Decreased peak expiratory flow in pediatric passive smokers

  • Fitri Yanti Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Muhammad Ali Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Ridwan M. Daulay Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Wisman Dalimunthe Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
  • Rini Savitri Daulay Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
Keywords: peak expiratory flow, passive smoker

Abstract

Background Indonesia ranks fifth among countries with the highest aggregate levels of tobacco consumption in the world. Infants and children exposed to environmental tobacco smoke have increased rates of asthma, respiratory and ear infections, as well as reduced lung function. The effects of tobacco smoke exposure on lung function in children have been reported to be dependent on the source of smoke and the length and dose of exposure. Lung function may also be affected by a child’s gender and asthma status.

Objective To compare peak expiratory flow (PEF) in pediatric passive smokers to that of children not exposed to second hand smoke, and to define factors that may affect PEF in passive smokers.

Methods In August 2009 we conducted a cross-sectional study at an elementary school in the Langkat district. Subjects were aged 6 to 12 years, and divided into two groups: passive smokers and those not exposed to secondhand smoke. Subjects’ PEFs were measured with a Mini-Wright peak flow meter. Measurements were performed in triplicate with the highest value recorded as the PEF. Demographic data including age, sex, weight, height, family income, parental education levels and occupations were obtained through questionnaires.

Results Of the 170 participants, 100 were passive smokers and 70 were not exposed to secondhand smoke. Age distribution, weight and height were similar in both groups. We observed a significant difference in PEFs between the group of passive smokers and the group not exposed to secondhand smoke, 211.3 L/minute (SD 61.08) and 242.7 L/minute (SD 77.09), respectively (P < 0.005). The number of years of exposure to smoke (P = 0.079) and the number of cigarettes smoked daily in the household (P = 0.098) did not significantly influence PEF.

Conclusion The PEF in pediatric passive smokers was significantly lower than that of children not exposed to secondhand smoke. PEF in passive smokers was not influenced by the number of years of smoke exposure or the number of cigarettes smoked daily in the household.

References

1. WHO Indonesia and Ministry of Health Republic of Indonesia. Tobacco consumption & prevalence in Indonesia. [cited 2009 June]. Available from: http://www.litbang.depkes.go.id/tobaccofree
2. Carlsen KH, Carlsen KCL. Respiratory effects of tobacco smoking on infants and young children. Pediatr Respir Rev. 2008;9:11-20.
3. Henderson AJ. The effects of tobacco smoke exposure on respiratory health in school-aged children. Pediatr Respir Rev. 2008;9:21-8.
4. WHO. Environmental tobacco smoke. Denmark. 2000. [cited 2009 June]. Available from: http://www.euro.who.int/8_lets.pdf
5. Daulay RM, Said M, Naning R, Dadiyanto DW. Prosedur tindakan pada penyakit respiratori. In: Rahajoe NN, Supriyatno B, Setyanto DB, editors. Buku Ajar Respirologi Anak. 1st ed. Jakarta: Ikatan Dokter Anak Indonesia; 2008. p. 583-95.
6. Kaswandani N. Uji fungsi paru pada batuk kronik. In: Trihono PP, Kurniati N, editors. Strategi pendekatan klinis secara professional batuk pada anak. Jakarta: Departemen Ilmu Kesehatan Anak FKUI-RSCM; 2006.p.26-39.
7. Wirjodiarjo M. Evaluasi klinik fungsi paru dalam pemecahan masalah kesehatan anak. In: Rahajoe N, Rahajoe NN, Boediman I, Said M, Wirjodiarjo M, Supriyatno B, editors. Perkembangan masalah pulmonologi anak saat ini. Jakarta: Pendidikan Kedokteran Berkelanjutan Ilmu Kesehatan Anak FK-UI; 1994.p.45-73
8. Wirjodiarjo M, Said M, Budiman HI. Perbandingan hasil pengukuran peak flow rate antara mini wright peak flow meter dan spirometer elektronik pada anak. Majalah Kedokteran Indonesia. 1992;42:575-84.
9. Aditama TY, Mangunnegoro H, Fachrurodji H, Saharawati D. Penggunaan arus puncak ekspirasi maksimal dalam penilaian faal paru. Medika.1987;7:670-72.
10. American Lung Association. Peak flow meters. 2008 June; [cited 2009 June]. Available from: http://www.lungusa.org/b.22586/peak_flow_meters.htm
11. Paton JY. A practical approach to the interpretation of lung testing in children. Pediatr Respir Rev. 2000;1:241-8.
12. Milner AD. Lung volume measurements in childhood. Pediatr Respir Rev. 2000;1:135-40.
13. Beardsmore SC. Ethical issues in lung function testing in children. Pediatr Respir Rev. 2000;1:342-346.
14. Delpisheh A, Kelly Y, Brabin BJ. Passive cigarette smoke exposure in primary school children in Liverpool. Public Health. 2006;120:65-9.
15. Wang S, Witten ML. Environmental tobacco smoke and lung function. In: Watson RR, Witten ML, editors. Environmental tobacco smoke. New York: CRC Press; 2000.p.301-5.
16. O’Connor GT, Weiss ST, Tager IB, Speizer FE. The effect of passive smoking on pulmonary function and nonspecific bronchial responsiveness in a population based sample of children and young adults. Am Rev Respir Dis. 1987;135:800-3.
17. Sherril DL, Martinez FD, Lebowitz MD, Holdaway MD, Flannery EM, Herbison GP, et al. Longitudinal effects of passive smoking on pulmonary function in New Zealand children. Am Rev Respir Dis. 1992;145:1136-40.
18. Young S, Souef PNL, Geelhoed GC, Stick SM, Turner KJ, Landau LI. The influence of family history of asthma and parental smoking on airway responsiveness in early infancy. N Engl J Med. 1991;324:1168-71.
19. Frischer T, Kuehr J, Meinert R, Karmaus W, Barth R, Hermann-Kunz E, et al. Maternal smoking in early childhood: a risk factor for bronchial responsiveness to exercise in primary-school children. J Pediatr. 1992;121:17-21.
20. Cook DG, Strachan DP, Carey IM. Health effects of passive smoking. 9; Parental smoking and spirometric indices in children. Thorax. 1998;53:884-93.
21. Bek K, Tomac N, Delibas A, Tuna F, Tezic HT, Sungkur M. The effect of smoking on pulmonary function during childhood. Postgrad Med J. 1999;75:339-41.
22. Venners SA, Wang X, Chen C, Wang B, Ni J, Jin Y, et al. Exposure-response relationship between paternal smoking and children’s pulmonary function. Am J Respir Crit Care Med. 2001;164:973-6.
23. Moshammer H, Hoek G, Luttman GH. Parental smoking and lung function in children: an international study. Am J Respir Crit Care Med. 2006;173:1255-63.
24. Wang X, Wypij D, Gold DR. A longitudinal study of the effects of parental smoking on pulmonary function in children 6-18 years. Am J Respir Crit Care Med. 1994;139:1139-52.
Published
2011-08-30
How to Cite
1.
Yanti F, Ali M, Daulay R, Dalimunthe W, Daulay R. Decreased peak expiratory flow in pediatric passive smokers. PI [Internet]. 30Aug.2011 [cited 23Dec.2024];51(4):198-01. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/870
Section
Articles
Received 2016-10-12
Accepted 2016-10-12
Published 2011-08-30