Kum-Nji Philip, Meloy Linda, Herrod Henry G
Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Pediatrics. 2006 May;117(5):1745-54. doi: 10.1542/peds.2005-1886.
Environmental tobacco smoke (ETS) exposure is probably one of the most important public health hazards in our community. Our aim with this article is to (1) review the prevalence of ETS exposure in the United States and how this prevalence is often measured in practice and (2) summarize current thinking concerning the mechanism by which this exposure may cause infections in young children.
We conducted a Medline search to obtain data published mainly in peer-reviewed journals.
There is still a very high prevalence of ETS exposure among US children ranging from 35% to 80% depending on the method of measurement used and the population studied. The mechanism by which ETS may be related to these infections is not entirely clear but may be through suppression or modulation of the immune system, enhancement of bacterial adherence factors, or impairment of the mucociliary apparatus of the respiratory tract, or possibly through enhancement of toxicity of low levels of certain toxins that are not easily detected by conventional means.
The prevalence of ETS exposure in the United States is still very high, and its role in causing infections in children is no longer in doubt even if still poorly understood. Research, therefore, should continue to focus on the various mechanisms of causation of these infections and how to best reduce the exposure levels.
接触环境烟草烟雾（ETS）可能是我们社区面临的最重要的公共卫生危害之一。本文的目的是：（1）回顾美国ETS接触的流行情况以及在实际中通常如何测量这种流行情况；（2）总结目前关于这种接触可能导致幼儿感染的机制的观点。
我们进行了一项医学文献数据库（Medline）检索，以获取主要发表在同行评审期刊上的数据。
美国儿童中ETS接触的流行率仍然非常高，根据所使用的测量方法和研究人群的不同，该流行率在35%至80%之间。ETS可能与这些感染相关的机制尚不完全清楚，但可能是通过抑制或调节免疫系统、增强细菌黏附因子、损害呼吸道的黏液纤毛装置，或者可能是通过增强某些常规方法不易检测到的低水平毒素的毒性。
美国ETS接触的流行率仍然很高，其在导致儿童感染方面的作用即使仍未完全明了，但已不容置疑。因此，研究应继续聚焦于这些感染的各种致病机制以及如何最佳地降低接触水平。
