Abstract
Whether indoor environmental smoke is harmful for preschool children’s respiratory health in a society where female smoking is rare has not been determined. This study is part of a cross-sectional study (CCHH study-phase one in Shanghai) and investigated associations between parental smoking and incense-burning and respiratory symptoms among 4–6 year old children in Shanghai, China. A number of 13335 valid questionnaires (response rate: 85.3%) were analyzed. A number of 56.1% (as reported by a parent) of preschool children in Shanghai are exposed to environmental tobacco smoke (ETS). A number of 40.3% of fathers and 0.9% of mothers are smokers. A number of 53.7% and 12.6% of Shanghai residents have used mosquito-repellent incense and incensation respectively. Children exposed to any parental smoking have higher prevalence of wheeze and croup than those not exposed. Current maternal smoking has a significant and positive association with wheeze (in the last 12 months, AOR, 95% CI: 1.83, 1.11–2.99). However, paternal smoking either currently or at child’s birth had only weak associations with wheeze and croup. Incense-burning (mosquito-repellent incense and incensation) had significant and negative association with doctor-diagnosed asthma (AOR, 95% CI: 0.85, 0.73–0.99) and hay fever (AOR, 95% CI: 0.80, 0.70–0.93). The results indicate that maternal smoking perhaps is a stronger risk factor for children’s respiratory health than paternal smoking.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Öerg M, Jaakkola M S, Woodward A, et al. Worldwide burden of disease from exposure to second-hand smoke: A retrospective analysis of data from 192 countries. Lancet, 2011, 377: 139–146
Pirastu R, Bellu C, Greco P, et al. Indoor exposure to environmental tobacco smoke and dampness: Respiratory symptoms in Sardinian children—DRIAS study. Environ Res, 2009, 109: 59–65
Raherisona C, Pénard-Morand C, Moreau D, et al. In utero and childhood exposure to parental tobacco smoke, and allergies in schoolchildren. Respir Med, 2007, 101: 107–117
Constant C, Sampaio I, Negreiro F, et al. Environmental tobacco smoke (ETS) exposure and respiratory morbidity in school age children. Rev Port Pneumol, 2011, 17: 20–26
Xepapadaki P, Manios Y, Liarigkovinos T, et al. Association of passive exposure of pregnant women to environmental tobacco smoke with asthma symptoms in children. Pediatr Allergy Immunol, 2009, 20: 423–429
Naydenov K G. On the association between home exposure and asthma and allergies among children in Bulgaria /The ALLHOME Study/. Doctoral Dissertation. Lyngby: Technical University of Denmark and ICIEE, 2007
Zuraimi M S, Tham K W, Chew F T, et al. Home exposures to environmental tobacco smoke and allergic symptoms among young children in Singapore. Int Arch Allergy Immunol, 2008, 146: 57–65
Tanaka K, Miyake Y, Arakawa M, et al. Prevalence of asthma and wheeze in relation to passive smoking in Japanese children. Ann Epidemiol, 2007, 17: 1004–1010
Gilliland F D, Li Y F, Peters J M. Effects of Maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children. Am J Respir Crit Care Med, 2001, 163: 429–436
Gilliland F D, Li Y F, Dubeau L, et al. Effects of glutathione s-transferase m1, maternal smoking during pregnancy, and environmental tobacco smoke on asthma and wheezing in children. Am J Respir Crit Care Med, 2002, 166: 457–463
Sun Y X, Sundell J. Life style and home environment are associated with racial disparities of asthma and allergy in Northeast Texas children. Sci Total Environ, 2011, 409: 4229–4234
Tsai C H, Huang J H, Hwang B F, et al. Household environmental tobacco smoke and risks of asthma, wheeze and bronchitic symptoms among children in Taiwan. Respir Res, 2010, 11: 11–20
Wu J G, Zhuang Z J, Niu C J, et al. A case-control study on risk factors of asthma among 4-15 years school-aged children in a district of Shanghai (in Chinese). J Environ Occup Med, 2010, 27: 193–197
Jaakkola J J K, Jaakkola M S. Effects of environmental tobacco smoke on the respiratory health of children. Scand J Work Environ Health, 2002, 28(Suppl 2): 71–83
Gold D R. Environmental tobacco smoke, indoor allergens, and childhood asthma. Environ Health Perspect, 2000, 108(Suppl 4): 643–651
Gergen P J. Environmental tobacco smoke as a risk factor for respiratory disease in children. Respir Physiol, 2001, 128: 39–46
Peat J K, Keena V, Harakeh Z, et al. Parental smoking and respiratory tract infections in children. Paediatr Respir Rev, 2001, 2: 207–213
Landau L I. Parental smoking: Asthma and wheezing illnesses in infants and children. Paediatr Respir Rev, 2001, 2: 202–206
Difranza J R, Aligne C A, Weitzman M. Prenatal and postnatal environmental tobacco smoke exposure and children’s health. Pediatrics, 2004, 113: 1007–1015
Henderson A J. The effects of tobacco smoke exposure on respiratory health in school-aged children. Paediatr Respir Rev, 2008, 9: 21–28
Glantz S, Gonzalez M. Effective tobacco control is key to rapid progress in reduction of non-communicable diseases. Lancet, 2011, 379: 1269–1271
Magnusson L L, Olesenz A B, Wennborg H, et al. Wheezing, asthma, hay fever, and atopic eczema in childhood following exposure to tobacco smoke in fetal life. Clin Exp Allergy, 2005, 35: 1550–1556
Zlotkowska R, Zejda J E. Fetal and postnatal exposure to tobacco smoke and respiratory health in children. Eur J Epidemiol, 2005, 20: 719–727
Krämer U, Lemmen C H, Behrendt H, et al. The effect of environmental tobacco smoke on eczema and allergic sensitization in children. British J Dermatology, 2004, 150: 111–118
Montefort S, Muscat H A, Caruana S, et al. Allergic conditions in 5-8-year-old Maltese schoolchildren: Prevalence, severity, and associated risk factors [ISAAC]. Pediatr Allergy Immunol, 2002, 13: 98–104
Mitchell E A, Stewart A W. The ecological relationship of tobacco smoking to the prevalence of symptoms of asthma and other atopic diseases in children: The International Study of Asthma and Allergies in Childhood (ISAAC). Eur J Epidemiol, 2001, 7: 667–673
Stabile L, Fuoco F C, Buonanno G. Characteristics of particles and black carbon emitted by combustion of incenses, candles and anti-mosquito products. Build Environ, 2012, 56: 184–191
Jetter J J, Guo Z S, Mcbrian J A, et al. Characterization of emissions from burning incense. Sci Total Environ, 2002, 295: 51–67
Wang B, Lee S C. Characteristics of emissions of air pollutants from mosquito coils and candles burning in a large environmental chamber. Atmos Environ, 2006, 40: 2128–2138
Liao C M, Chen S C, Chen J W, et al. Contributions of Chinese-style cooking and incense burning to personal exposure and residential PM concentrations in Taiwan region. Sci Total Environ, 2006, 358: 72–84
Liu W L, Zhang J F, Hashim J H, et al. Mosquito coil emissions and health implications. Environ Health Perspect, 2003, 111: 1454–1460
Chen S C, Wong R H, Shiu L J, et al. Exposure to mosquito coil smoke may be a risk factor for lung cancer in Taiwan. J Epidemiol, 2008, 18: 19–25
Wang I J, Tsai C H, Chen C H, et al. Glutathione S-transferase, incense burning and asthma in children. Eur Respir J, 2011, 37: 1371–1377
Koo L C, Ho J H C, Tominaga S, et al. Is Chinese incense smoke hazardous to respiratory health? Epidemiological results from Hong Kong. Indoor Environ, 1995, 4: 334–343
Asher M I, Keil U, Anderson H R. International study of asthma and allergies in childhood (ISAAC): Rationale and methods. Eur Respir J, 1995, 8: 483–491
Engman L H. Indoor environmental factors and its associations with asthma and allergy among Swedish pre-school children. Doctoral Dissertation. Lund: Lund University, 2006
Dostál M, Milcová A, Binkoá B, et al. Environmental tobacco smoke exposure in children in two districts of the Czech Republic. Int J Hyg Environ Health, 2008, 211: 318–325
Conrad A, Schulz C, Seiwert M, et al. German environmental survey IV: Children’s exposure to environmental tobacco smoke. Toxic Lett, 2010, 192: 79–83
Wanaporn A, Ladda M, Arinda M, et al. Prevalence and associated factors of passive smoking in Thai infants. Respir Med, 2008, 47: 443–446
Yi O, Kwon H J, Kim H, et al. Effect of environmental tobacco smoke on atopic dermatitis among children in Korea. Environ Res, 2012, 113: 40–45
Agabiti N, Mallone S, Forastiere F, et al. The impact of parental smoking on asthma and wheezing. Epidemiology, 1999, 10: 692–698
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is published under an open access license. Please check the 'Copyright Information' section either on this page or in the PDF for details of this license and what re-use is permitted. If your intended use exceeds what is permitted by the license or if you are unable to locate the licence and re-use information, please contact the Rights and Permissions team.
About this article
Cite this article
Liu, W., Huang, C., Hu, Y. et al. Associations between indoor environmental smoke and respiratory symptoms among preschool children in Shanghai, China. Chin. Sci. Bull. 58, 4211–4216 (2013). https://doi.org/10.1007/s11434-013-5728-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11434-013-5728-z