Exposição ao fumo do tabaco (EFT) e morbilidade respiratória em crianças em idade escolar
Environmental tobacco smoke (ETS) exposure and respiratory morbidity in school age children
C. Constanta,
, I. Sampaioa, F. Negreirob, P. Aguiarb, A.M. Silvac, M. Salgueiroc, T. Bandeirac
Corresponding author
a Serviço de Pediatria, Departamento da Criança e da Família, Clínica Universitária de Pediatria, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte EPE, Lisboa, Portugal
b Departamento de Bioestatística, Eurotrials - Consultores Científicos, S.A., Lisboa, Portugal
c Serviço de Pediatria, Núcleo de Estudos da Função Respiratória, Sono e Ventilação do Departamento da Criança e da Família, Clínica Universitária de Pediatria, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte EPE, Lisboa, Portugal
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"apellidos" => "Constant" "email" => array:1 [ 0 => "carolinaconstant@sapo.pt" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "Sampaio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "F." "apellidos" => "Negreiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Aguiar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "A.M." "apellidos" => "Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "M." "apellidos" => "Salgueiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "T." "apellidos" => "Bandeira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Serviço de Pediatria, Departamento da Criança e da Família, Clínica Universitária de Pediatria, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte EPE, Lisboa, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Bioestatística, Eurotrials - Consultores Científicos, S.A., Lisboa, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Serviço de Pediatria, Núcleo de Estudos da Função Respiratória, Sono e Ventilação do Departamento da Criança e da Família, Clínica Universitária de Pediatria, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte EPE, Lisboa, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Autor para correspondência." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Environmental tobacco smoke (ETS) exposure and respiratory morbidity in school age children" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-06-24" "fechaAceptado" => "2010-09-09" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec565828" "palabras" => array:5 [ 0 => "Exposição ao fumo do tabaco (EFT)" 1 => "Questionário" 2 => "Sibilância" 3 => "Função respiratória" 4 => "Crianças" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec565829" "palabras" => array:5 [ 0 => "Environmental tobacco smoke (ETS)" 1 => "Questionnaire" 2 => "Wheezing" 3 => "Pulmonary function testing" 4 => "Children" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span><span class="elsevierStyleSectionTitle">Introdução</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A exposição ao fumo do tabaco (EFT) é factor de risco para Doença Pulmonar Obstrutiva Crónica e um problema major de saúde pública. A EFT pré e/ou pós-natal determina redução precoce da função pulmonar e aumento da morbilidade respiratória, dependente da dose. Tem sido sugerido que a EFT domiciliária é influenciada por factores socioeconómicos.</p></span> <span><span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudo de rastreio epidemiológico transversal de dados de 313 crianças (52% rapazes) de 4 Escolas Básicas de Lisboa [1.° ano (54%) e 4.° ano]. A EFT e sintomatologia respiratória foram avaliadas a partir de questionário auto-preenchido pelos pais. Todas as crianças efectuaram espirometria na escola e 54% foram consideradas aceitáveis de acordo com critérios ATS/ERS. Efectuou-se análise descritiva e bivariada das variáveis com maior interesse e análise de regressão logística múltipla ajustada para as variáveis com significado clínico/estatístico.</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Em 41% dos casos a criança convivia com fumadores no domicílio (EFT na gravidez 18%, mãe fumadora 32%, pai fumador 38%). Os pais fumadores tinham escolaridade inferior e ocupações menos qualificadas. Tosse foi mais frequente nas crianças com mãe fumadora (OR ajustado = 2,1 95%CI 1,1–4,0) e sibilância nas crianças com EFT na gravidez e com mãe/pai fumadores. Todas as diferenças foram significativas (p<span class="elsevierStyleHsp" style=""></span>< <span class="elsevierStyleHsp" style=""></span>0,05). Não se encontrou associação entre educação parental e sintomatologia respiratória ou ETF e infecções respiratórias/asma/diminuição de valores espirométricos.</p></span> <span><span class="elsevierStyleSectionTitle">Conclusão</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A EFT é frequente em crianças em idade escolar em Lisboa e condiciona morbilidade respiratória significativa. Intervenções dirigidas devem ter em conta condições sociais. Neste estudo a espirometria de campo foi pouco útil na detecção precoce de diminuição da função pulmonar em crianças associada à EFT.</p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span><span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Tobacco smoke is a risk factor for Chronic Obstructive Pulmonary Disease and a major public health problem. Prenatal maternal smoking and post-natal environmental tobacco smoke (ETS) lead to dose-dependent decrease in lung function and respiratory morbidity. Influence of different socioeconomic indicators and ETS in the home has also been suggested.</p></span> <span><span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Data on 313 children (52% male) from 4 public schools in Lisbon was analyzed [1st (46%) and 4th graders]. ETS assessment and respiratory symptoms were based on a self-answered questionnaire. All children performed standard spirometry in the school setting and 54% were acceptable according to ATS/ERS criteria. Descriptive and bivariate analysis of the most relevant variables was done, followed by multiple logistic regression analysis adjusted to the variables with clinical/statistical relevance.</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">ETS in the home was found in 41% (maternal smoking during pregnancy 18%, smoking mother 32%, smoking father 38%). Smoking fathers had lower education and less qualified occupation. Cough was more frequent in children with a smoking mother (adjusted OR = 2.1 95CI 1.1–4.0) and wheezing in children with maternal smoking during pregnancy and smoking parents. All differences were significant (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05). No association was found between parental education and cough/wheeze or ETS and respiratory infections/asthma/decreased spirometric values.</p></span> <span><span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Children in Lisbon are frequently exposed to ETS which results in significant respiratory morbidity. Targeted interventions must have social conditions in consideration. In this study, field spirometry was not helpful in early detection of lung function disability in children associated with ETS.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:38 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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Article information
ISSN: 08732159Original language: Portuguese
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| 2021 January | 33 | 17 | 50 |
| 2020 December | 20 | 11 | 31 |
| 2020 November | 50 | 22 | 72 |
| 2020 October | 29 | 24 | 53 |
| 2020 September | 50 | 20 | 70 |
| 2020 August | 51 | 20 | 71 |
| 2020 July | 63 | 17 | 80 |
| 2020 June | 63 | 15 | 78 |
| 2020 May | 54 | 16 | 70 |
| 2020 April | 68 | 22 | 90 |
| 2020 March | 60 | 14 | 74 |
| 2020 February | 75 | 43 | 118 |
| 2020 January | 65 | 22 | 87 |
| 2019 December | 61 | 24 | 85 |
| 2019 November | 63 | 8 | 71 |
| 2019 October | 53 | 21 | 74 |
| 2019 September | 53 | 27 | 80 |
| 2019 August | 110 | 18 | 128 |
| 2019 July | 104 | 12 | 116 |
| 2019 June | 112 | 22 | 134 |
| 2019 May | 109 | 23 | 132 |
| 2019 April | 122 | 32 | 154 |
| 2019 March | 153 | 23 | 176 |
| 2019 February | 157 | 18 | 175 |
| 2019 January | 155 | 25 | 180 |
| 2018 December | 110 | 19 | 129 |
| 2018 November | 55 | 4 | 59 |
| 2018 October | 85 | 9 | 94 |
| 2018 September | 34 | 8 | 42 |
| 2018 August | 25 | 30 | 55 |
| 2018 July | 39 | 22 | 61 |
| 2018 June | 36 | 21 | 57 |
| 2018 May | 66 | 28 | 94 |
| 2018 April | 51 | 30 | 81 |
| 2018 March | 64 | 36 | 100 |
| 2018 February | 32 | 12 | 44 |
| 2018 January | 56 | 14 | 70 |
| 2017 December | 64 | 17 | 81 |
| 2017 November | 28 | 14 | 42 |
| 2017 October | 37 | 17 | 54 |
| 2017 September | 22 | 7 | 29 |
| 2017 August | 18 | 23 | 41 |
| 2017 July | 21 | 12 | 33 |
| 2017 June | 22 | 21 | 43 |
| 2017 May | 32 | 11 | 43 |
| 2017 April | 8 | 2 | 10 |
| 2017 March | 12 | 2 | 14 |
| 2017 February | 11 | 6 | 17 |
| 2017 January | 12 | 5 | 17 |
| 2016 December | 21 | 8 | 29 |
| 2016 November | 8 | 3 | 11 |
| 2016 October | 9 | 3 | 12 |
| 2016 September | 12 | 4 | 16 |
| 2016 August | 2 | 4 | 6 |
| 2016 July | 4 | 10 | 14 |
Show all
