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American Academy of Pediatrics
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Hair Nicotine Levels in Children With Bronchopulmonary Dysplasia

Joseph M. Collaco, Angela D. Aherrera, Patrick N. Breysse, Jonathan P. Winickoff, Jonathan D. Klein and Sharon A. McGrath-Morrow
Pediatrics March 2015, 135 (3) e678-e686; DOI: https://doi.org/10.1542/peds.2014-2501
Joseph M. Collaco
aEudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and
bJulius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and
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Angela D. Aherrera
aEudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and
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Patrick N. Breysse
bJulius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and
cJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
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Jonathan P. Winickoff
bJulius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and
dDivision of General Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Jonathan D. Klein
bJulius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and
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Sharon A. McGrath-Morrow
aEudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and
bJulius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and
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Abstract

BACKGROUND: Tobacco smoke exposure (TSE) may increase respiratory morbidities in young children with bronchopulmonary dysplasia (BPD). Rapid respiratory rates, close proximity to a smoking caregiver, and increased dermal absorption of tobacco smoke components can contribute to systemic exposure. In this study, hair nicotine levels were used as a biomarker of chronic TSE in young children with BPD to determine if hair nicotine levels correlate with caregiver self-report of TSE and respiratory morbidities.

METHODS: From 2012 to 2014, hair nicotine levels were measured from consecutive children seen in a BPD outpatient clinic and compared with caregiver questionnaires on household smoking. The relationship between respiratory morbidities and self-reported TSE or hair nicotine level was assessed.

RESULTS: The mean hair nicotine level from 117 children was 3.1 ± 13.2 ng/mg. Hair nicotine levels were significantly higher in children from smoking households by caregiver self-report compared with caregivers who reported no smoking (8.2 ± 19.7 ng/mg vs 1.8 ± 10.7; P < .001). In households that reported smoking, hair nicotine levels were higher in children with a primary caregiver who smoked compared with a primary caregiver who did not smoke. Among children with BPD who required respiratory support (n = 50), a significant association was found between higher log hair nicotine levels and increased hospitalizations and limitation of activity.

CONCLUSIONS: Chronic TSE is common in children with BPD, with hair nicotine levels being more likely to detect TSE than caregiver self-report. Hair nicotine levels were also a better predictor of hospitalization and activity limitation in children with BPD who required respiratory support at outpatient presentation.

  • bronchopulmonary dysplasia
  • prematurity
  • secondhand smoke
  • tobacco smoke exposure
  • nicotine
  • respiratory outcomes
  • Accepted December 22, 2014.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 135, Issue 3
1 Mar 2015
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Hair Nicotine Levels in Children With Bronchopulmonary Dysplasia
Joseph M. Collaco, Angela D. Aherrera, Patrick N. Breysse, Jonathan P. Winickoff, Jonathan D. Klein, Sharon A. McGrath-Morrow
Pediatrics Mar 2015, 135 (3) e678-e686; DOI: 10.1542/peds.2014-2501

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Hair Nicotine Levels in Children With Bronchopulmonary Dysplasia
Joseph M. Collaco, Angela D. Aherrera, Patrick N. Breysse, Jonathan P. Winickoff, Jonathan D. Klein, Sharon A. McGrath-Morrow
Pediatrics Mar 2015, 135 (3) e678-e686; DOI: 10.1542/peds.2014-2501
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