Wang X, Wypij D, Gold D R, Speizer F E, Ware J H, Ferris B G, Dockery D W
Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115.
Am J Respir Crit Care Med. 1994 Jun;149(6):1420-5. doi: 10.1164/ajrccm.149.6.8004293.
The association between parental cigarette smoking and children's pulmonary function was investigated in 8,706 nonsmoking white children, followed annually by questionnaire and spirometry between 6 and 18 yr. Exposure to maternal and paternal smoking was each divided into three components: exposure in the first 5 yr of life, cumulative exposure between age 6 and the year prior to each visit; parental smoking status reported at each visit. Regression splines were used to assess the effects of parental smoking on the level and growth rate of pulmonary function adjusting for age, height, city of residence, and parental education. Models best predicting pulmonary function level included current maternal smoking and exposure to maternal smoking in the first 5 yr of life but did not include the other measures of parental smoking. After adjusting for early exposure, current maternal smoking for each pack/d was associated with a reduced level of FEV1 (-0.4%, 95% CI: -0.9, 0.1), FEV1/FVC (-0.6%, 95% CI: -0.9, -0.4), and FEF25-75% (-2.3%, 95% CI: -3.6, -1.0) in children 6 to 10 yr. These effects were slightly smaller in children 11 to 18 yr. Adjusting for current maternal smoking, those exposed to maternal smoking in the first 5 yr of life had higher FVC (+0.5%, 95% CI: -0.1, 1.2) and lower FEV1/FVC (-0.7%, 95% CI: -1.1, -0.4) and FEF25-75% (-2.8%, 95% CI: -4.4, -1.2) than those not exposed in children 6 to 10 yr.(ABSTRACT TRUNCATED AT 250 WORDS)
对8706名不吸烟的白人儿童进行了研究，以调查父母吸烟与儿童肺功能之间的关联。在6至18岁期间，每年通过问卷调查和肺活量测定法对这些儿童进行随访。母亲和父亲吸烟的暴露情况各分为三个部分：生命最初5年的暴露情况、6岁至每次随访前一年的累积暴露情况；每次随访时报告的父母吸烟状况。使用回归样条来评估父母吸烟对肺功能水平和生长速率的影响，并对年龄、身高、居住城市和父母教育程度进行了调整。最佳预测肺功能水平的模型包括当前母亲吸烟以及生命最初5年中母亲吸烟的暴露情况，但不包括父母吸烟的其他测量指标。在调整早期暴露因素后，6至10岁儿童中，母亲每吸一包/天的香烟，其第一秒用力呼气容积（FEV1）水平降低（-0.4%，95%可信区间：-0.9，0.1）、FEV1/用力肺活量（FVC）降低（-0.6%，95%可信区间：-0.9，-0.4）、25%至75%用力呼气流量（FEF25-75%）降低（-2.3%，95%可信区间：-3.6，-1.0）。在11至18岁儿童中，这些影响略小。在调整当前母亲吸烟因素后，6至10岁儿童中，生命最初5年暴露于母亲吸烟的儿童比未暴露的儿童用力肺活量更高（+0.5%，95%可信区间：-0.1，1.2），FEV1/FVC更低（-0.7%，95%可信区间：-1.1，-0.4），FEF25-75%更低（-2.8%，95%可信区间：-4.4，-1.2）。（摘要截短至250字）
