Effects of Environmental Tobacco Smoke on Blood Lead Level and Anthropometric Status of Egyptian Preschool Children
Mai M. Youssef1 and Amal Saad2
1 Department of Child Health and 2 Department of Environmental and Occupational Medicine, National Research Center, Dokki, Cairo, Egypt
Corresponding author: Dr. Amal Saad
Department of Environmental and Occupational Medicine
National Research Center
Tahrir Street
Dokki, Cairo, Egypt
E-mail: amel_h3@yahoo.com
CEJOEM 2005, Vol.11. No.3.: 197–206
Key words: Environmental tobacco smoke, preschool children, cotinine-creatinine ratio, blood lead level, and anthropometric status
Abbreviations:
BLL BMI CC CCR
= Blood lead level = Body mass index = Chest circumference = Cotinine/creatinine ratio
Abstract: Passively smoking children proved to be exposed to many hazardous components of the environmental tobacco
smoke (ETS). Lead (Pb) was one of them. The aim of this study was to discuss passive smoking as a risk factor
for growth retardation of children. It evaluates the role of Pb, as a component of ETS, on the growth of
passively smoking preschool Egyptian children. The study included 175 children aged 1–6 years. Personal,
environmental, medical, and social questionnaires were completed by the parents. History of smoking habits
during pregnancy and after delivery was thoroughly asked. The questionnaire and urinary cotinine/creatinine
ratio (CCR) were used as biomarker of ETS exposure. Blood lead level (BLL) and haemoglobin (Hb) concentration
were determined. Anthropometrical assessment based on the measurement of weight, height, mid-arm and chest
circumferences was done for all children included. Statistical analysis of the results proved that the
weight-for-age percentile (WAP) and body mass index (BMI) of the children exposed to smoking fathers or both
parents were significantly lower, while BLL and CCR significantly higher compared to the non-exposed group.
The Hb concentration significantly decreased. All of the anthropometrical parameters of the passively smoking
children, except height, height-for-age percentile (HAP), and Hb concentration, inversely correlated with the
dose of ETS exposure, CCR, and BLL controlled for age and sex differences. In conclusion, passive smoking is
considered as a significant risk factor for the elevation of BLL, retardation of growth, and decline of the Hb
concentration in preschool children. The present data, indicating an inverse association between ETS and growth
of children, support the policy to further restrict children’s exposure.