Thirdhand Smoke in the NICU May Put Infants at Risk

A new study shows hospitalized infants are exposed to thirdhand smoke transferred from parents and visitors. The study also suggests steps that can reduce exposures and keep infants safe from this toxic substance.

October 10, 2020

By: Katherine Greiner

Many children are at high risk for exposure to thirdhand smoke, which may contribute to health problems such as ear infections and asthma. However, one group of very young children are at special risk: infants in the neonatal ICU who are particularly vulnerable to respiratory problems. Exposure to thirdhand smoke may increase that vulnerability.

Thirdhand smoke is a mixture of toxic chemicals that sticks to the skin, hair, and clothes of someone who smokes and can transfer to other people and surfaces by direct contact or through the air. Infants in a NICU can come into contact with thirdhand smoke if they are held by someone wearing contaminated clothing or they come in contact with a contaminated surface. Thirdhand smoke can enter infants’ bodies if swallowed, inhaled, or absorbed through the skin.

This new study, led by Dr. Thomas Northrup of The University of Texas Health Science Center at Houston, studied visitors to the NICU to learn more about how thirdhand smoke contamination is brought into the hospital. “We already determined that more than 75% of NICU medical staff may transport nicotine (a toxic substance that is an indicator of thirdhand smoke) into the NICU on their fingers. In this new study, we wanted to determine how much parents and other visitors contributed to THS in the NICU. Really, we want to make sure that parents and families of babies in the NICU are aware of any toxic substances they might be bringing into the NICU, and how to prevent that from happening,” said Dr. Northrup.

Researchers interviewed parents and family members of hospitalized infants to determine household nicotine use, including conventional cigarettes, electronic cigarettes, and smokeless tobacco. They also collected samples to measure nicotine on visitor’s fingers, on NICU furniture, and in infant’s urine.

Results of this study showed that nearly all of the infants’ urine samples showed measurable levels of cotinine (nicotine’s primary metabolite), even babies from homes where nicotine is not used.  However, nicotine levels were higher in babies from homes where nicotine was used than in babies from homes where nicotine was not used. Similarly, furniture testing showed nicotine was present on nearly all NICU furniture, but the highest levels were found on furniture with daily visits from a nicotine user.

It is encouraging that infants whose visitors reported any glove or gown use tended to have lower levels of nicotine on their visitors’ fingers and cotinine in infant urine, although these methods did not eliminate exposure entirely. Dr. Northrup continued, “It is also important to mention that higher levels of nicotine were found in younger infants, which may be due to underdeveloped skin and immune systems. The younger a child is, the more important it is to be cautious about their contact with possible risks like thirdhand smoke.”

Not smoking remains the best way to reduce the risk of thirdhand smoke. However, even non-smokers should be aware of the risks to very young children. Given the increased vulnerability of babies in the NICU, wearing gloves, gowns, and practicing good hand hygiene are all excellent ways of helping to prevent bringing something harmful with you when you visit and limiting infant exposure.

Note: Content may be edited for style and length.

Click here to learn more about this study.

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