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Open AccessArticle

The Association of Environmental Tobacco Smoke Exposure and Inflammatory Markers in Hospitalized Children

1
Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
2
School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
3
Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati; College of Medicine, Cincinnati, OH 45229, USA
4
Department of Psychology, San Diego State University, San Diego, CA 92123, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(23), 4625; https://doi.org/10.3390/ijerph16234625
Received: 25 September 2019 / Revised: 7 November 2019 / Accepted: 16 November 2019 / Published: 21 November 2019
Background: Environmental tobacco smoke (ETS) exposure is associated with altered cytokine levels in children. We sought to examine ETS exposure prevalence and the relationship between ETS exposure and cytokine levels in a sample of hospitalized children. (2) Methods: Inflammatory markers (IL-8, IL-1β, IL-10, and TNF-α) and cotinine were measured in saliva of hospitalized, nonsmoking children (N = 112). To assess the association between ETS exposure and immune system response, we built a multivariate regression model including the four inflammatory markers as the response variables and cotinine, age, sex, and discharge diagnosis as explanatory variables while assessing possible interaction effects. (3) Results: Mean age (SD) was 5.8(5.0) years; Geometric Mean (GeoM) cotinine = 1.8 [95% CI = 1.4–2.2]. Children with non-inflammatory other diagnoses had lower IL-10 (p = 0.003) and TNF-α (p = 0.009) levels than children with inflammatory other diagnoses. Children with asthma (p = 0.01) and bacterial illnesses and/or pneumonia (p = 0.002) had higher IL-8 levels. Independent of diagnosis, there was a significant curvilinear association between cotinine and IL-1β (p = 0.002) reflecting no association for cotinine levels <5 ng/mL and a positive association for >5 ng/mL. (4) Conclusions: Children with higher ETS exposure levels have higher IL-1β levels regardless of age, sex, and diagnosis. ETS exposure may increase pro-inflammatory immune responses in children and may interfere with native immune responses and the ability to heal and fight infection. View Full-Text
Keywords: cotinine; inflammatory markers; cytokines; secondhand smoke exposure; children cotinine; inflammatory markers; cytokines; secondhand smoke exposure; children
MDPI and ACS Style

Mahabee-Gittens, E.M.; Merianos, A.L.; Fulkerson, P.C.; Stone, L.; Matt, G.E. The Association of Environmental Tobacco Smoke Exposure and Inflammatory Markers in Hospitalized Children. Int. J. Environ. Res. Public Health 2019, 16, 4625.

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