Health effects of passive smoking. 3. Parental smoking and prevalence of respiratory symptoms and asthma in school age children

Abstract

Abstractthe early 1970s, 1-3 since when many epidemiological studies have reported on the Background -A systematic quantitative review of the evidence relating parental association of parental smoking and respiratory diseases throughout childhood. The US smoking to the prevalence of asthma and respiratory symptoms was conducted Environmental Protection Agency Review 4 which was essentially narrative concluded that amongst school age children. Methods -Sixty relevant studies were the evidence causally relating exposure to environmental tobacco smoke at home to residentified after consideration of 1593 articles selected by electronic search of the piratory symptoms was very strong amongst preschool children, but less compelling (though Embase and Medline databases using keywords relevant to passive smoking in statistically significant) in children of school age. A more recent quantitative review 5 failed children. The search was completed in April 1997 and identified 25 studies of to distinguish between different exposures and ages. asthma, 41 of wheeze, 34 of chronic cough, seven of chronic phlegm and six of breathIn this part of a series of systematic and quantitative reviews of the effect of exposure lessness which were included in a quantitative overview.to environmental tobacco smoke in childhood we summarise the evidence relating to the preResults -The pooled odds ratios for either parent smoking were 1.21 (95% CI 1.10 to valence of respiratory symptoms and asthma in school age children (5-16 years) as assessed 1.34) for asthma, 1.24 (95% CI 1.17 to 1.31) for wheeze, 1.40 (95% CI 1.27 to 1.53) for by population surveys. It follows on from our previous review of the effects of parental smokcough, 1.35 (95% CI 1.13 to 1.62) for phlegm, and 1.31 (95% CI 1.08 to 1.59) for ing on lower respiratory illness in infancy and early childhood. 6 Longitudinal and case-conbreathlessness. Adjustment for confounding had little effect. Evidence of trol studies of asthma incidence, prognosis, and severity will be reviewed separately. heterogeneity between studies appeared largely explicable by publication bias with a superfluity of small studies with large odds ratios. However, excluding these had Methods little effect on the pooled odds ratios. The   prevalence of all symptoms increased with This paper is part of a series of reviews of the the number of parents who smoked. While respiratory effects of exposure to environmental maternal smoking had a greater effect than tobacco smoke in children. For this broader paternal smoking, the effect of father only review published papers, letters, and review was clearly significant.articles were selected by an electronic search Conclusions -The relationship between of the Embase and Medline databases using the parental smoking and respiratory symp-search strategy described elsewhere. 6 Briefly, all toms seems very likely to be causal given references to passive smoking were selected by statistical significance, robustness to ad-the MESH heading Tobacco smoke pollution a...

Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community air pollution research.

“…Cohort studies have also shown increased risk of developing adult asthma from ETS (88), including occupational exposures (89). Among 3,914 nonsmoking adults followed 10 years, the relative risk for asthma onset from 10 years of working with a smoker was 1.45 (95% CI 1.21, 1.75) (85). A large survey of 4,197 never-smoking adults showed an elevated risk of physician-diagnosed asthma from any ETS exposure [OR 1.39 (95% CI 1.04-1.86)] but no increased risk of allergic rhinitis (90).…”

“…A recent meta-analysis concluded that studies showed an excess incidence of wheezing in smoking households, particularly in nonatopic children, suggesting a "wheezy bronchitis" pattern; however, in children with diagnosed asthma, parental smoking was associated with greater severity rather than incidence (78). A quantitative meta-analysis of studies up to April 1997 for 25 studies of asthma prevalence showed a pooled odds ratio (OR) for asthma of 1.21 (95% confidence interval [CI], 1.10-1.34) if either parent smoked (85). Well-conducted panel studies are still needed to evaluate acute exposure-response relationships using repeated measures methods.…”

Secondhand and Prenatal Tobacco Smoke Exposure

“…• persistent decreased lung function, [106][107][108][109]137,139,149,154 amplified in children with cystic fibrosis, 16 • infections, 137,139,151,[154][155][156][157] • bronchiolitis, 158 wheezing, 47 and use of bronchodilating drugs, 47…”

Respiratory disease screening in school-aged children using portable spirometry

“…A exposição pré e pós-natal à fumaça ambiental do tabaco (FAT) constitui um fator determinante na morbidade respiratória e na redução prematura da função pulmonar em crianças [18][19][20] . Demonstrou-se que a exposição à FAT, tanto in utero quanto pós-natal, influencia a frequência dos sintomas respiratórios 21,22 , havendo uma relação dose-dependente entre a dose de FAT (um ou dois pais fumantes), os sintomas respiratórios e os índices espirométricos 18,19,23 .…”

“…Demonstrou-se que a exposição à FAT, tanto in utero quanto pós-natal, influencia a frequência dos sintomas respiratórios 21,22 , havendo uma relação dose-dependente entre a dose de FAT (um ou dois pais fumantes), os sintomas respiratórios e os índices espirométricos 18,19,23 . No entanto, nenhum nível de exposição passiva à fumaça é seguro 24 .…”