"Childhood Secondhand Smoke Effects Persist"
Hallo zusammen, diese Woche ist mir der folgende Artikel in die Hände gefallen der zu diesem Thema passt
--> Passivrauchen im Kindesalter führt zu Emphysem-artigen Lungenveränderungen die in der Bildgebung im Erwachsenenalter (noch viele Jahrzehnte später!) messbar sind (!)
ATS: Childhood Secondhand Smoke Effects Persist
By Michael Smith, North American Correspondent, MedPage Today
Published: May 20, 2009
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo
SAN DIEGO, May 20 -- The effects of exposure to secondhand smoke in childhood may persist for decades, a researcher said here.
In a large cohort of nonsmokers, early signs of emphysema were noticeable on CT scans among those who had lived with one or more smokers in childhood, according to Gina Lovasi, Ph.D., of Columbia University.
Those signs -- a significant increase in the number of "air-like spaces" -- were not accompanied by any clinical symptoms, Dr. Lovasi said at the annual meeting of the American Thoracic Society.
"We do see a difference" in the structure of the lung, Dr. Lovasi told reporters, "but it's important to note that we didn't see a difference in lung function."
Action Points
________________________________________
Explain to interested patients that secondhand smoke is known to have a range of deleterious health consequences, but it's not known how long those effects persist.
Note that this study suggests that some effects may still be apparent among people in their 60s who lived with smokers as children.
Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
Still, the finding suggests that the "damage from early childhood tobacco exposure may persist into adulthood," she said.
Dr. Lovasi said the effects of secondhand tobacco smoke are well known, but it remains unclear how long they persist. To help clarify the issue, she and colleagues turned to the Multi-Ethnic Study of Atherosclerosis, or MESA.
In that study, healthy participants provided medical and personal histories and blood samples, and agreed to medical examinations and CT scanning of the chest.
While the primary goal of the study is to examine atherosclerosis, the CT scans of the heart also included large parts of the lungs, she said.
The CT scans of 1,781 nonsmokers, average age 61, were analyzed to determine the proportion of the lungs that was "air-like" and the amount that was tissue.
"Air spaces are normal," Dr. Lovasi said, "but large airspaces can cause a problem."
The study found:
• 17% of participants had lived with two or more smokers in childhood, while 30% had lived with one, and 52% had not lived with a smoker.
• In those who had lived with two or more smokers, the proportion of air-like spaces was 20%, compared with 18% in those who had lived with one and 17% in the remaining participants.
• After adjustment for possible confounders, the trend was significant at P=0.03.
Although the difference in relative air-like space between the groups was small on average, Dr. Lovasi noted that individual values ranged from 1% to 60%.
The study was limited because it represents a single point in time, Dr. Lovasi said. Also, the historical data is largely based on self-reporting.
While the participants in this study were healthy, the finding raises the possibility that the long-term effect of secondhand smoke is underestimated, said Phyllis Dennery, M.D., of the University of Pennsylvania School of Medicine, who moderated a press conference at which Dr. Lovasi presented her findings.
"I wonder if exposure to something else," beyond the secondhand smoke they lived with as children, might precipitate disease, she suggested. She said it might be that study participants remain healthy only because they have not suffered such a "second insult."
To settle that question, she said, the researchers "will have to do more work."
The MESA study is supported by the NIH. Dr. Lovasi did not report any conflicts.
Primary source: American Thoracic Society
Source reference:
Lovasi GS, et al "Environmental tobacco smoke exposure in childhood predicts early emphysema in adulthood: The MESA lung study" Am J Respir Crit Care Med 2009; 179: Abstract 3965.
By Michael Smith, North American Correspondent, MedPage Today
Published: May 20, 2009
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo
SAN DIEGO, May 20 -- The effects of exposure to secondhand smoke in childhood may persist for decades, a researcher said here.
In a large cohort of nonsmokers, early signs of emphysema were noticeable on CT scans among those who had lived with one or more smokers in childhood, according to Gina Lovasi, Ph.D., of Columbia University.
Those signs -- a significant increase in the number of "air-like spaces" -- were not accompanied by any clinical symptoms, Dr. Lovasi said at the annual meeting of the American Thoracic Society.
"We do see a difference" in the structure of the lung, Dr. Lovasi told reporters, "but it's important to note that we didn't see a difference in lung function."
Action Points
________________________________________
Explain to interested patients that secondhand smoke is known to have a range of deleterious health consequences, but it's not known how long those effects persist.
Note that this study suggests that some effects may still be apparent among people in their 60s who lived with smokers as children.
Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
Still, the finding suggests that the "damage from early childhood tobacco exposure may persist into adulthood," she said.
Dr. Lovasi said the effects of secondhand tobacco smoke are well known, but it remains unclear how long they persist. To help clarify the issue, she and colleagues turned to the Multi-Ethnic Study of Atherosclerosis, or MESA.
In that study, healthy participants provided medical and personal histories and blood samples, and agreed to medical examinations and CT scanning of the chest.
While the primary goal of the study is to examine atherosclerosis, the CT scans of the heart also included large parts of the lungs, she said.
The CT scans of 1,781 nonsmokers, average age 61, were analyzed to determine the proportion of the lungs that was "air-like" and the amount that was tissue.
"Air spaces are normal," Dr. Lovasi said, "but large airspaces can cause a problem."
The study found:
• 17% of participants had lived with two or more smokers in childhood, while 30% had lived with one, and 52% had not lived with a smoker.
• In those who had lived with two or more smokers, the proportion of air-like spaces was 20%, compared with 18% in those who had lived with one and 17% in the remaining participants.
• After adjustment for possible confounders, the trend was significant at P=0.03.
Although the difference in relative air-like space between the groups was small on average, Dr. Lovasi noted that individual values ranged from 1% to 60%.
The study was limited because it represents a single point in time, Dr. Lovasi said. Also, the historical data is largely based on self-reporting.
While the participants in this study were healthy, the finding raises the possibility that the long-term effect of secondhand smoke is underestimated, said Phyllis Dennery, M.D., of the University of Pennsylvania School of Medicine, who moderated a press conference at which Dr. Lovasi presented her findings.
"I wonder if exposure to something else," beyond the secondhand smoke they lived with as children, might precipitate disease, she suggested. She said it might be that study participants remain healthy only because they have not suffered such a "second insult."
To settle that question, she said, the researchers "will have to do more work."
The MESA study is supported by the NIH. Dr. Lovasi did not report any conflicts.
Primary source: American Thoracic Society
Source reference:
Lovasi GS, et al "Environmental tobacco smoke exposure in childhood predicts early emphysema in adulthood: The MESA lung study" Am J Respir Crit Care Med 2009; 179: Abstract 3965.
