title: Passive cigarette smoke exposure and other risk factors for invasive pneumococcal disease in children: a case-control study.
abstract: OBJECTIVE
  To investigate whether passive cigarette smoke exposure increases the risk of invasive pneumococcal disease in children.
  
  
  METHODS
  In a population-based case-control study, 171 children aged 0 to 12 years with culture-confirmed invasive pneumococcal disease during the years 1994 to 2004 were identified. Two controls were matched to each case on age and patterns of Health Plan membership. We reviewed medical records of subjects and family members for information on household cigarette smoke exposure within 2 years of the diagnosis of invasive pneumococcal disease. We collected information on sex, race, pneumococcal vaccination, selected medical conditions, and medications in the 3 months before the diagnosis.
  
  
  RESULTS
  Similar proportions of cases (25%) and controls (30%) had definite or probable passive smoke exposure (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.47-1.2). Cases of invasive pneumococcal disease were more likely to be nonwhite than controls (OR = 4.4, 95% CI = 2.3-8.2). Elevated risk of invasive pneumococcal disease was found in subjects with recent pulmonary diagnoses (OR = 2.2, 95% CI = 1.2-4.0) and recent antibiotic use (OR = 1.6, 95% CI = 1.1-2.3).
  
  
  CONCLUSIONS
  Passive cigarette smoke exposure was not associated with invasive pneumococcal disease in this pediatric population. Invasive pneumococcal disease was associated with recent pulmonary diagnoses and recent antibiotic use.
authors.affiliation: Pediatric Infectious Diseases Specialist for Northwest Permanente in Portland, OR. colleen.chun@kp.org.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Chun
authors.affiliation: Investigator at the Center for Health Research in Portland, OR. sheila.weinmann@kpchr.org.
authors.forename: Sheila
authors.initials: S
authors.lastname: Weinmann
authors.affiliation: Retired Senior Research Network Consultant for the Center for Health Research in Portland, OR. spakk@comcast.net.
authors.forename: Karen
authors.initials: K
authors.lastname: Riedlinger
authors.affiliation: Emeritus Senior Investigator for the Center for Health Research in Portland, OR. mullooly@comcast.net.
authors.forename: John P
authors.initials: JP
authors.lastname: Mullooly
mesh_terms: D002140:California; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D011008:Pneumococcal Infections / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution