Hallit Souheil, Raherison Chantal, Waked Mirna, Salameh Pascale
Faculty of Pharmacy, Lebanese University, Beirut, Lebanon AND Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon AND Faculty of Medicine and Medical Sciences, Holy Spirit University, Kaslik, Lebanon AND Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon AND Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research, Center Inserm Université de Bordeaux, Bordeaux, France.
Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm Université de Bordeaux, Bordeaux, France AND Department of Pulmonology, University Hospital, Bordeaux, France.
Iran J Allergy Asthma Immunol. 2017 Dec;16(6):488-500.
The aim of this study was to evaluate the associations between caregiver-reported use of medications, alcohol, cigarette and/or waterpipe (WP), and exposure to pesticides/detergents during pregnancy with childhood-onset asthma. The study design consisted of a case-control study, conducted between December 2015 and April 2016, recruited 1503 children, aged between 3-16 years old. A questionnaire assessed the sociodemographic characteristics (age, gender, education level of both parents), the family history of asthma, and other known risk factors of asthma (heating system at home, child history of recurrent otitis, humidity in the house, child went to a daycare, smoking and drinking alcohol during pregnancy, exposure to pesticides and detergents). The multivariate analysis showed that children living in North and South Lebanon and the children living in areas where pesticides are frequently used had an increased risk of asthma (ORa=1.625, CI 1.034-2.554, p=0.035, ORa=13.65, CI 3.698-50.385; p<0.001 and ORa=3.307, CI 1.848-5.918, p<0.001 respectively). Smoking WP during pregnancy and cigarette during lactation would increase the risk of asthma in children (ORa=6.11; CI 1.244-30.008; p=0.026 and ORa=3.44; CI 1.024-11.554; p=0.046 respectively). We conclude that asthma may originate from the environmental exposure to toxics such as pesticides and tobacco (cigarettes and WP) or to alcohol and prescribed medications during pregnancy and lactation. Spreading awareness by health professionals about these preventable causes can help educate the parents and children to prevent asthma and its exacerbation.
本研究的目的是评估照料者报告的孕期用药、饮酒、吸烟和/或吸食水烟情况以及接触杀虫剂/洗涤剂与儿童期哮喘之间的关联。该研究设计为病例对照研究，于2015年12月至2016年4月进行，招募了1503名3至16岁的儿童。一份问卷评估了社会人口学特征（年龄、性别、父母双方的教育水平）、哮喘家族史以及其他已知的哮喘风险因素（家中供暖系统、儿童反复中耳炎病史、家中湿度、儿童是否去过日托中心、孕期吸烟和饮酒、接触杀虫剂和洗涤剂）。多变量分析显示，生活在黎巴嫩北部和南部的儿童以及生活在频繁使用杀虫剂地区的儿童患哮喘的风险增加（优势比分别为1.625，95%置信区间为1.034 - 2.554，p = 0.035；优势比为13.65，95%置信区间为3.698 - 50.385；p < 0.001；优势比为3.307，95%置信区间为1.848 - 5.918，p < 0.001）。孕期吸食水烟和哺乳期吸烟会增加儿童患哮喘的风险（优势比分别为6.11；95%置信区间为1.244 - 30.008；p = 0.026和优势比为3.44；95%置信区间为1.024 - 11.554；p = 0.046）。我们得出结论，哮喘可能源于孕期和哺乳期环境中接触有毒物质，如杀虫剂和烟草（香烟和水烟）或酒精及处方药。卫生专业人员宣传这些可预防的病因有助于教育家长和儿童预防哮喘及其加重。
