二手烟与儿童健康

摘要：加拿大无烟加拿大医生杂志1999年五月号：
 

二手烟中包括40种以上的致癌毒素。
 

二手烟对加拿大儿童造成的疾病包括：

     

  • 下呼吸道感染以至死亡 

  • 中耳积水、中耳炎（13%） 

  • 鼓膜引流管（26％） 

  • 上呼吸道刺激 

  • 肺功能减弱 

  • 5岁以下肺炎（20%） 

  • 哮喘（13%） 

  • 儿童严重哮喘 

  • 减少肌肉供氧 

  • 扁桃腺炎（24%） 

  • 咳嗽（16%） 

  • 婴儿猝死综合症 

 
以下是原文
 
Physicians for a Smoke-Free Canada 1 May, 1999
Background
Second Hand Smoke & Children's Health
Health Impacts
Second-hand smoke (which is sometimes called environmental tobacco smoke or ETS) contains 
toxic substances,  over 40 of which cause cancer. Some of these substances are in stronger 
concentrations in second-hand smoke
  than they are in the smoke that goes directly into smokers' lungs.
ETS is causally linked with a number of adverse health effects in children (under 18), 
including:

    

  •   lower respiratory tract infections (i.e. croup and pneumonia)

  •   increased fluid in the middle ear

  •   upper respiratory tract irritation

  •   reduced lung function

  •   additional episodes of asthma

  •   increased severity of asthmatic symptoms in children

  •   reduced oxygen flow to tissues, comparable to children with anemia, cyanotic heart
      disease or chronic lung disease 


ETS is also associated with:

    


  •   Sudden Infant Death Syndrome (SIDS)

  •   acute middle ear infections (otitis media)

  •   tonsillectomy

  •   meningococcal infections

  •   cancers and leukemias in childhood

  •   slower growth

  •   adverse neurobehavioural effects

  •   upper respiratory tract infections (colds and sore throats)

  •   unfavorable cholesterol levels and initiation of atherosclerosis (heart disease) 


A U.S. analysis of over 100 reports on p?diatric diseases concluded that children's exposure
to tobacco smoke is responsible for up to:

    

  •   13% of ear infections (approximately 220,000 ear infections in Canadian children)*,

  •   24% of tonsillectomies and adenoidectomies (approx. 2,100 Canadian operations)

  •   26% of tympanostomy tube insertions (approx. 16,500 in Canada)

  •   13% of asthma cases (approx. 52,200 cases in Canada)

  •   16% of physician visits for cough (approx. 200,000 visits in Canada)

  •   20% of all lung infections in children under 5 (approx. 19,000 cases of pneumonia 
      in Canada)

  •   136-212 childhood deaths from lower respiratory infection (approx. 13-20 in Canada)

  •   148 childhood deaths from fires started by tobacco products (approx. 15 in Canada)

  •   1868-2708 SIDS deaths(approx. 180-270 in Canada)


*the number of Canadian cases is extrapolated from U.S. estimates provided by[Joseph diFranza
and Robert Lew, in "Morbidity and Mortality in Children Associated with the Use of Tobacco
Products by Other People," Paediatrics, 1996, 97:560-568.
[Samet, JM. Synthesis: The Health Effects of Tobacco Smoke Exposure on Children. January 7,
1999]
**[California EPA. Final Report: Health Effects of Exposure to Environmental Tobacco Smoke,
Sept. 1997]
Adult knowledge about impact on kids' health
Canadians overwhelmingly believe that cigarette smoke is harmful to the non-smoker. Only
9% think there is no danger to the non-smoker.
Canadians are most likely to identify lung cancer and bronchitis and other respiratory
problems as diseases associated with second-hand smoke. Smokers and those who live with
smokers are less likely to acknowledge the health effects of smoking. [Survey on Smoking in
Canada, 1994-95, Cycle 2, Statistics Canada]
Yet most Canadians are unfamiliar with the impact of second hand smoke on children's
illnesses. Only 1 in 5 Canadians surveyed believed that second-hand smoke could cause ear
infections. Even among those who know that second-hand smoke poses a danger, many
mistakenly believe that children's health is only harmed by smoking directly around them.
[Environmental Tobacco Smoke: Knowledge, Attitudes and Actions of Parents, Children 
 and Child Care
Providers, Health Canada, 1995].
 
Impact of mothers' smoking on the fetus
Maternal smoking can affect the fetus and the outcome of the pregnancy. Smoking deprives
the fetus of needed oxygen and other nutrients. This may result in:

    

  •   deficits in intellectual ability and behavioral problems

  •   low birth weight or intra-uterine growth retardation

  •   spontaneous abortion (miscarriage)

  •   stillbirth

  •   reduced lung function in the baby complications in pregnancy


Exposure to someone else's smoking can harm an expectant mother's baby. Research into
this area is still incomplete, and the full effects are still unknown. What we do know
is that the best chance for a healthy baby and healthy mother is a pregnancy where 
both are not Physicians for a Smoke-Free Canada 3 May, 1999
exposed to any tobacco smoke. [Environmental Tobacco Smoke (ETS) in Home Environments,
Health Canada, 1996].
Why kids are especially vulnerable
Young children are especially vulnerable to second-hand smoke in the home because:

    

  •   they breathe more air relative to body weight (and for the same level of exposure 
    will absorb more tobacco smoke toxins)

  •   they are less able to complain (either because they are too young, or because their
  complaints are ignored)

  •   their immune system is less protective

  •   they are less able to remove themselves from exposure


What's in second-hand smoke
Tobacco smoke contains more than 4,000 substances, of which more than 40 are known to
cause cancer.
These carcinogens include:
Arsenic, nickel, chromium, cadmium, lead, polonium-210, vinyl chloride, formaldehyde,
benz(a)anthracene, benzo[b]fouoranthene, benzo[j]fluoranthene, benzo[k]fluoranthene,
benzo[a]pyrene, chrysene, dibenz[a,h]anthracene, dibenzo[a,I]pyrene, dibenzo[a,l]pyrene,
indeno [1,2,3-c,d]pyrene, 5-methylchrysene, quinoline, dibenz[a,h]acridine, dibenz[a,j]
acridine, 7H-dibenzo[c,g]carbazole, N -nitrosodimethylamine, N -nitrosoethylmethylamine, 
N nitrosodiethylamine, N-nitrosopyrrolidine, N-nitrosodimethylamine, N -nitrosonornicotine, 
4- (methylnitrosamino)-1-(3-pyridyl)-1-butanone, N'-nitrosoanabasine, N -nitrosomorpholine, 
2- toluidine, 2-naphthylamine, 4-aminobiphenyl, acetaldehyde, crotonaldehyde, benzene,
acrylonitrile, 1,1-dimethylhydrazine, 2-nitropropane, ethylcarbamate, hydrazine.
Even if smoking is restricted to a single room, the harmful constituents of cigarette smoke 
can be dispersed throughout the house. Many of these highly dangerous chemicals are in 
invisible gas form.