title: The prevalence and effects of environmental tobacco smoke exposure among inner-city children:  lessons for pediatric residents.
abstract: OBJECTIVE
  To determine the prevalence of environmental tobacco smoke (ETS) exposure, to explore the relationship between ETS exposure and the use of health services, and to examine the degree to which pediatric residents document ETS exposure status and counsel parents.
  
  
  METHODS
  In 2006, the authors recruited dyads of children (0-12 years old) and their mothers from an inner-city pediatric group practice clinic. Mothers completed a survey, and the authors searched the children's medical charts. The authors compared ETS-exposed children with nonexposed children using chi-square, t test, and ANOVA analyses. They also ran logistic regression analyses to examine the relationship between the use of health services and selected child and maternal variables.
  
  
  RESULTS
  More than 60% (142/232) of children were exposed to ETS, and more than 69% (99/142) of those children had a mother who smoked. ETS exposure significantly predicted the overall number of sick visits, even after controlling for sociodemographic confounders (odds ratio = 7.44; 95% confidence internal = 1.21-44.55). About 80% (187/232) of mothers reported that their child's pediatrician had counseled them on the dangers of ETS exposure. Less than half (105/232) of the children's charts included their ETS exposure status.
  
  
  CONCLUSIONS
  Although pediatric residents often counsel parents on the dangers of ETS exposure, educators should teach residents to regard ETS exposure status as a fifth vital sign. By screening for and documenting ETS exposure status, residents can identify at-risk children and parents, who could benefit from counseling.
authors.affiliation: Children's Hospital of Richmond, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA. pkum-nji@mcvh-vcu.edu
authors.forename: Phillip
authors.initials: P
authors.lastname: Kum-Nji
authors.forename: Linda D
authors.initials: LD
authors.lastname: Meloy
authors.forename: Lori
authors.initials: L
authors.lastname: Keyser-Marcus
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001249:Asthma / Q000453:epidemiology; D044383:Black People / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003231:Conjunctivitis / Q000453:epidemiology; D003376:Counseling / Q000706:statistics & numerical data; D004282:Documentation; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency; D016014:Linear Models; D009819:Office Visits / Q000706:statistics & numerical data; D010033:Otitis Media / Q000453:epidemiology; D010372:Pediatrics; D010817:Physician-Patient Relations; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000706:statistics & numerical data*; D014505:Urban Population; D014768:Virginia / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American
chemical_list: D014028:Tobacco Smoke Pollution