title: Postnatal Environmental Tobacco Smoke Exposure Related to Behavioral Problems in Children.
abstract: OBJECTIVE
  The purpose of this study was to examine the association between pre and post environmental tobacco smoke (ETS) exposure and behavioral problems in schoolchildren.
  
  
  METHODS
  In the cross-sectional 6 cities Study conducted in France, 5221 primary school children were investigated. Pre- and postnatal exposure to secondhand tobacco smoke at home was assessed using a parent questionnaire. Child's behavioral outcomes (emotional symptoms and conduct problems) were evaluated by the Strengths and Difficulties Questionnaire (SDQ) completed by the parents.
  
  
  RESULTS
  ETS exposure during the postnatal period and during both pre- and postnatal periods was associated with behavioral problems in children. Abnormal emotional symptoms (internalizing problems) were related to ETS exposure in children who were exposed during the pre- and postnatal periods with an OR of 1.72 (95% Confidence Interval (CI)= 1.36-2.17), whereas the OR was estimated to be 1.38 (95% CI= 1.12-1.69) in the case of postnatal exposure only. Abnormal conduct problems (externalizing problems) were related to ETS exposure in children who were exposed during the pre- and postnatal periods with an OR of 1.94 (95% CI= 1.51-2.50), whereas the OR was estimated to be 1.47 (95% CI=1.17-1.84) in the case of postnatal exposure only. Effect estimates were adjusted for gender, study center, ethnic origin, child age, low parental education, current physician diagnosed asthma, siblings, preterm birth and single parenthood.
  
  
  CONCLUSIONS
  Postnatal ETS exposure, alone or in association with prenatal exposure, increases the risk of behavioral problems in school-age children.
authors.affiliation: EPAR, INSERM UMR-S 1136, Paris, France; Department of General Practice, UPMC Université Paris 6, School of Medicine, Paris, France; EPAR, Université Pierre et Marie Curie, UMR-S 1136, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Chastang
authors.affiliation: EPAR, INSERM UMR-S 1136, Paris, France; EPAR, Université Pierre et Marie Curie, UMR-S 1136, Paris, France.
authors.forename: Nour
authors.initials: N
authors.lastname: Baïz
authors.forename: Jean Sébastien
authors.initials: JS
authors.lastname: Cadwallader
authors.affiliation: Department of General Practice, UPMC Université Paris 6, School of Medicine, Paris, France.
authors.forename: Jean Sébastien
authors.initials: JS
authors.lastname: Cadwalladder
authors.affiliation: Department of General Practice, UPMC Université Paris 6, School of Medicine, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Robert
authors.forename: John L
authors.initials: JL
authors.lastname: Dywer
authors.affiliation: EPAR, INSERM UMR-S 1136, Paris, France.
authors.forename: John
authors.initials: J
authors.lastname: Dywer
authors.affiliation: Service de Pneumologie, CHU Marseille, Marseille, France.
authors.forename: Denis André
authors.initials: DA
authors.lastname: Charpin
authors.affiliation: CHU Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Caillaud
authors.affiliation: CHU Strasbourg, Strasbourg, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: de Blay
authors.affiliation: CHU Bordeaux, Bordeaux, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Raherison
authors.affiliation: CHU Reims, Reims, France.
authors.forename: François
authors.initials: F
authors.lastname: Lavaud
authors.affiliation: EPAR, INSERM UMR-S 1136, Paris, France; EPAR, Université Pierre et Marie Curie, UMR-S 1136, Paris, France.
authors.forename: Isabella
authors.initials: I
authors.lastname: Annesi-Maesano
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000502:physiology / Q000523:psychology; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D000066553:Problem Behavior / Q000523:psychology*; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012574:Schools; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D014028:Tobacco Smoke Pollution
chemical_list: D014028:Tobacco Smoke Pollution