title: The effect of passive smoking on the risk of otitis media in Aboriginal and non-Aboriginal children in the Kalgoorlie-Boulder region of Western Australia.
abstract: OBJECTIVE
  To determine the risk of otitis media (OM) associated with passive smoking in young children, and any competing effect between passive smoking and childcare attendance.
  
  
  METHODS
  Prospective cohort study of 100 Aboriginal and 180 non-Aboriginal children born in Kalgoorlie Regional Hospital between 1 April 1999 and 31 January 2003. These children underwent routine clinical examinations by an ear, nose and throat specialist up to three times before the age of 2 years, and tympanometry at routine field follow-up visits from the age of 4 months. Childrens' mothers were interviewed at 1-3 weeks postpartum to provide sociodemographic data.
  
  
  METHODS
  Associations between OM and exposure to environmental tobacco smoke (ETS) and childcare attendance.
  
  
  RESULTS
  82 Aboriginal and 157 non-Aboriginal children attended for routine clinical examinations. OM was diagnosed at least once in 74% of Aboriginal children and 45% of non-Aboriginal children; 64% of Aboriginal children and 40% of non-Aboriginal children were exposed to ETS. Exposure to ETS increased the risk of specialist-diagnosed OM in Aboriginal children (OR, 3.54; 95% CI, 1.68-7.47); few attended childcare. Non-Aboriginal children exposed to ETS but not attending childcare were at increased risk of OM (OR, 1.91; 95% CI, 1.07-3.42) while those attending childcare had no increased smoking-related risk. Tympanometry was performed on 87 Aboriginal and 168 non-Aboriginal children; a type B tympanogram (suggesting fluid in the middle ear) was also associated with passive smoking in Aboriginal children.
  
  
  CONCLUSIONS
  Reducing the exposure of children to ETS is a public health priority, especially for the Aboriginal population. A smoke-free environment will help reduce the burden of OM.
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Jacoby
authors.forename: Harvey L
authors.initials: HL
authors.lastname: Coates
authors.forename: Ashwini
authors.initials: A
authors.lastname: Arumugaswamy
authors.forename: Dimity
authors.initials: D
authors.lastname: Elsbury
authors.forename: Annette
authors.initials: A
authors.lastname: Stokes
authors.forename: Ruth
authors.initials: R
authors.lastname: Monck
authors.forename: Janine M
authors.initials: JM
authors.lastname: Finucane
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Weeks
authors.forename: Deborah
authors.initials: D
authors.lastname: Lehmann
mesh_terms: D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D010033:Otitis Media / Q000208:ethnology* / Q000209:etiology; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D011634:Public Health; D012307:Risk Factors; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014904:Western Australia / Q000453:epidemiology
chemical_list: D014028:Tobacco Smoke Pollution