Prevalence and Clinical Correlates of Thirdhand Smoke Exposure in a Pediatric Patient Population

儿科患者群体中三手烟暴露的患病率和临床相关性

基本信息

批准号：
10227009
负责人：
E. Melinda Mahabee-Gittens
金额：
$ 56.96万
依托单位：
CINCINNATI CHILDRENS HOSP MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-15 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10227009
关键词：
4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone 8-hydroxy-2&apos -deoxyguanosine Accident and Emergency department Affect Age Air Animals Asthma Biochemical Biological Biological Markers Carpet Chemicals Child Child Care Childhood Cigarette Clinical Cotinine DNA DNA Damage Disease Dust Environment Exposure to Foundations Frequencies Furniture Gases Hand Health Health Care Visit Home Home visitation Hospitalization Housing Human Impairment In Vitro Inflammation Inflammatory Isoprostanes Laboratories Life Link Lipids Longitudinal cohort study Mus Nicotine Nitrosamines Oxidants Oxidative Stress Oxides Parents Pattern Phase Pollution Prevalence Proteins Reporting Research Respiratory Signs and Symptoms Respiratory physiology Sampling Smoke Smoker Smoking Source Surface TNF gene Techniques Time Tobacco Tobacco Smoke Pollution Tobacco smoke Tobacco use Toddler Toy Validation carcinogenicity clinical effect clinical risk cytokine demographics design environmental tobacco smoke environmental tobacco smoke exposure innovation insight non-smoker oxidation patient population pediatric emergency pediatric patients pollutant prospective pulmonary function repository respiratory response response biomarker screening thirdhand smoke tobacco smoke exposure urinary

项目摘要

PROJECT SUMMARY Thirdhand smoke (THS) is the persistent toxic residue of tobacco smoke pollutants that attaches to surfaces, remains in dust, and becomes embedded in environments where secondhand smoke (SHS) has been released into the air. Even when parents are diligent in attempting to shield their children from tobacco smoke, exposure to SHS (SHSe) and THS (THSe) still occurs. Residue from previously smoked tobacco at home or in a car creates a pervasive reservoir of tobacco smoke pollutants that are within reach of a child's hand such as on carpets, furniture, clothes, and toys, and breathed in dust. Homes of smokers become reservoirs of these pollutants that persist for years, become more toxic with age, and are later reemitted into the gas phase, or react with common ambient oxidants and other environmental compounds to yield secondary pollutants such as carcinogenic tobacco-specific nitrosamines. The clinical effects of THSe are unknown because prior research has examined children exposed to both SHS and THS. Studies exclusively focusing on THSe are needed. Thus, we have conducted in-vitro, animal, and pilot pediatric studies that demonstrate that THSe is associated with high levels of inflammatory cytokines, respiratory illnesses, and oxidative stress including DNA damage, in mice. We have found even in the presence of smoking bans, children still have high levels of THS pollution on their hands and that nonsmokers' homes have high THS pollution levels. However, in the absence of large-scale, rigorous human studies, conclusions about the clinical effects of THSe cannot be made. Thus, we propose an innovative prospective longitudinal cohort study that will move the field forward and away from the laboratory to a pediatric clinical setting as the first pediatric study to use biochemical validation to identify children exposed to THS-only over time. We will screen 1000 children from the pediatric emergency department, a setting which cares for children with varying tobacco smoke exposure (TSE) levels and illnesses. Using strict screening and chemical analysis techniques, we will identify and compare children that comprise three distinct TSE groups: 1) THSe only group: live with nonsmokers, no reported SHSe, confirmed negative/low levels of SHSe, elevated levels of THSe; 2) Mixed SHSe+THSe group: live with smokers, reported SHSe, confirmed moderate/high levels of SHSe, high levels of THSe; and 3) No TSE group: live with nonsmokers, no reported SHSe, confirmed negative levels of SHSe and THSe. The prevalence and levels of THSe, demographics, and exposure and illness patterns of these groups will be compared over time. Next, we will disentangle which environmental sources contribute to THSe levels and the association between THSe and inflammatory (i.e., cytokines) and oxidative (i.e., DNA, lipid, protein oxidation) biomarkers and TSE- related clinical illnesses. Results will provide unique insights into how THSe and sources of tobacco smoke pollution affect the inflammatory, oxidative, and clinical responses in children. The potential impact of these findings is substantial as currently, the level of clinical risk attributable to THSe is unknown.

项目摘要第三次烟雾（THS）是附着在表面，保持灰尘，并嵌入到二手烟（SHS）的环境中被释放到空中。即使父母努力试图保护孩子免受烟草的影响烟雾，暴露于SHS（SHSE）和THS（THSE）仍然发生。以前抽烟的残留物在家中或在汽车中创建了一个普遍存在的烟草烟雾污染物的储层诸如地毯，家具，衣服和玩具等人的手，并用灰尘呼吸。吸烟者的家这些污染物的储层多年，随着年龄的增长而变得更具毒性，后来被重新融入气相，或与常见的环境氧化剂和其他环境化合物反应污染物，例如致癌烟草特异性亚硝胺。 THSE的临床效果未知因为先前的研究已经检查了暴露于SHS和THS的儿童。研究专注于需要这。因此，我们进行了体外，动物和试点儿科研究，证明了这一点 THSE与高水平的炎性细胞因子，呼吸道疾病和氧化应激有关包括小鼠的DNA损伤。我们已经发现，即使在吸烟禁令面前，孩子们仍然有很高的他们手上的污染水平和非吸烟者的房屋具有很高的THS污染水平。然而，在没有大规模，严格的人类研究的情况下，就THSE的临床影响得出的结论不可能是制成。因此，我们提出了一项创新的前瞻性纵向队列研究，该研究将向前进并从实验室到儿科临床环境，作为第一个使用生化的小儿研究验证以识别随着时间的流逝而暴露于TH的儿童。我们将从小儿筛选1000名儿童急诊室，照顾有不同烟草烟雾暴露（TSE）水平的儿童和疾病。使用严格的筛查和化学分析技术，我们将确定和比较儿童这包括三个不同的TSE组：1）仅三个组：与非吸烟者一起生活，没有报道的shse，确认的负数/低水平的THSE水平升高； 2）混合shse+thse组：与据报道，吸烟者确认了中等/高水平的shse，高水平的THSE； 3）没有TSE组：与非吸烟者一起生活，没有报道的SHSE，确认了负面水平的SHSE和THSE水平。流行和随着时间的流逝，将比较这些群体的THSE，人口统计学以及暴露和疾病模式的水平。接下来，我们将删除哪些环境来源促成THSE级别以及之间的关联 THSE和炎症（即细胞因子）和氧化（即DNA，脂质，蛋白质氧化）生物标志物和TSE- 相关的临床疾病。结果将为烟草烟的烟雾和来源提供独特的见解污染影响儿童的炎症，氧化和临床反应。这些的潜在影响发现很重要，因为目前，归因于THSE的临床风险水平尚不清楚。