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Hair nicotine levels detect smoke exposure in children with bronchopulmonary dysplasia
Chronic tobacco smoke exposure was found to be common among children with bronchopulmonary dysplasia, and hair nicotine levels were more reliable for detecting smoke exposure than caregiver self-reports.
“It is essential to understand how environmental exposures, such as tobacco smoke, influence respiratory morbidities in this vulnerable population,” Joseph M. Collaco, MD, MPH, of Johns Hopkins School of Medicine, and colleagues wrote. “However, some studies that rely on questionnaire data alone to assess tobacco smoke exposure have not found an association with respiratory morbidities.”
To assess the predictive value of hair nicotine levels compared with caregiver self-reports of exposure for respiratory morbidities, researchers evaluated 117 children (aged younger than 3 years) with bronchopulmonary dysplasia recruited from the Johns Hopkins Bronchopulmonary Dysplasia Clinic between January 2012 and January 2014.
Families of enrolled children completed two questionnaires that addressed issues of tobacco smoke exposure in the home and the patient’s history of ED visits, hospital admissions, use of systemic steroids, and use of antibiotics for respiratory indications. Researchers also collected hair samples from participants and tested the strands using hair nicotine analysis via gas chromatography and mass spectrometry.
The researchers analyzed chronic respiratory morbidities, including cough/wheeze, inhaled rescue beta-agonist use, activity limitations due to respiratory problems and nighttime respiratory problems. These were evaluated in relation to self-reported tobacco smoke exposure and hair nicotine levels.
The mean hair nicotine level was 3.1 ± 13.2 ng/mg among tested patients. Children from self-reported smoking households had higher hair nicotine levels compared with children whose caregivers reported no smoking (8.2 ± 19.7 ng/mg vs. 1.8 ± 10.7 ng/mg; P < .001).
Among smoking households, children with a primary caregiver who smoked had higher hair nicotine levels vs. those where the primary caregiver did not smoke (P = .046). In the 50 children with bronchopulmonary dysplasia who required respiratory support at presentation, there was a significant correlation between higher log hair nicotine levels, increased hospitalization and activity limitations.
“Hair nicotine levels also detected children exposed to tobacco smoke exposure that would have been missed by caregiver questionnaires,” the researchers wrote. “Hair nicotine levels may be useful in the clinical setting to predict which children may be at increased risk for respiratory morbidities during the first 3 years of life, and to identify children for appropriate tobacco smoke exposure interventions.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
