Detrimental effects of environmental tobacco smoke in relation to asthma severity.

TitleDetrimental effects of environmental tobacco smoke in relation to asthma severity.
Publication TypeJournal Article
Year of Publication2011
AuthorsComhair SAA, Gaston BM, Ricci KS, Hammel J, Dweik RA, Teague GW, Meyers D, Ampleford EJ, Bleecker ER, Busse WW, Calhoun WJ, Castro M, Chung K F, Curran-Everett D, Israel E, Jarjour NW, Moore W, Peters SP, Wenzel S, Hazen SL, Erzurum SC
Corporate AuthorsNational Heart Lung Blood Institute Severe Asthma Research Program
JournalPLoS One
Volume6
Issue5
Paginatione18574
Date Published2011
ISSN1932-6203
KeywordsAdolescent, Adult, Aged, Asthma, Child, Environmental Exposure, Female, Humans, Male, Middle Aged, Respiratory Function Tests, Superoxide Dismutase, Tobacco Smoke Pollution, Young Adult
Abstract

BACKGROUND: Environmental tobacco smoke (ETS) has adverse effects on the health of asthmatics, however the harmful consequences of ETS in relation to asthma severity are unknown.

METHODS: In a multicenter study of severe asthma, we assessed the impact of ETS exposure on morbidity, health care utilization and lung functions; and activity of systemic superoxide dismutase (SOD), a potential oxidative target of ETS that is negatively associated with asthma severity.

FINDINGS: From 2002-2006, 654 asthmatics (non-severe 366, severe 288) were enrolled, among whom 109 non-severe and 67 severe asthmatics were routinely exposed to ETS as ascertained by history and validated by urine cotinine levels. ETS-exposure was associated with lower quality of life scores; greater rescue inhaler use; lower lung function; greater bronchodilator responsiveness; and greater risk for emergency room visits, hospitalization and intensive care unit admission. ETS-exposure was associated with lower levels of serum SOD activity, particularly in asthmatic women of African heritage.

INTERPRETATION: ETS-exposure of asthmatic individuals is associated with worse lung function, higher acuity of exacerbations, more health care utilization, and greater bronchial hyperreactivity. The association of diminished systemic SOD activity to ETS exposure provides for the first time a specific oxidant mechanism by which ETS may adversely affect patients with asthma.

DOI10.1371/journal.pone.0018574
Alternate JournalPLoS ONE
PubMed ID21572527