title: Association of tobacco smoke exposure and atopic sensitization.
abstract: BACKGROUND
  Forty million children are regularly exposed to environmental tobacco smoke (ETS) each year, increasing their risk for premature death and middle ear and acute respiratory infections. Early life exposure to ETS also is clearly associated with wheezing. However, there is no clear understanding of the influence of ETS on the development of allergic sensitization.
  
  
  OBJECTIVE
  To determine the association of combined exposure to ETS and indoor allergens on IgE sensitization to aeroallergens in children.
  
  
  METHODS
  This case-control study enrolled 116 cases and 121 controls from low-income families from Kansas City, Missouri. The adjusted odds ratio was calculated using a logistic model to assess the association between ETS and allergic sensitization using dust allergen levels as a covariate.
  
  
  RESULTS
  Thirty-six percent of atopic children and 39% of controls were exposed to ETS (P < .05). Unadjusted analyses showed no significant influence of ETS on IgE sensitization to indoor allergens. Logistic regression analyses also showed no significant influence of ETS on sensitization when adjusted for levels of allergens in the home dust and family history of allergic rhinitis.
  
  
  CONCLUSIONS
  These data suggest that ETS exposure was not associated with IgE sensitization to indoor allergens, even when home allergen levels were taken into consideration. Further understanding of how components of tobacco smoke influence the immune response is necessary to interpret the disparate findings across studies.
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri. Electronic address: ceciaccio@cmh.edu.
authors.forename: Christina E
authors.initials: CE
authors.lastname: Ciaccio
authors.forename: Anita C
authors.initials: AC
authors.lastname: DiDonna
authors.forename: Kevin
authors.initials: K
authors.lastname: Kennedy
authors.forename: Charles S
authors.initials: CS
authors.lastname: Barnes
authors.forename: Jay M
authors.initials: JM
authors.lastname: Portnoy
authors.forename: Lanny J
authors.initials: LJ
authors.lastname: Rosenwasser
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D001249:Asthma / Q000209:etiology* / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004391:Dust / Q000276:immunology*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology* / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D039981:Pyroglyphidae / Q000276:immunology*; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000209:etiology* / Q000276:immunology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D000485:Allergens; D004391:Dust; D014028:Tobacco Smoke Pollution; D007073:Immunoglobulin E