Thirdhand Smoke Contamination in a Neonatal Intensive Care Unit (NICU)

新生儿重症监护病房 (NICU) 中的三手烟雾污染

• 批准号: 9324061
• 负责人: Thomas Francis Northrup
• 金额: $ 7.7万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9324061
• 关键词: Acute; Adult; Affect; Alcohols; Applications Grants; Area; Asthma; Atrial Fibrillation; Breathing; Bronchopulmonary Dysplasia; Carcinogens; Caregivers; Caring; Child; Childhood; Chronic; Cigarette; Clinical Research; Cotinine; DNA Damage; Data; Deposition; Dermal; Development; Disadvantaged; Distal; Environmental Tobacco Smoke; Ethanol; Excision; Exposure to; Extremely Low Birth Weight Infant; Fingers; Hair; Hand; Handwashing; Health; Health Hazards; Healthcare; High Prevalence; Home environment; Hospitalization; Hospitals; Household; Individual; Infant; Ingestion; Intensive Care Units; Intervention; Left; Life; Link; Measures; Mechanical ventilation; Mothers; Neonatal Intensive Care Units; Nicotine; Nursing Staff; Outcome; Pancreatic Diseases; Parents; Participant; Particulate Matter; Patients; Policies; Population; Pregnancy; Premature Infant; Procedures; Protective gloves; Protocols documentation; Proxy; Public Health; Publishing; Research; Research Personnel; Respiratory System; Risk; Risk Factors; Role; Route; Sampling; Skin; Smoke; Smoker; Smoking; Smoking Status; Surface; Time; Tobacco; Touch sensation; Urban Hospitals; Urine; Very Low Birth Weight Infant; Visit; Work; Wound Healing; base; cognitive function; early life exposure; environmental tobacco smoke exposure; experience; health disparity; high risk infant; high risk population; low socioeconomic status; negative affect; non-smoker; non-smoking; novel; particle; pollutant; pregnant; premature; prenatal exposure; primary caregiver; programs; respiratory; thirdhand smoke; toxicant; transmission process; uptake

Project Summary Thirdhand smoke (THS) is the particulate matter and residue left behind on surfaces from secondhand smoke (SHS) by smokers and those exposed to SHS. Over 18% of US adults smoke, with higher prevalence (23-42%) in low-SES populations, making THS a distinct public health hazard, especially for the 22% of all infants and children exposed to SHS and THS in their homes. THS contains and forms carcinogens and other toxicants that damage DNA, adversely affect cognitive functioning, and hinder respiratory development and wound healing. THS is difficult to remove from indoor surfaces and spreads easily from the breath, clothes, and hands of SHS-exposed individuals. It reacts easily with other pollutants to form carcinogens and exposes individuals, especially children, through multiple routes (e.g., dermal uptake). Repeated exposures of re- suspended particulate matter and THS returning to a gaseous state occur for months-to-years after a cigarette is extinguished. Studies have documented the presence of THS in homes, cars, and hotels with partial and total smoking bans. With the exception of our recently published pilot data, indicating THS contamination in a neonatal intensive care unit (NICU), healthcare settings with strict non-smoking policies and high numbers of visitors who smoke have been unexplored. The most fragile hospital populations are housed in the intensive care units. In particular, infants born prematurely (as early as 23 weeks gestation) and at extremely low birth weights (<1000 grams [2.2 pounds]) are arguably the most vulnerable. Parents visiting the NICU are disproportionately of lower socio-economic status and thus smoke at high rates (>26%), resulting in significant health disparities. Premature infants with underdeveloped respiratory systems often require mechanical ventilation and are at risk for numerous respiratory and other illnesses (e.g., bronchopulmonary dysplasia, asthma) during extended hospitalizations often spanning months. THS may negatively affect both acute and chronic health outcomes of NICU infants. The central aim of this small grant proposal is to characterize THS present in a large, urban hospital NICU using well-established, highly sensitive surface nicotine wipes. Our pilot data indicate that nicotine is detectable on NICU surfaces and in NICU infants’ urine. This initial work will determine the extent to which visitors (N=210) and staff (N=171) transport THS to the NICU and will quantify the amount of THS deposited in the NICU by sampling nicotine found on surfaces (N=80), across smoking and nonsmoking households. Infant urine cotinine will also be collected and quantify nicotine transmitted to the infant. A novel sub-study to explore the efficacy of hand cleaning to remove THS will also be conducted (n=20). Quantifying THS in a NICU caring for vulnerable infants will demonstrate THS’s pervasiveness and support further research to eliminate contamination via intervention and policy change. Results of this initial study will provide the impetus for larger clinical studies to determine acute and chronic effects of early exposure to nicotine-related carcinogens.

项目摘要 三手烟(THS)是二手烟遗留在地面上的颗粒物和残留物 吸烟者和暴露于SHS的人的吸烟(SHS)。超过18%的美国成年人吸烟，吸烟率更高 (23%-42%)，使THS成为一种明显的公共健康危害，特别是对22%的人来说 在家中暴露于SHS和THS的婴儿和儿童。它含有和形成致癌物质和其他 毒物破坏DNA，不利影响认知功能，阻碍呼吸发育和 伤口愈合。它很难从室内表面去除，很容易从呼吸、衣服、 以及接触过SHS的人的手。它很容易与其他污染物反应形成致癌物质并暴露在 个人，特别是儿童，通过多种途径(例如，皮肤吸收)。反复曝光的Re- 悬浮颗粒物和THS在吸烟后几个月到几年都会回到气体状态 已经熄灭了。研究已经记录了THS在家庭、汽车和酒店中的存在，以及部分和 全面禁烟。除了我们最近发布的试点数据显示，THS污染在 新生儿重症监护病房(NICU)，具有严格的禁烟政策和大量 吸烟的游客还没有被探索过。 最脆弱的医院人口居住在重症监护病房。特别是，出生的婴儿 早产(最早怀孕23周)，出生体重极低(1000克[2.2磅]) 可以说是最脆弱的。去NICU的父母不成比例地属于较低的社会经济水平 因此吸烟率很高(&gt；26%)，导致严重的健康差距。早产儿患有 不发达的呼吸系统通常需要机械通风，并面临着许多 延长住院期间的呼吸系统疾病和其他疾病(例如，支气管肺发育不良、哮喘) 通常跨越几个月。这可能会对NICU婴儿的急性和慢性健康结局产生负面影响。 这一小额拨款提案的中心目的是描述一家大型城市医院NICU中存在的THS的特征 使用久负盛名的高度敏感的表面尼古丁湿巾。我们的试点数据表明尼古丁是可以检测到的 在NICU表面和NICU婴儿的尿液中。这项初步工作将决定参观者在多大程度上 (N=210)和工作人员(N=171)将THS运送到NICU，并将量化THS存放在 NICU通过对吸烟和不吸烟家庭表面(N=80)上发现的尼古丁进行采样。婴儿期 尿可替宁也将被收集并量化传递给婴儿的尼古丁。一个新的次要研究来探索 还将进行手部清洁以清除THS的效果(n=20)。量化NICU护理中的THS 将证明THS的普遍性，并支持进一步的研究，以消除 通过干预和政策变化造成的污染。这项初步研究的结果将为更大规模的 临床研究，以确定早期接触尼古丁相关致癌物的急性和慢性影响。

项目成果

Evaluating the relationship of in utero nicotine exposure with hypoglycemia after delivery: An observational study.

评估子宫内尼古丁暴露与产后低血糖的关系：一项观察性研究。

• DOI: 10.3233/npm-230124
• 发表时间: 2023
• 期刊: Journal of neonatal-perinatal medicine
• 作者: Johnson,MaryG;Suchting,Robert;Scheid,LisaM;Holzapfel,LindsayN;Chalise,Aditi;Stotts,AngelaL;Chapman,JohnC;Khan,AmirM;Northrup,ThomasF
• 通讯作者: Northrup,ThomasF