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Abstract

Effect of Passive Smoking on the Growth of Pulmonary Function and Respiratory Symptoms in Schoolchildren

VOLUME 68 - NUMBER 3 / May - June (Original articles)

Rosario Fernández-Plata, Departments of Epidemiology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
Rosalba Rojas-Martínez, Population Health Research Center, Instituto Nacional de Salud Pública (INSP), Mexico City, Mexico
David Martínez-Briseño, Epidemiology and Social Science in Health, Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico
Cecilia García-Sancho, Epidemiology and Social Science in Health, Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico
José R. Pérez-Padilla, Department of Research on Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, SSA, Mexico City, Mexico

Background: Environmental tobacco smoke affects the current and future health of children. Objective: To determine whether schoolchildren aged 8-17 years old residing at an altitude of 2,240 m and exposed to tobacco smoke at home presented a reduction in the growth of pulmonary function and a greater problem of respiratory symptoms and infections compared with non-exposed children. Materials and Methods: We followed, with questionnaires and spirometry, 1,632 boys and 1,555 girls from Mexico City and its metropolitan area (the Metropolitan Study to Evaluate the Chronic Effects of Pollution in School-age Children [EMPECE]) every six months for six years. The impact of passive smoking was estimated by mixed-effects models and Generalized Linear and Latent Mixed Models (GLLAMM), stratifying by gender and adjusting for age, height, weight, and ozone levels. Results: Passive smoking (reported by one-half of participants) was associated with reduced spirometric lung function (log transformed or as Z-scores) and a higher frequency of self-reported respiratory symptoms and respiratory infections. Levels of forced expiratory volume in 1 second and forced vital capacity in individuals exposed to passive smoking were 6.8 and 14.1 ml, respectively, below those of non-exposed children, and these values decreased with increasing number of smokers at home and higher ozone levels. Conclusions: Passive smoking in children is a significant risk factor for respiratory disease and reduced lung function growth, which are additive with levels of air pollution, asthma, and the presence of respiratory symptoms.

Keywords: Pulmonary function testing. Epidemiology. Passive smoking. Respiratory symptoms. Asthma.

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