Ehrlich R, Kattan M, Godbold J, Saltzberg D S, Grimm K T, Landrigan P J, Lilienfeld D E
Department of Community Medicine, Mount Sinai Medical Center, New York, New York.
Am Rev Respir Dis. 1992 Mar;145(3):594-9. doi: 10.1164/ajrccm/145.3.594.
To assess the relationship between passive smoking and asthma, we investigated (1) whether passive smoking was more prevalent among asthmatic than control children and (2) whether exposure to tobacco smoke was higher in acute asthma than in nonacute asthma. Three groups were recruited into a case-control study: 72 acute asthmatic children from the emergency room (ER), 35 nonacute asthmatic children from the asthma clinic, and 121 control children from the ER. Both questionnaire and urinary cotinine/creatinine ratio (CCR) were used to assess passive smoking. Levels of CCR greater than or equal to 30 ng/mg were used to identify children exposed at home. Mean CCR was also computed. Acute and nonacute asthmatic children had similar prevalences of passive smoking at home. Acute cases showed a higher mean CCR than nonacute cases, but this was not significant. In comparing all asthmatic to control children, smoking by the maternal caregiver was more prevalent among asthmatic children (odds ratio OR = 2.0, 95% CI 1.1, 3.4). This was confirmed by CCR greater than or equal to 30 ng/mg (OR = 1.9, 95% CI 1.04, 3.35) and by the difference in mean CCR (43.6 versus 25.8 ng/mg, p = 0.06). We conclude that smoking by the maternal caregiver is associated with clinically significant asthma in children. We could not show that it is a trigger of acute asthma attacks.
为评估被动吸烟与哮喘之间的关系，我们进行了如下调查：（1）哮喘儿童中的被动吸烟情况是否比对照儿童更为普遍；（2）急性哮喘患者接触烟草烟雾的程度是否高于非急性哮喘患者。本病例对照研究招募了三组人群：72名来自急诊室（ER）的急性哮喘儿童、35名来自哮喘诊所的非急性哮喘儿童以及121名来自急诊室的对照儿童。通过问卷和尿可替宁/肌酐比值（CCR）来评估被动吸烟情况。CCR水平大于或等于30 ng/mg用于确定在家中接触烟草烟雾的儿童，并计算CCR的平均值。急性和非急性哮喘儿童在家中被动吸烟的患病率相似。急性病例的平均CCR高于非急性病例，但差异无统计学意义。在将所有哮喘儿童与对照儿童进行比较时，哮喘儿童中母亲吸烟的情况更为普遍（优势比OR = 2.0，95%可信区间1.1, 3.4）。CCR大于或等于30 ng/mg（OR = 1.9，95%可信区间1.04, 3.35）以及平均CCR的差异（43.6对25.8 ng/mg，p = 0.06）证实了这一点。我们得出结论，母亲吸烟与儿童临床上显著的哮喘有关。但我们无法证明它是急性哮喘发作的诱因。
