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Anastasiadis X, Matsas A, Panoskaltsis T, Bakas P, Papadimitriou DT, Christopoulos P. Impact of Chemicals on the Age of Menarche: A Literature Review. Children (Basel) 2023; 10:1234. [PMID: 37508731 PMCID: PMC10378553 DOI: 10.3390/children10071234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/01/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
A growing body of evidence suggests that chemicals interfere with the age of onset of menarche. We conducted a review in order to demonstrate the relationship between several categories of chemicals and menarche. We searched for English language papers using the Medline/PubMed database until April 2023. The chemical factors found to affect menarche were prenatal and antenatal smoke, phthalates, phenols, organochlorines, perfluoroalkyls and polyfluoroalkyls, metals, air pollutants and polybrominated diphenyl ethers. Low or high exposure to each chemical compound could affect the age of menarche, leading to early or delayed menarche. Furthermore, the results show that intrauterine exposure may have a different impact from antenatal exposure. There is evidence that endocrine-disrupting chemicals affect the age of menarche, but more research needs to be conducted.
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Affiliation(s)
- Xristos Anastasiadis
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Alkis Matsas
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Bakas
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Dimitrios T Papadimitriou
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Christopoulos
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
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Bigambo FM, Wang D, Niu Q, Zhang M, Mzava SM, Wang Y, Wang X. The effect of environmental factors on precocious puberty in children: a case-control study. BMC Pediatr 2023; 23:207. [PMID: 37127587 PMCID: PMC10149633 DOI: 10.1186/s12887-023-04013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/15/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Recently the prevalence of precocious puberty development is increasing among Chinese children. Proper understanding of the risk factors for precocious puberty in children is pivotal as could help to improve children's health. This study aims to evaluate the effect of environmental factors on precocious puberty in children. METHODS We matched the cases and controls by age at the ratio of 1:1 (201 cases and 201 controls) for girls and 1:4 (24 cases and 96 controls) for boys. We used conditional logistic regression to explore the effect of environmental factors on precocious puberty, and a random forest model to identify the most important risk factor. RESULTS In the multivariate regression, cesarean section (OR = 1.99, 95% CI: 1.05, 3.76), child body mass index [BMI] (OR = 1.25, 95% CI: 1.10, 1.43), maternal BMI (OR = 1.13, 95%CI: 1.01, 1.26), and exposure to secondhand smoke several times a month but less than once a week (OR = 4.09, 95%CI: 1.79,9.35), and almost every day (OR = 6.48, 95% CI: 2.14, 19.56) were risk factors for precocious puberty in girls. While maternal height (OR = 0.82, 95% CI: 0.75, 0.88), paternal height (OR = 0.91, 95% CI: 0.85, 0.98), bedtime at night (OR = 0.30, 95% CI: 0.17, 0.51), and night sleep (OR = 0.43, 95% CI: 0.21, 0.86) were protective factors. In boys, only exposure to secondhand smoke several times a month but less than once a week (OR = 7.94, 95% CI: 1.25, 50.33) was a risk factor for precocious puberty. In the random forest model, Child BMI was the most important risk factor for precocious puberty in girls. CONCLUSIONS Our findings suggest that environmental factors were associated with precocious puberty in children, particularly in girls.
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Affiliation(s)
| | - Dandan Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Rd, Nanjing, 210008, China
| | - Qing Niu
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Rd, Nanjing, 210008, China
| | - Mingzhi Zhang
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | | | - Yubing Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Rd, Nanjing, 210008, China.
| | - Xu Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Rd, Nanjing, 210008, China.
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Huang L, Cao Y, Zhang Z, Zhang Y, Kuang M, Luo Y, Zhang L. Status and correlates of children's exposure to secondhand smoke at home: A survey in Chongqing, China. Tob Induc Dis 2023; 21:38. [PMID: 36923486 PMCID: PMC10009880 DOI: 10.18332/tid/159802] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/27/2022] [Accepted: 01/25/2023] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION The home is the primary source of children's exposure to secondhand smoke. This study investigated the status and influencing factors of child exposure to secondhand smoke at home when people smoke in the household. METHODS Participants with at least one child living in their household from 10 communities in Chongqing were recruited and provided a self-administered questionnaire using a multistage proportional random sampling design from June to August 2021. The chi-squared test and binary logistic regression analyses were used to identify influencing factors. RESULTS The questionnaire completed by 1345 families showed that 631 (46.9%) families lived with smokers in their household, and 509 (80.7%) of those families reported that smoking occurred within the home while the children were present. Binary logistic regression analyses demonstrated that the time between waking up and household smokers having the first cigarette of the day (OR=0.44; 95% CI: 0.22-0.85), changes to smoking habits and behaviors within the last six months (OR=1.76; 95% CI: 1.06-2.90), attitudes towards tobacco control in the household (OR=2.91; 95% CI: 1.72-4.92), self-efficacy in maintaining a smoke-free home (OR=2.27; 95% CI: 1.36-3.79), having rules to maintain a smoke-free home (OR=3.25; 95% CI: 1.68-6.29), and the status of providing cigarettes to guests at home (OR=11.0; 95% CI: 1.33-90.8) were associated with exposure to SHS. CONCLUSIONS Education focusing on the impact of smoking on children's health should be encouraged. Smoke-free homes should be established, and smoking restrictions in the household should be enacted. Therefore, information about the available tobacco-control services should be given to family members and be used properly. It is an effective way to decrease the risk of at-home exposure to SHS for children, to overcome any obstacles in tobacco control.
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Affiliation(s)
- Longxian Huang
- Respiratory Medicine Department, The First Branch of the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yang Cao
- Health Center of Bafu Town, Bafu Town, People's Republic of China
| | - Zhiyong Zhang
- Integrated Traditional Chinese Medicine and Western Medicine Department, Healthcare Center, Jinlong Town, Chongqing, People's Republic of China
| | - Ya Zhang
- Nursing Department, Shiqiaopu Street Healthcare Center, Chongqing, People's Republic of China
| | - Mei Kuang
- Nursing Department, Township Hospital, Jinfeng Town, People's Republic of China
| | - Yetao Luo
- Clinical Epidemiology and Biostatistics Department, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Li Zhang
- College of Nursing, Chongqing Medical University, Chongqing, People's Republic of China
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Juber NF, Waits A, Dlamini LP, Nguyen T, Masango BZ. Associations between pediatric asthma and age at menarche: evidence from the Indonesian Family Life Survey. J Asthma 2023; 60:105-114. [PMID: 35034545 DOI: 10.1080/02770903.2022.2030750] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To examine the association between pediatric asthma and age at menarche, and to assess whether early life factors modify the association. METHODS This is a retrospective cross-sectional study using the Indonesian Family Life Survey Fifth Wave which had a total of 11 822 females aged 15-57 years to evaluate whether those with pediatric asthma were associated with earlier menarche, compared to females without asthma. We performed a weighted linear regression model adjusting for age, urbanicity, parental smoking, infectious disease history during childhood, childhood socioeconomic status, and health status during childhood. We also performed analyses by age at asthma diagnosis, interval length between asthma diagnosis and menarche, urbanicity, parental smoking, and infectious disease history during childhood. RESULTS In the adjusted model, females with pediatric asthma had an earlier average age at menarche by 5.2 months and those diagnosed with asthma at 5-8 years of age had the fastest acceleration by 14.9 months. The significant association persisted among those with 0-5 years interval between asthma diagnosis and menarche, who resided in urban areas, and those without infectious disease history during childhood. CONCLUSIONS Our findings showed that females with pediatric asthma were associated with an earlier age at menarche, and some early life factors modified the association. Better asthma management with more targeted strategies at those at risk of earlier menarche may improve the reproductive and future health of children with asthma. Future studies to elucidate the mechanisms between pediatric asthma and age at menarche are warranted.
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Affiliation(s)
- Nirmin F Juber
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, UAE
| | - Alexander Waits
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Tao Yuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | | | - Tan Nguyen
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Bongani Zakhele Masango
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Park M, Kim SH, Nari F, Jang BN, Park EC. Association between parents' country of birth and smoking risks in South Korean adolescents. Sci Rep 2022; 12:17094. [PMID: 36224213 PMCID: PMC9556516 DOI: 10.1038/s41598-022-20791-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 09/19/2022] [Indexed: 01/04/2023] Open
Abstract
This study aimed to determine whether significant associations exist between multicultural families and adolescent smoking risks in South Korea. Data from the Korea Youth Risk Behavior Web-based survey from 2016 to 2020 were analyzed. Participants were classified into four family types (South Korean mother-foreign father, South Korean father-foreign mother, both foreign parents, and both South Korean parents) according to their parents' country of birth and smoking was assessed using a self-reported questionnaire. A logistic regression analysis was used to examine the significance of the associations. Overall, 194,259 participants (boys: 94,793, girls: 99,466) enrolled in this study. Adolescents whose parents were born overseas were more likely to smoke than native South Korean adolescents (boys: odds ratio [OR] = 2.61, confidence interval [CI] = 1.79-3.81, girls: OR 3.94, CI 2.42-6.43). When the mother's country of birth was a developing country, there was an increased likelihood of girls smoking, and there was an increased likelihood of smoking among boys when the mother's country of birth was North Korea. When both parents were born abroad, and the mother's country of birth was a developing country, the likelihood of smoking risks among their multicultural teenage children increased. Policies and interventions need to be established and implemented to lower the smoking rate among multicultural teenagers.
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Affiliation(s)
- Minah Park
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Seung Hoon Kim
- grid.255588.70000 0004 1798 4296Department of Preventive Medicine, Eulji University College of Medicine, Daejun, Republic of Korea
| | - Fatima Nari
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Bich Na Jang
- Armed Forces Chuncheon Hospital, Chuncheon, Republic of Korea
| | - Eun-Cheol Park
- grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722 Republic of Korea
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Kim SH, Park M, Kim GR, Joo HJ, Jang SI. Association of Mixed Use of Electronic and Conventional Cigarettes and Exposure to Secondhand Smoke With Prediabetes. J Clin Endocrinol Metab 2022; 107:e44-e56. [PMID: 34436592 DOI: 10.1210/clinem/dgab558] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Indexed: 01/04/2023]
Abstract
CONTEXT Despite previous studies regarding the association between smoking and diabetes, the effects of electronic cigarettes and secondhand smoke (SHS) on glucose metabolism and insulin sensitivity have not been fully elucidated. OBJECTIVE To examine the association of mixed electronic and conventional cigarette use and exposure to SHS with prediabetes. DESIGN Data from the 2014-2018 Korean National Health and Nutrition Examination Survey were analyzed. SETTING Nationwide population-based. PARTICIPANTS Of 39 199 participants, 22 385 participants (9490 men, 12 895 women) without diabetes were included. The main independent variables were smoking behaviors, including exposure to SHS. INTERVENTIONS None. MAIN OUTCOME MEASURES Prediabetes (hemoglobin A1C of 5.7-6.4%). RESULTS Of 22 385 participants without diabetes, 6735 had prediabetes. Mixed cigarette use was associated with a 1.57-fold increase in the odds of prediabetes when compared with never-smoking [odds ratio (OR) = 1.57, 95% CI = 1.29-1.92] and a 1.27-fold increase when compared with conventional cigarette use only (OR = 1.27, 95% CI = 1.07-1.52). Participants who were current nonsmokers, but mixed users in the past had an increased risk of prediabetes (OR = 1.54, 95% CI = 1.04-2.13). There was no significant association between prediabetes and current nonsmoking in individuals with previous conventional cigarette use only. Among never-smokers, exposure to SHS significantly increased the risk of prediabetes (OR = 1.16, 95% CI = 1.04-1.30). CONCLUSIONS Mixed use of electronic and conventional cigarettes and exposure to SHS increased the risk of prediabetes. Further studies are required to comprehensively investigate the molecular biology underlying the effects of previous and current mixed use of electronic cigarettes and SHS on glucose metabolism.
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Affiliation(s)
- Seung Hoon Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Minah Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Gyu Ri Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hye Jin Joo
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
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Oh SS, Park S, You YA, Jee Y, Ansari A, Kim SM, Lee G, Kim YJ. Prenatal Exposure to Alcohol, Tobacco, and Coffee: Associated Congenital Complications and Adverse Birth Outcomes. Int J Environ Res Public Health 2021; 18:3140. [PMID: 33803679 PMCID: PMC8003057 DOI: 10.3390/ijerph18063140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 12/11/2022]
Abstract
A few studies to date have examined the association between prenatal exposure to alcohol, tobacco, and coffee, and congenital complications/adverse birth outcomes among South Korean populations. Thus, this study analyzed the data of 1675 Korean women with birth experience within the last 3 years for pregnancy-related health and nutritional behaviors and relative outcomes. During their pregnancies, 11.58% of the study population consumed alcohol at least once, 1.43% drank throughout all three trimesters, 1.13% smoked, 25.43% were exposed to secondhand smoking, and 28.18% consumed 3 coffees or more every day. Prenatal alcohol exposure was associated with 11.24 times increased risk of birth defects/disabilities [Odds Ratio (OR): 11.24, 95% Confidence Interval (CI) 1.07-117.86] and 10.66 times increased risk of inherited metabolic diseases (OR: 10.66, 95% CI: 1.08-104.82). Prenatal secondhand smoke exposure (OR: 1.62, 95% CI: 1.01-2.62) and coffee consumption (OR: 1.92, 95% CI: 1.22-3.03) was associated with increased risk of low birth weight. Such results were in alignment with that of previous studies and confirmed that prenatal alcohol, tobacco, and coffee exposure can have detrimental neonatal and maternal consequences.
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Affiliation(s)
- Sarah Soyeon Oh
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Department of Obstetrics & Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Sunwha Park
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Department of Obstetrics & Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Young-Ah You
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Medical Research Institute, College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
| | - Yongho Jee
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
| | - AbuZar Ansari
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Medical Research Institute, College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
| | - Soo Min Kim
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Korea
| | - Gain Lee
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Korea
| | - Young Ju Kim
- Fetal Alcohol Syndrome Prevention Center, Ewha Institute of Convergence Medicine, Ewha Womans University, Mokdong Hospital, Seoul 07985, Korea; (S.S.O.); (S.P.); (Y.-A.Y.); (Y.J.); (A.A.); (S.M.K.); (G.L.)
- Department of Obstetrics & Gynecology, College of Medicine, Ewha Womans University, Seoul 07985, Korea
- Medical Research Institute, College of Medicine, Ewha Womans University Seoul Hospital, Seoul 07985, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 03760, Korea
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Jeong SH, Jang BN, Kang SH, Joo JH, Park EC. Association between parents' smoking status and tobacco exposure in school-age children: assessment using major urine biomarkers. Sci Rep 2021; 11:4536. [PMID: 33633242 PMCID: PMC7907361 DOI: 10.1038/s41598-021-84017-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/02/2021] [Indexed: 11/11/2022] Open
Abstract
Children are at risk of exposure to secondhand smoke. We aimed to evaluate the extent of their exposure to it in relation to their parents' smoking status by using biomarkers relevant to smoking. We evaluated 847 school-age children (6-12 years) who lived with their parents, using data from the Korea National Health and Nutrition Examination Survey 2016-2018. Secondhand smoke exposure in children of non-smoking and smoking parents was assessed by measuring urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and cotinine concentrations. Overall, the parents of 482 (55.1%) children smoked and those of 392 (44.9%) children did not smoke. After adjusting for covariates, significantly higher concentrations of NNAL (β = 0.482, standard error [S.E.] = 0.065, P < 0.001) and cotinine (β = 0.472, S.E. = 0.06, P < 0.001) were found in children of smoking parents than in children of non-smoking parents. Children of parents who smoked a higher number of cigarettes showed higher NNAL and cotinine concentrations than children of non-smoking parents. Children with both parents who smoked showed the highest NNAL and cotinine concentrations. Children of smoking parents are at a higher risk of exposure to secondhand smoke. A smoke-free environment must be maintained to protect children from the harmful effects of secondhand smoke. Therefore, comprehensive national anti-smoking policies are required.
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Affiliation(s)
- Sung Hoon Jeong
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Bich Na Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Soo Hyun Kang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jae Hong Joo
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
- Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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