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Environmental Tobacco Smoke in the Residential Environment

Environmental Tobacco Smoke in the Residential Environment. Kimberly Yolton, Ph.D. Children’s Environmental Health Center, Cincinnati. Tobacco Smoke. Group A carcinogen Over 4000 chemicals 43 carcinogens including: benzene chromium cadmium polonium-210 formaldehyde. Prenatal Exposure.

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Environmental Tobacco Smoke in the Residential Environment

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  1. Environmental Tobacco Smoke in the Residential Environment Kimberly Yolton, Ph.D. Children’s Environmental Health Center, Cincinnati

  2. Tobacco Smoke • Group A carcinogen • Over 4000 chemicals • 43 carcinogens including: • benzene • chromium • cadmium • polonium-210 • formaldehyde

  3. Prenatal Exposure • 44% of female smokers continue to smoke during pregnancy • (Kahn, 2002)

  4. ETS Exposure in the Home • 43% of US children are exposed to ETS in their own homes by report • 85% of children have measurable cotinine levels (Pirkle, 1996)

  5. Cotinine Levels by Exposure Source Median Cotinine Level (ng/ml) Jordaan, 1999

  6. Prematurity Low Apgars Poor growth Ear infection Hearing loss Colic SIDS Respiratory illness Asthma exacerbation Atopy Tobacco Smoke Links to Child Health • $4.6 billion annually in health care costs

  7. Intelligence Reasoning Achievement Perceptual skills Reading Language Verbal comprehension Tobacco Smoke Links to Child Development General Developmental Delays and specific deficits in the following areas:

  8. Prenatal Tobacco Smoke Exposure and IQ at 9-12 years # cigaretttes Fried, 1998

  9. Tobacco Smoke Exposure and Adjusted Reasoning Scores at Age 5 * Mean Raven Scores Eskenazi, 1995

  10. NHANES III1988-1994 • 4399 children aged 6-16 • Denied tobacco use in past 5 days • Serum cotinine levels <15 ng/ml • Non smokers • ETS exposure Yolton, et al, in progress

  11. NHANES III1988-1994 • Cognitive testing • Math mean=100, SD=15 • Reading mean=100, SD=15 • Block design mean=10, SD=3 • Digit Span mean=10, SD=3 • Controls for potential covariates Gender Region Race/Ethnicity Marital Status Poverty Parent Education Lead Ferritin

  12. Mean Math and Reading Scores in 6-16 Year Olds by Cotinine Quintiles Yolton, in progress

  13. Adjusted Estimates of Cognitive Scores at Serum Cotinine <15 ng/ml Yolton, in progress

  14. Adjusted Estimates of Reading Score Change for 1 ng/ml Increase in Cotinine

  15. Adjusted Slope of Cognitive Scores Among Full Sample and Subsample with Prenatal Data Yolton, in progress

  16. Tobacco Smoke Links to Child Behavior • Impulsivity • Risk taking • Conduct disorder • Rebelliousness • Negativity • Attention deficits • Externalizing

  17. Prenatal Exposure and Behavior at Age 12 # Cigarettes p <.001 Fergusson, 1993

  18. Adjusted Estimated RR of Child Behavior Problems by Tobacco Smoke Exposure # cigarettes * * * Estimated Relative Risk * * * * Williams, 1998

  19. Evidence of Detrimental Effects of Tobacco Smoke • Health consequences • Developmental delays • Behavior problems • Prenatal exposure - clear evidence • Postnatal ETS exposure - inconclusive

  20. Research Needs: ImportanceEstimated Number of US Children 6-16 Yrs Exposed to Damaging Levels of ETS Yolton, in progress

  21. Research Needs:Methodologies • Use of biomarkers of exposure • Large studies to separate prenatal and postnatal exposure effects • Consistent measures of child outcome

  22. Research Needs:Topics • More studies focused on ETS effects on child development and behavior • Exploration into how ETS interacts with other prevalent toxicants • Discovery of mechanisms by which ETS exerts its effects

  23. Research Needs:Topics (continued) • Further exploration into the impact of ETS exposure during pregnancy • Development of novel intervention strategies to protect children from ETS exposure

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