Abstract: Environmental tobacco smoke and absenteeism related to respiratory illness in schoolchildren
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Citation: Gilliland FD, Berhane K, Islam T, Wenten M, Rappaport E, Avol E, Gauderman WJ, McConnell R, Peters JM. 2003. Environmental tobacco smoke and absenteeism related to respiratory illness in schoolchildren. American Journal of Epidemiology 157(10):861-869.
Abstract:
Household environmental tobacco smoke (ETS) exposure accounts for substantial
morbidity among young children, but the ETS-associated morbidity burden among
school-age children is less well defined. Illness-related school absenteeism
is a measure of a broad spectrum of adverse effects of ETS exposure in school-age
children. The authors investigated the relations between ETS exposure, asthma
status, and illness-related school absenteeism in a cohort of 1,932 fourth-grade
schoolchildren from 12 southern California communities during January-June
1996. Incidence rates and adjusted relative risks of illness-related absences
were determined by using an active surveillance system. The effects of ETS
exposure on absenteeism were assessed by using stratified incidence rates
and Poisson regression to adjust for sociodemographic factors. ETS exposure
was associated with an increased risk of respiratory-illness-related school
absences (relative risk (RR) = 1.27, 95% confidence interval (CI): 1.04, 1.56).
Children living in a household with two or more smokers were at increased
risk of such absences (RR = 1.75, 95% CI: 1.33, 2.30). Children's asthma status
affected their response to ETS. Compared with unexposed children without asthma,
children with asthma were at increased risk of respiratory-illness-related
school absences when exposed to one (RR = 2.35, 95% CI: 1.49, 3.71) or two
or more (RR = 4.45, 95% CI: 2.80, 7.07) household smokers. Children without
asthma also had an increased risk if exposed to two or more smokers (RR =
1.44, 95% CI: 1.04, 2.00). Therefore, ETS exposure is associated with increased
respiratory-related school absenteeism among children, especially those with
asthma.