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.
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.
Jacoby
Peter A
PA
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.
Coates
Harvey L
HL
Arumugaswamy
Ashwini
A
Elsbury
Dimity
D
Stokes
Annette
A
Monck
Ruth
R
Finucane
Janine M
JM
Weeks
Sharon A
SA
Lehmann
Deborah
D
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
D014028:Tobacco Smoke Pollution