Medicine & Dentistry-Pediatrics
University of Alberta
MD, FRCPC, MSc, PhD
Summary of research:
Seasonality of environmental tobacco smoke exposure in Alberta Children (ongoing) Exposure to cigarette smoke is known to increase childhood illness, increasing the likelihood that children will require medical care for ear infections, lung infections and asthma, as well as increasing the chance that children will develop asthma and take up smoking. The amount of tobacco smoke a child is exposed to in the previous week can be quantified by measuring a tobacco byproduct, cotinine, in urine. This project measures cotinine in children's urine in winter and summer, as well as collecting the family's report of tobacco smoke exposure and home environment in a questionnaire. Collection of summer data is ongoing. Surveillance of the lung microbial population in a series of pediatric patients with tracheostomy (University of Calgary, ongoing) Children receive tracheostomy (a breathing tube inserted in the neck) for many reasons. Some need a safe air way for long-term mechanical ventilation. Many need to bypass upper airway obstruction, such as a small jaw or narrow windpipe. Tracheostomies can be longstanding for some children; in others they are only there for a few weeks. Tracheostomy bypasses many barriers to bacteria reaching the lungs. Little is known about the bacteria that normally exist in these children's lungs, or how that population changes with infection. Children with tracheostomy often receive antibiotics, and changes to lung bacteria over time, including the development of antibiotic resistance, are also not well understood. The University of Calgary project will review patient charts over the past 10 years, and also prospectively enroll patients for future participation over a 2 year period, looking at both lung microbes and at other infections in the patient, as well as risk factors for infection such as aspiration (breathing stomach or mouth contents into the lungs). This is a pilot project that will use existing laboratory and health data. The project is approved by ethics and patient enrolment has begun. Lung microbial population in pediatric tracheostomy: a retrospective chart review (University of Alberta, application underway) This study is an offshoot of the University of Calgary pilot project, and will focus specifically on reviewing patient charts. This branch of the tracheostomy project is currently awaiting ethical approval. Future research in this area will involve recruiting tracheostomy patients for a more detailed analysis of the lung microbiome over time, as well as collecting more general health information. Contribution of environmental exposures to child health outcomes (University of Alberta, application underway) Environmental exposures are known to affect child health. Children whose mothers have certain exposures can be born smaller (tobacco smoke, forest fires, World Trade Center disaster). Children who have long term exposures to vehicle emissions have lower lung function, and those exposed to tobacco smoke have more ear and lung infections and are more likely to develop asthma and start smoking. This study will use industrial chemical release data that has already been mapped geographically over time, Environment Canada monitoring station data. Demographic data mapping socioeconomic status and health outcomes, including a detailed exposure and health outcome database, a neonatal outcome database and Alberta Health Services billing codes will be overlaid on the geographic and temporal map to flag associations between exposures, protective measures and child health outcomes. This information will be used to guide further investigations into the effects of specific exposures and exposure combinations on child health, as well as whether interventions and environmental factors such as green spaces can help protect children from negative outcomes. All health outcomes, including mental health, developmental issues, respiratory problems and gastrointestinal issues as well as neonatal outcomes and the development of childhood cancers will be included in this screening survey.