Involuntary smoking and asthma severity in children - Data from the Third National Health and Nutrition Examination Survey
Involuntary smoking and asthma severity in children - Data from the Third National Health and Nutrition Examination Survey
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DOI：
10.1378/chest.122.2.409
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发表时间：
2002-08-01
期刊：
影响因子：
9.6
通讯作者：
Redd, SC
中科院分区：
文献类型：
--
作者：
Mannino, DM;Homa, DM;Redd, SC
研究目标：我们试图确定美国烟草烟雾暴露水平高和低的儿童的哮喘严重程度指标。设计：横断面研究。背景：第三次全国健康和营养检查调查（1988 年至 1994 年）参与者的全国代表性调查。参与者。 523 名患有医生诊断为哮喘的儿童。测量和结果：我们根据可替宁（表明烟草烟雾暴露的尼古丁代谢物）的血清水平将研究参与者分为三等分。我们使用逻辑回归和线性回归模型，调整已知的协变量，以确定高环境烟草烟雾暴露对以下结果的影响：哮喘严重程度（根据报告的症状和呼吸道疾病频率确定）；肺功能；医生 P 就诊；和缺课。在我们的研究样本中，78.6%的儿童患有轻度哮喘，6.8%的儿童患有严重中度哮喘，14.6%的儿童患有重度哮喘。与接触低水平烟雾的哮喘儿童相比，接触高水平烟雾的哮喘儿童更有可能患有中度或重度哮喘（比值比，2.7 - 95% 置信区间 [CI]，1.1 至 6.8）和肺功能下降，平均 FEV1 下降 213 mL 或 8.1%（95% CI，-14.7 至 - 3.5）。结论：非自愿烟雾暴露与哮喘增加相关美国全国代表性哮喘儿童组的严重程度和肺功能恶化。
Study objectives: We sought to determine the indicators of asthma severity among children in the United States with high and low levels of tobacco smoke exposure.Design: Cross-sectional study.Setting: Nationally representative survey of participants in the Third National Health and Nutrition Examination Survey (from 1988 to 1994).Participants. Five hundred twenty-three children with physician-diagnosed asthma.Measurements and results: We stratified the study participants into tertiles on the basis of serum levels of cotinine (a metabolite of nicotine that indicates tobacco smoke exposure). We used logistic and linear regression modeling, adjusting for known covariates, to determine the effect of high environmental tobacco smoke exposure on the following outcomes: asthma severity (determined using reported symptom and respiratory illness frequency); lung function; physician P visits; and school absence. Among our study sample, 78.6% of children had mild asthma, 6.8% of children bad moderate asthma, and 14.6% of children had severe asthma. Asthmatic children with high levels of smoke exposure, compared with those with low levels of exposure, were more likely to have moderate or severe asthma (odds ratio, 2.7 95% confidence interval [CI], 1.1 to 6.8) and decreased lung function, with a mean FEV1 decrement of 213 mL or 8.1% (95% CI, -14.7 to - 3.5).Conclusions: Involuntary smoke exposure is associated with increased asthma severity and worsened lung function in a nationally representative group of US children with asthma.