Respiratory effects of environmental tobacco smoke in a panel study of asthmatic and symptomatic children.

The effect of environmental tobacco smoke (ETS) on respiratory health was investigated among 7- to 12-yr-old children with asthmatic (n = 74) or cough (n = 95) symptoms. For 3 mo the children measured their peak expiratory flow rate (PEFR) every morning and evening, and kept a daily diary of respiratory symptoms. They also noted daily whether they had used respiratory medication and whether someone had smoked inside their home. Eleven percent of the asthmatic children and 14% of the children with cough had exposure to ETS at home during the study. In multiple regression and analyses controlling for potential confounders, any exposure to ETS during the study was associated with a reduction of 42 L/min (95% confidence interval [CI]: 10 to 74 L/min) in morning and 41 L/min (95% CI: 8 to 74 L/min) in evening PEFR among asthmatic children. Among these children, a dose-dependent increase in the effect of ETS was also seen. Daily variation in ETS exposure was only weakly (-9.2 L/min; 95% CI: 2.9 to 21.2 L/min) associated with PEFR, but the previous day's ETS exposure was a risk factor for bronchodilator use (relative risk [RR]: 10.3; 95% CI: 1.3 to 83.7), as well as for cough (RR: 12.4; 95% CI: 2.4 to 63.3) and phlegm production (RR: 7. 8; 95% CI: 1.4 to 41.7), on any given day. Among children with cough only, there was only a weak suggestion of any possible ETS effect. In conclusion, we found that exposure to ETS was associated with a decline in peak flow and increases in respiratory symptoms and use of bronchodilator drugs among asthmatic children.

[1]  J Pekkanen,et al.  Air pollution and respiratory health among children with asthmatic or cough symptoms. , 1997, American journal of respiratory and critical care medicine.

[2]  J. Pekkanen,et al.  Prevalence and characteristics of children with chronic respiratory symptoms in eastern Finland. , 1995, The European respiratory journal.

[3]  T. Sterling,et al.  Re: "Concentration of indoor particulate matter as a determinant of respiratory health in children". , 1995, American journal of epidemiology.

[4]  S. Halken,et al.  Passive smoking as a risk factor for development of obstructive respiratory disease and allergic sensitization , 1995, Allergy.

[5]  J. Stoddard,et al.  Impact of parental smoking on the prevalence of wheezing respiratory illness in children. , 1995, American journal of epidemiology.

[6]  A. Woolcock,et al.  Effect of passive smoking, asthma, and respiratory infection on lung function in Australian children , 1994, Pediatric pulmonology.

[7]  A. Agudo,et al.  Exercise-induced airways narrowing and exposure to environmental tobacco smoke in schoolchildren. , 1994, American journal of epidemiology.

[8]  J. Couriel.  Passive smoking and the health of children. , 1994, Thorax.

[9]  D. Dockery,et al.  Maternal smoking during pregnancy as a predictor of lung function in children. , 1994, American journal of epidemiology.

[10]  E. Vartiainen,et al.  Twenty-year trends in coronary risk factors in north Karelia and in other areas of Finland. , 1994, International journal of epidemiology.

[11]  F. Forastiere,et al.  Passive smoking as a determinant of bronchial responsiveness in children. , 1994, American journal of respiratory and critical care medicine.

[12]  W. Karmaus,et al.  Influence of maternal smoking on variability of peak expiratory flow rate in school children. , 1993, Chest.

[13]  H. Magnussen,et al.  Effects of acute passive smoking on exercise-induced bronchoconstriction in asthmatic children. , 1993, Journal of applied physiology.

[14]  S. Chinn,et al.  Lung function, respiratory illness, and passive smoking in British primary school children. , 1993, Thorax.

[15]  R. Casale,et al.  Circadian rhythm of peak expiratory flow in children passively exposed and not exposed to cigarette smoke. , 1992, Thorax.

[16]  C A Perucci,et al.  Effects of environment and passive smoking on the respiratory health of children. , 1992, International journal of epidemiology.

[17]  Phil A. Silva,et al.  Longitudinal effects of passive smoking on pulmonary function in New Zealand children. , 1992, The American review of respiratory disease.

[18]  J D Spengler,et al.  Respiratory health and PM10 pollution. A daily time series analysis. , 1991, The American review of respiratory disease.

[19]  R. Barnabei,et al.  Impaired pulmonary function in schoolchildren exposed to passive smoking. Detection by questionnaire and urinary cotinine levels. , 1991, Respiration; international review of thoracic diseases.

[20]  R. Jörres,et al.  Acute effect of passive smoking on lung function and airway responsiveness in asthmatic children , 1991, Pediatric pulmonology.