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: 9166256
• 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 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9166256
• 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; Clothing; 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; Housing; Individual; Infant; Ingestion; Intensive Care Units; Intervention; Lead; 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; high risk infant; in utero; low socioeconomic status; non-smoker; non-smoking; novel; particle; pollutant; pregnant; premature; 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（Thirdhand Smoke，THS）是二手烟在表面留下的颗粒物和残留物。 吸烟者和暴露于SHS的人的SHS。超过18%的美国成年人吸烟， （23-42%）在低社会经济地位的人群中，使THS成为一个明显的公共卫生危害，特别是对所有22%的人来说， 在家中暴露于SHS和THS的婴儿和儿童。THS含有并形成致癌物质和其他 有毒物质，损害DNA，对认知功能产生不利影响，阻碍呼吸发育， 伤口愈合THS很难从室内表面去除，并且很容易从呼吸，衣服， 和接触过SHS的人的手它很容易与其他污染物反应形成致癌物质， 个人，特别是儿童，通过多种途径（例如，皮肤吸收）。反复暴露于再- 悬浮颗粒物和THS在吸烟后数月至数年内返回气态 都熄灭了研究已经证明了THS在家庭、汽车和酒店中的存在， 全面禁烟。除了我们最近公布的试点数据，表明THS污染在一个 新生儿重症监护室（NICU），严格禁烟政策的医疗机构和大量的 吸烟的游客尚未被调查。 最脆弱的住院病人被安置在重症监护室。特别是出生的婴儿 早产（早在妊娠23周）和极低出生体重（<1000克[2.2磅]） 可以说是最脆弱的访问NICU的父母不成比例地处于较低的社会经济地位 健康状况不佳，因此吸烟率很高（>26%），导致健康差距很大。早产儿 不发达的呼吸系统通常需要机械通气， 呼吸道和其他疾病（例如，支气管肺发育不良、哮喘） 通常跨越数月。THS可能会对NICU婴儿的急性和慢性健康结果产生负面影响。 这项小额赠款提案的主要目的是描述一家大型城市医院新生儿重症监护室中存在的THS 用的是公认的高灵敏度尼古丁擦拭巾我们的试验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游客在多大程度上 （N=210）和工作人员（N=171）将THS运送到NICU，并将量化存放在NICU中的THS量。 NICU通过对吸烟和非吸烟家庭表面发现的尼古丁进行采样（N=80）。婴儿 还将收集尿可替宁并定量传递给婴儿的尼古丁。一项新的子研究， 还将进行手部清洁以去除THS的功效（n=20）。量化THS在NICU护理 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来污染。这项初步研究的结果将为更大的 确定早期暴露于尼古丁相关致癌物的急性和慢性影响的临床研究。