MOE-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
Child Health Advocacy Institute, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China.
BMC Public Health. 2019 Jul 10;19(1):923. doi: 10.1186/s12889-019-7006-8.
The effect of secondhand smoke (SHS) exposure on child psychological problems remained inconclusive in previous studies. The aim of this study is to explore the association between SHS exposure and psychological symptoms in children.
This population-based cross-sectional survey used cluster random probability sampling and recruited children aged 6-13 years in 26 primary schools in Shanghai, China, in 2014. Duration of SHS exposure in children were categorized as none, < 1 h/day, 1-2 h/day, ≥3 h/day. Psychological symptoms were assessed by the parental version of the Strengths and Difficulties Questionnaire (SDQ). We used logistic regression to estimate the adjusted associations of SHS exposure with total SDQ and its specific domains. Multiple imputation was used for handling missing data.
A total of 17,571 children completed this survey, with a response rate of 99.7%. SDQ scores were available for 15,344 participants, of whom 20.9% were not exposed to SHS, 63.0% exposed for < 1 h/day, 10.4% for 1-2 h/day, and 5.7% for ≥3 h/day. Compared to children not exposed to SHS, SHS exposure was positively associated with total SDQ score: OR 1.42, 95% confidence interval (CI) 1.22 to 1.66 for SHS exposure < 1 h/day, OR 2.14, 95% CI 1.76 to 2.62 for 1-2 h/day and OR 2.53, 95% CI 2.01 to 3.18 for ≥3 h/day after adjusting for sex, age, mode of birth, family socio-economic status and place of birth. These associations did not vary by sex.
SHS exposure is an independent risk factor for psychological problems among children. Nonetheless, our study is unable to distinguish between fetal and child exposure to SHS.
二手烟（SHS）暴露对儿童心理问题的影响在以前的研究中尚无定论。本研究旨在探讨 SHS 暴露与儿童心理症状之间的关系。
本研究采用基于人群的横断面调查，使用聚类随机概率抽样方法，于 2014 年在上海市 26 所小学招募 6-13 岁儿童。儿童 SHS 暴露时间分为无、<1 小时/天、1-2 小时/天、≥3 小时/天。心理症状采用父母版的长处与困难问卷（SDQ）进行评估。我们使用逻辑回归估计 SHS 暴露与 SDQ 总分及其特定领域的调整关联。采用多重插补处理缺失数据。
共有 17571 名儿童完成了这项调查，应答率为 99.7%。15344 名参与者的 SDQ 评分可用，其中 20.9%的儿童未暴露于 SHS，63.0%的儿童暴露于 SHS 的时间<1 小时/天，10.4%的儿童暴露于 SHS 的时间为 1-2 小时/天，5.7%的儿童暴露于 SHS 的时间≥3 小时/天。与未暴露于 SHS 的儿童相比，暴露于 SHS 与 SDQ 总分呈正相关：暴露于 SHS<1 小时/天的 OR 为 1.42，95%置信区间（CI）为 1.22 至 1.66；暴露于 SHS 1-2 小时/天的 OR 为 2.14，95%CI 为 1.76 至 2.62；暴露于 SHS≥3 小时/天的 OR 为 2.53，95%CI 为 2.01 至 3.18，调整性别、年龄、分娩方式、家庭社会经济地位和出生地后。这些关联在性别间没有差异。
SHS 暴露是儿童心理问题的一个独立危险因素。尽管如此，我们的研究无法区分胎儿和儿童时期暴露于 SHS。
