Association of Secondhand Smoke Exposure with Pediatric Invasive Bacterial Disease and Bacterial Carriage: A Systematic Review and Meta-analysis

Lee, Chien‐Chang; Middaugh, Nicole; Howie, Stephen R. C.; Ezzati, Majid

doi:10.1371/journal.pmed.1000374

Cited by 58 publications

(35 citation statements)

References 76 publications

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“…However, in a systematic review of the association between ETS exposure and invasive bacterial disease, this association only occurred with meningococcal disease [50]. Another systematic review on the health effects of passive smoking also reported an increased risk for invasive meningococcal disease, pneumococcal carriage, and LRTI in children [51].…”

Section: Resultsmentioning

confidence: 99%

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Vanker

Gie

Zar

2017

Expert Review of Respiratory Medicine

148

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Introduction: Childhood respiratory illness is a major cause of morbidity and mortality particularly in low and middle-income countries. Environmental tobacco smoke (ETS) exposure is a recognised risk factor for both acute and chronic respiratory illness.Areas covered: The aim of this paper was to review the epidemiology of ETS exposure and impact on respiratory health in children. We conducted a search of 3 electronic databases of publications on ETS and childhood respiratory illness from 1990–2015. Key findings were that up to 70% of children are exposed to ETS globally, but under-reporting may mask the true prevalence. Maternal smoking and ETS exposure influence infant lung development and are associated with childhood upper and lower respiratory tract infection, wheezing or asthma. Further, exposure to ETS is associated with more severe respiratory disease. ETS exposure reduces lung function early in life, establishing an increased lifelong risk of poor lung health.Expert commentary: Urgent and effective strategies are needed to decrease ETS exposure in young children to improve child and long-term lung health in adults especially in low and middle income countries where ETS exposure is increasing.

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Section: Resultsmentioning

confidence: 99%

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Vanker

Gie

Zar

2017

Expert Review of Respiratory Medicine

148

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“…Moreover, there are multiple reports that secondhand smoke increases the incidence of nasal pneumococcal colonization in children (29)(30)(31), further emphasizing the need for additional mechanistic studies (6). In the current study, we sought to establish a mouse model of nasal pneumococcal colonization and cigarette smoke exposure.…”

Section: Discussionmentioning

confidence: 99%

Cigarette Smoke Attenuates the Nasal Host Response to Streptococcus pneumoniae and Predisposes to Invasive Pneumococcal Disease in Mice

et al. 2016

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Streptococcus pneumoniae is a leading cause of invasive bacterial infections, with nasal colonization an important first step in disease. While cigarette smoking is a strong risk factor for invasive pneumococcal disease, the underlying mechanisms remain unknown. This is partly due to a lack of clinically relevant animal models investigating nasal pneumococcal colonization in the context of cigarette smoke exposure. We present a model of nasal pneumococcal colonization in cigarette smoke-exposed mice and document, for the first time, that cigarette smoke predisposes to invasive pneumococcal infection and mortality in an animal model. Cigarette smoke increased the risk of bacteremia and meningitis without prior lung infection. Mechanistically, deficiency in interleukin 1␣ (IL-1␣) or platelet-activating factor receptor (PAFR), an important host receptor thought to bind and facilitate pneumococcal invasiveness, did not rescue cigarette smoke-exposed mice from invasive pneumococcal disease. Importantly, we observed cigarette smoke to attenuate nasal inflammatory mediator expression, particularly that of neutrophil-recruiting chemokines, normally elicited by pneumococcal colonization. Smoking cessation during nasal pneumococcal colonization rescued nasal neutrophil recruitment and prevented invasive disease in mice. We propose that cigarette smoke predisposes to invasive pneumococcal disease by suppressing inflammatory processes of the upper respiratory tract. Given that smoking prevalence remains high worldwide, these findings are relevant to the continued efforts to reduce the invasive pneumococcal disease burden.

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“…In those studies where a multivariate analysis has been carried out, different confounding factors are included in the models, making it difficult to compare. A recent meta-analysis found that second-hand exposure to tobacco smoke was associated with a significantly increased risk of IMD with an OR of 2.02 (95% CI 1.52 to 2.69) 46. In the three studies specifically addressing pre-school children (≤6 years), the association was stronger, but non-significant (OR=3.04, 95% CI 0.89 to 10.47), most likely due to inadequate power even with the combined analysis.…”

Section: Discussionmentioning

confidence: 99%

Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009: a population-based time series analysis

et al. 2014

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ObjectiveTo investigate the relationship between the prevalence of smoking in the population and incidence of invasive meningococcal disease (IMD) among children under 5 years of age.DesignRetrospective, longitudinal, observational study. Poisson regression controlled for confounding factors.SettingNorway, Sweden, Denmark and the Netherlands between 1975 and 2009.PopulationTotal population of approximately 35 million people in these four countries.Data sourcesData were collected from the Ministries of Health, National Statistics Bureaus and other relevant national institutes.ResultsIn Norway, there was a significant positive relationship between the annual prevalence of daily smokers among individuals aged 25–49 years and the incidence of IMD in children under 5 years of age, unadjusted (RR=1.04–1.06, 95% CI 1.02 to 1.07, p<0.001) and after adjustment for time of year (quarter), incidence of influenza-like illness and household crowding (RR=1.05–1.07, 95% CI 1.03 to 1.09, p<0.001). Depending on age group, the risk of IMD increased by 5.2–6.9% per 1% increase in smoking prevalence among individuals aged 25–49 years in adjusted analyses. Using limited datasets from the three other countries, unadjusted analysis showed positive associations between IMD in children related to older smokers in Sweden and the Netherlands and negative associations related to younger smokers in Sweden. However, there were no demonstrable associations between incidence of IMD and prevalence of smoking, after adjustment for the same confounding variables.ConclusionsThe reduced incidence of IMD in Norway between 1975 and 2009 may partly be explained by the reduced prevalence of smoking during this period. High-quality surveillance data are required to confirm this in other countries. Strong efforts to reduce smoking in the whole population including targeted campaigns to reduce smoking among adults may have a role to play in the prevention of IMD in children.

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Association of Secondhand Smoke Exposure with Pediatric Invasive Bacterial Disease and Bacterial Carriage: A Systematic Review and Meta-analysis

Abstract: Majid Ezzati and colleagues report the findings of a systematic review and meta-analysis that probes the association between environmental exposure to secondhand smoke and the epidemiology of pediatric invasive bacterial disease.

Cited by 58 publications

References 76 publications

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

Cigarette Smoke Attenuates the Nasal Host Response to Streptococcus pneumoniae and Predisposes to Invasive Pneumococcal Disease in Mice

Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009: a population-based time series analysis

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