Passive Exposure to Tobacco Linked to Increased Allergies in Children

Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, Interview with
Dr. Wojciech Feleszko
Department of Pediatric Respiratory Diseases and Allergy
The Medical University of Warsaw
Działdowska Warsaw, Poland

MedicalResearch: What are the main findings of the study?

Dr. Feleszko: We combined data from nineteen population-based cohort studies of 24 000 children and we found that household exposure to tobacco smoke after birth has immunomodulating effects.  We demonstrated an increased sensitivity to allergens, measured by serum IgE and skin testing which may contribute to the increased development of allergy in children exposed postnatally to household tobacco smoke.

MedicalResearch: Were any of the findings unexpected?

Dr. Feleszko: It has been hypothesized, that prenatal tobacco smoking may contribute to develop asthma, however the precise mechanisms remained unsolved. On the other hand evidence has been surfacing for many years which demonstrates the effect of tobacco smoke on immune function in animal models. This report is the first, demonstrating a direct association of passive smoking, immune dysregulation and allergic sensitization.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Feleszko: We hope that this report may supplement our understanding of what happens to preschool children, who present with frequent wheezing episodes and are exposed to parental tobacco smoking, even if their parents did not smoke during pregnancy. We do suggest, that they are at higher risk to develop allergic airway disease.

We hope our study makes aware about additional harms of tobacco smoking in preschoolers and may provide additional arguments to extend smoking-limiting policies.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Feleszko: Due to enormous detrimental effects of tobacco smoking in children we suggest to implement current clinical diagnosis of children with frequent respiratory episodes with reliable diagnostic tools to measure the level of environmental tobacco smoke exposure.

In future studies, efforts should be made to precisely and uniformly define the exposure to tobacco smoke (the number of cigarettes, hours of exposure, a period of exposure).


Environmental tobacco smoke exposure and risk of allergic sensitisation in children: a systematic review and meta-analysis

Wojciech Feleszko, Marek Ruszczyński, Joanna Jaworska, Agnieszka Strzelak, Bartłomiej Mateusz Zalewski, Marek Kulus

Arch Dis Child archdischild-2013-305444Published Online First: 23 June 2014 doi:10.1136/archdischild-2013-305444 


Last Updated on June 29, 2014 by Marie Benz MD FAAD