Abstract
To the Editor.— Kraemer et al 1 compared children with persistent middle-ear effusion (PMEE) admitted to a hospital for tympanostomy tube insertion with children admitted for other types of surgery and matched to patients with PMEE by age, sex, season, and surgical ward. Parents were interviewed about children's household exposure to cigarette smoke, frequency of nasal congestion, and frequency of defined atopic symptoms. The ratios of the proportions of children with PMEE to the proportions of children without PMEE in whom these factors were present were expressed as relative risks. When relative risks were calculated individually for nasal congestion, cigarettesmoke exposure (as measured by whether household residents reportedly smoked more than 0.5 packs per day), and atopy, nasal congestion was significantly different in children with and without PMEE, but cigarette smoke exposure and atopy were not. When risks were calculated for the three factors in pairs, exposure to
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