Association of e-Cigarette Exposure with Pediatric Otitis Media Recurrence

Area of Science:

• Pediatric Health
• Environmental Health
• Otolaryngology

Background:

• Otitis media (OM) is a frequent childhood illness, leading to numerous doctor visits, antibiotic prescriptions, and surgeries.
• Exposure to tobacco smoke is linked to a higher risk of recurrent, chronic, and surgical otitis media in children.
• Electronic cigarettes (e-cigarettes) represent a new form of tobacco product, with growing evidence of respiratory harm, yet their impact on children's health, particularly secondhand exposure, is understudied.

Purpose of the Study:

• To investigate the association between exposure to e-cigarette emissions (EE) and the recurrence of otitis media and the need for related surgeries in US children.

Main Methods:

• Utilized questionnaire data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018.
• Included 2022 pediatric participants aged 6-17 with data on ear infections and tobacco exposure.
• Employed weighted analyses and logistic regression models to assess the relationship between e-cigarette emissions exposure and otitis media outcomes.

Main Results:

• E-cigarette emissions (EE) exposure was present in 9% of participants.
• EE exposure was associated with an increased risk of experiencing three or more ear infections (OR=1.61, P=.047).
• This association lost statistical significance after adjusting for covariates like race and asthma (P=.081); no other significant links were found for ear infections or tympanostomy tube insertion with EE or other exposures.

Conclusions:

• Exposure to e-cigarette emissions may pose a greater risk for pediatric otitis media than previously recognized factors.
• Further research is essential to fully understand the health implications of e-cigarette emissions exposure in children.
• Findings suggest a potential, though not statistically significant after adjustment, link between EE and recurrent ear infections, warranting continued investigation.