Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Pediatrics. 2011 Oct;128(4):650-6. doi: 10.1542/peds.2011-1067. Epub 2011 Sep 2.
Involuntary tobacco smoke exposure causes substantial morbidity in children. We hypothesized that children exposed to tobacco smoke in the home would have increased school absenteeism with associated costs due to lost caregiver wages/time.
We analyzed data on health and absenteeism among schoolchildren aged 6 to 11 years identified in the 2005 National Health Interview Survey (NHIS). We used multivariate models to assess the relationships between adult-reported household smoking and child health and school absenteeism. Analyses were adjusted for children's and parents' demographic and socioeconomic characteristics. The value of lost caregiver time was estimated by using self-reported employment and earnings data in the NHIS and publicly available time-use data.
Children living with 1 or ≥ 2 adults who smoked in the home had 1.06 (95% confidence interval [CI]: 0.54-1.55) and 1.54 (95% CI: 0.95-2.12) more days absent from school per year, respectively, than children living with 0 smokers in the home. Living with ≥ 2 adults who smoked in the home was associated with increased reports of having ≥ 3 ear infections in the previous 12 months (adjusted odds ratio [aOR]: 2.65 [95% CI: 1.36-5.16]) and having a chest cold in the 2 weeks before interview (aOR: 1.77 [95% CI: 1.03-3.03]) but not with having vomiting/diarrhea in the previous 2 weeks (aOR: 0.93 [95% CI: 0.45-1.89]). Caregivers' time tending children absent from school was valued at $227 million per year.
Tobacco smoke exposure has significant consequences for children and families above and beyond child morbidity, including academic disadvantage and financial burden.
非自愿的二手烟暴露会导致儿童患多种疾病。我们假设，家中暴露于二手烟的儿童会因看护人缺勤导致工资/时间损失而增加缺课率，并产生相应费用。
我们分析了 2005 年全国健康访谈调查（NHIS）中年龄在 6 至 11 岁的在校儿童健康和缺勤数据。我们使用多元模型评估了成人报告的家庭吸烟与儿童健康和学校缺勤之间的关系。分析调整了儿童和父母的人口统计学和社会经济特征。看护人缺勤时间的价值是通过 NHIS 中的自我报告就业和收入数据以及公开的时间使用数据来估计的。
与家中没有吸烟者的儿童相比，家中有 1 位或≥2 位吸烟者的儿童每年缺课天数分别增加 1.06（95%置信区间[CI]：0.54-1.55）和 1.54（95% CI：0.95-2.12）。家中有≥2 位吸烟者与报告过去 12 个月中≥3 次耳部感染（调整后比值比[aOR]：2.65[95% CI：1.36-5.16]）和在访谈前 2 周内患感冒（aOR：1.77[95% CI：1.03-3.03]）的次数增加相关，但与过去 2 周内呕吐/腹泻（aOR：0.93[95% CI：0.45-1.89]）无关。看护人因孩子缺勤而照顾孩子的时间价值为每年 2.27 亿美元。
二手烟暴露对儿童及其家庭造成的影响不仅限于儿童患病，还包括学业劣势和经济负担。
