Health effects of passive smoking. 8. Passive smoking and risk of adult asthma and COPD: an update

Chronic ingestion of ethanol produces a variety of effects on female reproductive function, depending on the dose and the exposure time but the mechanism of alcohol-induced ovarian failure has been little studied. Also the effects of chronic ethanol consumption on the oocyte quality in relation to morphological alterations and PGE synthesis by the oocyte cumulus complexes (OCCs) have not been described. In this study, immature female mice were treated with 10% ethanol in drinking water for 30 days. Then they were induced to superovulate, and at 14, 16 and 20 h post-hCG the quality of the ovarian and oviductal oocytes and PGE production by OCC was determined. At 14 h post-hCG, the percentage of oviductal immature oocytes was increased in the ethanol-treated females (P < 0.05). At 16 h post-hCG, the percent of oviductal activated oocytes was higher in the treated females (P < 0.05), and the ovarian immature oocytes were decreased as compared to the control females (P < 0.05). At 20 h post-hCG, the ethanol-treated females had higher percents of activated oocytes in the oviducts and in the ovaries (P < 0.05) with respect to the controls. PGE synthesis by OCCs, assessed by RIA, was decreased in the treated female mice (P < 0.001). In summary, moderate chronic ethanol treatment in immature female mice can produce morphologic abnormalities in the oocytes (high parthenogenetic activated rates) and altered PGE production in the OCCs.     

Has the prevalence of asthma symptoms increased in Australian children?

This paper estimates whether an increase has occurred in the prevalence of asthma symptoms and diagnosed asthma in Australian children over the past two decades. Seventeen population-based studies undertaken in Australia since 1969 were reviewed. Inclusion criteria were studies using population samples of children aged 5-12 years, with standardized questionnaire measurements. Data from serial National Health Surveys were also examined for trends in recent and chronic asthma. The prevalence of recent (12 month) and cumulative wheeze increased, showing a significant correlation with year of study (r = 0.78 and r = 0.79, respectively). Diagnosed asthma showed a smaller but still significant increase (r = 0.65). The trends observed indicated that diagnosed asthma and reported wheeze have increased by almost 1% per year over the past two decades. Data since 1980 have provided estimates of bronchial hyperreactivity (BHR), but no trend was observed. Substantial increases were noted in the National Health Surveys, with recent asthma prevalence in children aged 5-14 increasing from 3.3% in 1983 to 8.3% in 1989, and chronic asthma prevalence increasing from 4.5% in 1977 to 15.2% in 1989. The findings of this review suggest an increase in the prevalence of asthma symptoms in children, but these observations could also be explained by changes in diagnostic fashion and an increased awareness of asthma symptoms.     

Traffic-related NO2 and the prevalence of asthma and respiratory symptoms in seven year olds

The aim of this study was to determine whether outdoor nitrogen dioxide (NO2) was associated with the prevalence of asthma and respiratory symptoms. In eight nonurban communities, 843 children resident for a minimum of 2 yrs were studied. Since industrial sources of air pollution were at least 20 km away from the study communities, NO2 was considered to primarily indicate traffic-related air pollution. NO2 was recorded at central monitors, and the 3 yr mean exposure was calculated. Asthma and respiratory symptoms were assessed according to the International Study on Asthma and Allergy in Childhood. Prevalence of asthma at some time ("ever asthma") was associated with long-term NO2. In parallel with increasing levels of NO2 (community specific 3 yr mean 6.0-17.0 parts per billion (ppb)), asthma prevalence was 2.5, 1.4, 1.6, 2.3, 3.4, 3.6, 7.6 and 8.5%, respectively (p=0.002 for trend). The prevalence odds ratios (PORs) for "ever asthma", following adjustment for gender, age, parental education, passive smoke exposure, type of indoor heating, and parental asthma, were 1.28 (95% confidence interval (95% CI) 0.20-7.98), 2.14 (95% CI 0.40-11.3) and 5.81 (95% CI 1.27-26.5), when each of two communities with low, regular and high NO2, respectively, were compared with the two communities with very low NO2. For symptoms "wheeze" (adjusted PORs for increased NO2: 1.47, 1.23 and 2.27) and "cough apart from colds" (adjusted PORs for increased NO2: 1.49, 1.93 and 2.07), a similar trend was seen. In this study a significant relationship was observed between traffic-related nitrogen dioxide and the prevalence of asthma and symptoms. Whether this association is causal has to be tested in longitudinal studies.     

Parental smoking and respiratory illnesses in Australian children aged 0-4 years: ABS 1989-90 National Health Survey results

OBJECTIVE: This study investigated the associations between parental smoking and respiratory infections in Australian children aged 0-4 years. METHODS: Data from the ABS 1989-90 National Health Survey were used. The exposure variables examined were maternal, paternal and combined family smoking. Outcome variables were parent-reported chronic or recent asthma, asthma wheeze, bronchitis, influenza, common cold, cough, otitis media and other respiratory conditions. Logistic regression techniques were used to control for confounding by socio-economic status, child's sex, maternal education, place of residence, ethnicity and family size. RESULTS: Of the 4,281 children in the sample, 45% lived in households with one or more current smokers and 29% had a mother who smoked. Maternal (but not paternal) smoking was significantly associated with asthma (OR 1.52, 95% CI 1.19-1.94) and asthma wheeze (OR 1.51, 95% CI 1.26-1.80). No other significant associations were observed. Positive and significant dose response relationships were found between the amount of maternal smoking and both asthma variables. Population attributable risks were calculated and almost 13% of asthma and asthma wheeze in 0-4 year old Australian children in 1989-90 was estimated to be due to maternal smoking. CONCLUSION: Large numbers of Australian children live in households with smokers. This study, like others, has shown an association between maternal smoking and respiratory illnesses in young children. Further strategies are needed to prevent or reduce young children's exposure to environmental tobacco smoke in their homes.     

Cigarette smoking by mothers during pregnancy and pulmonary function of their school age children

The paper examines the relation of maternal smoking during pregnancy and lung function of 1029 schoolchildren aged 9 years. Children from Cracow whose mothers had smoked during pregnancy had significantly lower lung function than the children whose mothers had not smoked in this period. On average, spirometric data of FEV1/FVC, FEF25-75% and PEFR were 1.1%, 4.7%, and 3.2% lower respectively, in those children whose mothers had smoked during pregnancy. The effect was statistically significant after accounting for potential confounders such as current smoking habit of parents. The results provide a new support for the hypothesis that deficit in lung function among children is associated with maternal smoking in pregnancy. The strongest effects were found to involve the function of small airways.     

Trends in the prevalence of asthma in Scottish and English primary school children 1982-92

BACKGROUND: Some doubts exist as to whether the increase in the prevalence of asthma is real or an artefact. The 10 year trend of asthma up to 1993 in England and Scotland was therefore assessed. METHODS: Information on asthma and bronchitis attacks, occasional wheeze, and persistent wheeze in the last 12 months, was obtained using a self administered questionnaire completed by the parents. Exactly the same questions were asked in 14 study areas in Scotland and 22 study areas in England in 1982 or 1983 and in 1992 or 1993 in 5-11 year old children. RESULTS: The numbers of children with data for all respiratory illness were 5556 (85.2%) and 5801 (87.1%) in England and 3748 (90.4%) and 3738 (90.4%) in Scotland in 1982 and 1992, respectively. There was a significant increase in asthma attacks (approximately three times more in 1992 than in 1982) and occasional wheeze (30-60% more in 1992 than in 1982) in both sexes in England and Scotland. Persistent wheeze also increased in both countries, but the increase was significant only in England (30-40% more in 1992 than in 1982). CONCLUSIONS: The study coincides with others that suggest that the increased prevalence of asthma may be due, in part, to changes in diagnostic behaviour. However, the continuing increase of persistent wheeze in the total sample suggests that part of the increase is real. There was no difference in the increase of persistent wheeze between Scotland and England, but the trend was only significant in England.     

A day treatment programme for children of school age.

A review of the literature on day treatment of children indicates that in spite of an array of program philosophies and clinical techniques, integration is a common major concern. However, the question of how to foster integration in children's day treatment programs is not formally discussed. The present paper outlines how a day program's philosophy and values can be implemented through administrative and program processes that comprise the program's infrastructure. The necessity for an infrastructure that can facilitate integration is highlighted by the growing trend to locate children's day treatment programs within community schools. (French abstract) (11 ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of acute passive smoking on exercise-induced bronchoconstriction in asthmatic children

This study was designed to investigate the acute effects of environmental tobacco smoke (ETS) in children with mild asthma during rest and exercise. We studied 13 children [8 males, 5 females; mean age 10 (range 8-13) yr; mean forced expired volume in 1 s (FEV1) 93% (range 82-108%) of predicted] with exercise-induced bronchoconstriction [46 +/- 4% (SE) fall in FEV1 after exercise during cold air breathing]. Children were exposed to ETS (20 ppm carbon monoxide) or ambient air (AA) for 1 h. During the first 54 min of exposure, children were at rest, and during the last 6 min they exercised on a bicycle ergometer (2 W/kg body wt). Spirometry was performed before and during exposure and after exercise. Respiratory symptoms were recorded before and after exposures. In seven children the experiments with AA and ETS were done in duplicate. FEV1 between 5 and 54 min of exposure at rest decreased by 3.2 +/- 0.8% (SE) during AA and by 7.2 +/- 2.3% during ETS exposure compared with preexposure values; the difference between AA and ETS was statistically significant (P = 0.04). The drop in FEV1 was achieved within 5 min and did not change with ongoing exposure. Analysis of individual data revealed that the mean changes during ETS were mainly effected by three children with a significant fall and one child with a significant improvement in FEV1 (P < 0.05). Maximum postexercise fall of FEV1 was 25 +/- 4% after AA and 24 +/- 3% after ETS, which did not differ significantly. Upper and lower respiratory tract symptoms were not significantly different between exposures.(ABSTRACT TRUNCATED AT 250 WORDS)     

Parental smoking and infection with Helicobacter pylori among preschool children in southern Germany

BACKGROUND: Endoscopic examination (direct laryngoscopy and bronchoscopy) is the method of choice for diagnosis of respiratory symptoms of unknown cause in children. However, gastroesophageal reflux is being recognized increasingly often as a cause of pediatric respiratory symptoms and is difficult to diagnose on the basis of findings from direct laryngoscopy and bronchoscopy. In cases in which gastroesophageal reflux was included in the differential diagnosis, we additionally performed esophagoscopy with esophageal mucosal biopsies. OBJECTIVES: To determine the feasibility, safety, and efficacy of routinely performing esophageal biopsies during triple endoscopy in children. METHODS: Twenty-four children ranging in age from 2 weeks to 10 years were referred for airway evaluation. Under general anesthesia, children underwent direct laryngoscopy and bronchoscopy and esophagoscopy with mucosal biopsy. RESULTS: Esophageal mucosa biopsy specimens were quickly and safely obtained during endoscopic evaluation. There were no complications. Reflux esophagitis was present in 54% of biopsy specimens, as suggested by basal cell hyperplasia, papillary elongation, and/or inflammatory cell infiltrates. CONCLUSION: Gastroesophageal reflux is often difficult to diagnose in the pediatric population. When direct laryngoscopy and bronchoscopy is performed during examination of the child with airway symptoms, the addition of esophagoscopy with mucosal biopsies will safely and quickly provide data regarding the potential contribution of gastroesophageal reflux.     

Declining prevalence of dental caries in school children in Singapore

Slime layers and capsules are common amongst medically relevant bacteria. We herein report that Treponema denticola, which has been associated with periodontitis, synthesizes or acquires an extracellular polysaccharide layer that we have observed through electron microscopy using the polysaccharide-specific dye Alcian blue and phosphotungstate. We have also visualized this extracellular layer by dark-field microscopy of Alcian blue-stained spirochete cells. A representative strain of each of the oral spirochete species T. denticola, Treponema vincentii and Treponema socranskii were differentiated by concanavalin A, phaseolus, lotus A and arachis lectins in a microtiter plate immunoassay for the detection of surface sugars.     

The impact of asthma and asthma-like illness in Seattle school children

The impact of asthma and asthma-like illness was measured in a population of 5-9-year-old Seattle public school children. Child health information was obtained from a survey of 1665 parents of first and second grade students to assess medical services use and impaired physical functioning among diagnosed asthmatics and those with current wheezing, defined as wheezing in the past 12 months without a diagnosis of asthma, relative to an asymptomatic population with neither condition. Relative to the asymptomatic population, the prevalence of respiratory-related activity limitation, and perception of poorer child health was larger among diagnosed asthmatics than children with current wheezing. However, the prevalence of sleep disturbances, school absences, medical services use, and parental concern over their child's health was similar for both the asthmatic and wheezing groups relative to the asymptomatic group. Also, in both symptomatic groups, a history of moderate or severe wheezing was associated with an increased prevalence of respiratory-related sleep disturbances and activity limitation. The similarity between the impact of diagnosed asthma and undiagnosed asthma-like illness suggests that the overall social and economic burden of asthma may be higher than previously estimated.     

Underrecognition and undertreatment of asthma in Cape Town primary school children

BACKGROUND: In view of the high local prevalence of asthma, the extent of recognition and appropriate management of childhood asthma was studied in a large suburban area of Cape Town. DESIGN: Cross-sectional study based on random community sample of schools. METHOD: 1,955 parents of sub B pupils from 16 schools completed a questionnaire, followed by: (i) an interview of the parents of 348 symptomatic children; and (ii) bronchial responsiveness testing on 254 children. The final case group consisted of 242 children with reported asthma or multiple asthma symptoms on both questionnaires. Children in whom asthma was acknowledged were compared with those in whom it was not. RESULTS: Overall, any past or current ('ever') asthma was acknowledged by respondents in only 53% of the children, and current asthma in only 37.1%. While most children had received treatment in the previous 12 months, 66.1% of the recognised group were on current treatment (23.2% on daily treatment), compared with 37% of the unrecognised group (3% daily). Salbutamol and theophylline syrups were the most common types of medication, while inhalers and anti-inflammatory medications were underused. Only a minority of parents reported the child ever having used a peak flow meter, or volunteered knowledge of preventive measures. Current treatment, and to a lesser degree recognition of asthma by parents, were more common among children on medical aid and of higher socio-economic status. CONCLUSIONS: These findings suggest that ways need to be found: (i) to increase the use of current asthma treatment guidelines by practitioners; (ii) to provide access to comprehensive care by children not on medical aid; and (iii) to improve education of parents in home management measures such as severity assessment and avoidance of smoking, allergen and dietary triggers.     

Passive smoking in children up to 5 years of age

Passive smoking is a major health risk in young children. We investigated the percentage of children with mothers and/or fathers who reported regular smoking. Data are the national and regional health surveys of the German Cardiovascular Prevention Study (GCP) conducted from 1984 to 1992 in West Germany. 2538 mothers aged 25-40 years were included. The prevalence of passive smoking in children due to smoking mothers was 33.6% 55.4% of the children up to 5 years lived in households with at least one smoking parent member. In 23.4% of these households both parents were smokers. If only one member of the parents smoked this was in two out of three cases the father. 28.2% of mothers with a child younger than one year were current smokers. This prevalence rate increased with the age of the youngest child up to 35.6% for mothers, whose youngest child was 5 years old. Multiple logistic regression analysis was performed to investigate the association between smoking behaviour and the following variables: mother's age, social class, family status, community size and year of the survey. It was found that lower social class members, unmarried or divorced mothers and inhabitants of large cities reported significantly more often regular current smoking. These results underscore the importance of special intervention programs to reduce smoking in parents with young children.     

Prevalence of asthma and wheeze in primary school children in northern Jordan

While the existence of chimeric cells in host tissue following organ transplantation is well documented, its distribution, temporal evolution and relationship to allograft survival is less clear. To explore this phenomenon, Lewis recipients of ACI cardiac allografts representing a wide range of immunosuppressive protocols and graft survival times were examined for the presence of chimerism using a sensitive polymerase chain reaction assay. Four groups of animals were examined: untransplanted animals receiving donor specific transfusion (DST)/cyclosporine A (CsA); allograft recipients with no treatment; recipients treated with DST/CsA/supplementary immunosuppression with rejection at 21-183 days; and recipients sacrificed with functioning allografts, treated with DST/CsA/supplementary immunosuppression and surviving > 200 days. To elucidate variations in the tissue distribution of chimeric cells, bone marrow, skin, liver, spleen, and thymus were examined in each animal. Untransplanted animals receiving DST/CsA displayed no evidence of chimerism. In animals receiving a cardiac allograft but no treatment, there was extensive evidence of chimerism in four of five animals. Chimerism was also detected in seven of nine animals with intermediate graft survival at the time of rejection. In animals with long-term graft survival, only four of eight displayed chimerism. These results suggest that, without immunosuppression, early chimerism does not lead to prolonged graft survival and that, even when graft survival is moderately prolonged, these cells are not sufficient to prevent rejection. In conclusion, chimerism appears to be a common phenomenon following transplantation, is not a result of DST, and may not be necessary for maintenance of long-term graft survival.     

Factors affecting smoking of elementary and high school children from Chile

The outcome of orthodontic treatment involving early extraction of 4 second molars was evaluated in 52 patients (29 girls, 23 boys). Computer-assisted analysis of cephalograms, casts and panoramic X-rays was performed at the start (T1, mean age 11.5 years) and at the end (T2, mean age 14.4 years) of treatment. Following treatment, mesial migration of upper and lower first molars was counteracted; however, treatment only moderately influenced normal development of the position of the incisors and the profile. At the end of treatment, the third molars had erupted in only 3 patients. Nevertheless, on average a significant mesial movement of these teeth was observed. In addition, there was a significant improvement in the axial inclination of the third molars, especially in the upper arch. This improvement was correlated with the original position of the teeth. All patients needed a longer follow-up period and it seems reasonable that some of them might require a second treatment phase to adjust the position of the third molars.     

Social relations of gifted children as a function of age and school program.

Examined social and personal concomitants of exceptional academic capability in the context of various educational settings. Students in Grades 5, 8, and 10 participated in the study. At each grade level, there were students in classes for the gifted (self-contained gifted), gifted students in regular classes (integrated gifted), and classmates of the integrated gifted (matched and random controls). Subjects completed self-report scales of social competence and feelings about school. Peer nominations for social competence were also obtained from children in the integrated classes. The integrated gifted children at all three grade levels had higher scores for academic self-concept than the other groups; there were no differences in social or physical self-concept. In Grade 5 only, the integrated gifted were rated by their classmates as higher in social competence than were controls. Although there were no significant differences among groups in terms of attitude toward school, feelings toward school became less positive as age increased. (PsycINFO Database Record (c) 2010 APA, all rights reserved)