Why should Canadians care about banning smoking in cars carrying children? Because second-hand smoke is more concentrated in a confined space. Within a vehicle, poisons found in smoke can reach high levels in a short amount of time.

A 2006 study in the American Journal of Preventive Medicine found that breathing in smoke from a single cigarette for only five minutes in a car exposes a person to the same amount of smoke as spending the equivalent time in a smoky bar. Babies and children are most vulnerable because they breathe more rapidly and take in more harmful chemicals for their size than adults do. Second-hand smoke affects their developing respiratory, immune and nervous systems.

In the United States, the Surgeon General recently released a report on the profound impact of second-hand smoke on children, revealing that kids exposed to second-hand smoke have an increased risk of sudden infant death syndrome (SIDS), acute respiratory infections such as bronchitis and pneumonia, middle ear infections, more severe asthma, respiratory symptoms and slowed growth of the lungs. The report concludes that there simply is no safe level of exposure to second-hand smoke; even brief exposures can prove harmful.

There is growing evidence as well that kids who are exposed to second-hand smoke in the womb and as infants have more behavioural problems, shorter attention spans, and lower marks than peers who aren’t exposed to smoke.

Since babies and children are powerless to protect themselves from this risk, The Canadian Lung Association is asking Canadians to take a stand with the “Clean Air for Kids” lobby. “This campaign is about protecting Canada’s children from the harmful effects of second-hand smoke,” said Nora Sobolov, president of The Lung Association. “Working together with Canadians, we are confident that action can be taken to ensure kids are not subjected to smoking in cars.”

What can you do? If you want to send a message directly to your provincial or territorial representative, visit The Lung Association.

Related:
• Discussion: Smoking outside “still harms kids”
• The dangers of third-hand smoke
• 15 ways to clean up your home’s air

First published in Breathing Space, a supplement of Allergic Living magazine.

The Lung Association has also asked Air Canada and WestJet to compromise by designating some flights as pet-free. “We’re worried that profit is taking a front seat and public health is taking a back seat,” says Cameron Bishop, director of government affairs for The Lung Association. “We want to help Canadians to express their views on the issue of pet-free flights.”

A poll released by the association found that 80 per cent of Canadians want Canada’s airlines to offer pet-free flights. In addition, 75 per cent of Canadians believe that the federal government has a responsibility to protect the health and safety of passengers and crew.

Bishop hopes the campaign will convince Parliament to hold hearings this fall to review the public health ramifications of the airlines’ policies. “We, of course, recognize the need for service animals or guide dogs to be allowed on flights,” he adds. “We just request that passengers be alerted to their presence.”

The campaign has received the support of thousands of Canadians like Monica Peterson, who has asthma and a severe allergy to cats. She was flying on a WestJet flight from Winnipeg to Victoria last year when her eyes started watering and her airways became congested. “When the plane was unloading, it turned out a cat was under the seat in front of me. Luckily it was a short flight; it was alarming that there wasn’t even a warning that pets were on board.”

When Traveling with Asthma, Pet Allergies or COPD:

• Check with the airline beforehand to try to get on a pet-free flight.
• Take your medications regularly and follow your asthma action plan.
• Use your rescue inhaler 20 minutes before boarding the plane.
• Speak to your doctor before traveling. You may need medications adjusted for the flight.
• Always have your medications with you – never keep them in checked baggage.

From the Fall 2009 issue of Allergic Living magazine.
To order that issue or to subscribe, click here.

© Copyright AGW Publishing Inc.

However, a leading Canadian pediatric allergist says acetaminophen – which is the active ingredient in these popular fever-reducing drugs – is safe for children if used properly. “There’s no proof that acetaminophen causes asthma,” says Dr. Allan Becker, a researcher with the Manitoba Institute of Child Health. Even the study authors say acetaminophen remains the medicine of choice for babies with high fevers. But they stress the importance of following the guideline that its use be limited to those cases, and not used casually.

The study reported that children who had been given acetaminophen once a year or more in their first year of life showed a 46 per cent higher risk of asthma symptoms by 6 or 7 years of age compared to those who hadn’t had the drug. The findings also indicate that the asthma risk increased threefold in 6-year-olds and 7-year-olds taking the tablets one or more times a month.

Researchers gathered the data from children in 73 countries, including Canada, as part of third phase of the International Study of Asthma and Allergies in Children (ISAAC) program. The findings were published in The Lancet, the well-known British medical journal.

This study shows an association between the use of acetaminophen and the definition of asthma in the survey, explains Dr. Becker. In a questionnaire, parents were asked whether their child had experienced wheeze – a whistling noise in the chest – in the past 12 months. “In the two participating Canadian centres, Hamilton and Saskatoon, 20 per cent and 17 per cent respectively answered yes to that question,” says Dr. Becker.

However, a sub-group of these parents was shown a video of a child with asthma wheezing, instead of getting the questionnaire. Only 12 and 10 per cent of this group answered that they had seen ‘wheezing’. “This tells us that many parents who said their child was wheezing really don’t understand what we mean when we say ‘wheezing’,” said Dr. Becker.

Stay tuned. Researchers have called for a large randomized trial to settle the acetaminophen debate once and for all.

First published in Breathing Space, a supplement of Allergic Living magazine.

The check-in attendant told the St. John’s resident that WestJet is a pet-friendly airline – small animals are allowed in the cabin in an enclosed kennel. In fact, there were two other cats on the flight. “I told her, ‘I cannot get on that plane. If I do, I could die,’” recalls Callahan.

He was offered a seat near the back. He explained that moving would make no difference since the air is re-circulated: “I can’t get away from a cat at 30,000 feet.” Callahan was told he could have a seat on the next flight, but turned that down since the airline could not guarantee there would be no cats on that plane.

“So I had two options, get on a WestJet plane and put my life in jeopardy or stay behind.” Instead, Callahan bought a last-minute ticket on the next Air Canada flight, which cost him $1,900 one way. Air Canada does not allow animals to travel in the passenger cabin.

“We’ve made the decision as an airline that we will continue to take them (pets) on board,” explains Richard Bartrem, vice-president of culture and communications at WestJet. “While we empathize with this gentleman’s situation, we will continue to offer this service as a benefit to our guests.”

The risk of a severe reaction for passengers with asthma is relatively low with air travel, according to Dr. Antony Ham Pong, an Ottawa allergist. Dander takes time to accumulate, so the level of dander would depend on how long the cat has been on the plane. “The risk is certainly lower than walking into a house where someone lives with a cat,” he says.

The level of reaction would also depend on a person’s asthma control. “If someone has uncontrolled asthma and he or she is sitting beside a cat, it can lead to big-time trouble,” says Dr. Ham Pong. “It could be fatal. But if his or her asthma is under control, it shouldn’t be a big issue. Just don’t sit next to the cat.”

Travelers should check ahead for pet policies on planes, trains and buses to reduce the risk of an asthma attack, the allergist says, adding that they should always carry their asthma and allergy medication on board, just in case.

Callahan is not content with WestJet’s policy, describing the airline’s attitude toward passengers with severe pet allergies as “terrible.” Although WestJet does post its pet-friendly policy on its website, it’s not easy to find. Callahan would like to see it on the homepage, so others with pet allergies will be well warned. However, Bartem says WestJet has no plans to post a warning on its homepage. So unless that policy changes, at least for this airline, it’s “flyer beware.”

To provide feedback, visit www.westjet.com, click on “contact us” and then select “e-mail guest relations”.

First published in Breathing Space, a supplement of Allergic Living magazine.
To contact the Lung Association in your region, click here.

Third-hand smoke can harm infants and babies

Even if a person makes an effort to avoid second-hand fumes by smoking alone or out a car window, they are still endangering others, especially kids. Small children are exposed to third-hand smoke when they are held by someone who was smoking, through breathing in smoke particles on hair and clothes. When they crawl or play on contaminated surfaces, their hands may pick up toxic residue, which ends up in their mouths.

Babies and children are particularly vulnerable to third-hand smoke because they breathe faster than adults and thus absorb more of the harmful chemicals. Their immature immune systems also make small children less able to fight off toxic pollution.

The term “third-hand smoke” garnered media attention when it appeared in a recent study published in the journal Pediatrics.

Study authors surveyed 1,500 U.S. households to learn about attitudes toward the health risks of third-hand smoke. They found that 65 per cent of non-smokers and 43 per cent of smokers surveyed agreed that this kind of residual smoke can harm children.

Third-hand smoke avoidance

•   Don’t allow smoking in your home and car. Remember that opening a window, running a fan or air purifier, or smoking near the chimney will not get rid of second- or third-hand smoke.

•   Keep your child away from any place where people usually smoke – even if they don’t smoke while your child is there.

•   If you smoke – quit. Your child will be healthier if you do.

•   If you won’t quit smoking, smoke outdoors. Wash your hands after smoking.

•   If you live with a smoker, support the person’s efforts to quit.

Related:
• Smoking in cars puts kids at risk
• All you need to know about asthma
• What to do when you think you have asthma

First published in Breathing Space, a supplement of Allergic Living magazine, Spring 2009 edition.
Click here to purchase issue online.

Issue also available at Chapters, Indigo, London Drugs and Shoppers Drug Mart newsstands.