Infants born at very low birth weights are at increased risk of lung ailments in the first 12 months of life, and a new study suggests that modifiable indoor respiratory triggers, namely exposure to cigarette smoke and pests in the home, may be at least partly to blame.

In a study of 124 very low birth weight infants, Dr Jill S. Halterman from University of Rochester, New York and colleagues analysed the impact of modifiable exposures on respiratory illness one year after discharge from the neonatal intensive care unit.

“In this study, we found that respiratory illnesses were very common among very low birth weight infants in their first year of life,” Dr Halterman noted in comments. “In fact, almost one in 10 infants had already been diagnosed with asthma at this very young age.”

According to the report in the Archives of Diseases in Childhood, 47 per cent of infants required one or more acute care visits and 11 per cent had to be hospitalized for respiratory illness.

Eighty-two per cent of infants were exposed to at least one indoor environmental trigger, and one-third lived in a home with a smoker. “The infants who lived with a smoker and those who were exposed to pests were more likely to need acute care for respiratory illnesses compared to those who weren’t exposed,” Dr Halterman reported.

Exposure to pests in the home was defined as a yes answer to – “had or wanted to have an exterminator or used any chemicals in the past year to control for pests.”

In analyses controlling for relevant factors including family history of asthma or allergies, both living with a smoker and exposure to pests were independently associated with the need for acute care for respiratory illness.

This is an important finding, Dr Halterman said, “because these represent modifiable exposures, which, if eliminated, could potentially have a significant influence on improving health for these young infants.”

She advises medical care providers to “talk to families about these risks and provide appropriate counselling and support to help families make needed changes in their homes.”

Reuters Health

Source: Archives of Diseases in Childhood, January 2009