European Journal of Epidemiology

, Volume 9, Issue 5, pp 517–526

Parental smoking and other risk factors for wheezing bronchitis in children

  • E. Rylander
  • G. Pershagen
  • M. Eriksson
  • L. Nordvall
Epidemiological Projects: News

Abstract

A population-based case-control study was performed to investigate etiologic factors for wheezing bronchitis and asthma in children up to four years of age. A total of 199 children hospitalized for the first time with these diagnoses at a major hospital in Stockholm in 1986–1988 constituted the cases, 351 children from the catchment area of the hospital were used as controls. Information on known and suspected risk factors was obtained through home interviews with a parent. Parental smoking was associated with a relative risk of 1.8 (95% confidence interval 1.3 – 2.6) corresponding to a population attributable proportion of 27%. The strongest association was seen for maternal smoking and children below 18 months of age. Other major risk factors included atopic heredity, recurrent upper respiratory tract infections and breast-feeding less than 3 months, which appeared to interact multiplicatively with parental smoking. The environmental factors had a stronger influence in the youngest age group, and the overall attributable proportion associated with parental smoking, short breast-feeding period and exposure to pets in the household was 43%. It is clear that successful primary prevention could dramatically reduce the incidence of wheezing bronchitis in children.

Key words

Case control study Wheezing Bronchitis Childhood asthma Passive smoking Risk factors 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Andersson L., Parker R., Strikas R.et al. (1988): Daycare center attendance and hospitalization for lower respiratory tract illness - Pediatrics, 182: 300–308.Google Scholar
  2. 2.
    Betrand J.M., Riley P., Popkin J. et al. (1985): The longterm pulmonary sequelae of prematurity: The role of familial airway hyperactivity and the respiratory disease syndrome - N. Engl. J. Med. 21: 742–745.Google Scholar
  3. 3.
    Breslow N.E. and Day N.E. (1980): Statistical methods in cancer research. Vol 1. The analysis of casecontrol studies — Lyon: International Agency for Research on Cancer.Google Scholar
  4. 4.
    Brunekreef B., Groot B. and Hock G. (1992): Pets, allergy and respiratory symptoms in children - Int. J. Epidemiol. 21: 338–342.Google Scholar
  5. 5.
    Busse W (1990): Respiratory infections: Their role in airway responsiveness and the pathogenesis of asthma - J. Allergy Clin. Immunol. 85: 4.Google Scholar
  6. 6.
    Friday G. (1988): Morbidity and mortality of'asthma -Pediatr. Clin. North Am. 35:5 - October.Google Scholar
  7. 7.
    Goren A.I. and Hellmann S. (1988): Prevalence of respiratory symptoms and diseases in schoolchildren living in a polluted and in a lowpolluted area in Israel- Environ Res. 45: 28–37.Google Scholar
  8. 8.
    Halken S., Host A., Husby S. et al. (1991): Recurrent wheezing in relation to environmental risk factors in infancy - Allergy 46: 507–514.Google Scholar
  9. 9.
    Horwood L.J., Fergusson D.M., Hons B.A. et al. (1985): Social and familial factors in the development of early childhood asthma - Pediatrics 75: 859–868.Google Scholar
  10. 10.
    Kramer M. (1988): Does breast feeding help protect against atopic disease? Biology, methodology and a golden pilule of controversy - J. Pediatr. 112: 181–190.Google Scholar
  11. 11.
    Lebowitz M.D. and Burrows B. (1976): Respiratory symptoms related to smoking habits in family members - Chest 69: 48–50.Google Scholar
  12. 12.
    Lucas A., Brooke O.G., Cole T.J. et al. (1990): Food and drug reactions, wheezing and eczema in preterm infants - Arch. Dis. Childh. 65: 411–415.Google Scholar
  13. 13.
    Neas L.M., Dockery D.W., Wale J.H. et al. (1991): Association of indoor nitrogen dioxide with respiratory symptoms and pulmonary function in children - Am. J. Epidemiol. 134: 204–219.Google Scholar
  14. 14.
    Neuspiel D., Rush D., Bullen N. et al. (1989): Parental smoking and post-infancy wheezing in children: A prospective cohort study - Am. J. Public Health 79: 168–171.Google Scholar
  15. 15.
    Ownby D. (1990): Environmental factors versus genetic determinants of childhood inhalant asthma -J. Allergy Clin. Immunol. 86: 279–287.Google Scholar
  16. 16.
    Palmieri M., Longobardi G., Napolitano G. et al. (1990): Parental smoking and asthma in childhood -Eur. J. Pediatr. 149: 738–740.Google Scholar
  17. 17.
    Pershagen G., Eriksson A. and Otterblad-Olausson P. (1992): Maternal smoking in pregnancy: Does it increase the risk of childhood cancer? - Int. J. Epidemiol. 21: 1–5.Google Scholar
  18. 18.
    Rowntree S., Cogswell J., Platt-Mills T.A.E. et al. (1985): Development of IgE and IgG antibodies to food and inhalant allergens in children at risk of allergic disease - Arch. Dis. Child. 60: 727–735.Google Scholar
  19. 19.
    Schwartz J., Gold D., Dockery D. et al. (1990): Predictors of asthma and persistent wheeze in a national sample of children in the United States. Am Rev. Respir. Dis. - 142: 55–62.Google Scholar
  20. 20.
    Seidman D.S., Laor A., Gale R. et al. (1991): Is low birth weight a risk factor for asthma during adolescence? - Arch. Dis. Childh. 66: 584–587.Google Scholar
  21. 21.
    Sherman C., Tosteson T., Tager L et al. (1990): Early childhood predictors of asthma - Am. J. Epidemiol. 132: 83–95.Google Scholar
  22. 22.
    Skoner D. and Caliguiri L. (1988): The wheezing infant - Pediatr. Clin. North Am. 35:5.Google Scholar
  23. 23.
    Stiernfeldt M., Berglund K., Lindsten J. et al. (1986): Maternal smoking during pregnancy and risk of childhood cancer - Lancet i 1350–1352.Google Scholar
  24. 24.
    Walker A. (1981): Proportion of disease attributable to the combined effect of two factors - Int. J. Epidemiol. 10: 81–85.Google Scholar
  25. 25.
    Weitzman M. and Gortmaker S. (1990): Racial, social and environmental risks for childhood asthma - Am. J. Dis. Control 144: 1189–1194.Google Scholar
  26. 26.
    Whittemore A. (1983): Estimating attributable risk from case-control studies - Am. J. Epidemiol. 117: 76–85.Google Scholar
  27. 27.
    Wilson N.M. (1989): Wheezy bronchitis revisited -Arch. Dis. Child. 64: 1194–1199.Google Scholar
  28. 28.
    Woodward A., Douglas R., Graham N. et al. (1990): Acute respiratory illness in Adelaide children: breast-feeding modifies the effect of passive smoking - J. Epidemiol. Community Health 44: 224–230.Google Scholar
  29. 29.
    Wright A., Holberg C., Martinez F. et al. (1989): Breast-feeding and lower respiratory tract illness in the first year of life - Br. Med. J. 29: 946–949.Google Scholar
  30. 30.
    Wright A., Holberg C., Martinez F. et al. (1991): Relationship of parental smoking to wheezing and non-wheezing, lower respiratory tract illnesses in infancy - J. Pediatr. 118: 207–214.Google Scholar

Copyright information

© Kluwer Academic Publishers 1993

Authors and Affiliations

  • E. Rylander
    • 1
    • 2
  • G. Pershagen
    • 1
    • 2
  • M. Eriksson
    • 2
  • L. Nordvall
    • 2
    • 3
  1. 1.Department of EpidemiologyInstitute of Environmental Medicine - Karolinska InstituteStockholmSweden
  2. 2.Department of PaediatricsSt Göran's Children's Hospital - Karolinska InstituteStockholmSweden
  3. 3.Department of Environmental Health and Infectious Diseases ControlKarolinska HospitalStockholmSweden
  4. 4.Department of Clinical ImmunologyKarolinska HospitalStockholmSweden

Personalised recommendations