Abstract
Background and Objective: The effect of passive smoking on odour identification in children has rarely been reported. This study assessed the ability of such young subjects to identify a variety of odours.
Methods: The study population consisted of 20 children, 10 who were exposed to passive smoke at home and 10 with nonsmoking parents.
Ten odourants were tested: vinegar, ammonia, peppermint, roses, bleach, vanilla, cough drops, turpentine, licorice, and mothballs. Each child was presented with five test trays containing all 10 odourants in random order.
Results: Of the total of 500 odours presented, the control group correctly identified 396 (79%) and the study group identified 356 (71%) (p < .005). The study group tended to misidentify 4 of the 10 odourants tested, namely, vanilla, roses, mothballs, and cough drops-56 of 200 (28%), compared with 96 of 200 (48%) in the control group. This was a highly significant finding (p < .0005).
Conclusion: This work demonstrated that children exposed to passive smoke have difficulty identifying odours in comparison with children raised in relatively smoke-free environments. The identification of four odourants, vanilla, roses, mothballs, and cough drops, was particularly diminished in this study group.
Sommaire
Introduction et objectifs: L'effet de la fumee passive sur l'identification des odeurs par les enfant n'a ete que rarement rapporte. Cette etude evalue donc l'habilete de ces jeunes sujets a identifier une variete d'odeurs.
Methodes: La population de cette etude est form6e de 20 enfants dont 10 etaient exposes a la fumee de cigarette a la maison et 10 de parents non-fumeurs. Nous avons teste 10 odeurs: le vinaigre, Pammoniaque, la menthe poivree, la rose, le javellisant, la vanille, les pastilles pour la toux, la terebenthine, la reglisse, et la boule A mites. Nous avons presente A chaque enfant 5 plateaux contenant chacun les 10 odeurs dans un ordre aleatoire.
Resultats: Sur un total de 500 odeurs, les enfants du groupe controle en ont identifie correctement 396 (79%) et ceux du groupe d'etude 356 (71%) (p < .005). Les enfants du groupe d'etude se sont trompes en particulier sur 4 odeurs: vanille, rose, boules a mites, et pastille pour la toux. Leur score de 56 sur 200 (28%) est tres significativement different de celui des temoins, 96 sur 200 (48%) (p < .0005).
Conclusion: Cette etude montre que les enfants exposes a la fumee secondaire ont plus de difficulte a identifier certaines odeurs que ceux eleves dans un environnement avec moins de fumee. L'identification de 4 odeurs, la vanille, la rose, les boules A mites, et les pastilles pour la toux, est particulierement affectee dans le groupe expose.
Key words: children, odourants, olfaction, passive smoking, smell
In 1966, the U.S. Public Health Service first suggested that tobacco smoking may be hazardous to olfactory function.1 However, it was only in the late 1980s that Frye et al.2 corroborated this relationship.
The purpose of this article was to assess whether children exposed to passive smoking showed an impairment in identifying a variety of odours.
Materials and Methods
Twenty healthy children, aged 10 to 15 years, were selected for the study: 10 who were exposed to passive smoke at home (study group) and 10 who were not (controls). All subjects in the study group had a parent who smoked at least one pack of cigarettes a day. All participants lived in the same town and attended the same school. None of the children in either the study or control group had a history of significant rhinitis or were allergic.
The test odourants included vinegar, roses, cough drops (Vicks), mothballs, ammonia, bleach (Clorox), turpentine, peppermint, vanilla, and licorice. An equivalent of 15 mL of each substance was placed in 40 mL of water in a glass bottle for odour identification.
For the trial, subjects were provided with a list of the test odours. They were told that they were to be presented only with the odourants listed, which they were to identify by sniffing each of the bottles. The bottles were arranged in blocks of 10 and were presented six times to each subject. Every time a new block was presented, the order was rearranged. The first block was used to familiarize the subjects with the test-taking procedure and was not included in the data. During the smell test, the subjects' eyes were covered to prevent visual input. Each subject was tested individually, and the results were marked on a matrix response sheet.
Statistical Analysis
Between the groups, differences in the rate and type of odour identification were analyzed for statistical significance by chi-square test.
Results
Of the 500 odours presented overall, the control group correctly identified 396 (79%) and the experimental group 356 (71%). This difference was statistically significant (X^sup 2^ = 8.156, p < .005) (Table 1).
Our examination of the matrix response sheet revealed that there were no errors in either group in identifying six of the odourants-vinegar, ammonia, bleach, turpentine, peppermint, and licorice-whereas both groups had errors for the other four-vanilla, roses, mothballs, and cough drops (Table 2). Further analysis showed a consistency in these misidentifications as follows. Mothballs tended to be mistaken for roses, roses for vanilla, vanilla for cough drops, and cough drops for mothballs.
For these four odourants, the rates of correct identification were 56 of 200 (28%) in the study group and 96 of 200 (48%) in the control group. This difference was highly significant (p < .0005) (Table 3).
Discussion
The adverse health effects of tobacco smoking have been known for many years.1 More recently, awareness of the dangers of involuntary or passive smoking has been steadily increasing. In 1986, the U.S. Surgeon General's Office published the following conclusions regarding the health effects of exposure to environmental tobacco smoke: (1) involuntary smoking may cause serious diseases, such as lung cancer, in healthy nonsmokers; (2) children of smoking parents have more respiratory infections, more severe respiratory symptoms, and poorer lung function with maturity than children of nonsmoking parents; (3) the separation of smokers and nonsmokers in the same airspace will reduce, but not entirely eliminate, nonsmoker exposure to environmental tobacco smoke.3 These findings were partly based on earlier reports indicating an association between involuntary smoke and a variety of respiratory system complaints. In 1974, Harlap and Davies4 reported a greater hospital admission rate for pneumonia and bronchitis in infants of smoking mothers compared with nonexposed infants, and, later, Pedreira et al.,5 in a study of 1144 infants and their families, found that maternal smoking was associated with an excess rate of acute bronchitis, tracheitis, and laryngitis. Burchfiel and colleagues6 conducted a 15-year longitudinal study of 3482 subjects under 10 years of age. The results showed that the agespecific incidence for cough, wheeze, phlegm, and bronchitis was higher for the children with two parents who smoked than for the children of nonsmokers. Ware et al.7 investigated 10,106 children aged 6 to 9 years and reported a higher prevalence of persistent cough and wheeze at the second examination in the children with smoking parents. Surprisingly, these effects were greater for maternal smoking, with the prevalence rates increasing linearly with the number of cigarettes smoked daily by the mother. In a study of two random communities in Michigan and Massachusetts, Gortmaker et al.8 found that asthma occurs with greater frequency in the children of smokers.
Two more recent works are also noteworthy. One emphasized that the children of smoking parents had a significantly poorer outcome of functional endoscopic sinus surgery for chronic sinusitis than those raised in a smoke-free environment? In the other, measurements of serum contine, a major metabolite of nicotine, were used to determine smoke exposure in 132 schoolchildren. The authors noted a 38% higher incidence of middle ear effusion in the exposed group.10
Although suspected, the effect of smoking on odour identification was not addressed in the surgeon general's report. The one definitive work in this area is that of Frye et al.,2 performed in 1986, demonstrating that the smoking-related loss in the ability to identify odours is not only dose related but is also found in past and current smokers.
To our knowledge, the effect of passive smoking on odour identification in children has not been reported in the English literature.
This article clearly demonstrates that children exposed to passive smoking have difficulty identifying odours in comparison with children raised in relatively smoke-free environments. Interestingly, misidentification was apparent for only 4 of the 10 odourants tested: vanilla, cough drops, roses, and mothballs. Errors were noted in both the study and control groups but occurred at a significantly higher rate in the former for these odours. Although an insult to the olfactory mechanism is most likely the case in the nicotine-exposed children, the possibility of them having a gustatory deficiency should also be considered for those odourants, such as vanilla and cough drops, that may stimulate taste.
In conclusion, the children of smoking parents may suffer from an impairment in olfactory function. These children tend to misidentify the odours of vanilla, roses, mothballs, and cough drops. The findings suggest that these four odourants may suffice in testing odour identification in children. The physiologic significance of this pattern requires further examination.
References
1. U.S. Public Health Service. Smoking and health. Report of the Advisory Committee to the Surgeon General of the Public Health Service. PHS publication no. 1103. U.S. Department of Health, Education, and Welfare, Public Health Service, 1964.
2. Frye RE, Doty RL, Schwartz B. Influence of cigarette smoking on olfaction: evidence for a dose-response relationship. JAMA 1990; 263:1233-1236.
3. The health consequences of involuntary smoking. Washington, DC: U.S. Government Printing Office, 1986.
4. Harlap D, Davies AM. Infant admissions to hospital and maternal smoking. Lancet 1974; i:529-532.
5. Pedreira FA, Guandolo VL, Feroli EJ, et al. Involuntary smoking and incidence of respiratory illness during the first year of life. Pediatrics 1985; 75:594-597.
6. Burchfiel CM, Higgins MW, Keller JB, et al. Passive smoking in childhood: respiratory conditions and pulmonary function in Tecumseh, Michigan. Am Rev Respir Dis 1986; 133:966-973.
7. Ware JH, Dockery DW, Spiro AM, et al. Passive smoking, gas cooking, and respiratory health of children living in six cities. Am Rev Respir Dis 1984; 129:366-374.
8. Gortmaker SL, Walker DK, Jacobs FH, Ruch-Ross H. Parental smoking and the risk of childhood asthma. Am J Public Health 1982; 2:574-579.
9. Younis RT, Lazar RH. Criteria for success in pediatric functional endonasal sinus surgery. Laryngoscope 1996; 106: 869-873.
10. Etzel RA, Pattishall EN, Haley NJ, et al. Passive smoking and middle ear effusion among children in day care. Pediatrics 1992; 90(2 Pt 1):228-232.
Benny Nageris, MD, Itzhak Braverman, MD, Tuvia Hadar, MD, Maynard C. Hansen, MD, and Saul Frenkiel, MD, FR CSC
Received 13/06/00. Received revised 08/02/01. Accepted for publication 21/03/01.
Benny Nageris and Tuvia Hadar: Department of Otolaryngology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Maynard C. Hansen: Department of Otolaryngology, University of Massachusetts Medical Center, Worcester, Massachusetts; Itzhak Braverman: Department of Otolaryngology, Hillel Yaffe Medical Center, Hadera, Israel; Saul Frenkiel. Department of Otolaryngology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec.
Address reprint requests to: Dr. Benny Nageris, Department of Otolaryngology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel.
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Copyright Decker Periodicals, Inc. Sep/Oct 2001
Abstract
BACKGROUND AND OBJECTIVE: The effect of passive smoking on odour identification in children has rarely been reported. This study assessed the ability of such young subjects to identify a variety of odours. METHODS: The study population consisted of 20 children, 10 who were exposed to passive smoke at home and 10 with nonsmoking parents. Ten odourants were tested: vinegar, ammonia, peppermint, roses, bleach, vanilla, cough drops, turpentine, licorice, and mothballs. Each child was presented with five test trays containing all 10 odourants in random order. RESULTS: Of the total of 500 odours presented, the control group correctly identified 396 (79%) and the study group identified 356 (71%) (p < .005). The study group tended to misidentify 4 of the 10 odourants tested, namely, vanilla, roses, mothballs, and cough drops-56 of 200 (28%), compared with 96 of 200 (48%) in the control group. This was a highly significant finding (p < .0005). CONCLUSION: This work demonstrated that children exposed to passive smoke have difficulty identifying odours in comparison with children raised in relatively smoke-free environments. The identification of four odourants, vanilla, roses, mothballs, and cough drops, was particularly diminished in this study group.
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Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer