This Article Full Text Full Text (PDF) All Versions of this Article: 200510-1552OCv1 173/11/1255    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moshammer, H. Articles by Fletcher, T. Search for Related Content PubMed PubMed Citation Articles by Moshammer, H. Articles by Fletcher, T.

Parental Smoking and Lung Function in Children

An International Study

Institute Environmental Health, ZPH, Medical University, Vienna, Austria; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Environmental Health Unit, National Center of Public Health Protection, Sofia, Bulgaria; GSF–National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany; Department of Health Statistics and Informatics, Regional Authority of Public Health, Banska Bystrica, Slovakia; Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom; National Institute of Environmental Health, "József Fodor" National Center for Public Health, Budapest, Hungary; Institute of Public Health, Ostrava, Czech Republic; and Department of Epidemiology, Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland

Correspondence and requests for reprints should be addressed to Prof. Manfred Neuberger, M.D., Kinderspitalgasse 15, A-1095 Wien, Austria. E-mail: manfred.neuberger{at}univie.ac.at

Rationale: Both prenatal and postnatal passive smoking have been linked with respiratory symptoms and asthma in childhood. Their differential contributions to lung function growth in the general children's population are less clear.

Objective: To study the relative impact of pre- and postnatal exposure on respiratory functions of primary school children in a wide range of geographic settings, we analyzed flow and volume data of more than 20,000 children (aged 6–12 yr) from nine countries in Europe and North America.

Methods: Exposure information had been obtained by comparable questionnaires, and spirometry followed a protocol of the American Thoracic Society/European Respiratory Society. Linear and logistic regressions were used, controlling for individual risk factors and study area. Heterogeneity between study-specific results and mean effects were estimated using meta-analytic tools.

Main Results: Smoking during pregnancy was associated with decreases in lung function parameters between –1% (FEV₁) and –6% maximal expiratory flow at 25% of vital capacity left (MEF₂₅). A 4% lower maximal midexpiratory flow (MMEF) corresponded to a 40% increase in the risk of poor lung function (MMEF < 75% of expected). Associations with current passive smoking were weaker though still measurable, with effects ranging from –0.5% (FEV₁) to –2% maximal expiratory flow (MEF₅₀).

Conclusions: Considering the high number of children exposed to maternal smoking in utero and the even higher number exposed to passive smoking after birth, this risk factor for reduced lung function growth remains a serious pediatric and public health issue.

Key Words: child • passive smoking • pregnancy • spirometry • tobacco

This article has been cited by other articles:

				J. A. Jarvie and R. E. Malone Children's Secondhand Smoke Exposure in Private Homes and Cars: An Ethical Analysis Am J Public Health, December 1, 2008; 98(12): 2140 - 2145. [Abstract] [Full Text] [PDF]

				J. Douwes, S. Cheng, N. Travier, C. Cohet, A. Niesink, J. McKenzie, C. Cunningham, G. Le Gros, E. von Mutius, and N. Pearce Farm exposure in utero may protect against asthma, hay fever and eczema Eur. Respir. J., September 1, 2008; 32(3): 603 - 611. [Abstract] [Full Text] [PDF]

				M K Kwok, C M Schooling, L M Ho, S S L Leung, K H Mak, S M McGhee, T H Lam, and G M Leung Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years: evidence from Hong Kong's "Children of 1997" birth cohort Tob. Control, August 1, 2008; 17(4): 263 - 270. [Abstract] [Full Text] [PDF]

				C. Wang, M. T. Salam, T. Islam, M. Wenten, W. J. Gauderman, and F. D. Gilliland Effects of In Utero and Childhood Tobacco Smoke Exposure and {beta}2-Adrenergic Receptor Genotype on Childhood Asthma and Wheezing Pediatrics, July 1, 2008; 122(1): e107 - e114. [Abstract] [Full Text] [PDF]

				S. F. Suglia, R. O. Wright, J. Schwartz, and R. J. Wright Association Between Lung Function and Cognition Among Children in a Prospective Birth Cohort Study Psychosom Med, April 1, 2008; 70(3): 356 - 362. [Abstract] [Full Text] [PDF]

				S. F. Suglia, L. Ryan, F. Laden, D. W. Dockery, and R. J. Wright Violence Exposure, A Chronic Psychosocial Stressor, and Childhood Lung Function Psychosom Med, February 1, 2008; 70(2): 160 - 169. [Abstract] [Full Text] [PDF]

				H. Chen, M. J. Cowan, J. D. Hasday, S. N. Vogel, and A. E. Medvedev Tobacco Smoking Inhibits Expression of Proinflammatory Cytokines and Activation of IL-1R-Associated Kinase, p38, and NF-{kappa}B in Alveolar Macrophages Stimulated with TLR2 and TLR4 Agonists J. Immunol., November 1, 2007; 179(9): 6097 - 6106. [Abstract] [Full Text] [PDF]

				G. Tino Clinical Year in Review I: Lung Cancer, Interventional Pulmonology, Pediatric Pulmonary Disease, and Pulmonary Vascular Disease Proceedings of the ATS, September 15, 2007; 4(6): 478 - 481. [Full Text] [PDF]

				D. Caudri, A. Wijga, U. Gehring, H. A. Smit, B. Brunekreef, M. Kerkhof, M. Hoekstra, J. Gerritsen, and J. C. de Jongste Respiratory Symptoms in the First 7 Years of Life and Birth Weight at Term: The PIAMA Birth Cohort Am. J. Respir. Crit. Care Med., May 15, 2007; 175(10): 1078 - 1085. [Abstract] [Full Text] [PDF]

				F. Godfrey Hold the Front Page: Smoking Bans Good for (Most) Workers' Health Am. J. Respir. Crit. Care Med., April 15, 2007; 175(8): 751 - 753. [Full Text] [PDF]

				T. S. Nawrot, A. Nemmar, and B. Nemery Update in Environmental and Occupational Medicine 2006 Am. J. Respir. Crit. Care Med., April 15, 2007; 175(8): 758 - 762. [Full Text] [PDF]

				A. Bush and I. Annesi-Maesano "Beam Me Up, Scotty!" Am. J. Respir. Crit. Care Med., January 1, 2007; 175(1): 1 - 2. [Full Text] [PDF]

				D. Menzies, A. Nair, P. A. Williamson, S. Schembri, M. Z. H. Al-Khairalla, M. Barnes, T. C. Fardon, L. McFarlane, G. J. Magee, and B. J. Lipworth Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places. JAMA, October 11, 2006; 296(14): 1742 - 1748. [Abstract] [Full Text] [PDF]

				Another Reason Not to Smoke During Pregnancy Journal Watch Women's Health, August 3, 2006; 2006(803): 1 - 1. [Full Text]

				S. Pattenden, T. Antova, M. Neuberger, B. Nikiforov, M. De Sario, L. Grize, J. Heinrich, F. Hruba, N. Janssen, H. Luttmann-Gibson, et al. Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure. Tob. Control, August 1, 2006; 15(4): 294 - 301. [Abstract] [Full Text] [PDF]

				M. D. Eisner and F. Forastiere Passive smoking, lung function, and public health. Am. J. Respir. Crit. Care Med., June 1, 2006; 173(11): 1184 - 1185. [Full Text] [PDF]