Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Respir Res. 2010 Jan 29;11(1):11. doi: 10.1186/1465-9921-11-11.
Although studies show that maternal smoking during pregnancy increases the risks of respiratory outcomes in childhood, evidence concerning the effects of household environmental tobacco smoke (ETS) exposure remains inconsistent.
We conducted a population-based study comprised of 5,019 seventh and eighth-grade children in 14 Taiwanese communities. Questionnaire responses by parents were used to ascertain children's exposure and disease status. Logistic regression models were fitted to estimate the effects of ETS exposures on the prevalence of asthma, wheeze, and bronchitic symptoms.
The lifetime prevalence of wheeze was 11.6% and physician-diagnosed asthma was 7.5% in our population. After adjustment for potential confounders, in utero exposure showed the strongest effect on all respiratory outcomes. Current household ETS exposure was significantly associated with increased prevalence of active asthma, ever wheeze, wheeze with nighttime awakening, and bronchitis. Maternal smoking was associated with the increased prevalence of a wide range of wheeze subcategories, serious asthma, and chronic cough, but paternal smoking had no significant effects. Although maternal smoking alone and paternal smoking alone were not independently associated with respiratory outcomes, joint exposure appeared to increase the effects. Furthermore, joint exposure to parental smoking showed a significant effect on early-onset asthma (OR, 2.01; 95% CI, 1.00-4.02), but did not show a significant effect on late-onset asthma (OR, 1.17; 95% CI, 0.36-3.87).
We concluded that prenatal and household ETS exposure had significant adverse effects on respiratory health in Taiwanese children.
尽管研究表明，孕妇在怀孕期间吸烟会增加儿童呼吸道疾病的风险，但有关家庭环境烟草烟雾（ETS）暴露影响的证据仍然不一致。
我们进行了一项基于人群的研究，纳入了来自台湾 14 个社区的 5019 名七、八年级儿童。通过父母的问卷调查来确定儿童的暴露情况和疾病状况。使用逻辑回归模型来估计 ETS 暴露对哮喘、喘息和支气管炎症状发生率的影响。
我们研究人群的终身喘息发生率为 11.6%，经医生诊断的哮喘发生率为 7.5%。在调整了潜在的混杂因素后，胎儿暴露对所有呼吸道疾病的影响最强。当前家庭 ETS 暴露与活动性哮喘、曾有喘息、喘息伴夜间觉醒和支气管炎的发生率增加显著相关。母亲吸烟与广泛的喘息亚类、严重哮喘和慢性咳嗽的发生率增加有关，但父亲吸烟没有显著影响。虽然母亲吸烟和父亲吸烟单独与呼吸道疾病结果没有显著相关性，但联合暴露似乎增加了影响。此外，父母双方吸烟的联合暴露对早发性哮喘（OR，2.01；95%CI，1.00-4.02）有显著影响，但对晚发性哮喘（OR，1.17；95%CI，0.36-3.87）没有显著影响。
我们得出结论，胎儿期和家庭 ETS 暴露对台湾儿童的呼吸道健康有显著的不良影响。
