Rylander E, Pershagen G, Eriksson M, Bermann G
Department of Epidemiology, Karolinska Institute, Stockholm, Sweden.
Epidemiology. 1995 May;6(3):289-93. doi: 10.1097/00001648-199505000-00017.
We conducted a case-control study to assess the role of exposure to environmental tobacco smoke (ETS) in the development of wheezing bronchitis in children. The study included 199 children age 4 months to 4 years, who were treated in hospital for wheezing bronchitis, and 351 population controls of the same age group. We estimated exposure to ETS from urinary cotinine measurements as well as from questionnaires to parents. The median urinary cotinine concentration was 5.7 micrograms per liter in cases and 4.4 micrograms per liter in controls. Breast-feeding was related to urinary cotinine excretion in children with smoking mothers. The risk of wheezing bronchitis increased in relation to parental smoking and urinary cotinine concentration. This effect was most prominent in children up to 18 months of age, among whom the relative risk was 3.3 in those with a urinary cotinine level exceeding 20 micrograms per liter (95% confidence interval = 1.5-7.6). Our data confirm that ETS is an important risk factor for wheezing bronchitis in children and indicate that a single urinary cotinine measurement offers no major advantages to questionnaire data for assessment of long-term exposure to ETS.
我们进行了一项病例对照研究，以评估暴露于环境烟草烟雾（ETS）在儿童喘息性支气管炎发病中的作用。该研究纳入了199名年龄在4个月至4岁之间因喘息性支气管炎住院治疗的儿童，以及351名同年龄组的人群对照。我们通过测定尿可替宁以及向家长发放问卷来估计ETS暴露情况。病例组尿可替宁浓度中位数为每升5.7微克，对照组为每升4.4微克。对于母亲吸烟的儿童，母乳喂养与尿可替宁排泄有关。喘息性支气管炎的风险随着父母吸烟情况和尿可替宁浓度的增加而升高。这种影响在18个月以下儿童中最为显著，尿可替宁水平超过每升20微克的儿童中，相对风险为3.3（95%置信区间=1.5-7.6）。我们的数据证实，ETS是儿童喘息性支气管炎的一个重要危险因素，并表明单次尿可替宁测量在评估长期ETS暴露方面相对于问卷数据并无显著优势。
