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Allergic sensitization, rhinitis, and tobacco smoke exposure in U.S. children and adolescents.
Int Forum Allergy Rhinol 2015; 5(6):471-6IF

Abstract

BACKGROUND

Childhood tobacco exposure has been linked with sinonasal pathology, and may be associated with allergic sensitization. This study evaluates the association between exposure to active smoking or secondhand smoke (SHS) and the prevalence of rhinitis and allergic sensitization in the U.S. pediatric population.

METHODS

Cross-sectional study in 2714 children and adolescents aged 6 to 19 in the National Health and Nutrition Examination Survey (NHANES), 2005-2006. Active smoking was defined as self-reported smoking or serum cotinine concentrations >10 ng/mL. SHS was defined as nonactive smokers who reported living with ≥1 smokers or had serum cotinine ≥0.011 ng/mL. Self-reported rhinitis was based on symptoms during the past 12 months, and allergen sensitization was defined as a positive response to any of the 19 specific immunoglobulin E (IgE) antigens tested.

RESULTS

About half of the population (54%) had detectable levels of IgE specific to at least 1 of the tested allergens, and 25% reported a history of rhinitis. After multivariate adjustment, an increased prevalence rate ratio (PRR) of self-reported rhinitis was seen in individuals in the highest cotinine tertile among active smokers (PRR, 1.73; 95% confidence interval [CI], 1.23 to 2.43), with a significant trend between increasing cotinine levels in individuals exposed to either secondhand smoke or active smoking (p = 0.05 for both analyses). Significantly less food allergen sensitization was observed in participants in the highest cotinine tertile of secondhand smoke (PRR, 0.61; 95% CI, 0.43 to 0.85).

CONCLUSION

Tobacco smoke exposure was associated with increased prevalence of rhinitis symptoms, but decreased prevalence of allergic sensitization. The results highlight the complex relationship between tobacco exposure and sinonasal pathology.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.Department of Preventive Medicine and Public Health, School of Medicine, Autonoma University, Madrid, Spain. Ciber of Epidemiology and Public Health (CIBERESP), Madrid, Spain.Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25884913

Citation

Shargorodsky, Josef, et al. "Allergic Sensitization, Rhinitis, and Tobacco Smoke Exposure in U.S. Children and Adolescents." International Forum of Allergy & Rhinology, vol. 5, no. 6, 2015, pp. 471-6.
Shargorodsky J, Garcia-Esquinas E, Navas-Acien A, et al. Allergic sensitization, rhinitis, and tobacco smoke exposure in U.S. children and adolescents. Int Forum Allergy Rhinol. 2015;5(6):471-6.
Shargorodsky, J., Garcia-Esquinas, E., Navas-Acien, A., & Lin, S. Y. (2015). Allergic sensitization, rhinitis, and tobacco smoke exposure in U.S. children and adolescents. International Forum of Allergy & Rhinology, 5(6), pp. 471-6. doi:10.1002/alr.21444.
Shargorodsky J, et al. Allergic Sensitization, Rhinitis, and Tobacco Smoke Exposure in U.S. Children and Adolescents. Int Forum Allergy Rhinol. 2015;5(6):471-6. PubMed PMID: 25884913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allergic sensitization, rhinitis, and tobacco smoke exposure in U.S. children and adolescents. AU - Shargorodsky,Josef, AU - Garcia-Esquinas,Esther, AU - Navas-Acien,Ana, AU - Lin,Sandra Y, Y1 - 2015/04/17/ PY - 2014/04/15/received PY - 2014/07/24/revised PY - 2014/09/12/accepted PY - 2015/4/18/entrez PY - 2015/4/18/pubmed PY - 2016/3/5/medline KW - allergy KW - children KW - rhinitis KW - smoking KW - tobacco SP - 471 EP - 6 JF - International forum of allergy & rhinology JO - Int Forum Allergy Rhinol VL - 5 IS - 6 N2 - BACKGROUND: Childhood tobacco exposure has been linked with sinonasal pathology, and may be associated with allergic sensitization. This study evaluates the association between exposure to active smoking or secondhand smoke (SHS) and the prevalence of rhinitis and allergic sensitization in the U.S. pediatric population. METHODS: Cross-sectional study in 2714 children and adolescents aged 6 to 19 in the National Health and Nutrition Examination Survey (NHANES), 2005-2006. Active smoking was defined as self-reported smoking or serum cotinine concentrations >10 ng/mL. SHS was defined as nonactive smokers who reported living with ≥1 smokers or had serum cotinine ≥0.011 ng/mL. Self-reported rhinitis was based on symptoms during the past 12 months, and allergen sensitization was defined as a positive response to any of the 19 specific immunoglobulin E (IgE) antigens tested. RESULTS: About half of the population (54%) had detectable levels of IgE specific to at least 1 of the tested allergens, and 25% reported a history of rhinitis. After multivariate adjustment, an increased prevalence rate ratio (PRR) of self-reported rhinitis was seen in individuals in the highest cotinine tertile among active smokers (PRR, 1.73; 95% confidence interval [CI], 1.23 to 2.43), with a significant trend between increasing cotinine levels in individuals exposed to either secondhand smoke or active smoking (p = 0.05 for both analyses). Significantly less food allergen sensitization was observed in participants in the highest cotinine tertile of secondhand smoke (PRR, 0.61; 95% CI, 0.43 to 0.85). CONCLUSION: Tobacco smoke exposure was associated with increased prevalence of rhinitis symptoms, but decreased prevalence of allergic sensitization. The results highlight the complex relationship between tobacco exposure and sinonasal pathology. SN - 2042-6984 UR - https://www.unboundmedicine.com/medline/citation/25884913/Allergic_sensitization_rhinitis_and_tobacco_smoke_exposure_in_U_S__children_and_adolescents_ L2 - https://doi.org/10.1002/alr.21444 DB - PRIME DP - Unbound Medicine ER -