Marco Tejero A, Pérez Trullén A, Córdoba García R, García Sánchez N, Cabañas Bravo M J
Centro de Salud Delicias Sur, Zaragoza, Spain.
An Pediatr (Barc). 2007 May;66(5):475-80. doi: 10.1157/13102512.
Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events.
A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed.
A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was > 20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked.
Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure.
儿童极易受到被动吸烟的伤害，因为如果周围存在环境烟草烟雾，他们无法避免接触。一些报告表明，家庭环境中的烟草烟雾暴露会增加儿童患呼吸道疾病的几率。本研究的目的是评估家庭被动吸烟是否与新的呼吸道疾病事件相关。
对410名14岁以下儿童进行了一项描述性回顾性研究。研究的变量包括：a）家庭中的吸烟者；b）每天吸烟的数量；c）上学情况；d）兄弟姐妹的数量；e）父母和兄弟姐妹之前的呼吸道疾病史；f）母亲孕期吸烟情况；g）上一年记录的呼吸道疾病事件数量。进行了单变量、双变量和多变量分析。
共有50.2%的儿童在家中与吸烟者共同生活。生活在无烟环境中的儿童，每人上呼吸道疾病事件的平均数量为2.53次，而当家庭成员中有一人吸烟时，这一数字为3.52次。对于整个呼吸道疾病而言，发现与年龄呈负相关[比值比（OR）=0.83；（95%置信区间：0.76 - 0.90）]，与母亲吸烟呈正相关[OR = 4.56（95%置信区间：1.84 - 11.34）]。对于上呼吸道疾病，如果母亲每天吸烟11 - 20支，OR为1.4；如果吸烟数量>20支，OR为1.9。对于下呼吸道疾病，如果母亲吸烟，比值比为3.48（95%置信区间：2.07 - 6.06）。
所研究的儿童中有50%在家中接触到环境烟草烟雾。年龄较小的儿童风险更高。呼吸道疾病的主要风险因素是母亲吸烟，且风险随着吸烟数量的增加而上升。健康教育对于保护儿童免受烟草烟雾暴露至关重要。
