title: Low birth weight and environmental tobacco smoke increases the risk of wheezing in adolescents: a retrospective cohort study.
abstract: BACKGROUND
  Low birth weight (LBW) and environmental tobacco smoke (ETS) exposure are each associated with wheezing in children. This study was designed to examine the combined association of LBW and ETS with wheezing.
  
  
  METHODS
  A retrospective birth cohort analysis linked with a national survey of allergic disorders among 1,018,031 junior high school students in Taiwan (1995-1996) was analyzed. The reported incidence of wheezing (yes or no) and ETS exposure (4 categories: 0, 1-20, 21-40 and greater than or equal to 41 household cigarettes per day) were obtained from validated questionnaires. Multiple logistic regression models were used to assess the associations of interest.
  
  
  RESULTS
  There were 844,003 (83%) subjects analyzed after the exclusion criteria. LBW was associated with an increased risk of reporting ever wheezing (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.01-1.16), current wheezing (OR = 1.09, 95% CI = 1.00-1.20) and wheezing with exercise (OR = 1.11, 95% CI = 1.02-1.21) within the smoke-free cohort. Higher ETS exposure correlated to a higher risk of wheezing (ever, current and with exercise). With ETS exposure, adolescents from the lowest birth weight cohorts were more likely to report wheezing (ever, current and with exercise).
  
  
  CONCLUSIONS
  ETS and LBW each has been related to increasing public health risk for respiratory symptoms among adolescents. Furthermore, LBW may aggravate the risk among those exposed to ETS. LBW, ETS and associated respiratory impairments may deserve special attention as part of a comprehensive environmental health risk assessment directed toward prevention and intervention.
authors.forename: Meng-Hung
authors.initials: MH
authors.lastname: Lin
authors.forename: James L
authors.initials: JL
authors.lastname: Caffrey
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Pau-Chung
authors.initials: PC
authors.lastname: Chen
authors.forename: Ching-Chun
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan. whocmu@gmail.com.
authors.forename: Wen-Chao
authors.initials: WC
authors.lastname: Ho
authors.forename: Trong-Neng
authors.initials: TN
authors.lastname: Wu
authors.forename: Ruey-Shiung
authors.initials: RS
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012135:Respiratory Sounds / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013624:Taiwan; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution