title: Exposure to environmental tobacco smoke and respiratory tract infections in pre-school children - a cross-sectional study in Poland.
abstract: OBJECTIVE
  Knowledge of the harmful influence of environmental tobacco smoke (ETS) has a positive impact on changing social behaviours worldwide. In many homes smoking is totally prohibited; in some others, partial limitations of tobacco consumption have been introduced.
  
  
  OBJECTIVE
  To study the correlation between the adopted rules of tobacco use in homes of 3-year-olds, and the kind and frequency of acute respiratory system infections within a 6-month period of attending pre-schools.
  
  
  METHODS
  The study was performed among children attending municipal pre-schools in Białystok, Poland. The data was collected by anonymous questionnaires completed by the parents of 302 children aged 3 years chosen randomly from 1,200 children attending 51 pre-schools. The exposure of children to tobacco smoke was measured by determining cotinine to creatinine ratio (CCR) in urine.
  
  
  RESULTS
  In the 150 families of children who were surveyed, 210 were smokers. Every day, the smokers consisted of fathers (37.3%) and mothers (23.6%). The 3-year-old children were divided into 3 groups according to smoking habits in their homes: 28.5% of the children under examination came from homes where tobacco smoking was forbidden (mean CCR - 15.21 ng/mg, SD=11.86), 26.2% came from homes where tobacco was smoked in separate rooms (mean CCR - 65.75 ng/ml, SD=81.51), 45.4% lived in homes where no rules connected with smoking had been established (mean CCR - 61.75 ng/ml, SD= 70.29). During the analyzed period of 6 months, 85% of the children had at least 1 respiratory tract infection (60% - upper, 16.9% - lower, 16.5% - upper and lower, 7.1% - otitis media).
  
  
  CONCLUSIONS
  The majority of the 3-year-old children who had lower respiratory tract infections required antibiotics and hospitalization. Living in a home where no tobacco rules were established may cause an increase of respiratory tract infections.
authors.affiliation: Department of Family Medicine and Community Nursing, Medical University, Bialystok, Poland.
authors.forename: Dorota Emilia
authors.initials: DE
authors.lastname: Bielska
authors.affiliation: Department of Family Medicine, Medical University, Wroclaw, Poland.
authors.forename: Donata
authors.initials: D
authors.lastname: Kurpas
authors.affiliation: Family Medicine Department, Medical University, Warsaw, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Nitsch-Osuch
authors.affiliation: Department of Clinical Toxicology and Environmental Disease, Jagiellonian University Collegium Medicum, Cracow, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Gomółka
authors.affiliation: Department of Pediatric Infectious Diseases, Medical University, Bialystok, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Ołdak
authors.affiliation: Department of Family Medicine and Community Nursing, Medical University, Bialystok, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Chlabicz
authors.affiliation: Department of Family Medicine and Community Nursing, Medical University, Bialystok, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Owłasiuk
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D002675:Child, Preschool; D003367:Cotinine / Q000652:urine*; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D011044:Poland / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000139:chemically induced / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution; D003404:Creatinine; D003367:Cotinine