AND NOW NEWLY RECOGNIZED RISKS OF “SECONDHAND” SMOKE?

Having a single study, and a small one at that, suggesting previously a unrecognized health risk does not necessarilly establish a convincing case, but an interesting and possibly important possibility came out of a major national medical meeting in late May.  At first glance the particular specialty convention and the proposed risk would not even seem connected, but here’s the story.   At the May  annual meeting of the American Urological Association in  Atlanta, a study was reported which suggested that youngsters exposed to environmental (“secondhand”) smoke had an increased risk for urinary symptoms such as increased frequency of having to urinate,  urgency in getting to the bathroom in time, and an increase in wetting accidents.  Again this was a small study with only 45 children enrolled, and there has been nothing in the previous medical literature dealing with this connection.  However, it has long been recognized that cigarette smoke contains substances that irritate the bladder and that it is associated with bladder cancer in adults.  The current study also noted that there are European reports of increased risk of bladder cancer in adults who had childhood exposure to secondhand smoke.  So there is certainly  some background connection of smoke irritation to the bladder.

In this study by New Jersey urologist Dr. Kelly Johnson and a research staff at Robert Wood Johnson and Rutgers University Hospitals evaluated  45 children between four and 17 years old presenting with  the  urine “storage” symptoms mentioned above.  After parent or patient completion of a survey  and physician clinical assessment, the severity of the symptoms was classified as very mild, mild, moderate or severe.  The results revealed that exposure to environmental smoke was associated with worse urine storage symptoms in the children, and that more extensive smoke exposure (mothers who smoked,  regular exposure to smoke in cars, etc.) were more likely to be associated with  severe degree of symptoms.   Conversely,  the children who did not have mothers who smoked and who were free of  significant vehicular exposure had very mild or mild symptom scores.

The results of this initial investigation  prompted Wake Forest pediatric urologist Dr. Anthony Atala, a spokesman for the American Urological Association, to remark that beyond the previous recognized risks of smoking, “we know know that smoking has a negative impact on urnary symptoms, particularly in young children,” and that these results should reinforce “the indisputable evidence that parents shouldn’t smoke around their children.”  It is very likely that future research will seek further support for this.  But even given the preliminary nature of this particular evidence, Dr. Atala’s concluding recommendation is pretty bulletproof.  In particular, if families have one or more caretakers who smoke and also children with bladder-related problems the groundwork has been laid for putting two and two together.