Exposure to tobacco smoke impairs children's respiratory health, putting them at increased risk of pneumonia, bronchiolitis, asthma and ear infections with greater rates of hospitalization and longer recovery periods from these conditions than unexposed children, according to background information in the article. The American Academy of Pediatrics recommends that pediatricians assess children's exposure to tobacco smoke beginning with their first doctor's visit. A simple, quick method for determining the child's risk is needed to facilitate that assessment in busy pediatric practices, the authors suggest.
Judith A. Groner, M.D., of The Ohio State University College of Medicine & Public Health, Columbus, and colleagues, compared answers to a series of easily administered screening questions about home secondhand smoke exposure to child hair cotinine levels. Hair cotinine is not derived directly from environmental tobacco smoke exposure but from absorbed nicotine, which is metabolized to cotinine and then deposited in growing hair. The researchers considered cotinine levels as a "gold standard" for measuring tobacco smoke exposure because it correlates well with nicotine levels in the blood, measures exposure over several months and is not influenced by short-term exposure.
Hair samples were collected from 291 healthy children, two weeks to three years of age, at a primary care clinic and the children were divided into three groups based on level of cotinine: low, medium and high exposure. The child's level of exposure was then compared to caregiver's answers to questions about smoking factors in the home. The questions included whether the mother (or p
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JAMA and Archives Journals
2-May-2005