Abstract
BackgroundThe use of biomarkers has expanded considerably, as an alternative to questionnaire-based metrics of environmental tobacco smoke (ETS); few studies have assessed the affect of such alternative metrics on diverse respiratory outcomes in children, and we aimed to do so.MethodsWe evaluated various measures of birth-year ETS, in association with multiple respiratory endpoints early years of life, in the novel context of a birth cohort at high risk for asthma. We administered questionnaires to parents, both at the end of pregnancy and at one year of life, and measured cotinine in cord blood (CCot; in 275 children) and in urine (UCot; obtained at 12 months in 365 children), each by radioimmunoassay. Multiple logistic regression was used to assess the association of the various metrics with recurrent wheeze at age 2 and with bronchial hyperresponsiveness (BHR) and asthma at age 7.ResultsSelf-reported 3rd trimester maternal smoking was associated with significantly increased risk for recurrent wheeze at age 2 (odds ratio 3.5 [95% confidence interval = 1.2,10.7]); the risks associated with CCot and 3rd trimester smoking in any family member were similar (OR 2.9 [1.2,7.0] and 2.6 [1.0,6.5], respectively). No metric of maternal smoking at 12 months appeared to significantly influence the risk of recurrent wheeze at age 2, and no metric of ETS at any time appeared to significantly influence risk of asthma or BHR at age 7.ConclusionsBiomarker- and questionnaire-based assessment of ETS in early life lead to similar estimates of ETS-associated risk of recurrent wheeze and asthma.
Highlights
The use of biomarkers has expanded considerably, as an alternative to questionnaire-based metrics of environmental tobacco smoke (ETS); few studies have assessed the affect of such alternative metrics on diverse respiratory outcomes in children, and we aimed to do so
In our previous work [2], we focused on the lattermost and demonstrated that questionnaire-based exposure to environmental tobacco smoke (ETS) at year 7, administered to parents within a birth cohort of high-risk children, was not a risk factor for asthma at year 7
The cohort consisted of 545 children from Vancouver and Winnipeg at high-risk of asthma, 380 (70%) of whom were followed over 7 years
Summary
The use of biomarkers has expanded considerably, as an alternative to questionnaire-based metrics of environmental tobacco smoke (ETS); few studies have assessed the affect of such alternative metrics on diverse respiratory outcomes in children, and we aimed to do so. In our previous work [2], we focused on the lattermost and demonstrated that questionnaire-based exposure to environmental tobacco smoke (ETS) at year 7, administered to parents within a birth cohort of high-risk children, was not a risk factor for asthma at year 7. Individual smoking was a dichotomized variable whereas cotinine measures were continuous variables Those children with data on each of the ETS metrics for a given exposure window were included. The fluxogram (Figure 1) summarizes the flow of our study
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