Dai Siyu, Chan Kate C
Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Tob Induc Dis. 2020 Jan 10;18:02. doi: 10.18332/tid/114461. eCollection 2020.
Young children are especially vulnerable to environmental tobacco smoke (ETS) exposure. This study was carried out to determine whether household ETS exposure was associated with respiratory symptoms and medical service utilisation among Hong Kong healthy children in their first eighteen months of age.
A secondary analysis was done on the data obtained from our previous cross-sectional territory-wide pneumococcal carriage surveillance study in Hong Kong in 2013-2014. All measures were reported by caregivers. Univariable and multivariable analyses were performed to examine the associations between ETS exposure and outcome measures. Covariates included children's sex, age, body mass index z score, history of breastfeeding, gestational age at birth, birthweight, maternal age, living region, overcrowding of living area, household income, child care attendance, and presence of siblings. Additional adjustment for season and households' respiratory symptoms were made to ascertain the association between ETS and children's respiratory symptoms.
The analysis included 1541 children (mean age: 11.2 ± 6.4 months; males: 50.7%). Current household ETS exposure (AOR=1.30; 95% CI: 1.00- 1.66; p=0.050) and postnatal maternal smoking (AOR=2.21; 95% CI: 1.06-4.64; p=0.035) were independently and significantly associated with all-cause doctor consultation in the past 3 months. Children living with more than one household smoker were more likely to have all-cause doctor consultation compared with the non-exposed children (AOR=1.70; 95% CI: 1.04-2.77, p=0.028). Postnatal maternal smoking was associated with all-cause hospitalisation in the past 3 months (AOR=2.48; 95% CI: 1.05-5.86; p=0.039). Children living in a household, where the daily consumption by household smokers was more than 20 cigarettes, were more likely to have respiratory symptoms compared with non-exposed children (AOR=1.99; 95% CI: 1.12-3.52; p=0.016).
Household ETS exposure in young children was associated with respiratory symptoms and all-cause outpatient or inpatient medical service utilisation. The associations were potentially dose-dependent.
幼儿尤其容易受到环境烟草烟雾（ETS）的影响。本研究旨在确定香港18个月大的健康儿童家庭中ETS暴露是否与呼吸道症状及医疗服务利用情况相关。
对我们之前在2013 - 2014年进行的全港肺炎球菌携带情况横断面监测研究中获取的数据进行二次分析。所有指标均由照顾者报告。进行单变量和多变量分析以检验ETS暴露与结果指标之间的关联。协变量包括儿童的性别、年龄、体重指数z评分、母乳喂养史、出生时的孕周、出生体重、母亲年龄、居住地区、居住面积拥挤程度、家庭收入、儿童保育情况以及是否有兄弟姐妹。对季节和家庭呼吸道症状进行额外调整以确定ETS与儿童呼吸道症状之间的关联。
分析纳入了1541名儿童（平均年龄：11.2±6.4个月；男性：50.7%）。当前家庭ETS暴露（比值比[AOR]=1.30；95%置信区间[CI]：1.00 - 1.66；p = 0.050）和产后母亲吸烟（AOR = 2.21；95% CI：1.06 - 4.64；p = 0.035）与过去3个月内的全因就诊独立且显著相关。与未暴露儿童相比，生活在有不止一名家庭吸烟者家庭中的儿童更有可能进行全因就诊（AOR = 1.70；95% CI：1.04 - 2.77，p = 0.028）。产后母亲吸烟与过去3个月内的全因住院相关（AOR = 2.48；95% CI：1.05 - 5.86；p = 0.039）。与未暴露儿童相比，生活在家庭吸烟者每日吸烟量超过20支的家庭中的儿童更有可能出现呼吸道症状（AOR = 1.99；95% CI：1.12 - 3.52；p = 0.016）。
幼儿家庭中的ETS暴露与呼吸道症状以及全因门诊或住院医疗服务利用情况相关。这些关联可能存在剂量依赖性。
