环境烟草烟雾和个人吸烟均与青少年哮喘和喘息相关
2011/07/06
摘要
背景:研究发现,环境烟草烟雾(ETS)是儿童哮喘的一个主要危险因素。在成人中,个人吸烟是导致呼吸道症状和呼吸道疾病的一个主要因素。这些暴露对青少年哮喘和喘息发病率的影响尚不清楚。
目的:本试验旨在研究ETS和个人吸烟的单独及联合作用,对青少年哮喘和喘息发病的影响。
方法:自1996开始,瑞典北部就开始进行一项学龄期儿童哮喘和过敏性疾病的纵向研究。3个市的所有年龄为7~8岁的儿童,对其中3430名(97%)参与者采用每年问卷调查进行随访。至16~17岁时,82%的初始参与者参加了2005年的调查。
结果:医生诊断的哮喘、过去喘息、当前喘息的患病率,在有孕期ETS暴露的参与者和每日吸烟者中显著增加。多变量分析显示,孕期ETS暴露是医生诊断的哮喘、过去喘息(OR 1.3-1.5)的一个危险因素,而个人每日吸烟是当前喘息的一个危险因素(OR 2.0)。对于每日吸烟者,如果有孕期ETS暴露时,哮喘和过去喘息的OR值最高,分别为1.7和2.5。此外,吸烟的数量/天数与喘息发生率之间存在明显的剂量-反应相关性。
结论:ETS和个人吸烟与青少年哮喘和喘息显著相关。孕期ETS暴露与一生症状相关,但青少年每日吸烟与当前症状的相关性更显著。
(陈欣 审校)
Thorax. 2011 Jan;66(1):20-5. Epub 2010 Nov 3.
Both environmental tobacco smoke and personal smoking is related to asthma and wheeze in teenagers.
Hedman L, Bjerg A, Sundberg S, Forsberg B, Rönmark E.
The OLIN Study Group, Sunderby Central Hospital of Norrbotten, Luleå, Sweden. linnea.hedman@nll.se
Abstract
BACKGROUND: Environmental tobacco smoke (ETS) has been reported as a significant risk factor for childhood asthma. Among adults, personal smoking is a major cause of respiratory symptoms and diseases. The effects of these exposures on the prevalence of asthma and wheeze among teenagers are less well known.
OBJECTIVE: The aim was to study the independent and combined effects of ETS and personal smoking on the prevalence of asthma and wheeze in teenagers.
METHODS: A longitudinal study of asthma and allergic diseases in schoolchildren has been in progress in Northern Sweden since 1996. All children aged 7-8 years in three municipalities were invited and 3430 (97%) participants have been followed by annual questionnaires. At the age 16-17 years, 82% of the initial participants took part in the 2005 survey.
RESULTS: Prevalence of physician-diagnosed asthma, ever wheeze and current wheeze was significantly higher among those exposed to maternal ETS and among daily smokers. In multivariate analyses, maternal ETS was a significant risk factor for physician-diagnosed asthma and ever wheeze (OR 1.3-1.5) and personal daily smoking for current wheeze (OR 2.0). ORs for asthma and ever wheeze were highest among daily smokers who were also exposed to maternal ETS with ORs of 1.7 and 2.5, respectively. A significant dose-response association between number of cigarettes/day and the prevalence of wheeze was also found.
CONCLUSIONS: Both ETS and personal smoking were significantly related to asthma and wheeze in teenagers. Maternal ETS exposure was associated with lifetime symptoms, but daily smoking among the teenagers was more strongly related to current symptoms
Thorax. 2011 Jan;66(1):20-5. Epub 2010 Nov 3.
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