Table 6.21

Atopy studies of markers for exposure to secondhand smoke

Farooqi and Hopkin 1998 Retrospective cohort 1975–1984 birth cohort
N = 1,934
United Kingdom (Oxfordshire)
  • Lg regression of predictors of atopic disease
  • Maternal atopy
  • Maternal smoking
  • 45.4% (879) developed atopic disorder (OR* = 1.16 [95% CI, 0.95–1.43])
  • 25% developed asthma (OR = 1.29[95% CI, 1.03–1.63], p <0.05)
  • 25% developed hay fever (OR = 1.04 [95% CI, 0.82–1.32])
  • 19% developed eczema (OR = 0.97 [95% CI, 0.75–1.26])
No significant association was found between maternal smoking and atopic symptoms
Lewis and Britton 1998 1970s birth cohort
N = 6,068 with complete follow-up data
Follow-up at 5, 10, and 16 years of age
United Kingdom
  • Wheeze
  • Eczema
  • Hay fever
  • Wheeze increased at 16 years of age in relation to maternal smoking
  • There was no evidence to support maternal smoking as a contributing factor to the development of atopy
Suggested that an independent effect of smoking reduced the effect of allergic disease; hay fever was less common with high levels of maternal smoking
Tariq et al. 1998 Birth cohort
N = 1,218
Followed to 4 years of age
Serum and cord IgE
  • 27% had symptoms of allergic disease by 4 years of age
  • Parental smoking did not increase allergen sensitization among children
Family history of atopy was deemed the most important risk
Kalyoncu et al. 1999 N = 738
358 boys, 380 girls
Aged 6–13 years
Turkey (Ankara)
  • Questionnaire
  • Prevalence of asthma, wheeze, rhinitis, and atopic dermatitis in the last 12 months
  • Secondhand smoke exposure affected occurrence of allergic rhinitis (OR = 1.84 [95% CI, 1.3–3.0])
  • Occurrence of any type of allergic disease or symptoms in the past 12 months was associated with secondhand smoke exposure (OR = 1.74 [95% CI, 1.18–2.56])
Kulig et al. 1999 Birth cohort
N = 342 of 1,314 from initial cohort
Studied from infancy to early childhood
Measured at 1, 2, and 3 years of age
Children were grouped into 4 exposure categories, depending on parental smoking Germany
  • Specific IgE
  • Questionnaire assessed parental smoking at birth, and at 18 and 36 months
  • Allergic sensitization to food and aeroallergens
  • By 3 years of age with prenatal exposure (OR = 2.3 [95% CI, 1.1–4.6]) and postnatal exposure (OR = 2.2 [95% CI, 0.9–5.9]) to secondhand smoke, there was an increased risk of food allergy
  • There was no association between secondhand smoke and cord blood IgE
Effect was restricted to food allergens; there were no consistent dose-response patterns; no association between secondhand smoke and sensitization to inhaled allergens was found
Lindfors et al. 1999 N = 189 children with asthma
Aged 1–4 years
  • Specific IgE antibody to cat and dog allergens
  • Questionnaire
  • House dust analysis
Secondhand smoke increased the risk for sensitization to cat (OR = 2.2 [95% CI, 0.9–4.9]) and dog (OR = 2.0 [95% CI, 0.9–4.5])There was an interaction between secondhand smoke exposure, window pane condensation, and a high level of cat allergen (OR = 42 [95% CI, 3.7–472.8]); wide CI
Suárez-Varela et al. 1999 Cross-sectional
N = 3,948
Aged 6–7 years
Spain (Valencia)
  • Rhinitis
  • Atopic dermatitis
  • Asthma
  • Secondhand smoke exposure
  • Severity of atopic disease increased in lower social classes
  • Secondhand smoke exposure increased in lower social classes
Vinke et al. 1999 N = 20
10 exposed and 10 unexposed
Immunohistochemical staining for Langerhans cells, T cells, B cells, granulocytes, macrophages, mast cells, and eosinophils in the nasal mucosaThere were more IgE-positive cells and eosinophils in the nasal mucosa of children exposed to secondhand smokeSecondhand smoke leads to a tissue infiltrate that resembles infiltrates in the nasal mucosa of children with allergy; no significant sensitization was found in nasal mucosa with increased IgE on cell surface
Kaan et al. 2000 397 high-risk infants in a controlled trial to prevent asthma and allergic disease
Canada (Vancouver and Winnepeg)
  • Total IgE
  • Serum cotinine in cord blood taken at birth
There was no correlation between cord blood IgE and cotinine levelsNone
Tariq et al. 2000 Birth cohort
N = 1,218
Tested at 1, 2, and 4 years of age 981 were skin-prick tested
Cord IgE from 1,064
United Kingdom (Isle of Wight)
  • Skin testing
  • Cord blood IgE
  • Maternal smoking did not increase allergen sensitization at 4 years of age
  • There was an inverse association between maternal smoking during and after pregnancy and allergen sensitization at 4 years of age
Smoking while pregnant has no effect on cord blood IgE at birth
Ulrik and Backer 2000 408 participants from case histories of 983 children
Aged 7–17 years Longitudinal surveys were 6 years apart
Denmark (Copenhagen)
  • Skin-prick test
  • Total serum IgE
  • Pulmonary function
  • Airway responsiveness
There was an increased risk of a positive skin prick at second survey with exposure to maternal smoking (OR = 2.0 [95% CI, 1.3–3.1], p = 0.002)None
Zacharasiewicz et al. 2000 N = 18,606 children
Aged 6–9 years
Nasal symptoms suggestive of atopic rhinitis
  • Maternal smoking during pregnancy and/or breastfeeding increased risks for rhinitis in the last 12 months (OR = 1.28 [95% CI, 1.07–1.52])
  • ≥50 cigarettes smoked at home: OR = 2.9 (95% CI, 1.21–6.95)
There was a demonstrated dose-response pattern for allergic symptoms depending on the amount of secondhand smoke exposure

OR = Odds ratio.

CI = Confidence interval.

IgE = Immunoglobulin E.

From: 6, Respiratory Effects in Children from Exposure to Secondhand Smoke

Cover of The Health Consequences of Involuntary Exposure to Tobacco Smoke
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
Office on Smoking and Health (US).

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