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Int J Pediatr Otorhinolaryngol. 1999 Oct 5;49 Suppl 1:S275-8.

Relationship between passive smoking, recurrent respiratory tract infections and otitis media in children.

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Department of Pediatric Otolaryngology, University Medical School of Lodz, Institute of Pediatrics, Poland.


The cause of upper respiratory tract infections (URTI) are multifactorial (enlarged adenoid, environmental conditions, staying at the care centers, smoking parents, allergy). Directly, viral infection causes damage to the ciliary cells and mucociliary clearance in the nasopharynx and Eustachian tube, promotes tubal occlusion and provokes otitis media. Enlarged adenoids reduce ventilation to the nasopharynx, increase accumulation of the secretion and provide a good condition for bacteria.


Evaluation of the factors playing a role in recurrent URTI and otitis media in children. Clinical and histopathological examination of adenoid tissue of children who were passive smokers and children who were not exposed to cigarette smoke. Evaluation of the difference between ciliary-mucous transport among passive smokers and children not exposed to cigarette smoke.


The analysis of interview questionnaires in 1000 children aged 3-14 years. Histopathological examinations of adenoid tissue excised in the group of children of recurrent upper respiratory tract infections and serous otitis media exposed and not exposed to cigarette smoke.


Among the risk factors for URTI, the most important are: (1) socio-economic conditions; (2) staying at day care centers; and (3) passive smoking. Allergy was confirmed in 35-38% of URTI children. Surgical treatment was undertaken in 11.4-32.5% of URTI children (tonsilloadenoidectomy). Histopathological and ultrastructural evaluation of adenoid tissue in passive smoking children indicates significant differences to children not exposed to cigarette smoke.

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