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Relationship of endotoxin and tobacco smoke exposure to wheeze and diurnal peak expiratory flow variability in children and adolescents
Author(s) -
LAWSON Joshua A.,
DOSMAN James A.,
RENNIE Donna C.,
BEACH Jeremy,
NEWMAN Stephen C.,
SENTHILSELVAN Ambikaipakan
Publication year - 2011
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2010.01911.x
Subject(s) - wheeze , cotinine , medicine , asthma , tobacco smoke , cross sectional study , passive smoking , saliva , pediatrics , environmental health , nicotine , pathology
Background and objective: The relationship between endotoxin exposure and asthma severity (wheeze and airways obstruction) is not well described. The effects of endotoxin and tobacco smoke exposure on self‐reported wheeze and diurnal PEF variability (DV‐PEF) were examined in children aged 6–18 years with asthma or wheeze. Methods: A cross‐sectional study was performed in a rural area. From this study, children who reported wheeze in the previous 12 months or a physician diagnosis of asthma ( n = 98) were selected for a case–control study. These subjects, who were the basis for the present analysis, completed: (i) a home environmental assessment, including dust collection to measure endotoxin levels: (ii) a clinic visit, including saliva collection to measure cotinine levels; and (iii) 2 week monitoring of twice daily symptom records, including wheeze, and PEF to calculate DV‐PEF. Results: Among these children, 22.4% reported wheeze during the monitoring period. Greater DV‐PEF was associated with higher endotoxin loads in play areas ( P < 0.05). The association between salivary cotinine levels and high DV‐PEF was modified by gender. In females, higher cotinine levels were associated with an increased risk of high DV‐PEF compared with lower cotinine levels ( P < 0.05), but this was not observed among males. Conclusions: Higher endotoxin exposure was associated with greater DV‐PEF among children with asthma or wheeze. While previous studies have suggested that endotoxin exposure protects against the development of asthma, individuals with the disease should avoid high exposure levels to limit exacerbations. The effect of tobacco smoke exposure on lung health may differ between male and female children.