Department of Psychiatry and Behavioural Neurosciences and Offord Centre for Child Studies, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Int J Epidemiol. 2009 Oct;38(5):1342-50. doi: 10.1093/ije/dyp253. Epub 2009 Jul 21.
Children are at high risk of exposure to environmental tobacco smoke and biofuel smoke at home in developing countries. This study examines whether exposure to cigarette and biofuel smoke is associated with height-for-age of children (0-59 months) in seven developing countries.
The data are from Demographic and Health Surveys conducted in Cambodia, Dominican Republic, Haiti, Jordan, Moldova, Namibia and Nepal between 2005 and 2007. The respondents were women (15-49 years) and their children in seven countries (n = 28 439), and men (15-59 years) from four countries. The outcome is a physical measurement of child height-for-age in standard deviation units.
Multilevel regression analysis showed that the country of residence modified the association between maternal smoking and child height-for-age. Exposure to maternal smoking was associated negatively with child height-for-age in Cambodia, Namibia and Nepal, whereas it was not in other countries. Multilevel regression analysis revealed that biofuel smoke exposure was associated with a decrease in child height-for-age [b = -0.13, 95% confidence interval (CI) = -0.19 to -0.07, P < 0.001]. No interaction was found between country of residence and biofuel smoke exposure. Multinomial logistic regression results showed that biofuel smoke exposure was associated with both stunting [odds ratio (OR) = 1.25, 95% CI = 1.08-1.44, P = 0.002) and severe stunting (OR = 1.27, 95% CI = 1.02-1.59, P = 0.04), after controlling for covariates.
The findings suggest that exposure to maternal smoking and biofuel smoke may contribute to growth deficiencies in young children. Programmes are needed to ensure smoke-free home environments for children.
发展中国家的儿童在家庭中极易受到环境烟草烟雾和生物燃料烟雾的影响。本研究考察了在 7 个发展中国家，儿童暴露于香烟和生物燃料烟雾是否与身高年龄比（0-59 个月）有关。
该数据来自于 2005 年至 2007 年在柬埔寨、多米尼加共和国、海地、约旦、摩尔多瓦、纳米比亚和尼泊尔进行的人口与健康调查。受访者为 7 个国家的妇女（15-49 岁）及其子女（n=28439）和 4 个国家的男子（15-59 岁）。结果是儿童身高年龄比的体格测量，以标准差单位表示。
多水平回归分析表明，居住国改变了母亲吸烟与儿童身高年龄比之间的关联。在柬埔寨、纳米比亚和尼泊尔，母亲吸烟与儿童身高年龄比呈负相关，而在其他国家则没有。多水平回归分析显示，生物燃料烟雾暴露与儿童身高年龄比下降有关[b=-0.13，95%置信区间（CI）=-0.19 至-0.07，P<0.001]。未发现居住国与生物燃料烟雾暴露之间存在交互作用。多项逻辑回归结果显示，生物燃料烟雾暴露与发育迟缓[比值比（OR）=1.25，95%CI=1.08-1.44，P=0.002]和严重发育迟缓（OR=1.27，95%CI=1.02-1.59，P=0.04）有关，在控制了协变量后。
研究结果表明，暴露于母亲吸烟和生物燃料烟雾可能导致幼儿生长发育不足。需要制定方案，确保儿童生活在无烟环境中。
