Passive smoking and middle ear problems in Kansas public school children

Kallail, K. James; Rainbolt, Harry; Bruntzel, Melvin D.

doi:10.1016/0021-9924(87)90017-7

Cited by 12 publications

(12 citation statements)

References 15 publications

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“…Green and Cooper [10] demonstrated an increase in risk with an odds ratio (OR) of 1.9 (95% confidence interval [CI], 1.2-2.9) for hearing loss. Although Kallail et al [11] did not demonstrate an association, this study suffers from a major limitation; cases and controls were not subject to the same screening procedure. Ra's cross-sectional study [12] demonstrated that children exposed to ETS were 4.9 times more likely to suffer from hearing loss associated with middle-ear diseases.…”

Section: Otitis Media and Environmental Tobacco Smokementioning

confidence: 94%

Air pollution and Otitis media: A review of evidence from epidemiologic studies

Heinrich

Raghuyamshi

2004

Curr Allergy Asthma Rep

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Otitis media (main types: acute otitis media and otitis media with effusion) is one of the most common childhood infections, particularly before the age of 3 years. The main causes are viral and/or bacterial ear infections, commonly accompanied by or following upper respiratory tract infection. Besides these infections, other risk factors, such as male sex, young age, genetic predisposition, low socioeconomic status, low vitamin A and C intake, and bottle-feeding are discussed. There is indication that exposure to environmental tobacco smoke is a major environmental risk factor, although additional effects of the exposure to ambient air pollutants is uncertain. Although some studies reported statistically significant increased risk for otitis media in children with high exposure to ambient air pollutants, the risks were not consistent among the studies. Owing to the scarcity of available data, far-reaching conclusions cannot be drawn yet. However, the evidence of an increased risk for environmental tobacco smoke exposure and identified increased risk for ambient air pollution exposure in some studies should stimulate future research using otitis media as one of the major outcomes in air pollution epidemiology.

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Section: Otitis Media and Environmental Tobacco Smokementioning

confidence: 94%

Air pollution and Otitis media: A review of evidence from epidemiologic studies

Heinrich

Raghuyamshi

2004

Curr Allergy Asthma Rep

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“…Air pollution, particularly indoors, has been considered as a risk factor for middle ear diseases [11,16,23,45,103], with indoor smoking by household members potentially being a substantial determinant of suspended particulate matter and respirable sulphates [11,22,25,67]. Thus, the problem of middle ear disease should be increased in buildings which are more airtight, but although this has been observed [35], other studies have failed to find an association between various indirect measures of airtightness and middle ear disease [11,22].…”

Section: Discussionmentioning

confidence: 95%

“…Smokers have also been reported to show greater hearing losses, and some, though not all, studies have reported an effect on the tympanic membrane [23]. In recent years, there has been an increasing awareness of the phenomenon of passive smoking, and in particular, possible adverse effects of smoking by parents on the health of their children.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence has been found that children who have been in contact with an active smoker have measurable metabolites of nicotine in their body fluids [41,44,52,69,71,72,77], and that the children of smokers have more respiratory symptoms than the children of non-smokers [61,63,70,96,97]. Reduced auditory function has also been reported in the children of mothers who smoked during pregnancy [23]. The underlying cause of middle ear disease is a blockage and/or dysfunction of the Eustachian tube, often as a result of an infection of the upper respiratory tract, and although there appear to be several mechanisms by which exposure to tobacco smoke might influence the development of middle ear diseases, the actual evidence in favour of any one of them is unconvincing.…”

Section: Discussionmentioning

confidence: 99%

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Parental Smoking and Middle Ear Disease in Children: A Review of the Evidence

Thornton

1999

Indoor Built Environ

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This report presents a detailed review of the available epidemiological evidence concerning the prevalence of middle ear infections in children in relation to their exposure to smoking by their parents or other household members and is based on English-language papers covering the period 1979–1998. Fifty-eight studies are included in the review, with the most widely used index of exposure being parental smoking. Smoking by all household members, by either parent separately and by the mother during pregnancy were also considered in some of the studies. Only 3 studies attempted to quantify exposure objectively, using measurements of cotinine and nicotine in hair, saliva and pericardial fluid. Tables listing unadjusted and adjusted relative risk estimates were constructed for both postnatal exposure to tobacco smoke and for maternal smoking during pregnancy. The results for postnatal exposure were separated into five disease categories. The overall data suggested some association of postnatal exposure to tobacco smoke with three categories; recurrent otitis media, otitis media with effusion and unspecified middle ear disease, with risk tending to increase with increasing exposure, but no association with acute otitis media or with persistent otitis media with effusion. However, reported associations were generally quite weak, with relative risks typically below 1.5. Problems in interpreting the data arise from the difficulty of distinguishing possible effects of environmental tobacco smoke and of maternal smoking during pregnancy (for which the data also suggest an association), the possibility that the underlying cause of middle ear disease is in fact an infection, and from the various possibilities of bias inherent in epidemiological studies of a weak association, particularly due to inadequate control of confounding. Though it is prudent for parents not to expose their children to high doses of environmental tobacco smoke for long periods, the overall epidemiological evidence does not convincingly demonstrate that exposure to environmental tobacco smoke increases the incidence of middle ear diseases in children.

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“…However, most of these studies have been cross-sectional and they have generally not controlled for in utero exposure to tobacco smoke. Several investigations have also shown a relationship between an excess of middle ear infections (MEI) in children and maternal smoking, but, there are some inconsistent reports (Iversen et ah 1985, Kallail et al 1987, Strachan et al 1989. Therefore it is desirable that the link between maternal smoking and an increased incidence of respiratory illnesses in childhood receives further study, particularly within a prospective research design.…”

Section: Introductionmentioning

confidence: 95%

Maternal smoking and childhood respiratory illnesses: A seven year cohort study

McMichael

Baghurst

Tong

et al. 1991

International Journal of Environmental Health Research

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In this prospective cohort study of 723 young children in South Australia, there was a strong doseresponse relationship between postnatal exposure to maternal smoking and increased incidence of respiratory illness in early childhood. Compared with children whose mothers did not smoke, the odds ratios were 1.58 (95% confidence interval (CI)): 0.83-2.93; p<0.10) and 2.67 (95% CI: 0.96-6.66; p < 0.10) for lower respiratory tract infections in children aged 0-2 years whose mothers smoked 1-20, or more than 20 cigarettes per day, respectively. The odds ratios for middle ear infections in 0-2 year-old children whose mothers smoked 1-20, or more than 20 cigarettes per day were 2.43 (95% CI: 1.56-3.79; p< 0.01) and 3.50 (95% CI: 1.55-8.28; p< 0.01), respectively, and for children aged 2-4 years were 1.58 (95% CI: 1.02-2.46; p<0.05) and 2.56 (95% CI: 1.04-6.89; p < 0.05), respectively. Multiple logistic regression analysis yielded adjusted odds ratios consistent with the results of simple analysis. The findings from this prospective study confirm earlier evidence that postnatal exposure to maternal smoking is a major risk factor for respiratory illness in early childhood.

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Passive smoking and middle ear problems in Kansas public school children

Cited by 12 publications

References 15 publications

Air pollution and Otitis media: A review of evidence from epidemiologic studies

Air pollution and Otitis media: A review of evidence from epidemiologic studies

Parental Smoking and Middle Ear Disease in Children: A Review of the Evidence

Maternal smoking and childhood respiratory illnesses: A seven year cohort study

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