title: Smoking exposure and allergic sensitization in children according to maternal allergies.
abstract: 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.
authors.affiliation: Respiratory Diseases Department, Hôpital du Haut-Lévèque, Bordeaux, France. chantal.raherison@chu-bordeaux.fr
authors.forename: Chantal
authors.initials: C
authors.lastname: Raherison
authors.forename: Céline
authors.initials: C
authors.lastname: Pénard-Morand
authors.forename: David
authors.initials: D
authors.lastname: Moreau
authors.forename: Denis
authors.initials: D
authors.lastname: Caillaud
authors.forename: Denis
authors.initials: D
authors.lastname: Charpin
authors.forename: Christine
authors.initials: C
authors.lastname: Kopferschmitt
authors.forename: François
authors.initials: F
authors.lastname: Lavaud
authors.forename: André
authors.initials: A
authors.lastname: Taytard
authors.forename: Isabella Annesi
authors.initials: IA
authors.lastname: Maesano
mesh_terms: 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*
chemical_list: D014028:Tobacco Smoke Pollution