ObjectiveThe objective of this study was to evaluate how indoor pollution from tobacco
and home heating may adversely affect respiratory health in young
children.DesignA birth cohort was followed longitudinally for 3 years to determine incidence
of lower respiratory illness (LRI).ParticipantsA total of 452 children born 1994–1996 in two districts in the
Czech Republic participated.EvaluationsIndoor combustion exposures were home heating and cooking fuel, mother’s
smoking during pregnancy, and other adult smokers in the household. Diagnoses
of LRI (primarily acute bronchitis) from birth to 3 years
of age were abstracted from pediatric records. Questionnaires completed
at delivery and at 3-year follow-up provided covariate information. LRI
incidence rates were modeled with generalized linear models
adjusting for repeated measures and for numerous potential confounders.ResultsLRI diagnoses occurred more frequently in children from homes heated by
coal [vs. other energy sources or distant furnaces; rate ratio (RR) = 1.45; 95% confidence interval (CI), 1.07–1.97]. Maternal prenatal smoking and other adult smokers also
increased LRI rates (respectively: RR = 1.48; 95% CI, 1.10–2.01; and
RR = 1.29; 95% CI, 1.01–1.65). Cooking
fuels (primarily electricity, natural gas, or propane) were
not associated with LRI incidence. For children never breast-fed, coal
home heating and mother’s smoking conferred substantially
greater risks: RR = 2.77 (95% CI, 1.45–5.27) and
RR = 2.52 (95% CI, 1.31–4.85), respectively.ConclusionsMaternal smoking and coal home heating increased risk for LRI in the first 3 years
of life, particularly in children not breast-fed.RelevanceFew studies have described effects of coal heating fuel on children’s
health in a Western country. Breast-feeding may attenuate adverse
effects of prenatal and childhood exposures to combustion products.
The purpose of this study was to ascertain whether pulmonary function in children who were lifetime residents of the highly polluted district of Teplice in northern Bohemia was lower than that for children who were lifetime residents of the cleaner district of Prachatice in southern Bohemia. Forced expiratory spirometry was measured twice (February/March and April) in approximately 235 eighth-grade students in each district. On both testing occasions, height-adjusted forced expiratory volume in 1 s and forced expiratory flow between 25% and 75% forced vital capacity were significantly lower (p < .001) in children from Teplice than in those from Prachatice. These differences were not associated with parental smoking habits, presence of pets, heating/cooking fuels, private home/apartment residency, or rural/urban residency. In Teplice, no differences were observed between lung functions measured at the end of the high pollution season (February/March) and those measured after the children breathed much cleaner air for a 4-wk period (April). This result was suggestive of a condition of chronically depressed lung function. No differences across times were observed in Prachatice, indicating that our measurements were reliable.
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