Thacher J D, Gruzieva O, Pershagen G, Neuman Å, van Hage M, Wickman M, Kull I, Melén E, Bergström A
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
Allergy. 2016 Feb;71(2):239-48. doi: 10.1111/all.12792. Epub 2015 Nov 13.
The relation between secondhand tobacco smoke (SHS) exposure and the development of allergic sensitization in children is unclear. The aim of this study was to determine whether maternal smoking during pregnancy and postnatal SHS exposure contributes to the development of allergic sensitization in children and adolescents up to 16 years of age.
We included 3316 children from a birth cohort followed up for 16 years. SHS exposure and symptoms of allergic disease were assessed using repeated parental questionnaires. Serum immunoglobulin E against eight common inhalant and six food allergens was assessed at ages 4, 8, and 16 years with ImmunoCAP. The association between SHS exposure and sensitization was explored using logistic regression and generalized estimating equations.
Exposure to SHS in infancy without prior exposure in utero was associated with an excess risk of food sensitization at age 4 years (OR 1.47, 95% CI 1.08-2.00), with comparable ORs at ages 8 and 16 years. In longitudinal analyses, an overall association was indicated between SHS in infancy and food sensitization up to age 16 years (OR 1.24, 95% CI 0.98-1.56). Maternal smoking during pregnancy was unrelated to sensitization up to 16 years of age. When sensitization was combined with concurrent symptoms of allergic disease, SHS in infancy was associated with an overall elevated risk of eczema with sensitization (OR 1.62, 95% CI 1.20-2.18).
SHS exposure in infancy appears to increase the risk of sensitization to food allergens up to age 16 years, as well as eczema in combination with sensitization.
二手烟暴露与儿童过敏性致敏的发展之间的关系尚不清楚。本研究的目的是确定孕期母亲吸烟及产后二手烟暴露是否会导致16岁以下儿童和青少年过敏性致敏的发展。
我们纳入了来自一个出生队列的3316名儿童，对其进行了16年的随访。使用重复的家长问卷评估二手烟暴露和过敏性疾病症状。在4岁、8岁和16岁时，使用免疫捕获法评估针对八种常见吸入性过敏原和六种食物过敏原的血清免疫球蛋白E。使用逻辑回归和广义估计方程探讨二手烟暴露与致敏之间的关联。
婴儿期暴露于二手烟而在子宫内未预先暴露与4岁时食物致敏的额外风险相关（比值比1.47，95%置信区间1.08 - 2.00），8岁和16岁时的比值比相当。在纵向分析中，婴儿期二手烟暴露与16岁前的食物致敏之间存在总体关联（比值比1.24，95%置信区间0.98 - 1.56）。孕期母亲吸烟与16岁前的致敏无关。当致敏与过敏性疾病的并发症状相结合时，婴儿期二手烟暴露与伴有致敏的湿疹总体风险升高相关（比值比1.62，95%置信区间1.20 - 2.18）。
婴儿期暴露于二手烟似乎会增加16岁前对食物过敏原致敏的风险，以及伴有致敏的湿疹风险。
