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. 2017 Feb 23;16(1):14.
doi: 10.1186/s12940-017-0223-7.

Lifetime secondhand smoke exposure and childhood and adolescent asthma: findings from the PIAMA cohort

Edith B Milanzi  1 , Bert Brunekreef  2   3 , Gerard H Koppelman  4   5 , Alet H Wijga  6 , Lenie van Rossem  3 , Judith M Vonk  5   7 , Henriëtte A Smit  3 , Ulrike Gehring  2
Affiliations

Lifetime secondhand smoke exposure and childhood and adolescent asthma: findings from the PIAMA cohort

Edith B Milanzi et al. Environ Health. .

Abstract

Background: Secondhand smoke (SHS) exposure is a modifiable risk factor associated with childhood asthma. Associations with adolescent asthma and the relevance of the timing and patterns of exposure are unclear. Knowledge of critical windows of exposure is important for targeted interventions.

Methods: We used data until age 17 from 1454 children of the Dutch population-based PIAMA birth cohort. Residential SHS exposure was assessed through parental questionnaires completed at ages 3 months, 1-8 (yearly), 11, 14, and 17 years. Lifetime exposure was determined as; a) time window-specific exposure (prenatal, infancy, preschool, primary school, and secondary school); b) lifetime cumulative exposure; c) longitudinal exposure patterns using latent class growth modeling (LCGM). Generalized estimation equations and logistic regression were used to analyze associations between exposure and asthma at ages 4 to 17 years, adjusting for potential confounders.

Results: With all three methods, we consistently found no association between SHS exposure and asthma at ages 4 to 17 years e.g. adjusted overall odds ratio (95% confidence interval) 0.67 (0.41-1.12), 1.00 (0.66-1.51) and 0.67 (0.41-1.11) for prenatal maternal active smoking, infancy, and preschool school time window exposures, respectively.

Conclusion: We assessed lifetime SHS exposure using different methods. Different timing and patterns of SHS exposure were not associated with an increased risk of asthma in childhood and adolescence in our study. More longitudinal studies could investigate effects of lifetime SHS exposure on asthma in adolescence and later life.

Keywords: Asthma; Environmental epidemiology; Longitudinal data; Secondhand smoke.

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Figures

Fig. 1
Fig. 1
Frequency distribution of time-window-specific SHS exposure
Fig. 2
Fig. 2
Longitudinal patterns for SHS exposure from birth until age 17
Fig. 3
Fig. 3
Adjusted overall and age-specific association of SHS exposure with asthma at ages 4 to 17 for prenatal, infant and preschool time-window-specific exposures. Adjusted for gas cooking at 3 months, overweight at 3 years, presence of pets at 3 months, presence of molds at 1 year, outdoor NO2 exposure at home address at birth, gender, active smoking, breastfeeding, older siblings at birth, parental atopy, parental education, region and maternal age
Fig. 4
Fig. 4
Adjusted association of SHS exposure with asthma at age 17 for primary and secondary school time windows and lifetime exposures. Adjusted for gas cooking at 3 months, overweight at 3 years, presence of pets at 3 months, presence of molds at 1 year, outdoor NO2 exposure at home address at birth, gender, active smoking, breastfeeding, older siblings at birth, parental atopy, parental education, region and maternal age
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