Relationship of environmental tobacco smoke to otitis media (OM) in children.
Relationship of environmental tobacco smoke to otitis media (OM) in children.
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DOI：
10.1016/j.ijporl.2012.03.017
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发表时间：
2012-07
影响因子：
1.5
通讯作者：
Katona, Gabor
中科院分区：
文献类型：
--
作者：
Csakanyi, Zsuzsanna;Czinner, Antal;Spangler, John;Rogers, Todd;Katona, Gabor
许多（但不是全部）研究发现环境烟草烟雾 (ETS) 与急性中耳炎 (AOM) 及其他不良耳科结果之间存在相关性。鉴于其高昂的个人和社会成本以及 ETS 对中耳疾病影响的不同研究结果，本研究的目的是评估 ETS 对复发性（两次或多次）AOM 发作的影响和可能的决定因素。该研究在匈牙利布达佩斯 Heim Pal 儿童医院耳鼻喉 (ENT) 科进行。通过一份 22 项问卷调查，对 412 名到耳鼻喉科门诊就诊的儿童的护理人员进行了调查，内容涉及儿童家庭的人口统计、社会经济和吸烟行为；以及看护者对孩子 AOM 发作次数的自我报告。在 412 名参与者中，155 名（38%）儿童的父母吸烟。在双变量分析中，两次或多次 AOM 发作与报告的听力问题、日托入学率、父母就业和儿童年龄增长相关。在多变量逻辑回归中，父母吸烟使孩子复发 AOM 的风险增加一倍以上，而母亲就业的增加（例如兼职或全职与失业）则使风险增加至四倍。在父母吸烟的儿童中，每天吸半包烟和去日托中心的人数分别增加一倍或近三倍，AOM 复发的风险增加一倍或近三倍。匈牙利耳鼻喉科诊所的儿童在童年时期接触 ETS 的比例很高。这种暴露与 AOM 发作、耳鼻喉科手术和传导性听力损失有关。此类数据不仅在匈牙利，而且在欧洲和世界各地都支持严格的无烟法。
Many, but not all, studies have found a correlation between environmental tobacco smoke (ETS) and acute otitis media (AOM) and other adverse otologic outcomes. Given its high personal and societal costs and the divergent findings of the effect of ETS on middle ear disease, the aim of the current study was to assess the impact and possible determinant factors of ETS on recurrent (two or more) episodes of AOM. The study was performed at Heim Pal Children's Hospital, Ear, Nose and Throat (ENT) Department, Budapest, Hungary. Caregivers of a convenience sample of 412 children attending the ENT outpatient clinic were surveyed via a 22-item questionnaire regarding demographics, socioeconomics, and smoking behaviours of the child's family; as well as caregivers' self report of the number of AOM episodes of the child. Of the 412 participants, 155 (38%) children's parents smoked. In bivariate analysis, two or more episodes of AOM correlated with reported hearing problems, day care enrolment, parental employment and increased age of the child. In multivariate logistic regression, parental smoking more than doubled a child's risk for recurrent AOM while increased maternal employment (e.g. part-time or full-time vs. unemployed) boosted risk up to fourfold. Among children whose parents smoked, half-packs of cigarettes smoked per day and day care attendance doubled or nearly tripled, respectively, the risk of recurrent AOM episodes. Childhood exposure to ETS is high among an ENT clinic population of Hungarian children. Such exposure correlates with AOM episodes, ENT operations and conductive hearing loss. Data such as these argue for strict laws smoke-free laws not only in Hungary, but also in Europe and around the world.
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