Tobacco Free Research Institute, Dublin, Ireland.
Pediatrics. 2011 Aug;128(2):263-70. doi: 10.1542/peds.2011-0023. Epub 2011 Jul 11.
The association between parent-reported postnatal secondhand tobacco smoke exposure in the home and neurobehavioral disorders (attention-deficit/hyperactivity disorder, learning disabilities, and conduct disorders) among children younger than 12 years in the United States was examined using the 2007 National Survey on Children's Health. Excess neurobehavioral disorders attributable to secondhand smoke (SHS) exposure in the home in 2007 were further investigated.
The methods used in this study were multivariable logistic regression models that accounted for potential confounders and complex survey designs to evaluate associations.
A total of 6% of 55 358 children (aged < 12 years), corresponding to a weighted total of 4.8 million children across the United States, were exposed to SHS in the home. The weighted prevalence and 95% confidence intervals of each of the children's neurobehavioral outcomes were 8.2% (7.5-8.8) with learning disabilities, 5.9% (5.5-6.4) with attention-deficit/hyperactivity disorder, and 3.6% (3.1-4.0) with behavioral and conduct disorders. Children exposed to SHS at home had a 50% increased odds of having ≥2 childhood neurobehavioral disorders compared with children who were not exposed to SHS. Boys had a significantly higher risk. Older children, especially those aged 9 to 11 years, and those living in households with the highest poverty levels were at greater risk. In absolute terms, 274 100 excess cases in total of these 3 disorders could have been prevented if children had not been exposed to SHS in their homes.
The findings of the study, which are associational and not necessarily causal, underscore the health burden of childhood neurobehavioral disorders that may be attributable to SHS exposure in homes in the United States.
本研究使用 2007 年美国全国儿童健康调查数据，检验了家庭中父母报告的产后二手烟暴露与 12 岁以下儿童神经行为障碍（注意缺陷多动障碍、学习障碍和品行障碍）之间的关联。进一步探讨了 2007 年家庭中二手烟（SHS）暴露导致的神经行为障碍超额病例数。
本研究采用多变量逻辑回归模型，考虑了潜在混杂因素和复杂的调查设计，以评估关联。
共有 6%的 55358 名（年龄<12 岁）儿童在家中接触 SHS，这相当于全美范围内有 480 万儿童受到影响。每种儿童神经行为结果的加权患病率及其 95%置信区间分别为：学习障碍 8.2%（7.5-8.8）、注意缺陷多动障碍 5.9%（5.5-6.4）、行为和品行障碍 3.6%（3.1-4.0）。与未接触 SHS 的儿童相比，在家中接触 SHS 的儿童发生≥2 种儿童神经行为障碍的可能性增加了 50%。男孩的风险显著更高。年龄较大的儿童，尤其是 9 至 11 岁的儿童，以及生活在贫困程度最高的家庭中的儿童，风险更高。从绝对数量上看，如果儿童没有在家中接触 SHS，那么总共可以预防这 3 种疾病的 274100 例超额病例。
本研究的发现是关联而非因果关系，强调了美国儿童神经行为障碍的健康负担，这可能与家庭中 SHS 暴露有关。
