RT Journal Article
SR Electronic
T1 Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 1041
OP 1048
DO 10.1136/thoraxjnl-2017-211383
VO 73
IS 11
A1 Andreas M Neophytou
A1 Sam S Oh
A1 Marquitta J White
A1 Angel C Y Mak
A1 Donglei Hu
A1 Scott Huntsman
A1 Celeste Eng
A1 Denise Serebrisky
A1 Luisa N Borrell
A1 Harold J Farber
A1 Kelley Meade
A1 Adam Davis
A1 Pedro C Avila
A1 Shannon M Thyne
A1 William Rodríguez-Cintrón
A1 José R Rodríguez-Santana
A1 Rajesh Kumar
A1 Emerita Brigino-Buenaventura
A1 Saunak Sen
A1 Michael A Lenoir
A1 L Keoki Williams
A1 Neal L Benowitz
A1 John R Balmes
A1 Ellen A Eisen
A1 Esteban G Burchard
YR 2018
UL http://thorax.bmj.com/content/73/11/1041.abstract
AB Background Secondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose–responses using biomarkers of exposure have not been widely reported.Objectives Assess dose–response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature.Methods We performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose–response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines.Results The OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose–response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures.Conclusions Exposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose–response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.