Sequelae of Childhood Respiratory Disease
Gurwitz and associates studied 17 children a decade after acute hydrocarbon pneumonitis at mean age 18 months. Eighty-two percent had pulmonary function abnormalities usually on the basis of either small airway obstruction and/or loss of elastic recoil. None of the children smoked but the pathophysiologic changes seen were similar to those of smokers. These children may be especially susceptible to the additional insults of smoking and air pollution.
Comment: The implications of these studies are profound. Childhood respiratory insults may be much more significant than previously believed. Subsequent additional insults such as smoking may tip the balance toward chronic obstructive pulmonary disease.
