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Relationship of passive cigarette smoking to otitis media (OM) in children

2011 SRNT Annual Meeting February 16-19, 2011. Westin Harbour Castle Toronto , Canada. Relationship of passive cigarette smoking to otitis media (OM) in children. Zsuzsanna Csákányi 1 – Gábor Katona 1 - Antal Czinner 2. 1 Heim Pal Children’s Hospital ENT Department, Budapest, Hungary

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Relationship of passive cigarette smoking to otitis media (OM) in children

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  1. 2011 SRNT Annual Meeting February 16-19, 2011. Westin Harbour Castle Toronto, Canada Relationship of passive cigarette smoking to otitis media (OM) in children Zsuzsanna Csákányi1 – Gábor Katona 1 - Antal Czinner2 1Heim Pal Children’s Hospital ENT Department, Budapest, Hungary 2Heim Pal Children’s Hospital Pediatric Department, Budapest, Hungary

  2. Middle ear inflammation (OM) • Most frequent in children • Serious health problem • High health care costs The most frequent disease in children

  3. Otitis media – multifactorial disease • viral and bacterial infections • auditory tube dysfunction • immun system immaturity • social and environmental • factors

  4. Otitis media – multifactorial disease Exploration and elimination of factors contribute to OM pathogenesis Reduce the OM frequency

  5. Exposure to ETS in children • Serious public health problem • Many associated pediatric condition • Acute and long-term health problems • Causal relationship to middle ear disease? • Divergent findings

  6. Aims of the study • Impact of ETS on OM • Determinant factors of ETS on OM • Parental concern about their child’s • ETS exposure

  7. Patients and methods • Heim Pal Children’s Hospital, ENT Department, • Budapest, Hungary; (January-December 2009) • 218 children(6 months-18 yrs, mean: 5.81 yrs,SD: 3.87) • N=80with OM & N=138without OM • Children living in smoking & non-smoking family • Questionnaire method

  8. Questionnaire • Items addressing 6 main domains: • Ear problems • Smoking habits • Maternal smoking during pregnancy • SES-socioeconomic status • Maternal education • Parental concern about their child’s ETS exposure

  9. Statistical analysis • Bivariate analysis: • - frequency of AOM infections and household • characteristics • Multivariable regression analysis: • - expected determinants of OM prevalence • (household characteristics, frequency and • duration of exposure to smokers, parental • employment status) • Statistical significance was set at p<0.05 • Models controlled for age,gender,SES and maternal education

  10. Results

  11. Incidence of AOM correlates with: • Being around a smoker at least once a • week • Less than daily ventilation of house or • flat • Urban residence • Father employment status • Child’s age

  12. Incidence of AOM does not correlate with: • Flat size • Smoking at home • Smoking during pregnancy • Being around a smoker one hour daily • Maternal employment • Maternal education • Mean number of persons living in the household

  13. Number of lifetime AOM episodes (Linear regression model) Model controlled for child’s sex and maternal education.

  14. Predictors of 4 ≤ episodes of AOM (Logistic regression models) • Age in months(OR 1.02; 95% CI: 1.01-1.03) • Child around a smoker for at least once • a week(OR: 3.84; 95% CI: 1.44-10.2) Models controlled for child’s sex and mother’s education.

  15. Correlates of mean cigarettes smoked per day in the household • 36.2% of children had family members who smoked • at least one cigarette per day • More episodes of AOM (p=0.059) • Living in the countryside (p<0.05) • Paternal unemployment (p<0.02)

  16. Caregiver’s perception of harm to child from ETS

  17. Summary • Exposure to ETS correlated with presence and increasing number of lifetime AOM episodes • Children being around the smoker at least once a week have fourfold increase in the number of AOM episodes

  18. Summary • Mean number of cigarettes smoked per day increased with rural residence and father’s unemployment status • Frequent occurrence ofOM among rural population -- lower living standards and -- higher unemployment rate

  19. Summary • Smoking during pregnancy results in very low birth weight or premature birth • Nearly half the parents considered their child is not exposed to the harmful effects of ETS Tobaccocontrol issues

  20. AcknowledgementProf.John Spangler and Prof.Todd Rogersfor statistical analyses and useful advices This study was supported by the Fogarty Found

  21. Thank you for your attention!

  22. Predictors of 4 ≤ episodes of AOM (Logistic regression models) Models controlled for child’s sex and mother’s education.

  23. Correlates of mean cigarettes smoked per day in the household 36.2%

  24. Caregiver’s perception of harm to child from ETS based on level of child’s exposure(s) 37% 29% 44% Models controlled for child’s sex and mother’s education.

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