Published online October 31, 2008
PEDIATRICS Vol. 122 Supplement November 2008, pp. S182 (doi:10.1542/peds.2008-2139R)
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ALLERGY


Home Exposures to Environmental Tobacco Smoke and Allergic Symptoms Among Young Children in Singapore

Jennifer M. Maloney, MD

New York, NY

ABSTRACT

Zuraimi MS, Tham KW, Chew FT, Ooi PL, David K. Int Arch Allergy Immunol. 2008;146(1):57–65

PURPOSE OF THE STUDY. To investigate the association of environmental tobacco smoke (ETS) exposure among preschool-aged children with allergic symptoms in homes in Singapore.

STUDY POPULATION. The authors studied children between the ages of 1.5 and 6 years who were attending 687 child care centers in Singapore.

METHODS. This study used a cross-sectional design, adopting an expanded and modified International Study on Asthma and Allergies in Childhood (ISAAC) questionnaire for the evaluation of asthma and allergies in 6794 children attending 120 randomly selected child care centers. Specific information on demographics and ETS exposures was obtained. Adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) were determined by using Poisson multivariate regression with a log-link function and robust variance estimates as recommended for cross-sectional studies.

RESULTS. The response rate was 70.0%, and 4759 children from 97 centers participated. After adjusting for covariates, it was found that home ETS exposure was associated with increased risks of current symptoms of rhinitis (PR: 1.23 [95% CI: 1.01–1.50]) and rhinoconjunctivitis (PR: 1.79 [95% CI: 1.26–2.54]). These associations followed dose-response trends with respect to the number of cigarettes smoked or smokers in the home. Home ETS exposures were also associated with higher PRs of wheeze, nocturnal cough, and doctor-diagnosed asthma. Compared with paternal smoking, higher risks of the above-listed outcomes were found for maternal smoking.

CONCLUSIONS. Home ETS exposure is a risk factor associated with rhinitis and asthma among preschool-aged children.

REVIEWER COMMENTS. This article provides additional evidence that exposure to ETS is associated with asthma and rhinitis. These findings support the continued need to discuss the risks of ETS exposure when reviewing anticipatory guidance items with families.


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