Search

Resume Introduction Le tabagisme environnemental est un facteur de morbidite et de mortalite actuellement reconnu. Les premieres victimes sont les enfants, et ce quelquefois des leur conception, mais les adultes ne sont pas epargnes. En pratique, l’evaluation de l’exposition a la fumee de tabac peut etre realisee par des marqueurs biologiques plus ou moins specifiques du tabac. Etat des connaissances L’exposition fœtale au tabagisme maternel et le tabagisme environnemental de l’enfant peuvent avoir des repercussions tres graves qui engagent directement le pronostic vital du fœtus et du nourrisson. Il augmente le risque d’avortement spontane, de grossesse extra-uterine, de retard de croissance intra-uterin, de rupture prematuree des membranes, de prematurite, d’hematome retro-placentaire, de placenta praevia et de mort subite du nourrisson. Les pathologies respiratoires et cardiovasculaires chez l’adulte sont egalement influencees par le tabagisme environnemental. En France, le tabagisme passif provoque la mort prematuree de 3 000 personnes par an. Perspectives Une meilleure connaissance des risques lies a l’exposition au tabagisme passif devrait faciliter l’application de la legislation dont l’un des principaux objectifs est de proteger les non-fumeurs. Conclusions La prevention du tabagisme ainsi que l’aide au sevrage tabagique ne peuvent se concevoir sans une meilleure application de la loi Evin.

Environmental tobacco smoke is a recognized factor of morbidity and mortality. The first victims are children, sometimes starting from conception, but adults are not spared. In practice, evaluation of exposure to tobacco smoke can be achieved with more or less specific markers of tobacco smoke.Exposure of the fetus to maternal smoking and of the infant to environmental smoke can have a serious sometimes life-threatening impact. Such exposure increases the risk of spontaneous abortion, ectopic pregnancy, intrauterine growth retardation, premature membrane rupture, preterm birth, retroplacental hematoma, placenta praevia, and sudden infant death. Adult respiratory and cardiovascular disease are also influenced by environmental smoke. In France passive smoking causes premature death of 3000 persons per year.Better knowledge of the risks of exposure to passive smoking can facilitate application of legislation with the objective of protecting non-smokers.Rigorous application of current legislation is important to achieve the stated goals of prevention of smoking as well as assistance to cease smoking.

We report a new case of diffuse pulmonary lymphangiomatosis in a 22 year-old man with a dysmorphic syndrome. The disease started with dyspnea which became rapidly disabling. The diagnosis was established from a pulmonary biopsy. Our patient developed severe chronic respiratory failure. Diffuse pulmonary lymphangiomatosis is a very uncommon disease. It is seen predominantly in children, exceptionally in adults, and affects both sexes equally. Symptoms like dyspnea and cough, pulmonary function with restrictive pattern, and interstitial syndrome, are not specific. Only pathology is evocative, characterized primarily by multifocal proliferation of pulmonary lymphatic vessels and increased number of complex anastomosing channels. These channels tend to dilate with time. The prognosis is poor and the treatment essentially palliative.