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The effect of passive smoking on the risk of otitis media in Aboriginal and non-Aboriginal children in the Kalgoorlie–Boulder region of Western Australia

Peter A Jacoby, Harvey L Coates, Ashwini Arumugaswamy, Dimity Elsbury, Annette Stokes, Ruth Monck, Janine M Finucane, Sharon A Weeks and Deborah Lehmann
Med J Aust 2008; 188 (10): 599-603.

Summary

Objectives: To determine the risk of otitis media (OM) associated with passive smoking in young children, and any competing effect between passive smoking and childcare attendance.

Design, participants and setting: Prospective cohort study of 100 Aboriginal and 180 non-Aboriginal children born in Kalgoorlie Regional Hospital between 1 April 1999 and 31 January 2003. These children underwent routine clinical examinations by an ear, nose and throat specialist up to three times before the age of 2 years, and tympanometry at routine field follow-up visits from the age of 4 months. Childrens’ mothers were interviewed at 1–3 weeks postpartum to provide sociodemographic data.

Main outcome measures: Associations between OM and exposure to environmental tobacco smoke (ETS) and childcare attendance.

Results: 82 Aboriginal and 157 non-Aboriginal children attended for routine clinical examinations. OM was diagnosed at least once in 74% of Aboriginal children and 45% of non-Aboriginal children; 64% of Aboriginal children and 40% of non-Aboriginal children were exposed to ETS. Exposure to ETS increased the risk of specialist-diagnosed OM in Aboriginal children (OR, 3.54; 95% CI, 1.68–7.47); few attended childcare. Non-Aboriginal children exposed to ETS but not attending childcare were at increased risk of OM (OR, 1.91; 95% CI, 1.07–3.42) while those attending childcare had no increased smoking-related risk. Tympanometry was performed on 87 Aboriginal and 168 non-Aboriginal children; a type B tympanogram (suggesting fluid in the middle ear) was also associated with passive smoking in Aboriginal children.

Conclusions: Reducing the exposure of children to ETS is a public health priority, especially for the Aboriginal population. A smoke-free environment will help reduce the burden of OM.

  • Peter A Jacoby1
  • Harvey L Coates2
  • Ashwini Arumugaswamy1
  • Dimity Elsbury1
  • Annette Stokes1
  • Ruth Monck1
  • Janine M Finucane1
  • Sharon A Weeks3
  • Deborah Lehmann1

  • 1 Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA.
  • 2 Princess Margaret Hospital for Children, Perth, WA.
  • 3 Professional Hearing Services, Perth, WA.

Correspondence: deborahl@ichr.uwa.edu.au

Acknowledgements: 

We thank F Lannigan for his clinical expertise, V Verma and D Hill for audiological assessments. The Eastern Goldfields Division of General Practice, the midwives at Kalgoorlie Regional Hospital, G Stokes and his family, and T Canning, J Doyle and B Scott, Goldfields South East Health Region gave their continuous support to the study. We thank Ann Larson and Michael Alpers for their critical review of an earlier draft of the manuscript. This study was funded through National Health and Medical Research Council (NHMRC) project grant no. 212044 and two Healthway grants (no. 6028 and no. 10564). Deborah Lehmann is currently funded through NHMRC program grant no. 353514. World Vision provided funding for L Dorizzi, R Bonney and P Bonney to assist with fieldwork. Donations from the Lions Club, Kalgoorlie, Kalgoorlie Consolidated Gold Mines, BHP Billiton, the Friends of the Institute, Sands & McDougall and the Lotteries Commission enabled the purchase of essential equipment. We thank all the families who agreed to take part in the study. A complete list of investigators on the Kalgoorlie Otitis Media Research Project is available in reference 25.25

Competing interests:

None identified.

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