Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong's "Children of 1997" birth cohort.
Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong's "Children of 1997" birth cohort.
复制标题
DOI：
10.1136/tc.2007.023887
复制
发表时间：
2008-08-01
期刊：
影响因子：
5.2
通讯作者：
Leung, G M
中科院分区：
文献类型：
--
作者：
Kwok, M K;Schooling, C M;Leung, G M
背景：二手烟（SHS）暴露是一种可改变的健康不良原因。尽管2007年香港出台了公共场所禁烟令，但婴儿和儿童仍继续在家中暴露于SHS。目的：确定SHS暴露的关键窗口及其对生命前8年严重感染性发病率的影响持续时间。方法：香港“一九九七年儿童”出生组别是一项以人口为基础的前瞻性研究，研究对象为8327名儿童，占一九九七年四月及五月出生儿童总数的88%，其中7 402人（89%）在2005年接受了跟踪调查，直至其8岁生日。我们使用多变量考克斯回归来评估产后SHS暴露与首次入住公立医院风险之间的关系（合计占总住院日的95%以上），用于从出生到8岁的呼吸道感染、其他感染和所有感染，针对所有个体和脆弱亚组。总的来说，家庭在生命早期3米范围内的SHS暴露与8岁之前因传染病入院的风险较高有关（风险比1.14，95%CI 1.00至1.31），调整性别，出生体重，胎龄，喂养方法，母亲年龄，父母最高教育和首选服务部门的代理后。在出生后的前6个月，这种关联最强（HR 1.45，95% CI 1.15 - 1.83）。在易受影响的亚组中，如早产儿，这种关联一直持续到8岁（HR 2.00，95% CI 1.08至3.72）。暴露于SHS的婴儿在生命的前3个月是最容易感染的原因hospitalis.CONCLUSION：家庭SHS暴露在婴儿早期增加严重的感染性发病率，需要住院治疗。减少婴儿，特别是更脆弱的婴儿的SHS暴露将降低由于感染原因造成的卧床日负担。
BACKGROUND: Second-hand smoke (SHS) exposure is a modifiable cause of ill health. Despite the smoking ban in public places introduced in Hong Kong in 2007, infants and children continue to be exposed within the home.AIMS: To determine the critical windows of SHS exposure and the duration of its impact on serious infectious morbidity in the first 8 years of life.METHODS: The Hong Kong "Children of 1997" birth cohort is a prospective, population-based study of 8327 children comprising 88% of all births in April and May 1997, of whom 7402 (89%) were followed up until their eighth birthday in 2005. We used multivariable Cox regression to assess the relation between postnatal SHS exposure and risk of first admission to public hospitals (together accounting for >95% total bed-days overall) for respiratory, other and all infections from birth to 8 years of age, for all individuals and for vulnerable subgroups.RESULTS: Overall, household SHS exposure within 3 metres in early life was associated with a higher risk of admission for infectious illness up until 8 years of age (hazard ratio 1.14, 95% CI 1.00 to 1.31), after adjustment for sex, birthweight, gestational age, feeding method, maternal age, highest parental education and proxies of preferred service sector. The association was strongest in the first 6 months of life (HR 1.45, 95% CI 1.15 to 1.83). In vulnerable subgroups such as premature babies, the association held through to 8 years of age (HR 2.00, 95% CI 1.08 to 3.72). Infants exposed to SHS in the first 3 months of life were most vulnerable to infectious causes of hospitalisation.CONCLUSION: Household SHS exposure in early infancy increases severe infectious morbidity requiring hospital admission. Reducing SHS exposure in infants and particularly in more vulnerable infants will lower the bed-days burden due to infectious causes.