Keskinoglu Pembe, Cimrin Dilek, Aksakoglu Gazanfer
Dokuz Eylul University, School of Medicine, Department of Public Health, Inciralti/Izmir, Turkey.
J Trop Pediatr. 2007 Oct;53(5):319-24. doi: 10.1093/tropej/fmm037. Epub 2007 May 21.
Environmental tobacco smoke is an important public health problem. The objective of this study was to evaluate the effect of passive smoking on lower respiratory tract infections (LRTIs) in children aged 2-12 years. A case-control study was conducted on matched-pair design. One-hundred and fifty children with LRTIs and 150 healthy children were included in the study. Data were collected through questionnaire and urine samples for the determination of cotinine levels, and were analysed by McNemar chi-square, paired t-test and Pearson correlation tests. The prevalence of parental self-reported, indoor smoking was 71.3% in children with LRTI and 72.0% in healthy children. Employing 30 ng mg(-1), the cut-off level of urinary cotinine/creatinine as commonly accepted, 87.3% of the children with LRTIs and 84.7% of healthy children were found to be passive smokers (p = 0.61, odds ratio (OR) = 0.93; confidence interval (CI) = 0.34-2.53). If 60 ng mg(-1) of urinary cotinine/creatinine was accepted as a cut-off level, it was observed that the rates of passive smoking were 76.7% and 50.7%, respectively (p = 0.000, OR = 4.72; 95% CI = 2.62-8.52). Dose-dependent exposure to environmental tobacco smoke was found to be associated with the incidence of LRTI.
环境烟草烟雾是一个重要的公共卫生问题。本研究的目的是评估被动吸烟对2至12岁儿童下呼吸道感染（LRTIs）的影响。采用配对设计进行了一项病例对照研究。该研究纳入了150名下呼吸道感染儿童和150名健康儿童。通过问卷调查和尿液样本收集数据以测定可替宁水平，并采用McNemar卡方检验、配对t检验和Pearson相关检验进行分析。下呼吸道感染儿童中父母自我报告的室内吸烟患病率为71.3%，健康儿童中为72.0%。以通常认可的尿可替宁/肌酐截断水平30 ng mg⁻¹为标准，发现87.3%的下呼吸道感染儿童和84.7%的健康儿童为被动吸烟者（p = 0.61，优势比（OR）= 0.93；置信区间（CI）= 0.34 - 2.53）。若将尿可替宁/肌酐60 ng mg⁻¹作为截断水平，则观察到被动吸烟率分别为76.7%和50.7%（p = 0.000，OR = 4.72；95% CI = 2.62 - 8.52）。发现环境烟草烟雾的剂量依赖性暴露与下呼吸道感染的发生率相关。
