Atopy, passive smoking, respiratory infections and asthma among children from kindergarten and elementary school

CONTEXT: It has been demonstrated that children exposed to parents who smoke have more respiratory infections and asthma. OBJECTIVE: To study the association of both respiratory infections and asthma attacks with atopy, passive smoking and time spent daily at school, among children aged 4 to 9 years old from a kindergarten and elementary school in the city of São Paulo between May and July of 1996. TYPE OF STUDY: Descriptive study. SETTING: A kindergarten and elementary school with linkages to Universidade Federal de São Paulo (UNIFESP)/Escola Paulista de Medicina. PARTICIPANTS: 183 children between 4 and 9 years old. MAIN MEASUREMENTS: A questionnaire consisting of 31 questions was answered by the parents of 183 children, and skin tests for inhaled antigens were performed on 88 children whose parents had given prior agreement for the procedure. RESULTS: Among the children, 51% had had respiratory infections during the preceding 3 months and 25.7% were asthmatic, of whom 52.1% had had one or more asthma attacks during the preceding 3 months. Children exposed to passive smoking did not have more respiratory infections or asthma attacks in comparison with those not exposed. We observed a significant association between atopic disorders in parents and children who were not exposed to passive smoking. There were also associations between atopic disorders in parents and asthma attacks in their infants, and between such disorders and a higher incidence of respiratory infections in the infants during the preceding 3 months. However, the presence of two or more positive skin tests for allergies did not have a correlation with respiratory infections and asthma attacks in this sample. In addition to this, children who studied full time at school did not have a higher occurrence of respiratory infections and asthma attacks. CONCLUSIONS: The presence of respiratory infections and asthma was associated with atopic parents but not with the presence of two or more positive skin tests for allergies among the children. Also, respiratory infections and asthma attacks were not associated with smoking parents or with the length of time spent by the children at school.CONTEXTO: Foi demonstrado que crianças de pais fumantes estão mais predispostas a infecções respiratórias e asma. OBJETIVO: Estudar a associação de infecções respiratórias e crises de asma em crianças de quatro a nove anos de idade, matriculadas em uma escola que funciona como pré-escola e 1o. grau em São Paulo, Capital, nos meses de maio a julho de 1996, com presença de atopia, exposição ao fumo passivo e tempo de permanência na escola (parcial ou integral). TIPO DE ESTUDO: Estudo descritivo. LOCAL: Pré-escola e de primeiro grau da Universidade Federal de São Paulo (UNIFESP). CASUÍSTICA: 183 crianças, sendo 104 meninos e 79 meninas, entre 4 e 9 anos. VARIÁVEIS ESTUDADAS: Foi administrado um questionário contendo 31 questões aos responsáveis pelas crianças e realizados 88 testes cutâneos de alergia para inalantes, nas crianças cujos pais haviam fornecido consentimento prévio. RESULTADOS: Do total de crianças, 51% tiveram infecções respiratórias nos últimos três meses e 25,7% eram asmáticas, sendo que 52,1% delas tiveram uma ou mais crises nos últimos três meses. As crianças expostas à fumaça de cigarro no domicílio não tiveram mais infecções respiratórias e crises de asma que as não-expostas. A positividade a dois ou mais testes cutâneos de alergia não se correlacionou significantemente à presença de infecções respiratórias e crises de asma nas crianças estudadas, embora tenha havido associação estatisticamente significante entre pais com história de atopia e filhos com mais infecções respiratórias e/ou crises de asma, assim como pais com história de atopia e filhos com menor exposição à fumaça de cigarro. As crianças com permanência em tempo integral na escola não tiveram maior ocorrência de infecções respiratórias e crises de asma. CONCLUSÃO: A presença de infecções respiratórias e crises de asma está associada à atopia dos pais, mas não à presença de positividade a dois ou mais testes cutâneos de alergia nas crianças. Por outro lado, a presença de infecções respiratórias e crises de asma não estiveram associadas com exposição passiva à fumaça de cigarro no domicílio e com tempo de permanência na escola.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina PreventivaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina, Doenças RespiratóriasUNIFESP, EPM, Depto. de Medicina PreventivaUNIFESP, EPM, Depto. de Medicina, Doenças RespiratóriasSciEL

Atopy, passive smoking, respiratory infections and asthma among children from kindergarten and elementary school

CONTEXT: It has been demonstrated that children exposed to parents who smoke have more respiratory infections and asthma. OBJECTIVE: To study the association of both respiratory infections and asthma attacks with atopy, passive smoking and time spent daily at school, among children aged 4 to 9 years old from a kindergarten and elementary school in the city of São Paulo between May and July of 1996. TYPE OF STUDY: Descriptive study. SETTING: A kindergarten and elementary school with linkages to Universidade Federal de São Paulo/Escola Paulista de Medicina. PARTICIPANTS: 183 children between 4 and 9 years old. MAIN MEASUREMENTS: A questionnaire consisting of 31 questions was answered by the parents of 183 children, and skin tests for inhaled antigens were performed on 88 children whose parents had given prior agreement for the procedure. RESULTS: Among the children, 51% had had respiratory infections during the preceding 3 months and 25.7% were asthmatic, of whom 52.1% had had one or more asthma attacks during the preceding 3 months. Children exposed to passive smoking did not have more respiratory infections or asthma attacks in comparison with those not exposed. We observed a significant association between atopic disorders in parents and children who were not exposed to passive smoking. There were also associations between atopic disorders in parents and asthma attacks in their infants, and between such disorders and a higher incidence of respiratory infections in the infants during the preceding 3 months. However, the presence of two or more positive skin tests for allergies did not have a correlation with respiratory infections and asthma attacks in this sample. In addition to this, children who studied full time at school did not have a higher occurrence of respiratory infections and asthma attacks. CONCLUSIONS: The presence of respiratory infections and asthma was associated with atopic parents but not with the presence of two or more positive skin tests for allergies among the children. Also, respiratory infections and asthma attacks were not associated with smoking parents or with the length of time spent by the children at school