Is it exposure to cigarette smoke or to smokers which increases the risk of meningococcal disease in teenagers?
Is it exposure to cigarette smoke or to smokers which increases the risk of meningococcal disease in teenagers?
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DOI：
10.1093/ije/dyi295
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发表时间：
2006-04-01
影响因子：
7.7
通讯作者：
Booy, R
中科院分区：
文献类型：
--
作者：
Coen, PG;Tully, J;Booy, R
背景被动吸烟似乎会增加青少年患脑膜炎球菌病（MD）的风险。这种影响是否是由于暴露于香烟烟雾或接触smokers.Methods我们进行了一项前瞻性的以人口为基础的病例对照研究，年龄，性别匹配对照1：1匹配。参与者为1999年1月至2000年6月在6个地区（占英格兰人口的65%）住院时招募的15-19岁MD患者及其匹配对照。通过保密访谈收集潜在危险因素的数据，包括7个被动吸烟变量。进行因素分析，以评估被动吸烟暴露变量的维度。结果共纳入病例对照组144对，男性占51%，中位年龄17.6岁。因素分析发现两个独立的因素代表被动吸烟（P < 0.01），一个与“吸烟暴露”，另一个与“吸烟者接触”。仅吸烟者接触是MD的显著风险因素（OR = 1.8; 95% CI 1.0-3.3; P = 0.05）。在多变量分析中，这个因素仍然与MD独立的潜在混杂因素，如积极吸烟者的地位和家庭crowding.Conclusion接触吸烟者与MD的青少年的风险增加。这更可能是由于吸烟者携带率较高，而不是暴露于烟雾，并强调了公共卫生措施的重要性，以停止吸烟。在评估被动吸烟风险的流行病学研究中，应尽可能将接触烟雾与接触吸烟者区分开来。
Background Passive smoking appears to increase the risk of meningococcal disease (MD) in adolescents. Whether this effect is attributable to exposure to cigarette smoke or contact with smokers is unknown.Methods We conducted a prospective population-based case-control study with age, sex matched-controls in 1:1 matching. Participants were 15-19 year old with MD recruited at hospital admission in six regions (65% of the population of England) from January 1999 through June 2000, and their matched controls. Data on potential risk factors were gathered by confidential interview, including seven passive smoking variables. Factor analysis was performed to assess the dimensionality of the passive smoking exposure variables. The data were analysed with univariate and multivariate conditional logistic regression.Results 144 case-control pairs were recruited (51% male; median age 17.6). Factor analysis identified two independent factors representing passive smoking (P < 0.01), one associated with 'exposure to smoke', the other with 'smoker contact'. Only smoker contact was a significant risk factor for MD (OR = 1.8; 95% CI 1.0-3.3; P = 0.05). In multivariate analysis this factor was still associated with MD independently of potential confounders such as active smoker status and household crowding.Conclusion Contact with smokers is associated with increased risk of MD in adolescents. This is more likely to be due to higher carriage rates in smokers than to exposure to smoke and emphasizes the importance of public health measures to stop smoking. In epidemiological studies that assess risk from passive smoking, exposure to smoke should be differentiated where possible from contact with smokers.