中心城区年轻哮喘患儿人群中与二手烟暴露相关的因素
2011/07/06
摘要
目的：通过检测中心城区年轻哮喘患儿唾液中的可替宁水平，研究与二手烟（SHS）暴露相关的社会和环境因素。
方法：数据来自于基于家庭的、对急诊（ED）出院后治疗的持续哮喘高风险患儿行为干预研究(N = 198)。SHS 暴露通过唾液可替宁水平和看护者主诉来判断。看护者人口统计学和心理状态、家庭吸烟行为和哮喘患病，与儿童可替宁浓度进行比较。卡方检验和ANOVA及多变量回归模型用于研究可替宁浓度与家庭吸烟行为和哮喘患病之间的关系。
结果：超过一半（52%）的儿童可替宁水平与SHS暴露相关，而且平均可替宁浓度高于2.42 ng/ml (SD 3.2)。看护者是家庭的主要吸烟者（57%），63%的看护者主诉家庭禁烟。学龄前儿童和那些有主诉抑郁和较高程度应激的看护者的儿童，与对照儿童相比，具有较高的可替宁水平。有家庭吸烟禁令的住家儿童，年轻儿童平均可替宁浓度高于年长儿童【可替宁：2.24 ng/ml (SD 3.5) ，3～5岁；0.63 ng/ml (SD 1.0) ，6～10岁；P<0.05】。在多变量模型中，与儿童较高可替宁浓度相关的因素为家庭吸烟人数增加(β = 0.24)、年轻儿童的年龄(3～5 岁) 【β = 0.23; p <0 .001, R(2) = 0.35】。
结论：有超过一半的中心城区年轻哮喘患儿有SHS暴露，看护者是主要的家庭吸烟者。年轻儿童和存在抑郁和应激的看护者家庭儿童具有吸烟暴露高风险，即使家庭有吸烟禁令。对这些高危儿童采取的措施是帮助看护者戒烟，以减少儿童的吸烟暴露。
（苏楠 审校）
J Asthma. 2011 May 5. [Epub ahead of print]
Factors Associated with Second-Hand Smoke Exposure in Young Inner-City Children with Asthma.
Butz AM, Halterman JS, Bellin M, Tsoukleris M, Donithan M, Kub J, Thompson RE, Land CL, Walker J, Bollinger ME.
Source
Department of Pediatrics, School of Medicine, Johns Hopkins University , Baltimore, MD , USA.
Abstract
OBJECTIVES：To examine the association of social and environmental factors with levels of second-hand smoke (SHS) exposure, as measured by salivary cotinine, in young inner-city children with asthma.
METHODS：We used data drawn from a home-based behavioral intervention for young high-risk children with persistent asthma post-emergency department (ED) treatment (N = 198). SHS exposure was measured by salivary cotinine and caregiver reports. Caregiver demographic and psychological functioning, household smoking behavior, and asthma morbidity were compared with child cotinine concentrations. Chi-square and ANOVA tests and multivariate regression models were used to determine the association of cotinine concentrations with household smoking behavior and asthma morbidity.
RESULTS：Over half (53%) of the children had cotinine levels compatible with SHS exposure and mean cotinine concentrations were high at 2.42 ng/ml (SD 3.2). The caregiver was the predominant smoker in the home (57%) and 63% reported a total home smoking ban. Preschool aged children and those with caregivers reporting depressive symptoms and high stress had higher cotinine concentrations than their counterparts. Among children living in a home with a total home smoking ban, younger children had significantly higher mean cotinine concentrations than older children (cotinine: 3-5 year olds, 2.24 ng/ml (SD 3.5); 6-10 year olds, 0.63 ng/ml (SD 1.0); p < .05). In multivariate models, the factors most strongly associated with high child cotinine concentrations were increased number of household smokers (β = 0.24) and younger child age (3-5 years) (β = 0.23; p < .001, R(2) = 0.35).
CONCLUSION： Over half of the young inner-city children with asthma were exposed to SHS, and caregivers are the predominant household smokers. Younger children and children with depressed and stressed caregivers are at significant risk of smoke exposures, even when a household smoking ban is reported. Further advocacy for these high-risk children is needed to help caregivers quit and to mitigate smoke exposure.
J Asthma. 2011 May 5. [Epub ahead of print]
目的：通过检测中心城区年轻哮喘患儿唾液中的可替宁水平，研究与二手烟（SHS）暴露相关的社会和环境因素。
方法：数据来自于基于家庭的、对急诊（ED）出院后治疗的持续哮喘高风险患儿行为干预研究(N = 198)。SHS 暴露通过唾液可替宁水平和看护者主诉来判断。看护者人口统计学和心理状态、家庭吸烟行为和哮喘患病，与儿童可替宁浓度进行比较。卡方检验和ANOVA及多变量回归模型用于研究可替宁浓度与家庭吸烟行为和哮喘患病之间的关系。
结果：超过一半（52%）的儿童可替宁水平与SHS暴露相关，而且平均可替宁浓度高于2.42 ng/ml (SD 3.2)。看护者是家庭的主要吸烟者（57%），63%的看护者主诉家庭禁烟。学龄前儿童和那些有主诉抑郁和较高程度应激的看护者的儿童，与对照儿童相比，具有较高的可替宁水平。有家庭吸烟禁令的住家儿童，年轻儿童平均可替宁浓度高于年长儿童【可替宁：2.24 ng/ml (SD 3.5) ，3～5岁；0.63 ng/ml (SD 1.0) ，6～10岁；P<0.05】。在多变量模型中，与儿童较高可替宁浓度相关的因素为家庭吸烟人数增加(β = 0.24)、年轻儿童的年龄(3～5 岁) 【β = 0.23; p <0 .001, R(2) = 0.35】。
结论：有超过一半的中心城区年轻哮喘患儿有SHS暴露，看护者是主要的家庭吸烟者。年轻儿童和存在抑郁和应激的看护者家庭儿童具有吸烟暴露高风险，即使家庭有吸烟禁令。对这些高危儿童采取的措施是帮助看护者戒烟，以减少儿童的吸烟暴露。
（苏楠 审校）
J Asthma. 2011 May 5. [Epub ahead of print]
Factors Associated with Second-Hand Smoke Exposure in Young Inner-City Children with Asthma.
Butz AM, Halterman JS, Bellin M, Tsoukleris M, Donithan M, Kub J, Thompson RE, Land CL, Walker J, Bollinger ME.
Source
Department of Pediatrics, School of Medicine, Johns Hopkins University , Baltimore, MD , USA.
Abstract
OBJECTIVES：To examine the association of social and environmental factors with levels of second-hand smoke (SHS) exposure, as measured by salivary cotinine, in young inner-city children with asthma.
METHODS：We used data drawn from a home-based behavioral intervention for young high-risk children with persistent asthma post-emergency department (ED) treatment (N = 198). SHS exposure was measured by salivary cotinine and caregiver reports. Caregiver demographic and psychological functioning, household smoking behavior, and asthma morbidity were compared with child cotinine concentrations. Chi-square and ANOVA tests and multivariate regression models were used to determine the association of cotinine concentrations with household smoking behavior and asthma morbidity.
RESULTS：Over half (53%) of the children had cotinine levels compatible with SHS exposure and mean cotinine concentrations were high at 2.42 ng/ml (SD 3.2). The caregiver was the predominant smoker in the home (57%) and 63% reported a total home smoking ban. Preschool aged children and those with caregivers reporting depressive symptoms and high stress had higher cotinine concentrations than their counterparts. Among children living in a home with a total home smoking ban, younger children had significantly higher mean cotinine concentrations than older children (cotinine: 3-5 year olds, 2.24 ng/ml (SD 3.5); 6-10 year olds, 0.63 ng/ml (SD 1.0); p < .05). In multivariate models, the factors most strongly associated with high child cotinine concentrations were increased number of household smokers (β = 0.24) and younger child age (3-5 years) (β = 0.23; p < .001, R(2) = 0.35).
CONCLUSION： Over half of the young inner-city children with asthma were exposed to SHS, and caregivers are the predominant household smokers. Younger children and children with depressed and stressed caregivers are at significant risk of smoke exposures, even when a household smoking ban is reported. Further advocacy for these high-risk children is needed to help caregivers quit and to mitigate smoke exposure.
J Asthma. 2011 May 5. [Epub ahead of print]
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肺癌CT筛查结果对戒烟的影响
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戒烟对老年患者疼痛的影响
