Environmental and Occupational DisordersEnvironmental tobacco smoke exposure and nocturnal symptoms among inner-city children with asthma☆,☆☆
Section snippets
Methods
This study examined data collected from 2 identical baseline surveys designed to evaluate and improve asthma management among inner-city children and their families. In the first study, 24 inner-city elementary schools from Baltimore, Maryland, and 31 inner-city schools from Washington, DC, were invited to participate. In the second study 32 additional inner-city elementary schools in Baltimore were contacted. The surveys were conducted between October 1996 and September 1997 and were approved
Demographic, health care, and environmental characteristics
The majority of the children in our study were African American (98%) and female (60%), with a mean age of 8.2 ± 2.0 years. The child's mother was the caregiver 89% of the time, a family relative 6% of the time, or the child's father 2% of the time. The mean age of the caregivers was 34.7 ± 8.1 years. Ninety percent of the families reported that they had health plans that covered all or part of the cost of prescription medications, and 93% reported having medical assistance or insurance that
Discussion
The primary finding of this study was that caregivers of children with asthma who were exposed to moderate-to-high levels of ETS were more likely to report frequent nocturnal symptoms than those exposed to low levels. Even after controlling for potentially confounding factors, such as child age, caregiver education, and asthma care and management (ie, use of anti-inflammatory medications), in homes with ETS exposure, children with moderate-to-high exposure levels were nearly 3 times as likely
Acknowledgements
We thank Drs Jodi Segal, Jerry Krishnan, and Gregory Diette for their helpful comments on earlier drafts of this manuscript.
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2018, Respiratory MedicineCitation Excerpt :The National Asthma Education and Prevention Program (NAEPP) Expert Panel Report 2 guidelines [3] recommend that asthma severity be assessed using a combination of frequency of clinical respiratory symptoms (day- and night-time symptoms) and objective lung function criteria (determined with forced expiratory volume in one second [FEV1]). Exposures to dust mite [4,5], furred pets [6,7], and tobacco smoke [8,9] have been shown to be associated with asthma severity. While exposure to indoor mold or dampness have also been reported to worsen asthma symptoms [10,11], to date, the impact of many indoor microbial components in the exacerbation of asthma remains poorly assessed.
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Supported by grants HL 5201304 and HL 5283303 from the National Heart, Lung, and Blood Institute of the National Institutes of Health.
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Reprint requests: Susan J. Bartlett, PhD, Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224.