Raherison Chantal, Pénard-Morand Céline, Moreau David, Caillaud Denis, Charpin Denis, Kopfersmitt Christien, Lavaud François, Taytard André, Annesi-maesano Isabella
Service des Maladies Respiratoires, Hôpital du Haut-Lévèque, Avenue Magellan, 33604 Pessac, France.
Respir Med. 2007 Jan;101(1):107-17. doi: 10.1016/j.rmed.2006.04.010. Epub 2006 Jun 2.
Among early-life environmental factors, parental smoking (ETS) has been associated with adverse respiratory outcomes in children. The aim of the study was to evaluate whether parental smoking might lead to asthma and allergies taking into account family history of asthma, personal atopy, breast feeding as confounders and owing pets and day-care during the first 6 months of life as modifiers. About 9000 children of fourth and fifth grade were selected in six cities of France. About 7798 answered an epidemiological questionnaire, underwent a medical examination including skin prick test positivity to common allergens, skin examination for eczema, and run test to assess exercise-induced asthma (EIA). Prevalence of allergies was, respectively, 25.2% for eczema, 12.9% for rhinitis, 9.9% for asthma and 25% for atopy. About 8.3% had an EIA. About 21.6% of children were exposed to maternal tobacco smoking during pregnancy. Maternal smoking, in utero and later, was significantly related to lifetime wheezing (odds ratio (OR): 1.24[1.10-1.56]) and asthma (OR: 1.22[1.04-1.66]). There was no association between atopy, rhinitis, eczema and parental smoking, respectively. ETS remains a risk factor of wheezing in childhood. Counselling parents of children to quit smoking still remains a public health policy.
在早期生活环境因素中，父母吸烟（接触二手烟）与儿童不良呼吸结局有关。本研究的目的是评估父母吸烟是否会导致哮喘和过敏，同时考虑哮喘家族史、个人特应性、母乳喂养作为混杂因素，以及在生命的前6个月养宠物和日托作为调节因素。在法国的六个城市中选取了约9000名四、五年级儿童。约7798名儿童回答了一份流行病学调查问卷，并接受了医学检查，包括对常见过敏原的皮肤点刺试验阳性、湿疹的皮肤检查以及评估运动诱发性哮喘（EIA）的跑步试验。湿疹的过敏患病率分别为25.2%，鼻炎为12.9%，哮喘为9.9%，特应性为25%。约8.3%的儿童患有运动诱发性哮喘。约21.6%的儿童在孕期接触过母亲吸烟。母亲在孕期及之后吸烟与终生喘息（优势比（OR）：1.24[1.10 - 1.56]）和哮喘（OR：1.22[1.04 - 1.66]）显著相关。特应性、鼻炎、湿疹与父母吸烟之间分别无关联。接触二手烟仍然是儿童喘息的一个危险因素。建议儿童家长戒烟仍是一项公共卫生政策。
