Childhood exposure to environmental tobacco smoke and chronic respiratory symptoms in non-smoking adults: The Singapore Chinese Health Study
Childhood exposure to environmental tobacco smoke and chronic respiratory symptoms in non-smoking adults: The Singapore Chinese Health Study
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DOI：
10.1136/thx.2005.042960
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发表时间：
2005-12-01
期刊：
影响因子：
10
通讯作者：
London, SJ
中科院分区：
文献类型：
--
作者：
David, GL;Koh, WP;London, SJ
背景：儿童时期接触环境烟草烟雾与儿童呼吸道疾病密切相关；方法：对 1993 年至 1998 年入组时年龄为 45 - 74 岁的新加坡华裔人群中从未吸烟者的儿童时期环境烟草烟雾暴露与慢性咳嗽、痰和哮喘诊断之间的关系进行了研究。从 1999 年至 2004 年，对受试者进行了采访，内容涉及 18 岁之前和之后的环境烟草烟雾暴露以及当前慢性咳嗽和哮喘症状的存在和持续时间。结果：在 35 000 名从不吸烟者中，吸烟的母亲 (19%) 少于父亲 (48%)。尽管目前很少有受试者 (20%) 与吸烟者一起生活 (20%) 或工作 (4%)，但 65% 的受试者表示在 18 岁之前与每天吸烟的人一起生活。在对年龄、性别、方言群体以及 18 岁之后目前和过去在家中和工作中接触吸烟者进行调整后，18 岁之前与吸烟者一起生活会增加慢性干咳的几率（149 例，比值比为 2.1，95% CI 1.4 至 3.3），并且在较小程度上增加痰。这种关联随着儿童时期吸烟者数量的增加而加强。与哮喘或慢性支气管炎没有关联。有证据表明，成人纤维摄入量较低的受试者之间存在更强的关联，此前已发现纤维摄入量对呼吸道症状有保护作用。结论：在这项针对非吸烟者的大型研究中，童年时期与吸烟者一起生活与成年后的慢性干咳和痰有关，与后来暴露于环境烟草烟雾无关。
Background: Childhood exposure to environmental tobacco smoke has been extensively associated with childhood respiratory illness; fewer studies have addressed the effects on adults.Methods: Childhood environmental tobacco smoke exposure in relation to chronic cough, phlegm, and asthma diagnosis was studied in never smokers from a cohort of Singaporeans of Chinese ethnicity aged 45 - 74 years at enrolment from 1993 to 1998. From 1999 to 2004 subjects were interviewed regarding environmental tobacco smoke exposure before and after the age of 18 and the presence and duration of current symptoms of chronic cough and phlegm production and asthma diagnosis.Results: Among 35 000 never smokers, fewer had smoking mothers (19%) than fathers (48%). Although few subjects currently lived (20%) or worked (4%) with smokers, 65% reported living with a daily smoker before the age of 18 years. Living with a smoker before the age of 18 increased the odds of chronic dry cough (149 cases, odds ratio 2.1, 95% CI 1.4 to 3.3) and, to a lesser extent, phlegm, after adjustment for age, sex, dialect group, and current and past exposure to smokers at home and at work after the age of 18. Associations strengthened with higher numbers of smokers in childhood. There was no association with asthma or chronic bronchitis. There was evidence to suggest a stronger association among subjects with a lower adult intake of fibre which has previously been found to be protective for respiratory symptoms.Conclusions: In this large study of non- smokers, living with a smoker in childhood was associated with chronic dry cough and phlegm in adulthood, independent of later exposures to environmental tobacco smoke.