One in six children hospitalized for bronchiolitis tested positive for marijuana exposure

BALTIMORE — One in six children hospitalized for bronchiolitis in Colorado had been exposed to marijuana, according to data presented at the Pediatric Academic Societies Meeting.

Karen M. Wilson, MD, MPH, an associate professor of pediatrics at the University of Colorado School of Medicine, advised clinicians to be wary of marijuana legalization efforts like those in Colorado, adding that PCPs should counsel patients to never smoke tobacco or marijuana in front of children.

“We have found that secondhand marijuana smoke contains many of the same chemicals that are found in tobacco smoke, and that can include things like volatile organic compounds and polycyclic aromatic hydrocarbons,” Wilson said in her presentation. “We do know that active marijuana smoking is associated with respiratory problems and structural and functional brain abnormalities, including neurocognitive deficits, in adults, and this effect is thought to be even greater in adolescents due to their ongoing brain development. However, we know very little about the effect of secondhand marijuana smoke exposure for children, and any potential health effects it may have.”

To determine the prevalence of secondhand marijuana exposure in a youth cohort hospitalized for bronchiolitis in Colorado, Wilson and colleagues performed a secondary analysis of a study of children aged 1 month to 2 years. Participants were recruited January 2013 to April 2014. Recreational marijuana use was legalized in Colorado on Jan. 1, 2014.

Parents completed a survey regarding their child’s health, with the researchers adding a question about marijuana use by contacts in October 2013. Urine samples were analyzed by the CDC for cotinine and marijuana metabolites, including COOH-THC.

Of the 180 eligible participants, 99 were enrolled and 43 urine samples were available for testing.

According to the researchers, of the 25 children assessed for exposure to marijuana smokers, 16% reported contact. In addition, COOH-THC was detected in 16% of the samples. Exposure did not differ by gender or age, but nonwhite children were more likely to be exposed than white (44% vs. 9%; P < .05). Among children with household contacts using marijuana, 75% had detectible levels of COOH-THC, compared to 10% of those with no reported contacts (P < .05). In children with cotinine levels of more than 2 ng/mL, 55% tested positive for COOH-THC, compared with 6% of those with lower cotinine exposure (P < .01).

“We found that a substantial portion of children hospitalized with bronchiolitis in Colorado have evidence of exposure to marijuana,” Wilson said. “Understanding the consequences of marijuana smoke exposure in children is critical and urgent, especially as marijuana becomes increasingly legal and available. Pediatric care providers should screen for both marijuana and tobacco exposure and counsel parents not to smoke either one of them around children, because there is no evidence that secondhand marijuana exposure in children is safe.” – by Jason Laday

Disclosure: Wilson reports no relevant financial disclosures.

Reference:

Wilson KM, et al. Marijuana exposure in children hospitalized for bronchiolitis. Presented at: Pediatric Academic Societies meeting; April 30 to May 3, 2016; Baltimore.