Smoking exposure and allergic sensitization in children according to maternal allergies.
BACKGROUND
Although the negative impact of environmental tobacco smoke (ETS) on airway diseases in children is well known, the effect of ETS on allergic sensitization is still debated.


OBJECTIVE
To evaluate how maternal allergies modulate the effect of tobacco exposure on allergic sensitization in childhood.


METHODS
Of 9000 children in grades 4 and 5 selected in 6 cities in France, 7798 participated in a survey that consisted of an epidemiologic questionnaire, skin prick testing to common allergens, and skin examination for eczema. Tobacco exposure was obtained from parent questionnaires.


RESULTS
Twenty-five percent of the children had allergic sensitization, 25.2% had eczema, 11.6% had allergic rhinitis, 9.9% had asthma, and 8.3% had exercise-induced asthma. Twenty percent of the children were exposed to tobacco in utero. Maternal exposure had a greater impact than paternal exposure on children's allergic sensitization. Prenatal exposure was more associated with sensitization than postnatal exposure. Children with maternal allergies and exposure to maternal ETS during pregnancy were at higher risk for sensitization to house dust mite (25.7% vs. 14.0%; odds ratio, 1.95; 95% confidence interval, 1.19-3.18; P = .006). In contrast, sensitization to food allergens was not associated with tobacco exposure.


CONCLUSIONS
Children exposed to maternal smoking had a higher risk of sensitization to house dust mite, especially when the mothers were allergic.
Raherison
Chantal
C
Respiratory Diseases Department, Hôpital du Haut-Lévèque, Bordeaux, France. chantal.raherison@chu-bordeaux.fr
Pénard-Morand
Céline
C
Moreau
David
D
Caillaud
Denis
D
Charpin
Denis
D
Kopferschmitt
Christine
C
Lavaud
François
F
Taytard
André
A
Maesano
Isabella Annesi
IA
D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D012882:Skin Tests; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000706:statistics & numerical data*
D014028:Tobacco Smoke Pollution