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Persistent wheeze. Its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a
Insights
Parental smoking is linked to persistent wheezing and reduced lung function in children. Early-life respiratory symptoms and parental smoking are key risk factors for obstructive airway disease development.
Area of Science:
- Pediatric Pulmonology
- Environmental Health
- Epidemiology
Background:
- Childhood respiratory symptoms can predict adult obstructive airway disease.
- Persistent wheezing is a common chronic symptom in young children.
- Early life exposures may influence long-term respiratory health.
Purpose of the Study:
- To investigate early-life risk factors for adult obstructive airway disease.
- To examine the relationship between respiratory symptoms, parental smoking, and lung function in children.
- To identify predictors of reduced lung function (FEF-Z score) in children.
Main Methods:
- Study involved 650 children aged 5-9 years and their families in East Boston.
- Data collected included respiratory symptoms, medical history, smoking history, and spirometry.
- Statistical analyses included correlation, prospective evaluation, and multiple linear regression.
Main Results:
- Persistent wheezing affected 9.2% of children and was associated with cough, phlegm, asthma history, hay fever, and respiratory hospitalizations.
- Children with persistent wheeze had a higher incidence of acute lower respiratory illness.
- Parental cigarette smoking showed a linear relationship with persistent wheezing and lower mean normalized forced expiratory flow (FEF-Z score).
- Mother's smoking status and child's persistent wheeze were significant predictors of the children's mean FEF-Z score.
Conclusions:
- Early-life persistent wheezing and parental smoking are significant risk factors for reduced lung function in children.
- These findings highlight the importance of addressing environmental exposures like parental smoking to prevent childhood respiratory issues and potential adult obstructive airway disease.
- Interventions targeting parental smoking cessation could improve pediatric respiratory health outcomes.
Abstract:
In a study of early-life risk factors for the development of adult obstructive airway disease, respiratory symptoms, disease and smoking histories, and spirometry were obtained for 650 children 5 to 9 yr of age and their families in East Boston, Massachusetts. Persistent wheezing was the most frequently reported chronic symptom, occurring in 9.2% (60/650) of the population. Children with persistent wheezing were more likely to report cough and phlegm (p < 0.001), a history of asthma (p < 0.001), hay fever (p < 0.02), or past hospitalization with a respiratory illness (p < 0.001) than their asymptomatic peers. Prospective evaluation of a subsample of the 650 children confirmed a greater occurrence of acute lower respiratory illness in those children with persistent wheeze. Parental cigarette smoking was linearly related to the occurrence of persistent wheezing (p = 0.012) and lower degrees of mean normalized forced expiratory flow during the middle half of the forced vital capacity (FEF-Z score). A multiple linear regression identified the mother's current smoking status and current persistent wheeze as significant predictors of the children's mean FEF-Z score. Other variables, such as the father's smoking, children's personal smoking, a doctor's diagnosis of asthma, and a past history of lower respiratory illness were not significant predictors of the FEF-Z score.