Parental smoking and post-infancy wheezing in children: a prospective cohort study.

The contribution of parental smoking to wheezing in children was studied in a subset of all British births between April 5 and 11, 1970 (N = 9,670). Children of smoking mothers had an 18.0 per cent cumulative incidence of post-infancy wheezing through 10 years of age, compared with 16.2 per cent among children of nonsmoking mothers (risk ratio 1.11, 95% CI: 1.02, 1.21). This difference was confined to wheezing attributed to wheezy bronchitis, of which children of smokers had 7.4 per cent, and those of nonsmokers had 5.2 per cent (risk ratio 1.44, 95% CI: 1.24, 1.68). The incidence of wheezy bronchitis increased as mothers smoked more cigarettes. After multiple logistic regression analysis was used to control for paternal smoking, social status, sex, family allergy, crowding, breast-feeding, gas cooking and heating, and bedroom dampness, the association of maternal smoking with childhood wheezy bronchitis persisted. Some of this effect was explained by maternal respiratory symptoms and maternal depression, but not by neonatal problems, the child's allergic symptoms, or paternal respiratory symptoms. There was a 14 per cent increase in childhood wheezy bronchitis when mothers smoked over four cigarettes per day, and a 49 per cent increase when mothers smoked over 14 cigarettes daily.     

Medical care of asthma and wheezing illness in children: a community survey.

A survey was carried out to investigate the medical care of asthma and wheezing illness in a school population. Children with current wheezing illness were identified by a screening questionnaire to the parents of 5100 children in one school cohort from all schools in an outer London borough. Of the 89% who responded, 11.1% reported wheezing within the past 12 months. Parents of a sample of 284 wheezy children aged about 9 were interviewed at home about their child's illness and the related use of drugs and services. There was evidence of substantial underuse of services and this was not associated with social, family, or general practice factors. Considerable proportions of children were not having drug treatment, were receiving only non-antiasthmatic drugs, or were using antiasthmatic drugs incorrectly. The most important social and family factor associated with undertreatment was poor maternal mental health, and this factor appeared to explain the observed association of manual social class with undertreatment. Only about half of the most severe group were labelled as having "asthma," and those with this label were more likely to be receiving treatment and using outpatient services. The results show that the potential of modern treatment to prevent disability due to wheezing illness is not being realised despite the existence of a free and accessible health service.     

Asthma in schoolchildren. Demographic associations and peak expiratory flow rates compared in children with bronchitis.

The frequency of asthma in 10 971 school-children between the ages of 5 and 14 years was reported by their parents to be 3-8%. Of these, 20-7% were said to have had bronchitis, 5-9% pneumonia, and 4-7% eczema. Asthma was reported more commonly in boys than girls and was greatest in children of social classes I and II. One-third of the children were reported to have their first attack before the age of 2 years. Few (18%) first attacks started after the age of 5 years. There was no evidence that bronchitis predisposed to the later development of asthma, or vice versa. Within each age-sex group children with a history of asthma had lower peak expiratory flow rates than children who gave no such history. These diffences in PEFR were greater than for children with a history of bronchitis.     

维生素D受体基因多态性与儿童喘息性疾病相关性研究

目的通过研究维生素D受体（VDR）基因多态性与儿童喘息性疾病之间的相关性,探讨儿童支气管哮喘和喘息性支气管炎发病的遗传易感因素。方法应用聚合酶链反应-限制性长度多态性的方法检测儿童支气管哮喘30例、喘息性支气管炎40例及正常对照40例的维生素D受体ApaI基因多态性,比较3组的基因型及其等位基因的分布频率。结果 3组VDR基因型的分布频率差异有统计学意义（χ2=11.726,P=0.020）,其中支气管哮喘组与正常对照组及喘息性支气管炎组的基因分布频率差异均有统计学意义（χ2=9.317,P=0.009;χ2=10.546,P=0.005）,但喘息性支气管炎组与正常对照组的基因分布频率差异无统计学意义（χ2=0.06,P=0.97）。3组VDR基因等位基因频率差异有统计学意义（χ2=8.561,P=0.014）,其中支气管哮喘组与正常对照组及喘息性支气管炎组的等位基因频率差异均有统计学意义（χ2=6.850,P=0.009;χ2=7.622,P=0.006）,但喘息性支气管炎组与正常对照组的基因分布频率差异无统计学意义（χ2=0.028,P=0.876）。结论 VDR ApaI基因多态性与儿童支气管哮喘具有相关性,VDR基因可能是儿童支气管哮喘的遗传易感基因。喘息性支气管炎组与支气管哮喘组VDR基因分布频率差异有统计学意义,但与正常对照组差异无统计学意义,可能喘息性支气管炎与支气管哮喘的发病在基因水平上不具有同源性。     

Fetal and Postnatal Exposure to Tobacco Smoke and Respiratory Health in Children

The aim of this paper was to find out whether fetal exposure to environmental tobacco smoke (ETS), as compared to postnatal ETS exposure, is an independent risk factor for respiratory symptoms and diseases in younger schoolchildren. The cross-sectional epidemiological study comprised population of 1,561 Polish schoolchildren, aged 9–11 years. Information on the exposure to tobacco smoke and other sources of indoor air pollution at home, respiratory and allergic health status, and socio-economic status of the family was obtained by questionnaire survey. The respiratory health status was described by presence of wheezing, attacks of dyspnoea (noted during the last year or ever), bronchitis, wheezy bronchitis and asthma, ever diagnosed by a physician. Multivariate logistic regression analysis with adjustment for age, sex, area of residence, household density, damp and mould stains found at home, use of coal-fired stove, co-habitant pets, mother’s education and paternal current and past smoking habit was used to assess the effect of fetal and postnatal exposures on respiratory health outcomes. The results of the multivariate analyses revealed statistically significant associations between fetal exposure to ETS and wheezing ever: log OR = 1.4 (95% CI: 1.0–2.0), attacks of dyspnoea ever: log OR = 1.8 (95% CI: 1.1–2.9), bronchitis: log OR = 2.1 (95% CI: 1.5–2.9), and wheezy bronchitis: log OR = 1.8 (95% CI: 1.1–2.9). The effect of postnatal ETS was statistically significant only for bronchitis: log OR = 1.4 (95% CI: 1.1–1.9). The results of our study showed that fetal exposure to tobacco smoke is an independent risk factor for symptoms of wheeze and wheezy bronchitis in schoolchildren when compared to postnatal ETS exposure.     

The prevalence and management of asthma in primary-aged schoolchildren in the south of England

A postal questionnaire survey of headteachers in 149 Infant, Junior and Primary schools (response rate: 63.8%) indicated poor asthma record keeping and a need for regular staff training in asthma. Dealing with an emergency was a major concern of headteachers. In 25 of the schools surveyed, an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was distributed to parents of children in Years 3 and 4 (7-9 years). Headteacher-reported asthma prevalence was 11.9% in these schools, while ISAAC parental reports indicated a current or previous diagnosis of asthma in 24.3% children, with 17.8% receiving asthma treatment and 18.9% reporting wheeze in the previous 12 months. Of six wheezing children per Year 3/4 class, one was receiving no treatment for asthma, three had experienced four or more attacks of wheeze in the previous year with one wheezing child per two Year 3/4 classes experiencing more than 12 such attacks. Four in six children experienced exercise-related wheeze, while only one in five schools allowed asthma medication at Physical Education lessons. A whole school policy on asthma together with some regularly updated staff education and training by an asthma-trained nurse would address many of the issues raised in this study.     

Significance of anamnestic factors in the background of pathologic airway alterations

The results of 867 diagnostic bronchoscopies, between August 1992 and August 1993, were studied by the retrospective analysis of the patients' files. The average age of the children was 46 months (6 days-25 years). The proportion of girls and boys were 38.6% and 61.4%. Data of the history were: therapy resistant recurrent wheezy bronchitis in 31.9%, recurrent pneumonia in 31.1%, stridor in 22.1%, recurrent croup in 17.4%, bronchial asthma in 10.1%, monosymptomatic cough in 9.5% and recurrent bronchitis in 8.0%. The 768 (89%) pathologic findings were: 1. by bronchoscopy (n = 867): acute inflammation of the mucous membrane 7.3%, chronic bronchitis 75.1%, mucous secretion 44.5%, purulent secretion 20.8%, cricoid stenosis 4.6%, tracheal stenosis 11.2%, left main stem bronchus stenosis 27.8%; 2. by bronchography (n = 202): bronchial deformation 43.1%, bronchiectasis 5.4%, gracile bronchi 2.0%. The following significant relations were proved between the anamnesis and the results of the bronchoscopy and/or bronchography by statistical analysis: recurrent wheezy bronchitis/chronic bronchitis (p < 0.001; chi 2 = 16.35), approximately/purulent secretion (p = 0.039; chi 2 = 4.26), approximately/left main stem bronchus stenosis (p < 0.001; chi 2 = 19.27); stridor/tracheal stenosis (p < 0.001; chi 2 = 58.67), approximately/left main stem bronchus stenosis (p < 0.001; chi 2 = 63.45), approximately/cricoid stenosis (p = 0.0015; chi 2 = 10.8), approximately/other stenosis (p = 0.002; chi 2 = 9.69); recurrent croup/cricoid stenosis (p < 0.001; chi 2 = 18.34); bronchial asthma/bronchial deformation (p = 0.026; chi 2 = 4.95). The results show the importance of the bronchological examination in the diagnosis of chronic chest symptoms in children.     

儿童反复喘息与4位点哮喘基因预测模型的关系及危险因素分析

目的 探讨儿童反复喘息与4位点哮喘基因预测模型的关系,分析反复喘息的危险因素。方法 选取2019年1月—2021年3月在玉环市人民医院住院或门诊就诊的喘息儿童91例,根据哮喘预测指数(API)是否阳性,分为API阳性组55例,API阴性组36例,同时选择健康体检儿童30例为对照组。比较3组儿童4位点哮喘基因预测模型的高危率;将反复喘息儿童进行单因素及多因素Logistic回归分析。结果 API阳性组4位点哮喘基因预测模型的高危率较API阴性组及对照组显著升高(χ²=12.487,P＜0.05);API阳性组4位点哮喘基因预测模型的高危风险是API阴性组的2.54倍,是对照组的5.32倍。单因素分析儿童反复喘息与4位点哮喘基因预测模型的高危型、过敏史、过敏疾病家族史、吸入过敏原阳性、食入过敏原阳性、被动吸烟、嗜酸性粒细胞计数升高及呼吸道合胞病毒感染等因素有关(χ²=13.831,22.817,25.475,20.573,6.373,11.487,10.790,10.789,P＜0.05),而与居住环境无关(P＞0.05)。多因素Logistic回归分析显示4位点哮喘基因预测模型的高危型(OR=5.535,95%CI:1.928~15.893)、过敏史(OR=4.921,95%CI:1.661~14.577)、过敏疾病家族史(OR=4.460,95%CI:1.560~12.749)、吸入过敏原阳性(OR=13.105,95%CI:2.436~70.503)、被动吸烟(OR=3.704,95%CI:1.304~10.521)为喘息的独立危险因素。结论 反复喘息儿童,尤其是API阳性儿童,4位点哮喘基因预测模型的高危率显著升高;反复喘息与多种因素有关,其中4位点哮喘基因预测模型高危型是一个重要原因。     

Childhood morbidity and adulthood ill health.

STUDY OBJECTIVE--The aim of the study was to investigate the relationship between the state of health in childhood and ill health in early adult life. DESIGN--The study used data collected as part of the National Child Development Study and related health at 7 years of age to that at 23. A wide range of information on child health in the cohort was available, which was used to construct a broader measure of health status than selected diagnostic categories. SETTING--The survey population was nationwide. PARTICIPANTS--The study population included all children born in the week 3-9 March 1958. They were followed up at 7, 11, 16, and 23 years. Of the target population of 17,733 births, 12,537 (76%) were retraced and interviewed at 23. MEASUREMENTS AND MAIN RESULTS--Children at age 7 were allocated to 13 morbidity groups; 20% of children had reported no ill-health apart from the common infectious diseases, but 10% were included in four or more of the morbidity groups. Children with no reported morbidity retained their health advantage into early adulthood: ratios of observed to expected ill health for four of the five indices examined at age 23 were all significantly below one (self rated health 0.81, asthma and/or wheezy bronchitis 0.63, allergies 0.79, emotional health 0.75). Children with more morbidity at age 7 had higher ratios of ill health in adulthood. A chronic condition in childhood was associated not only with excess morbidity in the short term but also with a poor health rating in early adult life (ratio = 1.38). Morbidity was significantly increased for most of the adulthood indices among children with asthma and/or wheezy bronchitis. However most ill health in young adulthood occurred in study members with a relatively healthy childhood. CONCLUSIONS--Although the state of health in childhood has long term implications, it does not form a substantial contribution to ill health in early adult life.     

Indoor risk factors for asthma and wheezing among Seattle school children.

Indoor risk factors for physician-diagnosed asthma and wheezing in the past 12 months without previous asthma diagnosis were assessed in a survey of parents of 5-9-year-old Seattle primary school students. Among the 925 respondents, 106 (11%) reported a physician diagnosis of asthma, 66 (7%) had wheezing without diagnosis, and 753 (82%) were asymptomatic. After adjusting for age, sex, gender, ethnicity, medical history, socioeconomic status (SES) and parental asthma status, an increased risk of physician diagnosis of asthma was associated with household water damage, the presence of one or more household tobacco smokers, and at least occasional environmental tobacco smoke (ETS) exposure. Similarly, an increased risk of wheezing in the past 12 months among children without diagnosed asthma was associated with household water damage, presence of one or more household tobacco smokers, and occasional or more frequent ETS exposure. No increased risk of either condition was associated with gas, wood, or kerosene stove use, household mold, basement water, or wall/window dampness. Similarities in the indoor risk factors patterns between diagnosed asthma and wheezing without diagnosis suggested a similar etiology of these two conditions. The slightly higher association between ETS and asthma may indicate that parents of diagnosed asthmatics were more conscious of ETS, and were more likely to prohibit household smoking by resident smokers. Future research is needed to quantify which aspects of household water damage are related to respiratory illness.     

Prevalence and consequences of asthma and wheezing in African-American and White adolescents.

PURPOSE: To describe the functional consequences of health care utilization for wheezing symptoms and diagnosed asthma in a multiracial school-based population. METHODS: Wheezing symptoms and physician-diagnosed asthma were measured in 2059 eighth graders with the International Study of Asthma and Allergies in Children video questionnaire. The sample site population was 40% African-American, 53% White, and 49% girls. Thirty-two percent of the children were on the free school lunch program. Adolescents self-reported their wheezing symptoms and physician diagnosis in response to the video wheezing scenes. They also answered questions on activity limitations, school attendance, and sleep disturbances owing to their wheezing symptoms. Multiple logistic regression was used to calculate odds ratios and adjust for potential confounders. RESULTS: Nine percent of the adolescents reported physician-diagnosed asthma with current symptoms and 27% reported current wheezing with no diagnosis of asthma. Physician-diagnosed asthmatics and wheezers were 2.6 (95% confidence interval [CI] 1.9, 3.6) and 1.8 (95% CI 1.4, 2.2) times more likely, respectively, to miss school days because of wheezing symptoms than asymptomatic adolescents. Diagnosed asthmatics were 7.8 (95% CI 5.5, 11.2) times and wheezers 4.7 (95% CI 3.5, 6.1) times more likely to have sleep disturbances than asymptomatic adolescents. Diagnosed asthmatics were 49 (95% CI 30.0, 79.8) times and wheezers 4.8 (95% CI 3.0, 7.5) times as likely to report a clinic visit for wheezing than asymptomatic adolescents. African-Americans had similar prevalence of wheezing, compared with Whites, although African-Americans were 1.4 (95% CI 1.1, 1.9) times as likely to have physician-diagnosed asthma. Girls were twice as likely to report physician-diagnosed asthma and wheezing symptoms as were boys. CONCLUSIONS: Adolescents with wheezing experienced functional consequences comparable to those of adolescents with physician-diagnosed asthma. Although wheezers may have less severe asthma than diagnosed asthmatics, the functional consequences of wheezing are likely to impair school performance and limit activity.     

Prevalence of Asthma in a General Population Cohort of Farm Children: Comparison of Estimates Based on Parental Report and Medical Record Review

ABSTRACT

Methods of ascertaining and defining asthma in epidemiologic research vary, and the extent of agreement between such measures is not clearly understood. Within a broader investigation of early-life farm exposures and risk of childhood asthma and other atopic conditions, the authors sought to generate and compare population-based estimates of asthma prevalence among farm children using several definitions, based on both parental report and medical chart review. The Marshfield Epidemiologic Study Area (MESA) is a geographically defined, population-based cohort that receives nearly all health care from Marshfield Clinic and affiliated institutions. The region includes about 2200 farms, and over 9500 children aged 5 to 17 years who were born in the region served as the study population. A stratified random sample of 1000 overselecting for likely farm resident children was drawn. Parents of 553 children completed the survey and gave permission to review medical records. Informative records were available for 531 (96%). A weighted analysis provided estimates for the full study population. Asthma ascertainment included parental reports of past asthma diagnosis, history of wheezing, and asthma medication use, as well as documentation of asthma diagnoses and medication use in the medical chart. Prevalence of asthma among farm children using a broad composite definition was 24.8%. Prevalence based on parental reports of a specific asthma diagnosis was 11.2%, whereas medical chart documentation of a past asthma diagnosis was found for 10.1% of farm children. Seventy-one percent of parental reports were validated in the charts, and 80% of chart-confirmed diagnoses were reported by the parent. Basing asthma prevalence for farm children on a history of asthma medication use gave a higher estimate than did history of a diagnosis. Of farm children, 19.2% reported wheezing or respiratory whistling, with 8.1% occurring in the past year. Observational research on asthma can be substantially influenced by ascertainment methods and case definitions. Although prevalence estimates based on a past asthma diagnosis were quantitatively similar for parental reports and chart confirmation, agreement on specific cases between the two sources was less than expected. Care should be taken to clearly describe asthma case definitions when reporting results of observational asthma research.     

Prevalence of asthma and asthma symptoms among 13 and 14-year-old schoolchildren, Brazil

OBJECTIVE: Before the use of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire in epidemiologic surveys, little could be told about the comparative occurrence of asthma in the world due to differences in employed methods. In Brazil, the ISAAC questionnaire has been used in some urban regions. In this study it was applied in both, urban and rural areas, in order to estimate the prevalence of asthma among schoolchildren living in Montes Claros, Brazil. METHODS: A cross-sectional study was carried out using the ISAAC written questionnaire with four questions added on exposures of interest. The questionnaire was self-applied in 3,770 randomly selected schoolchildren aged 13 and 14 years. RESULTS: The prevalence of "wheezing in the last year" was 15.8%, and "asthma or bronchitis ever" was 23.8% with no statistically significant difference between boys and girls. There were significant differences between girls and boys regarding "wheezing ever" (37.8% and 33.6%), "sleeping disturbed by wheezing" (13.7% and 9.5%), and "nocturnal dry coughing without respiratory infection" (36.6% and 28.7%), respectively. "Wheezing in the last year" was found to be positively associated with "pet contact" (OR=1.27; 95% CI: 1.03-1.56), and "family history of asthma" (OR=1.79; 95% CI: 1.50-2.14), and negatively associated with "rural school" (OR=0.63; 95% CI: 0.44-0.91). But no association was found with sex, age, private/public school, and passive smoking. CONCLUSIONS: The prevalence of asthma in Montes Claros was high and some symptoms were seen mainly among girls. The occurrence of "wheezing in the last year" showed to be associated with family history, contact with pets and urban schools.     

Risk factors for recurrent wheezing in children under 13 years old in the South of Brazil]

OBJECTIVE: To study the prevalence of and major factors associated with recurrent wheezing in children younger than 13 years of age in the urban area of Rio Grande, in the state of Rio Grande do Sul, Brazil. METHODS: The presence of recurrent wheezing was investigated in a cohort as part of a cross-sectional study that was begun in 1997 that focused on the morbidity from respiratory diseases in children then between 0 and 5 years of age. During home visits in 2004 a standardized questionnaire given by trained interviewers was used to obtain information concerning the family's socioeconomic and living conditions, maternal care during pregnancy and delivery, and children's current and previous morbidity patterns. The statistical analysis included the calculation of the odds ratio (OR) and 95% confidence interval (95% CI), with nonconditional logistic regression adjustment for potential confounding factors, according to a predefined hierarchical model. RESULTS: Of the 775 children studied in 1997, 685 were located in 2004 (loss of 11.6%). In this group, the prevalence of recurrent wheezing at the time of the interview was 27.9%. After adjustment, the risk factors were: current rhinitis (OR=45.7; 95% CI: 24.2 to 86.5), use of wood stove for cooking (OR=2.7; 95% CI: 1.4 to 4.9), child's history of acute respiratory infection (OR=2.1; 95% CI: 1.3 to 3.5), bottle feeding (OR=2.1; 95% CI: 1.1 to 3.8), history of asthma in siblings (OR=1.9; 95% CI: 1.2 to 3.2), maternal history of asthma (OR=1.8; 95% CI: 1.1 to 2.9), and fewer than six prenatal medical consultations (OR=1.6; 95% CI: 1.1 to 2.4). Paternal schooling<9 years was a protective factor against recurrent wheezing (OR=0.6; 95% CI: 0.4 to 0.9). CONCLUSIONS: These results suggest that the management of recurrent wheezing and asthma must consider checking for and simultaneously treating rhinitis. The measures to minimize the effects of recurrent wheezing should include educational and treatment programs focusing on asthma.     

Frequency of and risk factors for allergy in primary school children: results of a population survey

During May 1986, a survey to assess the frequency of allergic disorders was conducted among primary school children of Alghero, Sardinia, using a structured self-administered questionnaire. The following problems were investigated: allergic conjunctivitis, asthma, wheezing, allergic rhinitis, urticaria and eczema. Of the original 1823 questionnaires distributed, 1961 (92.8%) were completed by parents and returned. Overall, 238 children (14.1%) were reported to have shown at least one episode of one or more of the above and were regarded as 'allergic'. Among the potential risk factors investigated, statistically significant differences (P less than 0.05) between allergic and non-allergic children were only found for history of allergy in at least one parent (odds ratio, OR = 2.2) and exposure to passive smoking (OR = 1.4).     

Parental smoking and other risk factors for wheezing bronchitis in children

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.     

CHILDREN'S HOUSING AND THEIR HEALTH AND PHYSICAL DEVELOPMENT

Summary The housing conditions of children in the National Child Development Study were related to their health and their height at the age of 16. Although children in crowded homes missed more school for medical reasons, the only illness they reported more often than children in better conditions was bronchitis. Those with inadequate amenities did not miss more school, although they also reported more bronchitis, as well as bilious attacks. Children in council houses were shorter than those in owner-occupied homes, but the only difference in height related to the conditions of the home was that crowded boys were slightly shorter than those who were not crowded. There was therefore little evidence of an association between poor housing and either ill-health or retarded growth among Britain's 16-year-olds in the 1970s, and this was still the case for children who had spent longer periods of their childhood in unsatisfactory housing.     

The impact of parental smoking on asthma and wheezing. SIDRIA Collaborative Group. Studi Italiani sui Disturbi Respiratori nell'Infanzia e l'Ambiente.

To evaluate the impact of parental smoking on childhood asthma and wheezing, we studied two random samples of subjects ages 6-7 and 13-14 years in ten areas of northern and central Italy. Standardized questionnaires were completed by parents of 18,737 children and 21,068 adolescents (response rates, 92.8% and 96.3%, respectively) about their smoking habits and the respiratory health of their children. Adolescents were asked about their respiratory health and personal smoking. We compared two groups of cases with healthy subjects: (1) "current asthma" (children, 5.2%; adolescents, 6.2%) and (2) "current wheezing" not labeled as asthma (children = 4.5%, adolescents = 8.5%). Exposure to smoke of at least one parent increased the relative risk of current asthma among children [odds ratio (OR) = 1.34; 95% confidence interval (CI) = 1.11-1.62] and of current wheezing among adolescents (OR = 1.24; 95% CI = 1.07-1.44). Maternal smoking had a stronger effect than paternal smoking. Maternal smoking during pregnancy was associated with current asthma (OR = 1.62; 95% CI = 1.34-1.96) and current wheezing in children (OR = 1.31; 95% CI = 1.06-1.62); the effects were lower among adolescents. Among subjects with a negative history of parental asthma, maternal smoking was associated with current wheezing in both age groups, whereas among those with a positive history of parental asthma it was associated with current asthma in children, but not in adolescents. We estimated that 15% (95% CI = 12-19) of the current asthma cases among children and 11% (95% CI = 8.3-14) of the current wheezing cases among adolescents are attributable to parental smoking in Italy.     

Increase in the self-reported prevalence of asthma and hay fever in adults over the last generation: a matched parent–offspring study

Abstract: The study compared current measures on a population-based cohort of adults with past measures on their parents to determine whether the prevalence of self-reported asthma and hay fever in adults increased between 1968 and the early 1990s. In 1968, 8585 cohort members (99 per cent of eligible Tasmanian 7-year-old school children born in 1961), 16 273 (95 per cent) of their parents (mean age 35 years) and 20 937 siblings completed a questionnaire about asthma and hay fever. In 1991–1993, 1494 members (75 per cent) of a stratified random sample of the cohort (aged 29 to 32 years), 75 per cent resident in Tasmania, were surveyed again. In 1968, the proportion of parents who reported having ever had asthma or attacks of wheezing like asthma was 10.9 per cent, independent of age and sex. In 1991–1993, the estimated adult prevalence of having ever suffered from attacks of asthma or wheezy breathing was 23.2 per cent. The proportion reporting at least one asthma attack within the previous 10 years, 5 years, 2 years, 12 months and 6 months was 17.6 per cent, 16.1 per cent, 14.5 per cent, 13.3 per cent and 10.3 per cent, respectively. For hay fever, the adult prevalence was 19.2 per cent in 1968, and 41.3 per cent in 1991–1993. The self-reported lifetime prevalence of asthma and hay fever among adults in the 1961 birth cohort of Tasmanians was twice as high in 1991–1993 as in their parents 25 years earlier. The change in disease interpretation necessary to account fully for the change in prevalence provides evidence for a real increase. Nevertheless, unavoidable subtle differences in questioning could account for half the observed change in prevalence.