Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Environmental Tobacco Smoking, Parental Allergy History and Pediatric Asthma and Wheezing

부모에 의한 간접흡연 및 부모의 알레르기성 질환력과 소아 천식과의 관계에 관한 연구

  • Lee, Keun-Bok (Department of Sociology in Yonsei University) ;
  • Lee, Weon-Yong (Department of Preventive Medicine, College of Medicine, Chung-Ang University)
  • 이근복 (연세대학교 사회학과 대학원) ;
  • 이원영 (중앙대학교 의과대학 예방의학교실)
  • Published : 2009.09.30
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Abstract

Objectives: This study was conducted to investigate whether joint effects between family allergy history and environmental tobacco smoke(ETS) by parents were associated with pediatric asthma and wheezing. Methods: The study objects of this study were 2301 element school students and their parents in an urban-rural areas of Gyeonggi-do. Pediatric asthma and wheezing were identified by measures of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires. We investigated history of parental allergy, ETS, and other socioeconomic status of both parent. Data were analyzed using logistic regression methods. Results: After adjusting other variables, children with maternal asthma history were more likely to be reported life time wheezing (OR: 3.79 95%CI:2.43-5.90), recent wheezing (OR:4.09 95%CI:2.28-7.38), and diagnostic asthma (OR:2.61 95%CI: 1.44-4.75). Paternal asthma history increasing risk of life time wheezing (OR 2.01 95%CI:1.19-3.38) and recent wheezing (OR:2.38 95%CI:1.24-4.56). Joint effect between parental allergy history and ETS significantly effected on child's life time wheezing and recent wheezing. The risks of life time wheezing (OR:2.47 95%CI:1.64-3.717) and recent wheezing (OR: 2.51 95%CI:1.34-4.69) were significantly higher than others without both factors. The risk of recent wheezing of children with maternal recent smoking and parental allergy history (OR:4.83 95%CI:1.89-12.33) was higher than their counterpart. Conclusions: The result of this study implies that children with family allergy history and passive smoking are more likely to be get asthma and wheezing than children with family allergy history and non-passive smoking. This study provide the object information to increase the efficiency of non-smoking campaign and education for decreasing pediatric asthma risk.

이 연구는 부모의 알레르기 질환력을 고려해 간접흡연 노출과 소아 천식의 관계를 밝히는 것을 목적으로 이루어졌다. 이를 위해 경기도의 농촌과 도시를 대표하는 두 개 지역 소재 3개 초등학교 학생을 대상으로 이루어진 설문조사 자료를 이용하였다. 이 자료 중 이 연구는 설문에 응답한 대상자 중 평생 천명, 최근 천명, 의사진단 천식을 비롯해 간접흡연, 부모 알레르기 질환 여부에 응답한 2,301명을 최종 분석 대상으로 삼았다. 천식 및 천명을 이 분형 종속 변수로 삼고 로지스틱 회귀 분석을 통해 최근 1년간 간접흡연에의 노출과 부모의 알레르기 질환력이 천식 및 천명 질환에 미치는 독립 적인 효과를 분석하였으며 둘 간의 상호작용 효과를 추정하였다. 분석 결과 아버지와 어머니의 알레르기성 질환 병력은 평생 천명, 최근 천명에 유의한 영향력을 미치는 것으로 나타났으며 어머니의 천식 병력의 경우에는 의사 진단 천식에도 유의한 영향을 미치는 것으로 밝혀졌다. 그러나 어머니나 아버지의 최근 흡연과 소아 천식과의 관계는 통계적 유의성을 확보하지 못했다. 부모의 알레르기 질환력과 간접흡연간의 상호작용효과는 ‘부모알레르기 질환도 없고 간접흡연 노출도 없는 집단’, ‘부모 알레르기 질환력은 없지만 최근 흡연 노출은 있는 집단’, ‘부모 알레르기 질환력은 있지만 최근 흡연 노출은 없는 집단’, 그리고 ‘부모 알레르기 질환도 있으며 간접흡연 노출도 있는 집단’을 비교해 평가하였다. 분석 결과 부모의 알레르기 질환력과 간접흡연의 노출간의 상호작용효과는 어머니의 최근 흡연의 경우에 자녀의 최근 천명에서 유의한 효과를 보였으며 아버지의 최근 흡연의 경우에는 평생 천명과 최근 천명에서 유의한 효과를 타나냈다. 부모의 알레르기 질환과 최근 어머니의 흡연이 모두 없는 집단에 비해서 두 요인 다 있는 집단에서 자녀의 최근 천명이 나타날 교차비는 4.83배(95%CI:189-12.33)로 높았다. 또 아버지가 최근 1년간 흡연을 했으며 부모의 알레르기 질환력이 있는 집단에서는 아버지가 흡연하지도 않고 부모의 알레르기질환도 없는 집단에 비해 자녀의 최근 천명이 나타날 확률이 2.50배(95%CI:1.34-4.70) 높았으며 평생천명이 나타날 확률 역시 2.47배(95%CI:1.64-3.72)높았다. 이러한 연구 결과는 부모의 알레르기 질환력이 있는 경우에는 간접흡연의 노출이 자녀의 천식 및 천명의 유의한 위험 요인이라는 사실을 보여 준다. 따라서 향후에는 간접흡연의 노출과 상호작용하는 특정한 유전자 군에 대한 연구가 필요 할 것이다. 또한 소아 천식의 위험을 낮추기 위해서는 부모의 금연을 중심으로 한 간접흡연 노출을 줄일 수 있는 개입이 필요하며 나아가 부모가 알레르기질환이 있는 집단에 대한 집중적인 금연 교육이 소아 천식을 효과적으로 줄일 수 있을 것으로 여겨진다.

Keywords

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