US Prevalence and Trends in Tobacco Smoke Exposure Among Children and Adolescents With Asthma

Kit, Brian K.; Simon, Alan E.; Brody, Debra J.; Akinbami, Lara J.

doi:10.1542/peds.2012-2328

Cited by 64 publications

(52 citation statements)

References 33 publications

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“…Asthma affects 18% of older adolescents, 30 and is associated with substantial risk for disruption in school, work, and activities of daily life. 31 The capacity of college health centers to manage asthma may be undermined by the potential for exacerbations related to stress, 32 poor adherence, 33 and secondhand smoke exposure in dorms or parties. 34 Only approximately half of schools could manage diabetes on campus.…”

Section: Discussionmentioning

confidence: 99%

College Health Service Capacity to Support Youth With Chronic Medical Conditions

Lemly

Lawlor²,

Scherer

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:The population of youth with chronic medical conditions is growing and many attend college. Yet we know little about US colleges' capacity to identify and care for these youth, nor how transition guidelines and financing models should incorporate college health. WHAT THIS STUDY ADDS:This is the first study to find that although many colleges can provide some clinical care for youth with chronic conditions, few colleges have systems to identify and track these students, elucidating gaps that pediatricians and institutions need to address. abstract BACKGROUND AND OBJECTIVE: Twenty percent of US youth have a chronic medical condition and many attend college. Guidelines for transition from pediatric to adult care do not address college health services, and little is known about their capacity to identify, support, and provide care for these youth. The objective of this study was to describe college health center policies, practices, and resources for youth with chronic medical conditions (YCMC). METHODS: Survey of medical directors from health centers of a representative sample of 200 4-year US colleges with $400 enrolled undergraduate students. Patterns of identification, management, and support for youth with a general chronic medical condition and with asthma, diabetes, and depression, were investigated; x 2 and Fisher exact tests were used to ascertain differences by institutional demographics. RESULTS: Directors at 153 institutions completed the survey (76.5% response rate). Overall, 42% of schools had no system to identify YCMC. However, almost a third (31%) did identify and add to a registry of incoming YCMC on review of medical history, more likely in private (P , .001) and small (,5000 students, P = .002) colleges; 24% of health centers contacted YCMC to check-in/make initial appointments. Most institutions could manage asthma and depression (83% and 69%, respectively); 51% could manage diabetes on campus.CONCLUSIONS: Relatively few US colleges have health systems to identify and contact YCMC, although many centers have capacity to provide primary care and management of some conditions. Guidelines for transition should address policy and practices for pediatricians and colleges to enhance comanagement of affected youth. Dr Lemly designed the study along with Dr Weitzman, supervised data collection and analyses, and drafted the initial manuscript; Ms Lawlor carried out the data collection and reviewed the manuscript; Dr Scherer performed the analyses and reviewed and revised the manuscript; Ms Kelemen carried out initial study design and supervised data collection, and reviewed the manuscript; Dr Weitzman conceptualized and designed the study, supervised data collection and analyses, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.www.pediatrics.org/cgi

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Section: Discussionmentioning

confidence: 99%

College Health Service Capacity to Support Youth With Chronic Medical Conditions

Lemly

Lawlor²,

Scherer

et al. 2014

Pediatrics

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“…The level of exposure to ETS has been decreasing since 1988 but the rate of decrease has slowed considerably since 2004. 57 The factors most strongly associated with ETS exposure among inner-city children are the number of smokers in the house and younger age. 58 …”

Section: Contributing Factorsmentioning

confidence: 99%

Inner City Asthma

Gergen¹,

Togias²

2015

Immunology and Allergy Clinics of North America

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SYNOPSIS The inner city has long been recognized as an area of high asthma morbidity and mortality. A wide range of factors interact to create this environment. These factors include well-recognized asthma risk factors that are not specific to the inner city, the structure and delivery of health care, the location and function of the urban environment, and social inequities. This article will review these facets and discuss successful and unsuccessful interventions in order to understand what is needed to solve this problem.

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“…1 Most children with asthma are exposed to secondhand smoke (SHS), and children from low-income families are more likely to be exposed. 2 Although SHS exposure has decreased for children in general, it remains stable in children with asthma. 3 SHS exposure has previously been associated with asthma severity based on symptom reporting, school absence, illness frequency, and lower forced expiratory volume in 1 second .…”

Section: Is Secondhand Smoke Exposure Associated With Increased Exacementioning

confidence: 99%

Is Secondhand Smoke Exposure Associated With Increased Exacerbation Severity Among Children Hospitalized for Asthma?

Andrews

Shirley

Ojukwu

et al. 2015

Hospital Pediatrics

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Objective: To determine the association between secondhand smoke (SHS) exposure and length of stay (LOS) and other exacerbation severity indicators in children hospitalized for asthma. Methods: We conducted a retrospective chart review at 2 children’s hospitals. Patients aged 2 to 18 hospitalized for asthma in 2012 were included. Outcome variables included LOS, PICU, magnesium, and intravenous (IV) steroids. Bivariate analysis determined differences between SHS-exposed and non–SHS-exposed groups. Geometric means were used for LOS to account for skewed distribution. Logistic and zero-truncated negative binomial regression models were used to determine the independent association between SHS exposure and hospitalization severity indicators. Results: A total of 623 patients were included; 41% reported SHS exposure. Mean LOS was 47.5 hours. In the SHS-exposed group, LOS was 50.0 (95% confidence interval [CI] 46.7–54.0) and in the nonexposed group it was 45.8 (95% CI 43.4–48.4) (P = .02). In regression analysis, institution modified the effect of SHS exposure on LOS. At Children’s Hospital Colorado, SHS exposure was associated with a 20% increase in LOS (incidence rate ratio 1.2, 95% CI 1.1–1.3). At the Medical University of South Carolina, there was no significant association. SHS-exposed patients were more likely to receive IV steroids (odds ratio 1.6, 95% CI 1.1–2.3) Conclusions: Among children hospitalized for asthma, we identified a significant association at 1 institution between SHS exposure and LOS and found that IV steroid use was significantly associated with LOS at both institutions. Eliminating SHS exposure among children with asthma is important.

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US Prevalence and Trends in Tobacco Smoke Exposure Among Children and Adolescents With Asthma

Cited by 64 publications

References 33 publications

College Health Service Capacity to Support Youth With Chronic Medical Conditions

College Health Service Capacity to Support Youth With Chronic Medical Conditions

Inner City Asthma

Is Secondhand Smoke Exposure Associated With Increased Exacerbation Severity Among Children Hospitalized for Asthma?

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