title: Hair nicotine levels in children with bronchopulmonary dysplasia.
abstract: BACKGROUND
  Tobacco smoke exposure (TSE) may increase respiratory morbidities in young children with bronchopulmonary dysplasia (BPD). Rapid respiratory rates, close proximity to a smoking caregiver, and increased dermal absorption of tobacco smoke components can contribute to systemic exposure. In this study, hair nicotine levels were used as a biomarker of chronic TSE in young children with BPD to determine if hair nicotine levels correlate with caregiver self-report of TSE and respiratory morbidities.
  
  
  METHODS
  From 2012 to 2014, hair nicotine levels were measured from consecutive children seen in a BPD outpatient clinic and compared with caregiver questionnaires on household smoking. The relationship between respiratory morbidities and self-reported TSE or hair nicotine level was assessed.
  
  
  RESULTS
  The mean hair nicotine level from 117 children was 3.1 ± 13.2 ng/mg. Hair nicotine levels were significantly higher in children from smoking households by caregiver self-report compared with caregivers who reported no smoking (8.2 ± 19.7 ng/mg vs 1.8 ± 10.7; P < .001). In households that reported smoking, hair nicotine levels were higher in children with a primary caregiver who smoked compared with a primary caregiver who did not smoke. Among children with BPD who required respiratory support (n = 50), a significant association was found between higher log hair nicotine levels and increased hospitalizations and limitation of activity.
  
  
  CONCLUSIONS
  Chronic TSE is common in children with BPD, with hair nicotine levels being more likely to detect TSE than caregiver self-report. Hair nicotine levels were also a better predictor of hospitalization and activity limitation in children with BPD who required respiratory support at outpatient presentation.
authors: Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and Julius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and mcollac1@jhmi.edu.
authors: Joseph M
authors: JM
authors: Collaco
authors: Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and.
authors: Angela D
authors: AD
authors: Aherrera
authors: Julius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
authors: Patrick N
authors: PN
authors: Breysse
authors: Julius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and Division of General Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors: Jonathan P
authors: JP
authors: Winickoff
authors: Julius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and.
authors: Jonathan D
authors: JD
authors: Klein
authors: Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, and Julius B. Richmond FAMRI Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and.
authors: Sharon A
authors: SA
authors: McGrath-Morrow
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001997:Bronchopulmonary Dysplasia / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006197:Hair / Q000737:chemistry; D006801:Humans; D007223:Infant; D008297:Male; D009538:Nicotine / Q000032:analysis*; D011379:Prognosis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D057566:Self Report; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000032:analysis
chemical_list: D015415:Biomarkers; D014028:Tobacco Smoke Pollution; D009538:Nicotine
keywords: bronchopulmonary dysplasia; nicotine; prematurity; respiratory outcomes; secondhand smoke; tobacco smoke exposure
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