Association of Environmental Tobacco Smoke Exposure in Childhood with Early Emphysema in Adulthood Among Nonsmokers

The MESA-Lung Study

Adult nonsmokers who lived during childhood with at least one smoker had more advanced diffuse emphysema than nonsmokers who grew up in households without a smoker. Emphysema and early chronic obstructive pulmonary disease are among the leading causes of death worldwide. Exposure to tobacco smoke is a possible cause of diffuse emphysema.

This article presents a study of the association between environmental tobacco smoke (ETS) exposure during childhood and early emphysema in adult nonsmokers. The authors analyzed the lung portions of CT scan images from the Multi-Ethnic Study of Atherosclerosis (MESA)-Lung Study. The study assessed the severity of emphysema using two discreet measures: early emphysema and percent emphysema. The authors defined early emphysema using a measurement termed “alpha”; “alpha” described the relationship between the number of emphysematic holes and their size on the CT scan of a given individual; percent emphysema was the percentage of emphysema-like lung, or the percentage of voxels in the lung falling below a certain level of Hounsfield units (HU).

The authors obtained data about participants’ childhood ETS exposure. Participants reported the number of smokers in their childhood homes and identified which parents smoked. Statistical analyses employed adjusted regression models that accounted for several covariates, including: history of asthma, exposure to tobacco smoke during adulthood, and exposure to dust at work. Childhood ETS exposure was associated with higher percent emphysema and higher early emphysema.

This article presents a study that examined CT scan images from the MESA-Lung study. Childhood ETS exposure was associated with two measures of early emphysema in adult nonsmokers.

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