Merianos Ashley L, Jandarov Roman A, Mahabee-Gittens E Melinda
a School of Human Services, University of Cincinnati , Cincinnati , OH , USA.
b Department of Environmental Health , University of Cincinnati , Cincinnati , OH , USA.
J Asthma. 2019 Apr;56(4):369-379. doi: 10.1080/02770903.2018.1463379. Epub 2018 May 1.
To investigate the association between secondhand smoke exposure (SHSe) and asthma symptoms, medication use, and emergency department (ED)/urgent care (UC) utilization among adolescents.
We performed a secondary cross-sectional analysis of Population Assessment of Tobacco and Health Study Wave 2 (2014-2015) including asthmatic adolescents (N = 2198). Logistic regression models and Poisson regression models were built.
Participants with SHSe ≥1 hour in the past 7 days were at increased risk of reporting shortness of breath and harder to exercise aOR, 1.22; 95% CI, 1.04-1.43), wheezing (aOR, 1.26; 95% CI, 1.01-1.56), wheezing disturbing sleep (aOR, 1.88; 95% CI, 1.35-2.63), wheezing during/after exercise (aOR, 1.41; 95% CI, 1.19-1.66), wheezing limiting speech (aOR, 2.11; 95% CI, 1.55-2.86), dry cough at night (aOR, 1.86; 95% CI, 1.54-2.24), and asthma symptoms disturbing sleep (aOR, 2.25; 95% CI, 1.81-2.79). Participants with SHSe ≥1 hour were more likely to take asthma medications (aOR, 1.25; 95% CI, 1.03-1.52), including steroids (aOR, 1.86; 95% CI, 1.19-2.91), oxygen therapy (aOR, 2.88; 95% CI, 1.82-4.54), and controlling medications (aOR, 1.50; 95% CI, 1.24-1.82). Symptoms and medications varied by living with a smoker and home SHSe. Participants with SHSe were at increased risk of having a higher number of asthma attacks that required steroid use. Participants who lived with a smoker and had home SHSe were at increased risk of having higher ED/UC visits for asthma.
SHSe reduction efforts are needed for asthmatic adolescents, and EDs/UCs are promising venues.
探讨青少年二手烟暴露（SHSe）与哮喘症状、药物使用以及急诊室（ED）/紧急护理（UC）就诊之间的关联。
我们对烟草与健康人口评估研究第2波（2014 - 2015年）进行了二次横断面分析，纳入哮喘青少年（N = 2198）。构建了逻辑回归模型和泊松回归模型。
在过去7天内二手烟暴露≥1小时的参与者报告呼吸急促和运动困难的风险增加（调整后的比值比[aOR]，1.22；95%置信区间[CI]，1.04 - 1.43）、喘息（aOR，1.26；95% CI，1.01 - 1.56）、喘息影响睡眠（aOR，1.88；95% CI，1.35 - 2.63）、运动期间/运动后喘息（aOR，1.41；95% CI，1.19 - 1.66）、喘息限制说话（aOR，2.11；95% CI，1.55 - 2.86）、夜间干咳（aOR，1.86；95% CI，1.54 - 2.24）以及哮喘症状影响睡眠（aOR，2.25；95% CI，1.81 - 2.79）的风险增加。二手烟暴露≥1小时的参与者更有可能使用哮喘药物（aOR，1.25；95% CI，1.03 - 1.52），包括类固醇（aOR，1.86；95% CI，1.19 - 2.91）、氧气疗法（aOR，2.88；95% CI，1.82 - 4.54）以及控制药物（aOR，1.50；95% CI，1.24 - 1.82）。症状和药物使用因与吸烟者同住和家庭二手烟暴露情况而异。二手烟暴露的参与者因哮喘发作需要使用类固醇的次数增加的风险更高。与吸烟者同住且家庭存在二手烟暴露的参与者因哮喘到急诊室/紧急护理就诊次数增加的风险更高。
哮喘青少年需要努力减少二手烟暴露，急诊室/紧急护理是有前景的场所。
