Passive smoking and allergies in children
Study design and objective
The aim of this prospective birth cohort study was to investigate the relationship between in utero and postnatal exposure of children to environmental tobacco smoke and IgE-sensitization.
Study population and primary end-points
The study was conducted in Stockholm, Sweden and followed-up families with young children. A total of 4089 families participated and answered questionnaires which survey smoking habits in the family and allergic symptoms in the children. Questionnaires were completed when the children was aged 2 months, 1, 2 and 4 years old. Blood tests for IgE antibodies to common food and inhalant allergens were performed at age 4 years.
Results
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Early exposure of children to environmental tobacco smoke was significantly associated with increased risk for sensitization to mold, cat, horse, and food allergens at 4 years but not to seasonal allergens such as pollens.
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A dose-response relationship for passive smoking exposure at 2 months and IgE sensitization was observed.
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IgE sensitization was strongest in cases of biparental smoking, followed by maternal smoking, and then paternal smoking.
Weakness of the study
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There is a difficulty in distinguishing the effects of prenatal from postnatal exposure to tobacco smoke.
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There might be bias due to the common and early use of daycare facilities in
Sweden. 75% of the study cohort was at daycare centers by age 2.
The study was funded by the Swedish Heart and Lung Foundation, Stockholm County Council, the Gillbergska Foundation and the Swedish Asthma and Allergy Foundation, the Swedish Foundation for Health Care Sciences and Allergy Research, and the Swedish Research Council.
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