Salivary cotinine, doctor-diagnosed asthma and respiratory symptoms in primary schoolchildren
Salivary cotinine, doctor-diagnosed asthma and respiratory symptoms in primary schoolchildren
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DOI：
10.1007/s10995-007-0229-9
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发表时间：
2008-03-01
影响因子：
2.3
通讯作者：
Brabin, Bernard J.
中科院分区：
文献类型：
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作者：
Delpisheh, Ali;Kelly, Yvonne;Brabin, Bernard J.
由于气道功能受损，儿童如果接触环境烟草烟雾 (ETS)，就有出现不良呼吸道症状的风险。对英国默西塞德郡低社会经济地区 15 所小学的 425 名儿童（5-11 岁）进行了一项基于社区的横断面研究，通过家长填写的问卷和儿童唾液可替宁测量结果来调查不良呼吸道症状与 ETS 暴露之间的关联。总体而言，28.9% 的儿童患有医生诊断的哮喘 (DDA)，11.3% 的儿童有呼吸道疾病住院史。 12.6%的儿童出现咳嗽、喘息和呼吸困难三联征（C+W+B+）。可替宁的几何平均水平为 0.37 ng/ml（95% CI，0.33-0.42 ng/ml），估计有 45.6% 的儿童接触过 ETS。据报告，9.2% 的父亲和 7.2% 的母亲有哮喘家族史。与没有 DDA 的儿童相比，患有 DDA 的儿童唾液可替宁水平显着升高（P = 0.002）。可替宁验证的水平[调整后的优势比 (AOR)，1.8； 95% CI，1.4-2.5）、低社会经济（弱势）地位（AOR，1.4；1.1-2.9）、儿童的男性性别（AOR，1.6；1.1-2.5）和母亲吸烟（AOR，2.2；1.4-3.1）与 DDA 显着相关。可替宁验证水平（AOR，1.4；1.1-2.9）以及母亲吸烟（AOR，1.8；1.1-2.5）也与 C+W+B+ 独立相关。使用唾液可替宁作为 ETS 暴露的指标可用于告知父母其哮喘儿童的暴露风险，并可能有助于加强威慑工作，减少儿童时期父母吸烟的暴露。
Due to impaired airway function, children are at risk for adverse respiratory symptoms if exposed to environmental tobacco smoke (ETS). A community-based, cross-sectional study of 425 children (5-11 years) attending 15 primary schools in a low socio-economic area of Merseyside/UK was undertaken to investigate the association of adverse respiratory symptoms and ETS exposure using a parent-completed questionnaire and children's salivary cotinine measurements. Overall, 28.9% of children had doctor-diagnosed asthma (DDA) and 11.3% a history of hospital admission for respiratory illnesses. The symptom triad of cough, wheeze and breathlessness (C+W+B+) occurred in 12.6% of children. The geometric mean cotinine level was 0.37 ng/ml (95% CI, 0.33-0.42 ng/ml) and it was estimated that 45.6% of children were ETS exposed. A history of asthma in the family was reported for 9.2% of fathers and 7.2% of mothers. Salivary cotinine level was significantly increased in children with DDA compared to those without (P = 0.002). Cotinine-validated levels [adjusted odds ratio (AOR), 1.8; 95% CI, 1.4-2.5), low socio-economic (disadvantaged) status (AOR, 1.4; 1.1-2.9), child's male gender (AOR, 1.6; 1.1-2.5) and maternal smoking (AOR, 2.2; 1.4-3.1) were significantly associated with DDA. The cotinine-validated level (AOR, 1.4; 1.1-2.9) as well as maternal smoking (AOR, 1.8; 1.1-2.5), were also independently associated with C+W+B+. The use of salivary cotinine as an indicator of ETS exposure could be used to inform parents of exposure risk to their asthmatic children and may help re-enforce deterrent efforts to reduce childhood parental smoking exposure.