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首页> 外文期刊>Thorax: The Journal of the British Thoracic Society >Health effects of passive smoking. 4. Parental smoking, middle ear disease and adenotonsillectomy in children.
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Health effects of passive smoking. 4. Parental smoking, middle ear disease and adenotonsillectomy in children.

机译：被动吸烟对健康的影响。 4.小儿吸烟，中耳疾病和腺扁桃体切除术。

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BACKGROUND: A systematic quantitative review was conducted of evidence relating parental smoking to acute otitis media, recurrent otitis media, middle ear effusion, and adenoidectomy and/or tonsillectomy. METHODS: Forty five relevant publications were identified after consideration of 692 articles selected by electronic search of the Embase and Medline databases using keywords relevant to passive smoking in children. The search was completed in April 1997 and identified 13 studies of acute otitis media, nine of recurrent otitis media, five of middle ear effusion, nine of glue ear surgery, and four of adenotonsillectomy. A quantitative meta-analysis was possible for all outcomes except acute otitis media, using random effects modelling where appropriate to pool odds ratios from each study. RESULTS: Evidence for middle ear disease is remarkably consistent, with pooled odds ratios if either parent smoked of 1.48 (95% CI 1.08 to 2.04) for recurrent otitis media, 1.38 (1.23 to 1.55) for middle ear effusion, and 1.21 (0.95 to 1.53) for outpatient or inpatient referral for glue ear. Odds ratios for acute otitis media are in the range 1.0 to 1.6. No single study simultaneously addresses selection bias, information bias and confounding, but where these have been investigated or excluded in the design or analysis, the associations with parental smoking persist virtually unchanged. Large French and British studies are inconsistent with regard to the association of parental smoking and tonsillectomy. CONCLUSIONS: There is likely to be a causal relationship between parental smoking and both acute and chronic middle ear disease in children.
机译：背景：对父母吸烟与急性中耳炎，复发性中耳炎，中耳积液，腺样体切除术和/或扁桃体切除术相关的证据进行了系统的定量审查。方法：在考虑了692篇文章后，确定了45篇相关出版物，这些文章是通过电子搜索Embase和Medline数据库并使用与儿童被动吸烟相关的关键字进行选择的。搜索于1997年4月完成，确定了13项关于急性中耳炎的研究，9例复发性中耳炎，5例中耳积液，9例胶耳手术和4例腺扁桃体切除术。除急性中耳炎外，所有结局均可能进行定量荟萃分析，并在适当情况下使用随机效应模型汇总各研究的优势比。结果：中耳疾病的证据非常一致，如果父母一方复发性中耳炎的吸烟率为1.48（95％CI 1.08至2.04），中耳积液为1.38（1.23至1.55）以及1.21（0.95至0.95），则合计比值比很明显。 1.53）用于门诊或住院转诊的粘胶耳。急性中耳炎的赔率在1.0到1.6的范围内。没有一项单独的研究能够同时解决选择偏见，信息偏见和混淆，但是在设计或分析中已对这些偏见进行了调查或排除的情况下，与父母吸烟的关联性实际上保持不变。关于父母吸烟和扁桃体切除术的关联，法国和英国的大量研究不一致。结论：父母吸烟与儿童急性和慢性中耳疾病之间可能存在因果关系。

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