REVIEW OF MECHANISMS OF EFFECT OF ETS WITH RELEVANCE TO HEALTH EFFECTS IN CHILDREN

摘要

Environmental tobacco smoke (ETS) is widely accepted as a significant risk factor for ill health in children, and links have been suggested with sudden infant death syndrome, middle ear disease, increased susceptibility to respiratory infections, and increased severity and prevalence of asthma. Elucidating the toxic mechanisms underlying the effects is, however, difficult, particularly given the complex mixture of more than 4000 chemicals that make up ETS. A detailed critical assessment of the published literature, focusing on studies in neonatal and juvenile animals, with supporting data from in vitro work, concludes that: (ⅰ) ETS exposure early in life may lead to changes in immune response, leading to airway hyper- or hypo-responsiveness; (ⅱ) in experimental animals, chronic stimulation by ETS of C-fibres and rapidly adapting receptors (RAR) may account for cough, wheeze and sputum production; and (ⅲ) the perinatal period is a critical period for exposure to ETS.