EXPOSURE OF CHILDREN WITH CYSTIC-FIBROSIS TO ENVIRONMENTAL TOBACCO-SMOKE
EXPOSURE OF CHILDREN WITH CYSTIC-FIBROSIS TO ENVIRONMENTAL TOBACCO-SMOKE
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DOI：
10.1056/nejm199009203231203
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发表时间：
1990-09-20
影响因子：
158.5
通讯作者：
RUBIN, BK
中科院分区：
文献类型：
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作者：
RUBIN, BK
背景：在儿童中，被动暴露于环境烟草烟雾与生长抑制和呼吸道感染频率增加有关。假设这种关联在患有慢性肺部疾病的儿童中更为明显，我们检查了囊性纤维化儿童的生长、营养状况、肺功能和临床状况与他们暴露于环境烟草烟雾的关系。方法：我们研究了43名儿童（6至11岁），他们刚参加了一个夏令营，然后在无烟环境中待了两周。其中24名儿童（56%）来自吸烟者家庭。结果：通过年龄调整后的住院率（r = 0.58）、呼气峰值流速（r = -0.39）、生长和营养指标(包括体重百分位数（r = -0.37）、身高百分位数（r = -0.44）、中臂围（r = -0.42）和肱三头肌皮肤厚度（r = -0.31）来评估，烟雾暴露（每天在家中吸烟）的估计值与疾病的总体严重程度之间似乎存在剂量依赖关系。这些影响在女孩身上最为明显。然而，当仅分析24名来自吸烟者家庭的儿童时，剂量依赖关系仅存在于住院次数和身高上。在营地开始时肺功能良好（n = 21）或身高体重正常（n = 27）的儿童中，暴露于烟草烟雾中的儿童在两周的营地中比来自无烟家庭的儿童体重增加明显更多。结论：这些数据表明，被动暴露于烟草烟雾对囊性纤维化儿童的生长和健康有不利影响，尽管不能排除社会、经济或其他因素决定家庭吸烟状况和儿童营养状况的可能性。
Background: In children, passive exposure to environmental tobacco smoke has been associated with growth suppression and an increased frequency of respiratory tract infections. On the assumption that this association would be more pronounced in children with chronic pulmonary disease, we examined the growth, nutritional status, lung function, and clinical condition of children with cystic fibrosis in relation to their exposure to environmental tobacco smoke. Methods: We studied 43 children (age, 6 to 11 years) on entry to a summer camp and then again after two weeks in this smoke-free environment. Twenty-four of the children (56 percent) came from homes with smokers. Results: There appeared to be a dose-dependent relation between the estimate of smoke exposure (cigarettes smoked per day in the home) and overall severity of disease, as assessed by the age-adjusted rate of hospital admissions (r = 0.58), peak expiratory flow rate (r = -0.39), and measures of growth and nutrition, including weight percentile (r = -0.37), height percentile (r = -0.44), midarm circumference (r = -0.42), and triceps skin-fold thickness (r = -0.31). These effects were most evident in the girls. When only the 24 children from homes with smokers were analyzed, however, the dose-dependent relation was present only for the number of hospital admissions and for height. Among the children with good lung function (n = 21) or with normal weight for height (n = 27) at the start of camp, those who had been exposed to tobacco smoke gained significantly more weight during the two weeks of camp than did the children from smoke-free homes. Conclusions: These data suggest that passive exposure to tobacco smoke adversely affect the growth and health of children with cystic fibrosis, although the possibility cannot be ruled out that social, economic, or other factors determined both the smoking status of the household and the nutritional status of the children.