Journal Article

Detrimental Effects of Environmental Tobacco Smoke in Relation to Asthma Severity

Gaston, Benjamin M., Chung, Kian Fan, Comhair, Suzy A. A., Dweik, Raed A., Castro, Mario, Hazen, Stanley L., Moore, Wendy, Hammel, Jeffrey, Israel, Elliot, Peters, Stephen P., Ampleford, Elizabeth J., Meyers, Deborah, Busse, William W., Erzurum, Serpil C., Bleecker, Eugene R., Calhoun, William J., Ricci, Kristin S., Jarjour, W. Nizar, Teague, W. Gerald, Wenzel, Sally, Curran-Everett, Douglas

2011

Overview

Environmental tobacco smoke (ETS) has adverse effects on the health of asthmatics, however the harmful consequences of ETS in relation to asthma severity are unknown. In a multicenter study of severe asthma, we assessed the impact of ETS exposure on morbidity, health care utilization and lung functions; and activity of systemic superoxide dismutase (SOD), a potential oxidative target of ETS that is negatively associated with asthma severity. From 2002-2006, 654 asthmatics (non-severe 366, severe 288) were enrolled, among whom 109 non-severe and 67 severe asthmatics were routinely exposed to ETS as ascertained by history and validated by urine cotinine levels. ETS-exposure was associated with lower quality of life scores; greater rescue inhaler use; lower lung function; greater bronchodilator responsiveness; and greater risk for emergency room visits, hospitalization and intensive care unit admission. ETS-exposure was associated with lower levels of serum SOD activity, particularly in asthmatic women of African heritage. ETS-exposure of asthmatic individuals is associated with worse lung function, higher acuity of exacerbations, more health care utilization, and greater bronchial hyperreactivity. The association of diminished systemic SOD activity to ETS exposure provides for the first time a specific oxidant mechanism by which ETS may adversely affect patients with asthma.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acuity / Adolescent / Adult / Adults / Aged / Analysis / Antioxidants / Asthma / Asthma - blood / Asthma - chemically induced / Asthma - physiopathology / Biology / Bladder cancer / Brain research / Bronchodilators / Child / Cotinine / Critical care / Departments / Emergency medical care / Emergency medical services / Emergency response / Environmental effects / Environmental Exposure - adverse effects / Exposure / Female / Haplotypes / Health care / Health risk assessment / Health services utilization / Humans / Hyperreactivity / Hypersensitivity / Internal medicine / Lungs / Male / Medicine / Middle Aged / Morbidity / Mortality / Mutation / Oxidative stress / Oxidizing agents / Passive smoking / Pediatrics / Plasma / Quality of life / Respiratory function / Respiratory Function Tests / Respiratory system agents / Smoke / Smoking / Studies / Superoxide dismutase / Superoxide Dismutase - blood / Superoxides / Tobacco / Tobacco smoke / Tobacco Smoke Pollution - adverse effects / Traumatic brain injury / Urine / Womens health / Young Adult