TNF-308 Modifies the Effect of Second-hand Smoke on Respiratory Illness-Related School Absences

Background: In India, biomass fuel is burned in many homes under inefficient conditions, leading to a complex milieu of particulate matter and environmental toxins known as household air pollution (HAP). Pregnant women are particularly vulnerable as they and their fetus may suffer from adverse consequences of HAP. Fractional exhaled nitric oxide (FeNO) is a noninvasive, underutilized tool that can serve as a surrogate for airway inflammation. We evaluated the prevalence of respiratory illness, using pulmonary questionnaires and FeNO measurements, among pregnant women in rural India who utilize biomass fuel as a source of energy within their home. Methods: We prospectively studied 60 pregnant women in their 1st and 2nd trimester residing in villages near Nagpur, Central India. We measured FeNO levels in parts per billion (ppb), St. George’s Respiratory Questionnaire (SGRQ-C) scores, and the Modified Medical Research Council (mMRC) Dyspnea Scale. We evaluated the difference in the outcome distributions between women using biomass fuels and those using liquefied petroleum gas (LPG) using two-tailed t-tests. Results: Sixty-five subjects (32 in Biomass households; 28 in LPG households; 5 unable to complete) were enrolled in the study. Age, education level, and second-hand smoke exposure were comparable between both groups. FeNO levels were higher in the Biomass vs. LPG group (25.4 ppb vs. 8.6 ppb; p-value = 0.001). There was a difference in mean composite SGRQ-C score (27.1 Biomass vs. 10.8 LPG; p-value < 0.001) including three subtotal scores for Symptoms (47.0 Biomass vs. 20.2 LPG; p-value< 0.001), Activity (36.4 Biomass vs. 16.5 LPG; p-value < 0.001) and Impact (15.9 Biomass vs. 5.2 LPG; p-value < 0.001). The mMRC Dyspnea Scale was higher in the Biomass vs. LPG group as well (2.9 vs. 0.5; p < 0.001). Conclusion: Increased FeNO levels and higher dyspnea scores in biomass-fuel-exposed subjects confirm the adverse respiratory effects of this exposure during pregnancy. More so, FeNO may be a useful, noninvasive biomarker of inflammation that can help better understand the physiologic effects of biomass smoke on pregnant women. In the future, larger studies are needed to characterize the utility of FeNO in a population exposed to HAP.

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Association between passive smoking and respiratory illness: a case control study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20170755 ◽

2017 ◽

Vol 4 (3) ◽

pp. 764

Author(s):

Sreevishnu S. ◽

Jesha Mohammedali M. ◽

Sheela P. Haveri

Keyword(s):

Passive Smoking ◽

Case Control Study ◽

Respiratory Illness ◽

Case Control ◽

Married Women ◽

Second Hand Smoke ◽

Medical College ◽

Second Hand Smoke Exposure ◽

Control Study

Background: The adverse effect of passive smoking on human health and quality of life is a debatable matter. There is high risk of respiratory illness among spouses of smokers due to exposure to passive smoke. The objective of present study was to find an association between second hand smoke exposure and risk of developing respiratory illness in the last six months among married women aged 20 years and above and currently living together.Methods: A case-control study was conducted during a 6-month period (January to June 2016) among married women aged 20 years and above, who have been currently living with their husband for at least past two years in Perinthalmanna. Women with known respiratory disease such as bronchial asthma and tuberculosis were excluded. The sample size was calculated to be 87 cases and 87 controls. The cases were selected from the out-patient department of MES Medical College, Perinthalmanna, Kerala, India. The controls were selected from ward 28, Perinthalmanna. From each house only one female was interviewed.Results: The major symptoms in the cases were headache (35%), morning cough (34%) and chest pain (25%). The odds of having a respiratory illness when the husband is a smoker is 1.527 (95% C.I. 0.804 to 2.899) and the odds ratio increases to 4.7 (95% C.I.2.11 to 10.86) if the husband smokes at home.Conclusions: The study showed that the risk of having respiratory illness is higher in females when the husband is a smoker and the risk increases four times if the husband smokes at home.

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SECOND HAND SMOKE

PEDIATRICS ◽

10.1542/peds.56.3.367 ◽

1975 ◽

Vol 56 (3) ◽

pp. 367-367

Author(s):

Keyword(s):

Carbon Monoxide ◽

Circulatory System ◽

Respiratory Illness ◽

Driving Safety ◽

Second Hand Smoke ◽

Mainstream Smoke ◽

Asthmatic Children ◽

Sidestream Smoke ◽

American Lung Association ◽

Harmful Effects

Plenty of ammunition is now at hand to help the nonsmoking majority defend itself against the health menace of "second-hand" smoke. The American Lung Association rounded up information based on recent research concerning the harmful effects of tobacco smoke on innocent bystanders. "Sidestream" smoke from the burning end of a cigarette and "mainstream" smoke pulled in by the smoker and then exhaled are more than merely nuisances to the nostrils and eyes of others, the Lung Association said. In an article in its monthly magazine, the Bulletin, entitled ‘Facts About Second-Hand Cigarette Smoke," the agency warned that this "double exposure" offers serious threats to the lungs and circulatory system of the unwilling inhaler. For example: Twice as much tar and nicotine is found in sidestream smoke from the end of a burning cigarette as in mainstream smoke. Ten cigarettes an hour smoked in an enclosed auto pollute the air so much that the carbon monoxide doubles in the blood of smokers and nonsmokers alike and could interfere with driving safety. Parents who smoke at home can aggravate symptoms in asthmatic children and even trigger attacks in some. Even among non-asthmatic children of such parents, researchers found twice as much respiratory illness. The Lung Association added that researchers found that smoking seven cigarettes in one hour—even in a ventilated room—lifted carbon monoxide levels in the seat next to the smoker to 90 ppm, almost twice the maximum set for industry. In an enclosed auto, smoking ten cigarettes also produced carbon monoxide levels up to 90 ppm.

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High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00158 ◽

2020 ◽

Vol 5 (4) ◽

pp. 1006-1010

Author(s):

Jennifer Raminick ◽

Hema Desai

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Oxygen Therapy ◽

Respiratory Illness ◽

High Flow ◽

Oral Feeding ◽

Respiratory Support ◽

Acute Respiratory Illness ◽

High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

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