Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma.
- Author(s): Neophytou, Andreas M
- Oh, Sam S
- White, Marquitta J
- Mak, Angel CY
- Hu, Donglei
- Huntsman, Scott
- Eng, Celeste
- Serebrisky, Denise
- Borrell, Luisa N
- Farber, Harold J
- Meade, Kelley
- Davis, Adam
- Avila, Pedro C
- Thyne, Shannon M
- Rodríguez-Cintrón, William
- Rodríguez-Santana, José R
- Kumar, Rajesh
- Brigino-Buenaventura, Emerita
- Sen, Saunak
- Lenoir, Michael A
- Williams, L Keoki
- Benowitz, Neal L
- Balmes, John R
- Eisen, Ellen A
- Burchard, Esteban G
- et al.
Published Web Location
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225993/pdf/nihms-989472.pdfAbstract
BACKGROUND:Secondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose-responses using biomarkers of exposure have not been widely reported. OBJECTIVES:Assess dose-response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature. METHODS:We performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose-response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines. RESULTS:The OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose-response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures. CONCLUSIONS:Exposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose-response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.
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