BABIES MAY BE 2ND-HAND CRACK VICTIMS

NEW HAVEN, Conn.--Many infants brought into city hospital emergency rooms
may be suffering from exposure to secondhand smoke from crack cocaine,
according to a new study from the Yale School of Medicine.

The study showed that between one-sixth and one-third of children under 1
year old who were sick enough to require urine tests at a city emergency
room may have been exposed to crack smoke.

The children tested were about 13 percent of the overall number of
infants seen at Yale-New Haven Hospital between December 1993 and
September 1994, according to the study published last month in the journal
of the American Academy of Pediatrics.

The study also showed that many of the children whose urine tested positive
for crack cocaine suffered from respiratory problems such as wheezing and
coughing.

Researchers presume that the exposure is from secondhand smoke, likely from
the children's parents or other caretakers, and not from ingesting cocaine
directly.

"We're pretty sure it's passive cocaine exposure, but we're not 100 percent
sure where the cocaine came from," said the study's principal investigator,
Dr. Andrew S. Lustbader. "You have to assume people are not giving their
children cocaine, but unfortunately we don't exactly know." The researchers
stressed that the urine samples were routine and were ordered to determine
the cause of the children's illnesses -not because cocaine exposure was
suspected. The samples were anonymous and were not used for any law
enforcement purposes.

They examined 124 random urine samples from 122 sick children. About 36
percent of them tested positive for cocaine exposure; close to 19 percent
appeared to have some level of exposure, but the results were inconclusive.

Close to 64 percent of the children who tested positive were suffering from
stomach problems, most accompanied by fever, and 67 percent had respiratory
problems, such as wheezing. The children who tested positive for cocaine
exposure also had medical histories that showed they had more illnesses
requiring medical attention.

Babies younger than 4 days old were not included in the study to eliminate
the possibility that the exposure was prenatal.

The researchers cautioned that many mothers of children who tested positive
for cocaine did not report being crack cocaine users themselves.

Doctors have long recognized that many babies exposed to cocaine in the
womb -so-called crack babies -suffer from a variety of health problems,
including low birth weight and attention deficit disorder.

Doctors also know that passive exposure to smoke from crack cocaine is a
potential health hazard for children, but the extent of that hazard has not
been clearly defined.

The researchers stressed that more study is needed to confirm the results,
as well as to determine the long-term health effects and rate of death in
children exposed to crack smoke.

Lustbader said he hoped the report would make doctors more aware that
children coming into the emergency room could have had such exposure.

"We think after other studies are done like this, it would be wise, for
populations that are at risk, to test for cocaine in little kids who come
into the emergency room -not to report it ... but to find out what's wrong
with them," Lustbader said.

"The problem, though, is of course that if parents feel their kids are
going to be tested for cocaine, they may be slower to bring them into the
hospital." The researchers conceded that the findings may have been skewed
because all study subjects were seen in an inner-city hospital that serves
a high-risk population and the test methods used were highly sensitive,
having a lower threshold for testing positive than those used for adults.

Another limit to the study was a lack of information regarding exposure to
cigarette smoke in the home and whether the children could have been
exposed to cocaine directly through breast feeding, although the study's
authors said breast feeding did not appear to be the primary source of
exposure.

The number of children who tested positive was only a small portion of all
those who entered the emergency room. During the study period, doctors in
the emergency room saw a total of 2,548 children younger than 1 year old.
About 13 percent of them were sick enough to warrant urine tests; of those
children, the study examined the urine samples of about half .

Copyright Los Angeles Times

Checked-by: (Joel W. Johnson)