Abstract
The aim of this paper was to find out whether fetal exposure to environmental tobacco smoke (ETS), as compared to postnatal ETS exposure, is an independent risk factor for respiratory symptoms and diseases in younger schoolchildren. The cross-sectional epidemiological study comprised population of 1,561 Polish schoolchildren, aged 9–11 years. Information on the exposure to tobacco smoke and other sources of indoor air pollution at home, respiratory and allergic health status, and socio-economic status of the family was obtained by questionnaire survey. The respiratory health status was described by presence of wheezing, attacks of dyspnoea (noted during the last year or ever), bronchitis, wheezy bronchitis and asthma, ever diagnosed by a physician. Multivariate logistic regression analysis with adjustment for age, sex, area of residence, household density, damp and mould stains found at home, use of coal-fired stove, co-habitant pets, mother’s education and paternal current and past smoking habit was used to assess the effect of fetal and postnatal exposures on respiratory health outcomes. The results of the multivariate analyses revealed statistically significant associations between fetal exposure to ETS and wheezing ever: log OR = 1.4 (95% CI: 1.0–2.0), attacks of dyspnoea ever: log OR = 1.8 (95% CI: 1.1–2.9), bronchitis: log OR = 2.1 (95% CI: 1.5–2.9), and wheezy bronchitis: log OR = 1.8 (95% CI: 1.1–2.9). The effect of postnatal ETS was statistically significant only for bronchitis: log OR = 1.4 (95% CI: 1.1–1.9). The results of our study showed that fetal exposure to tobacco smoke is an independent risk factor for symptoms of wheeze and wheezy bronchitis in schoolchildren when compared to postnatal ETS exposure.
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References
Rothman KJ, Greenland S. Modern Epidemiology. Philadelphia: Lippincott and Raven, 1998
J Cunningham DW Dockery FE Speizer (1994) ArticleTitleMaternal smoking during pregnancy as a predictor of lung function in children Am J Epidemiol 139 1139–1152 Occurrence Handle8209873
K Demissie P Ernst L Joseph (1998) ArticleTitleThe role of domestic factors and day-care attendance on lung function of primary school children Respir Med 92 928–935 Occurrence Handle10.1016/S0954-6111(98)90192-5 Occurrence Handle10070566
GS Leonardi D Houthuijs B Nikiforov et al. (2002) ArticleTitleRespiratory symptoms, bronchitis and asthma in children of Central Europe Eur Respir J 20 890–898 Occurrence Handle10.1183/09031936.02.00260802 Occurrence Handle12412680
CESAR: Central European Study on Air Pollution and Respiratory Health. PHARE report, 1998: I. Evaluation. II. Questionnaires. III. Manuals and Protocols. IV. Study Results
MD Lebowitz JJ Quackenboss M Kollander (1989) ArticleTitleThe new standard inventory questionnaire for estimation of indoor concentrations J Air Pollut Control Assoc 39 1411–1429
MI Asher HR Anderson AW Stewart J Crane (1998) ArticleTitleWorldwide variations in the prevalence of asthma symptoms: The International Study of Asthma and Allergies in Childhood (ISAAC) Eur Respir J 12 315–335 Occurrence Handle10.1183/09031936.98.12020315 Occurrence Handle9727780
Stata Statistical Software. StataCorp. 2003, Release 8.0 College Station, TX, USA
DG Cook DP Strachan (1997) ArticleTitleParental smoking and prevalence of respiratory symptoms and asthma in school age children Thorax 52 1081–1094 Occurrence Handle9516904
Samet JM. Synthesis: The health effects of tobacco smoke exposure on children. World Health Organization. Framework convention on tobacco control, 1999, WHO/NCD/TFI/99.11
JJK Jaakkola MS Jaakkola (2002) ArticleTitleEffects of environmental tobacco smoke on the respiratory health of children Scand J Work Environ Health 28 Supp 71–83
DP Strachan DG Cook (1998) ArticleTitleHealth effects of passive smoking 6. Parental smoking and childhood asthma: Longitudinal and case–control studies Thorax 53 204–212 Occurrence Handle9659358
SH Arshad RJ Kurukulaaratchy M Fenn S Matthews (2005) ArticleTitleEarly life factors for current wheeze, asthma and bronchial hyperresponsiveness at 10 years of age Chest 127 502–508 Occurrence Handle10.1378/chest.127.2.502 Occurrence Handle15705988
FD Gilliland YF Li L Dubeau K Berhane et al. (2002) ArticleTitleEffects of glutathione S-Transferase M1, maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children Am J Respir Crit Care Med 166 457–463 Occurrence Handle10.1164/rccm.2112064 Occurrence Handle12186820
JN Finkelstein CJ Johnston (2004) ArticleTitleEnhanced sensitivity of the postnatal lung to environmental insults and oxidant stress Pediatrics 113 1092–1096 Occurrence Handle15060204
JE Cotes (1992) Lung function. Assessment and Application in Medicine Blackwell Scientific Publications Oxford
RG Feldman (1998) Occupational and Environmental Toxicology Lippincott and Raven Philadelphia, New York
KC Lodrup Carlson JJK Jaakkola P Nafstad K-H Carlson (1997) ArticleTitleIn utero exposure to cigarette smoking influences lung function at birth Eur Respir J 10 1774–1779 Occurrence Handle10.1183/09031936.97.10081774 Occurrence Handle9272918
FD Gilliland K Berhane R Mc Connell et al. (2000) ArticleTitleMaternal smoking during pregnancy, environmental tobacco smoke exposure and childhood lung function Thorax 55 271–276 Occurrence Handle10.1136/thorax.55.4.271 Occurrence Handle10722765
RT Stein CJ Holberg D Sherill et al. (1999) ArticleTitleInfluence of parental smoking on respiratory symptoms during the first decade of life Am J Epidemiol 149 1030–1037 Occurrence Handle10355379
J Cunningham GT O’Connor DW Dockery FE Speizer (1996) ArticleTitleEnvironmental tobacco smoke, wheezing and asthma in children in 24 communities Am J Respir Crit Care Med 153 218–224 Occurrence Handle8542119
FD Gilliland Yu-Fen Li JM Peters (2001) ArticleTitleEffects of maternal smoking during pregnancy and environmental tobaco smoke on asthma and wheezing in children Am J Respir Crit Care Med 163 429–436 Occurrence Handle11179118
N Agabiti S Mallone F Forastiere et al. (1999) ArticleTitleThe impact of parental smoking on asthma and wheezing Epidemiology 10 692–698 Occurrence Handle10.1097/00001648-199911000-00005 Occurrence Handle10535782
JR DiFranza CA Aligne M Weitzman (2004) ArticleTitlePrenatal and postnatal environmental tobacco smoke exposure and children’s health Pediatrics 113 1007–1015 Occurrence Handle15060193
S Lewis D Richards J Bynner N Butler J Britton (1995) ArticleTitleProspective study of risk factors for early and persistant wheezing in childhood Eur Respir J 8 349–356 Occurrence Handle10.1183/09031936.95.08030349 Occurrence Handle7789476
RI Ehrlich D Du Toit E Jordaan et al. (1996) ArticleTitleRisk factors for childhood asthma and wheezing Importance of maternal and household smoking Am J Respir Crit Care Med 154 681–688 Occurrence Handle8810605
W Jedrychowski E Flak (1997) ArticleTitleMaternal smoking during pregnancy and postnatal exposure to tobacco smoke as predisposition factors to acute respiratory infections Environ Health Perspect 105 302–306 Occurrence Handle9171991
von Mutius E, Sears MR. Risk factors for development of asthma. In: Chung F, Fabbri LM (eds), Asthma, Vol. 8. Eur. Respir. Monograph, 2003: 57–73
A Mielck P Reitmeir M Wjst (1996) ArticleTitleSeverity of childhood asthma by socioeconomic status Int J Epidemiol 25 388–393 Occurrence Handle9119565
RJ Hancox BJ Milne DR Taylor et al. (2004) ArticleTitleRelationship between socioeconomic status and asthma: A longitudinal cohort study Thorax 59 376–380 Occurrence Handle10.1136/thx.2003.010363 Occurrence Handle15115861
DB Coultas GT Peake JM Samet (1989) ArticleTitleQuestionnaire assessment of lifetime and recent exposure to environmental tobacco smoke Am J Epidemiol 130 338–347 Occurrence Handle2750729
B Jazwiec-Kanyion R Zlotkowska JE Zejda (1998) ArticleTitleAssessment of answer repeatability in a questionnaire evaluation of respiratory tract symptoms in children (in Polish) Pneumonol Alergol Pol 66 456–463 Occurrence Handle10354695
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Zlotkowska, R., Zejda, J.E. Fetal and Postnatal Exposure to Tobacco Smoke and Respiratory Health in Children. Eur J Epidemiol 20, 719–727 (2005). https://doi.org/10.1007/s10654-005-0033-z
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DOI: https://doi.org/10.1007/s10654-005-0033-z