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Published on: February 12, 2015
Parental smoking and lung function in children: an international study
Hanns Moshammer1, Gerard Hoek, Heike Luttmann-Gibson
1Institute Environmental Health, ZPH, Medical University, Vienna, Austria.
Insights
Prenatal smoke exposure significantly harms children's lung function growth, while postnatal passive smoking has a weaker impact. These findings highlight smoking as a critical pediatric public health issue affecting lung development.
Area of Science:
- Pediatric respiratory health
- Environmental epidemiology
- Public health
Background:
- Prenatal and postnatal passive smoking are linked to childhood respiratory issues and asthma.
- The distinct effects of prenatal versus postnatal smoke exposure on lung function growth in children are not well understood.
Purpose of the Study:
- To investigate the differential impact of prenatal and postnatal smoke exposure on the respiratory function of primary school children.
- To analyze lung function data from over 20,000 children across Europe and North America.
Main Methods:
- Utilized comparable questionnaires for exposure assessment and standardized spirometry (American Thoracic Society/European Respiratory Society protocol).
- Employed linear and logistic regressions, controlling for individual risk factors and study area.
- Applied meta-analytic tools to estimate heterogeneity and mean effects across studies.
Main Results:
- Maternal smoking during pregnancy was associated with reduced lung function, including a -1% to -6% decrease in FEV1 and MEF25.
- A 4% reduction in MMEF correlated with a 40% increased risk of poor lung function.
- Postnatal passive smoking showed weaker, yet measurable, effects on lung function (FEV1, MEF50).
Conclusions:
- Prenatal and postnatal smoke exposure are significant risk factors for diminished lung function growth in children.
- Given the high prevalence of exposure, this remains a critical pediatric and public health concern.
- Interventions targeting smoking cessation and smoke-free environments are crucial for protecting children's respiratory health.
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.
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