The feasibility of an air purifier and secondhand smoke education intervention in homes of inner city pregnant women and infants living with a smoker
The feasibility of an air purifier and secondhand smoke education intervention in homes of inner city pregnant women and infants living with a smoker
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DOI：
10.1016/j.envres.2017.10.020
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发表时间：
2018-01-01
影响因子：
8.3
通讯作者：
Diette, Gregory B.
中科院分区：
文献类型：
--
作者：
Rice, Jessica L.;Brigham, Emily;Diette, Gregory B.
目的：二手烟(SHS)和其他空气污染物对孕妇和婴儿的健康造成不利影响。一项旨在减少孕妇或婴儿吸烟家庭空气污染的可行性研究已经完成。方法：与巴尔的摩市卫生局合作，招募了18岁的妇女和0-12个月婴儿的孕妇、非吸烟者或产后(任何吸烟状态)。家庭中至少有一个吸烟者。干预措施包括两台空气净化器和二手烟教育。结果：50名女性(平均年龄27岁，92%非裔美国人，71%单身，94%符合医疗补助条件，34%报告吸烟)进入研究，86%完成研究。在50名女性中，32人在注册时有婴儿，18人怀孕。干预后，70%的参与者报告吸烟者不太可能在室内吸烟，77%的人在最后一次访问时至少打开了一个空气净化器。参与者的满意度很高(91%)，98%的人会推荐空气净化器。室内PM2.5值显著降低(P<；0.001)。非吸烟妇女唾液中可替宁显著降低(P<；0.01)，而婴儿唾液中可替宁无明显变化(P=0.6)。结论：空气净化器结合SHS教育是一种可行的家庭干预措施。这些数据表明，不吸烟的成年人室内PM2.5和唾液可替宁减少。空气净化器不是戒烟和家庭/汽车禁烟的替代方案。应该强烈鼓励所有孕妇戒烟，并建议有婴儿的非吸烟母亲完全避免接触SHS。这项研究为未来评估临床终点的干预提供了支持。
Objectives: Secondhand smoke (SHS) and other air pollutants adversely affect the health of pregnant women and infants. A feasibility study aimed at reducing air pollution in homes of pregnant women or infants living with a smoker was completed.Methods: In collaboration with the Baltimore City Health Department, women 18 years of age and either pregnant nonsmokers, or post-partum (any smoking status) with an infant age 0-12 months were recruited. Homes had at least one smoker. Intervention included two air purifiers and secondhand smoke education. Outcomes included feasibility, change in fine particulate matter (PM2.5), air nicotine, and salivary cotinine pre- and post-intervention.Results: Fifty women were enrolled (mean age 27 years, 92% African American, 71% single, 94% Medicaid eligible, 34% reported smoking) and 86% completed the study. Of the 50 women, 32 had infants and 18 were pregnant at time of enrollment. Post-intervention, 70% of participants reported smokers were less likely to smoke indoors, and 77% had at least one air purifier turned on at the final visit. Participant satisfaction was high (91%) and 98% would recommend air purifiers. Indoor PM2.5 was significantly decreased (P < 0.001). Salivary cotinine was significantly decreased for non-smoking women (P < 0.01) but not infants, and no significant change in air nicotine occurred (P = 0.6).Conclusions: Air purifiers with SHS education is a feasible intervention in homes of women and infants. These data demonstrate reduction in indoor PM2.5 and salivary cotinine in non-smoking adults. Air purifiers are not an alternative for smoking cessation and a home/car smoking ban. Smoking cessation should be strongly encouraged for all pregnant women, and nonsmoking mothers with infants should be counseled to completely avoid SHS exposure. This study provides support for a future intervention evaluating clinical endpoints.