Ahu PAKETÇİ, Abdülkadir BOZAYKUT, Cem PAKETÇİ, Rabia GÖNÜL SEZER

İki yaş altı Çocuklarda Sigara Maruziyeti ve Tekrarlayan Bronşiyolit Atakları Arasındaki İlişkinin İncelenmesi

Giriş: Tekrarlayan hışıltı atakları özellikle sosyoekonomik düzeyi düşük olan ailelerde, kalabalık ortamda yaşayan, sigara dumanına maruz kalan ve anne sütü alamayan bebeklerde daha sık olarak görülür.Materyal ve Method: Bu çalışma 2009-2011 tarihleri arasında, Çocuk Sağlığı ve Hastalıkları Kliniği'ne başvurup ilk atak bronşiyolit tanısı alan hastalarda prospektif olarak yapıldı.Sonuçlar: Çalışmaya yaşları 1-24 ay arası toplam 500 infant dahil edildi. Evde sigara kullanımı hastaların %46,6’sında (n=233) mevcuttu. Tekrarlayan bronşiyolit atağı geçiren çocukların, evde sigara maruziyet oranları istatistiksel olarak anlamlı derecede yüksek saptandı (p<0,001).Tartışma: Çalışmamızda, sigara maruziyeti tekrarlayan hışıltı atakları açısından risk faktörü olarak bulundu. Sigara dumanına maruziyet azaltılarak tekrarlayan akut bronşiyolit ataklarının azaltılabileceğini düşünmekteyiz.

Anahtar Kelimeler:

bronşiyolit, sigara, sütçocuğu

The evaluation of relationship between passive smoking and recurrent episodes of bronchiolitis in children under two-years old

Objective: Recurrent episodes of wheezing are more common in infants especially with low socioeconomic status who are exposed to smoking, who are not breastfed and lives in crowded families.Material and Methods: This study was performed prospectively with infants diagnosed as first attack bronchiolitis from the outpatient clinics between 2009 to 2011.Results: The study included 500 infants aged between 1-24 months. Cigarette smoking was present in 46,6% (n=233) of the families. There was a significant relationship between recurrent episodes of bronchiolitis and exposure to cigarette smoke (p<0,001).Conclusion: In this study, exposure to cigarette smoke was detected as a risk factor for recurrent episodes of bronchiolitis. The decrease of smoking in the population can prevent recurrence of bronchiolitis.

Keywords:

bronchiolitis, smoking, infant,

PDF

___

Mc Connochie KM, Hall CB,Walsh EE, Raghman KJ. Variation in the severity of respiratory syncytial virus infections with subtype. J Pediatr 1999;117:52-62.
Wright AL, Holber C, Martinez FD, Taussig LM. Relationship of parenteral smoking to wheezing and nonwheezing respiratory tract illness. Group Health Medical Associates J Pediatr 1991;118: 207- 214.
Martinez FD. Definition of pediatric asthma nad associated risk factors. Pediatr Pulmonol 1997;15: 9- 12.
Lodrup Carlsen KC, Carlsen KH, Nafstad P, Bakketeig L. Perinatal risk factors for recurrent wheeze in early life. Pediatr Allergy Immunol. 1999;10:89-95.
Chulada PC, Arbes SJ Jr, Dunson D, Zeldin DC. Breast-feeding and the prevalence of asthma and wheeze in children: analyses from the Third National Health and Nutrition Examination Survey, 1988-1994. J Allergy Clin Immunol. 2003;111:328-36.
Jones LL, Hashim A, McKeever T, Cook DG, Britton J, Leonardi-Bee J. Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis. Respir Res. 2011;12:5.
Semple MG, Taylor-Robinson DC, Lane S, Smyth RL. Household tobacco smoke and admission weight predict severe bronchiolitis in infants independent of deprivation: prospective cohort study. PLoS One. 2011;6:e22425.
Arshad SH, Kurukulaaratchy RJ, Fenn M, Matthews S. Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age. Chest. 2005;127:502-508.
Lannerö E, Wickman M, Pershagen G, Nordvall L. Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE) Respir Res. 2006;7:3.
Elliot J, Vullermin P, Robinson P. Maternal cigarette smoking is associated with increased inner airway wall thickness in children who die from sudden infant death syndrome. Am J Respir Crit Care Med. 1998;158:802–06.
Gürkan F, Kiral A, Dağli E, Karakoç F. The effect of passive smoking on the development of respiratory syncytial virus bronchiolitis. Eur J Epidemiol. 2000;16:465-8.
Karaman O, Uguz A, Uzuner N. Risk factors in wheezing infants. Pediatr Int. 1999;41:147-50.
Rullo VE, Arruda LK, Cardoso MR, Valente V, Zampolo AS, Nóbrega F, Naspitz CK, Solé D. Respiratory infection, exposure to mouse allergen and breastfeeding: role in recurrent wheezing in early life. Int Arch Allergy Immunol. 2009;150:172-8.