Maternal smoking promotes chronic obstructive lung disease in the offspring as adults

Beyer D, Mitfessel H, Gillissen, Gillissen A

Description

In utero and/or childhood environmental tobacco smoke exposure is well known to adversely affect lung function and to depreciate child's health in many ways. Fewer studies have assessed the long-term effects on COPD development and disease severity in later adulthood. Methods COPD patients were interviewed using a structured questionnaire regarding their personal as well as the smoking habits of their parents. Data were compared with the disease history, e.g. COPD exacerbation rate, and their lung function data. Results Between 2003 and 2004 COPD patients were recruited a) in a private practice specialized in pulmonary medicine (n = 133) and b) in a hospital (n = 158). 75% of their fathers and only 15.4 of all mothers smoked regularly. COPD patients from smoking mothers had lower FEV1 predicted than those raised in household without maternal smoking exposure: 39.4 ± 9.5% vs. 51.9 ± 6.0% (P = 0.037). Fathers had no effect on FEV1 regardless if they are smokers or non-smokers. Rate of severe exacerbations requiring hospitalization remained unaffected by parental second hand smoke exposure. Conclusion Maternal smoking negatively affects lung function of their offspring even in late adulthood when they develop COPD. It even aggravates the cumulative effect of active cigarette consumption. Clinical course of the COPD remained unaffected.

Sujets

• Chronic obstructive pulmonary disease
• Passive smoking

Informations

• Publié par: biomed
• Publié le: 01 janvier 2009
• Nombre de lectures: 4
• Langue: English

Extrait

December 7, 2009

Eur J Med Res (2009) 14(Suppl. IV): 27-31

EUROPEAN JOURNAL OF MEDICAL RESEARCH

27

© I. Holzapfel Publishers 2009

M ATERNAL S MOKING P ROMOTES C HRONIC O BSTRUCTIVE L UNG D ISEASE IN THE O FFSPRING AS A DULTS

1 21 D. Beyer , H. Mitfessel , A. Gillissen

1 2 St. George Medical Center, Robert-Koch-Hospital, Leipzig, Germany;Practice in Pulmonary Medicine, Remscheid, Germany

Abstract Intr oduction:In utero and/or childhood environmen- tal tobacco smoke exposure is well known to adversely affect lung function and to depreciate child's health in many ways. Fewer studies have assessed the long-term effects on COPD development and disease severity in later adulthood. Methods:COPD patients were interviewed using a structured questionnaire regarding their personal as well as the smoking habits oftheir parents. Data were compared with the disease history, e.g. COPD exacer- bation rate, and their lung function data. Results:Between 2003 and 2004 COPD patients were recruited a) in a private practice specialized in pul- monary medicine (n = 133) and b) in a hospital (n = 158). 75% oftheir fathers and only 15.4 ofall moth- ers smoked regularly. COPD patients from smoking mothers had lower FEV1 predicted than those raised in household without maternal smoking exposure: 39.4 ± 9.5% vs. 51.9 ± 6.0% (P = 0.037). Fathers had no effect on FEV1 regardless ifthey are smokers or non-smokers. Rate ofsevere exacerbations requiring hospitalization remained unaffected by parental sec- ond hand smoke exposure. Conclusion:Maternal smoking negatively affects lung function oftheir offspring even in late adulthood when they develop COPD. It even aggravates the cu- mulative effect ofactive cigarette consumption. Clini- cal course ofthe COPD remained unaffected. Key words:chronic obstructive pulmonary disease, COPD, second hand smoking I NTRODUCTION Second hand smoking is well known for its deteriorat- ing effects in man. It increases significantly recurrent colds, cough and phlegm, throat problems, and the presence ofrespiratory symptoms by roughly a factor of 2[1, 2]. It even has been linked to increase the risk for lung cancer by the factor of1.3, particularly when the exposure occurs before the age of25 [3]. Cigarette smoking is still quite common in many parts ofthe world. In parallel, exposure to second-hand smoke continues to be widespread despite declines in smok- ing in developed countries and despite evidence ofse- rious health effects in infants and children. In addition to whatever effects direct and postnatal second-hand

tobacco smoke exposure have on the occurrence of asthma, bronchitis, cardio-vascular diseases and im- paired levels and growth oflung function in adoles- cents, there is an underlying alteration in the prenatal and early postnatal development ofthe structural and mechanical characteristics ofthe lung that contribute substantially to these deficits. These developmental ef- fects are important contributors to the future risks for impaired pulmonary function in adolescence [4, 5]. While the detrimental effect ofparental smoking exposure on the respiratory health ofchildren is well known since years [6], information on the long-lasting consequence on human health, particularly regarding the development ofdiseases like chronic obstructive pulmonary disease (COPD) is sparse [7, 8]. Conse- quently, the purpose ofthis study was to assess the risk ofenvironmental smoke exposure at home during childhood a) for COPD severity, b) for disease insta- bility defined as higher exacerbation rate in later adult- hood, and c) whether it might have an add-on effect to yearlong active smoke exposure.

P ATIENTS AND M ETHODS

This study has been approved by the ethics committee of theSaxonian Physician Association, Dres- den/Germany (Code No.: EK-AMG-89/2003). Pa- tients who refuse to participate or who were unable to understand the written informed consent form were excluded. A structured 11 pages questionnaire was used to question prospectively COPD patients for their family and social history, previous occupation and possible occupational exposure status, parental and personal smoking habits. Diseases during childhood and adoles- cence were recorded as well as the year ofCOPD di- agnosis and frequency ofexacerbations, defined as those that required hospitalization and treatment with antibiotics and/or systemic corticosteroids [9]. At the time ofthe interview, following parameter were gath- ered from the patient: anthropometric data, dyspnoea using MRC-scale, lung function, blood gas analysis, and a current medication. To exclude concurrent dis- eases as defined below, patients were examined using EKG, echocardiography, X-ray ofthe chest. Inclusion criteria were: COPD according to the GOLD (Global obstructive Lung Disease [10]) defini- tion ofall stages, age ≥30 years, negative reversibility