Academic journal article Central European Journal of Public Health

Household Environmental Tobacco Smoke and Respiratory Diseases among Children in Nis (Serbia)

Academic journal article Central European Journal of Public Health

Household Environmental Tobacco Smoke and Respiratory Diseases among Children in Nis (Serbia)

Article excerpt

SUMMARY

The authors investigated the relationship between household environmental tobacco smoke (ETS) exposure and prevalence of respiratory symptoms and diseases as well as absenteeism related to respiratory illness in schoolchildren. The study sample consisted of 1,074 children aged 7-11 years from three primary schools in Nis (Serbia). ETS exposure was associated with wheezing (OR-1.48; 1.09-2.01), bronchitis (OR-1.66; 1.23-2.23), headache (OR-1.45; 1.08-1.95), and fatigue (OR-1.38; 1.02-1.85) in exposed children. The other risk factors with possible influences weren't assessed. There was no statistically significant difference in the number of physicians' visits as well as in absenteeism from school due to illness in children exposed to ETS in comparison to non exposed children. The tobacco smoke effect on children is an essential and urgent problem with life lasting negative health effects which are preventable.

Key words: environmental tobacco smoke, respiratory diseases

INTRODUCTION

Household environmental tobacco smoke (ETS) is a major source of indoor air contaminants and it presents an important public health problem (1). Environmental tobacco smoke is a dynamic, complex mixture of more than 4,000 chemicals found in both vapour and particle phases. Many of these chemicals are known toxic or carcinogenic agents.

Many previous studies have shown that a large number of children are exposed to environmental tobacco smoke in their homes (2-4). The World Health Organization estimated that approximately half of the children in the world are exposed to ETS, mostly in their homes (5). In the United States, approximately 60% of children aged 3 to 1 1 years are exposed to secondhand smoke (6) and 25% live with one or more smokers in their home (7).

Children are particularly vulnerable to the harmful effects of environmental tobacco smoke because of their relatively underdeveloped immune and pulmonary systems, their small body size, and their higher rates of ventilation (8, 9).

Exposures to ETS have been associated with a variety of adverse health effects in children. Several recent studies link ETS with increased incidence and prevalence of asthma and increased severity of asthmatic symptoms in children of mothers who smoke heavily (10). These respiratory illnesses in childhood may very well contribute to the significant lung function reductions associated with exposure to ETS in adults. There is also strong evidence of increased middle ear effusion (1 1), reduced lung function, and reduced lung growth (12). Some U.S. studies have also shown a relationship between environmental tobacco smoke and cognitive abilities among children and adolescents (13).

The aim of this study was to estimate the effects of environmental tobacco smoke on prevalence of respiratory symptoms and diseases as well as absenteeism related to respiratory illness in schoolchildren.

MATERIALS AND METHODS

Three primary schools in Nis (Serbia) with a total of 1,309 children aged 7 to 1 1 years were chosen randomly. Assessment of exposure to ETS was done by using the original questionnaire. Trained physicians filled in questionnaires during interviews with children's parents. The study sample consisted of 1,074 children and the response rate was 82%.

Exposure of children to ETS was examined on the basic responses to following questions: "Does anyone smoke in the house?", and "How many smokers live at home?".

The second part of the questionnaire was about prevalence of respiratory symptoms (nasal congestion, nasal secretion, dyspnea, wheezing, cough), respiratory diseases (sinusitis, bronchitis, asthma, pneumonia), nonspecific symptoms (watery eyes, dry throat, headache, fatigue) and absenteeism related to respiratory illness in children in the past 12 months. Respiratory diseases were considered if an affirmative answer was given to the following questions: "Has any doctor diagnosed your child with asthma (sinusitis, bronchitis, pneumonia)? …

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