Correlates of recurrent wheezing in school-age children. The Physicians of Raleigh Pediatric Associates.

Abstract

Correlates of recurrent wheezing were examined in a case-control study involving 343 children ranging from 7 to 12 yr of age and recruited from a general pediatric practice. Positive skin tests for allergy were observed in 35% of a random sample of children without recurrent wheezing, and in 77% and 90% of children who had experienced from two to four episodes and five or more episodes, respectively, of recent wheezing. By logistic regression analysis, sensitization to dust mite (odds ratio [OR]: 5.2; 95% CI: 3.0 to 9.0), cat (OR: 15.5; 95% CI: 3.4 to 70.8), and Alternaria (OR: 6.8; 95% CI: 2.1 to 21.5) antigens was consistently associated with recurrent wheezing. Sensitization to pollen antigen(s), observed in 60% of allergic children, was not associated with wheezing. A family history of asthma was a significant predictor of recurrent wheezing (OR: 3.2; 95% CI: 1.7 to 5.9) after adjusting for its association with positive skin tests. Environmental tobacco smoke (ETS) exposure was associated with an increased risk of recurrent wheezing in nonallergic children and in allergic females, but not in allergic males. ETS exposure was not associated with positive skin tests for allergy. A history of wheezing with respiratory illness before 2 yr of age was associated with a modest risk of recurrent wheezing between 7 and 12 yr of age (OR: 2.3; 95% CI: 1.2 to 4.6), a risk that did not differ by allergic status or gender. Theoretically, the prevalence of recurrent wheezing in this population could be reduced approximately 65% by controlling exposure to indoor allergens and ETS.

Environmental tobacco smoke exposure and risk of allergic sensitisation in children: a systematic review and meta-analysis

“…The definition of smoking varied across the studies and only few reports used cotinine urine measurements to verify tobacco smoke exposure 5 30 36. Each study included in this review was investigated for possible confounding factors and the data used in meta-analysis were statistically adjusted for these factors when possible (see online supplementary table SI, SII, SIII and table A3).…”

“…Eight studies (9033 participants) 4 5 19 22 27 29 33 36 were eligible for dichotomous meta-analysis. In two other reports (4080 children) analysis was based on OR only, we therefore applied generic inverse variance analysis in order to estimate an overall effect.…”

Parental smoking and childhood asthma: longitudinal and case-control studies

“…Only one study from Nigeria28 reported a substantial reduction in the odds ratio for either parent smoking, from 2.12 to 1.41 after adjustment for pet ownership, indoor mould, cockroaches, wood smoke, and use of mosquito coils. In the remaining five studies the odds ratio for parental smoking was altered little by adjustment: from 1.32 to 1.3 after adjustment for family history of asthma and duration of breast feeding in Sweden33; from 1.44 to 1.49 after adjustment for age, sex, socioeconomic status, gas cooking, indoor mould, feather bedding, and pet ownership in the UK35; from 1.74 to 1.8 after adjustment for family history of asthma and skin prick positivity to common aeroallergens in the USA36; from 1.97 to 1.87 after adjustment for personal and family history of atopic disease, socioeconomic status, indoor mould, and salt preference in South Africa37; and from 2.79 to 2.82 after adjustment for maternal asthma, history of bronchiolitis, and a range of obstetric and perinatal variables in the USA 39…”

Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey

“…The proportion of children sensitised to A tenuis increased with the number of episodes. However, significant associations were also observed for sensitisation to mites and especially to cats 25. The relation between skin test reactivity and forced expiratory volume in one second was examined in children aged 6 to 12 years with asthma or frequent wheezing as part of the second national health and nutrition survey.…”