to control environmental pollutants that additionally put at risk children´s health.
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    ABSTRACT: El tabaquismo pasivo, sobre todo en el niño, es un problema importante de salud pública. Las consecuencias deletéreas de la inhalación pasiva del humo del tabaco (IPHT) son máximas durante la infancia y no afectan sólo a la esfera respiratoria. El tabaquismo durante el embarazo puede producir modificaciones de los programas de desarrollo porque interactúa con los niveles de transcripción de genes modulando el funcionamiento de numerosos sistemas. El cerebro y el pulmón son los objetivos potenciales de esta agresión que compromete el pronóstico vital de los niños (incremento del riesgo de muerte súbita inexplicable) y sus capacidades de desarrollo neurológicas (alteraciones cognitivas). De los factores de riesgo de enfermedades respiratorias en pediatría (asma, bronquiolitis), el tabaquismo pasivo es, sin duda, el factor que influye de manera más determinante tanto en la frecuencia de la enfermedad como en su gravedad. A más largo plazo, resultan muy preocupantes los problemas de adicción, de consumo de psicótropos, los déficits de atención y los retrasos escolares. Cabe la posibilidad de que la inducción de lesiones intimales arteriales pueda estar ligada a la IPHT. El incremento de los riesgos de infección de las vías respiratorias es responsable de una mayor morbilidad de los niños de padres fumadores, con un coste sanitario no desdeñable. Se debe hacer todo lo posible para prevenir la IPHT. Las distintas medidas gubernamentales no han permitido, hasta ahora, reducir de forma significativa la agresión de la que son víctimas cada día millares de fetos, recién nacidos y niños. Se debe combatir el importante y verdadero impacto del tabaquismo materno durante el embarazo junto con los sanitarios implicados (obstetras y matronas), que no siempre son conscientes de los efectos a largo plazo de esta intoxicación en los niños.
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