Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis, and Food Allergy in Adults and Children: A Systematic Review and Meta-Analysis

English version České info

Background:
Allergic rhinitis, allergic dermatitis, and food allergy are extremely common diseases, especially among children, and are frequently associated to each other and to asthma. Smoking is a potential risk factor for these conditions, but so far, results from individual studies have been conflicting. The objective of this study was to examine the evidence for an association between active smoking (AS) or passive exposure to secondhand smoke and allergic conditions.

Methods and Findings:
We retrieved studies published in any language up to June 30th, 2013 by systematically searching Medline, Embase, the five regional bibliographic databases of the World Health Organization, and ISI-Proceedings databases, by manually examining the references of the original articles and reviews retrieved, and by establishing personal contact with clinical researchers. We included cohort, case-control, and cross-sectional studies reporting odds ratio (OR) or relative risk (RR) estimates and confidence intervals of smoking and allergic conditions, first among the general population and then among children.

We retrieved 97 studies on allergic rhinitis, 91 on allergic dermatitis, and eight on food allergy published in 139 different articles. When all studies were analyzed together (showing random effects model results and pooled ORs expressed as RR), allergic rhinitis was not associated with active smoking (pooled RR, 1.02 [95% CI 0.92–1.15]), but was associated with passive smoking (pooled RR 1.10 [95% CI 1.06–1.15]). Allergic dermatitis was associated with both active (pooled RR, 1.21 [95% CI 1.14–1.29]) and passive smoking (pooled RR, 1.07 [95% CI 1.03–1.12]). In children and adolescent, allergic rhinitis was associated with active (pooled RR, 1.40 (95% CI 1.24–1.59) and passive smoking (pooled RR, 1.09 [95% CI 1.04–1.14]). Allergic dermatitis was associated with active (pooled RR, 1.36 [95% CI 1.17–1.46]) and passive smoking (pooled RR, 1.06 [95% CI 1.01–1.11]). Food allergy was associated with SHS (1.43 [1.12–1.83]) when cohort studies only were examined, but not when all studies were combined.

The findings are limited by the potential for confounding and bias given that most of the individual studies used a cross-sectional design. Furthermore, the studies showed a high degree of heterogeneity and the exposure and outcome measures were assessed by self-report, which may increase the potential for misclassification.

Conclusions:
We observed very modest associations between smoking and some allergic diseases among adults. Among children and adolescents, both active and passive exposure to SHS were associated with a modest increased risk for allergic diseases, and passive smoking was associated with an increased risk for food allergy. Additional studies with detailed measurement of exposure and better case definition are needed to further explore the role of smoking in allergic diseases.

Please see later in the article for the Editors' Summary

Vyšlo v časopise: Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis, and Food Allergy in Adults and Children: A Systematic Review and Meta-Analysis. PLoS Med 11(3): e32767. doi:10.1371/journal.pmed.1001611
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001611

Souhrn

Zdroje

1. OzdoganogluT, SonguM (2012) The burden of allergic rhinitis and asthma. Ther Adv Respir Dis 6: 11–23.

2. BauchauV, DurhamSR (2004) Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 24: 758–764.

3. BergerWE (2004) Allergic rhinitis in children: diagnosis and management strategies. Paediatr Drugs 6: 233–250.

4. RonaRJ, KeilT, SummersC, GislasonD, ZuidmeerL, et al. (2007) The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol 120: 638–646.

5. DaVeigaSP (2012) Epidemiology of atopic dermatitis: a review. Allergy Asthma Proc 33: 227–234.

6. MeltzerEO, BlaissMS, DereberyMJ, MahrTA, GordonBR, et al. (2009) Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol 124: S43–S70.

7. NathanRA (2007) The burden of allergic rhinitis. Allergy Asthma Proc 28: 3–9.

8. AlanneS, MaskunittyA, NermesM, LaitinenK, PekurinenM (2012) Costs of allergic diseases from birth to two years in Finland. Public Health 126: 866–872.

9. SpergelJM (2010) From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol 105: 99–106.

10. TanRA, CorrenJ (2011) The relationship of rhinitis and asthma, sinusitis, food allergy, and eczema. Immunol Allergy Clin North Am 31: 481–491.

11. AsherMI, MontefortS, BjörksténB, LaiCK, StrachanDP, et al. (2006) Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 368: 733–743.

12. GhouriN, Hippisley-CoxJ, NewtonJ, SheikhA (2008) Trends in the epidemiology and prescribing of medication for allergic rhinitis in England. J R Soc Med 101: 466–72.

13. MosgesR, KlimekL (2007) Today's allergic rhinitis patients are different: new factors that may play a role. Allergy 62: 969–975.

14. LanneröE, WickmanM, van HageM, BergströmA, PershagenG, et al. (2008) Exposure to environmental tobacco smoke and sensitisation in children. Thorax 63: 172–176.

15. Diaz-SanchezD, RumoldR, GongHJr (2006) Challenge with environmental tobacco smoke exacerbates allergic airway disease in human beings. J Allergy Clin Immunol 118: 441–446.

16. PedenD, ReedCE (2010) Environmental and occupational allergies. J Allergy Clin Immunol 125(2 Suppl 2): S150–S160.

17. WarrenCW, JonesNR, PerugaA, ChauvinJ, BaptisteJP, et al. (2008) Global youth tobacco surveillance, 2000–2007. MMWR Surveill Summ 57: 1–28.

18. MurinS, RafiiR, BilelloK (2011) Smoking and smoking cessation in pregnancy. Clin Chest Med 32: 75–91.

19. CakirE, ErsuR, UyanZS, OktemS, VarolN, et al. (2010) The prevalence and risk factors of asthma and allergic diseases among working adolescents. Asian Pac J Allergy Immunol 28: 122–129.

20. LeeCH, ChuangHY, HongCH, HuangSK, ChangYC, et al. (2011) Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis. Br J Dermatol 164: 483–489.

21. BendtsenP, GrønbaekM, KjaerSK, MunkC, LinnebergA, et al. (2008) Alcohol consumption and the risk of self-reported perennial and seasonal allergic rhinitis in young adult women in a population-based cohort study. Clin Exp Allergy 38: 1179–1185.

22. LudvigssonJF, MostromM, LudvigssonJ, DuchenK (2005) Exclusive breastfeeding and risk of atopic dermatitis in some 8300 infants. Pediatr Allergy Immunol 16: 201–208.

23. MetsäläJ, LundqvistA, KailaM, GisslerM, KlaukkaT, et al. (2010) Maternal and perinatal characteristics and the risk of cow's milk allergy in infants up to 2 years of age: a case-control study nested in the Finnish population. Am J Epidemiol 171: 1310–1316.

24. McKeeverTM, LewisSA, SmithC, CollinsJ, HeatlieH, et al. (2001) Siblings, multiple births, and the incidence of allergic disease: a birth cohort study using the West Midlands general practice research database. Thorax 56: 758–762.

25. WangIJ, GuoYL, LinTJ, ChenPC, WuYN (2010) GSTM1, GSTP1, prenatal smoke exposure, and atopic dermatitis. Ann Allergy Asthma Immunol 105: 124–129.

26. TariqSM, MatthewsSM, HakimEA, StevensM, ArshadSH, et al. (1998) The prevalence of and risk factors for atopy in early childhood: a whole population birth cohort study. J Allergy Clin Immunol 101: 587–593.

27. BurkeH, Leonardi-BeeJ, HashimA, Pine-AbataH, ChenY, et al. (2012) Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis. Pediatrics 129: 735–744.

28. Baena-CagnaniCE, GómezRM, Baena-CagnaniR, CanonicaGW (2009) Impact of environmental tobacco smoke and active tobacco smoking on the development and outcomes of asthma and rhinitis. Curr Opin Allergy Clin Immunol 9: 136–140.

29. PattendenS, AntovaT, NeubergerM, NikiforovB, De SarioM, et al. (2006) Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure. Tob Control 15: 294–301.

30. StrachanDP, CookDG (1998) Health effects of passive smoking. 5. Parental smoking and allergic sensitisation in children. Thorax 53: 117–123.

31. FreimanA, BirdG, MetelitsaAI, BarankinB, LauzonGJ (2004) Cutaneous effects of smoking. J Cutan Med Surg 8: 415–423.

32. Just-SarobéM (2008) Smoking and the skin. Actas Dermosifiliogr 99: 173–184.

33. National Institute for Public Health and the Environment (2010) Risk factors for food allergy. Bilthoven (The Netherlands): RIVM Report 340007001.

34. Wells G, Shea B, O'Connell D, Peterson J, Welch V, et al.. (2012) The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Health Research Institute website. Available: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 16 August 2012.

35. Rothman KJ, Greenland S, Lash TL (2008) Measure of effect and measures of association. Modern epidemiology. 3rd edition. Philadelphia: Lippincott, Williams and Wilkins. P61.

36. TakkoucheB, Cadarso-SuarezC, SpiegelmanD (1999) Evaluation of old and new tests of heterogeneity in epidemiologic meta-analysis. Am J Epidemiol 150: 206–215.

37. EggerM, Davey SmithG, SchneiderM, MinderC (1997) Bias in meta-analysis detected by a simple, graphical test. Br Med J 315: 629–634.

38. Costa-BouzasJ, TakkoucheB, Cadarso-SuarezC, SpiegelmanD (2001) HEpiMA: software for the identification of heterogeneity in meta-analysis. Comput Methods Programs Biomed 64: 101–107.

39. OzasaK, TakenakaH, TakagiN, AoikeA, KawaiK (1995) A case-control study of risk factors for Japanese cedar pollinosis. Jpn J Hyg 50: 622–630.

40. LinSY, RehDD, ClippS, IraniL, Navas-AcienA (2011) Allergic rhinitis and secondhand tobacco smoke: a population-based study. Am J Rhinol Allergy 25: e66–e71.

41. MiyakeY, TanakaK, ArakawaM (2011) Case-control study of IL13 polymorphisms, smoking, and rhinoconjunctivitis in Japanese women: the Kyushu Okinawa Maternal and Child Health Study. BMC Med Genet 12: 143.

42. WrightAL, HolbergCJ, HalonenM, MartinezFD, MorganW, et al. (1994) Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics 94: 895–901.

43. Annesi-MaesanoI, OryszczynM-P, NeukirchF, KauffmannF (1997) Relationship of upper airway disease to tobacco smoking and allergic markers: a cohort study of men followed up for 5 years. Int Arch Allergy Immunol 114: 193–201.

44. LewisSA, BrittonJR (1998) Consistent effects of high socioeconomic status and low birth order, and the modifying effect of maternal smoking on the risk of allergic disease during childhood. Respir Med 92: 1237–1244.

45. ShaheenSO, SterneJAC, MontgomerySM, AzimaH (1999) Birth weight, body mass index and asthma in young adults. Thorax 54: 396–402.

46. BergmannRL, EdenharterG, BergmannKE, LauS, WahnU (2000) Socioeconomic status is a risk factor for allergy in parents but not in their children. Clin Exp Allergy 30: 1740–1745.

47. TariqSM, HakimEA, MatthewsSM, ArshadSH (2000) Influence of smoking on asthmatic symptoms and allergen sensitisation in early childhood. Postgrad Med J 76: 694–699.

48. MagnussonLL, OlesenAB, WennborgH, OlsenJ (2005) Wheezing, asthma, hayfever, and atopic eczema in childhood following exposure to tobacco smoke in fetal life. Clin Exp Allergy 35: 1550–1556.

49. JohanssonA, LudvigssonJ, HermanssonG (2008) Adverse health effects related to tobacco smoke exposure in a cohort of three-year olds. Acta Pædiatr 97: 354–357.

50. NagataC, NakamuraK, FujiiK, KawachiT, TakatsukaN, et al. (2008) Smoking and risk of cedar pollinosis in Japanese men and women. Int Arch Allergy Immunol 147: 117–124.

51. KeilT, LauS, RollS, GruberC, NickelR, et al. (2009) Maternal smoking increases risk of allergic sensitization and wheezing only in children with allergic predisposition: longitudinal analysis from birth to 10 years. Allergy 64: 445–451.

52. CodispotiCD, LevinL, LeMastersGK, RyanP, ReponenT, et al. (2010) Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rinitis. J Allergy Clin Immunol 125: 1054–1060.

53. BakkeP, GulsvikA, EideGE (1990) Hay fever, eczema and urticaria in southwest Norway. Lifetime prevalences and association with sex, age, smoking habits, occupational airborne exposures and respiratory symptoms. Allergy 45: 515–522.

54. LeuenbergerP, SchwartzJ, Ackermann-LiebrichU, BlaserK, BologniniG, et al. (1994) Passive smoking exposure in adults and chronic respiratory symptoms (SAPALDIA Study) Swiss Study on Air Pollution and Lung Diseases in Adults, SAPALDIA Team. Am J Respir Crit Care Med 150: 1222–1228.

55. NgTP, TanWC (1994) Epidemiology of allergic rhinitis and its associated risk factors in Singapore. Int J Epidemiol 23: 553–558.

56. MoyesCD, WaldonJ, RamadasD, CraneJ, PearceN (1995) Respiratory symptoms and environmental factors in schoolchildren in the Bay of Plenty. N Z Med J 108: 358–361.

57. WüthrichB, SchindlerC, MediciTC, ZellwegerJP, LeuenbergerP (1996) IgE levels, atopy markers and hay fever in relation to age, sex and smoking status in a normal adult Swiss population. SAPALDIA (Swiss Study on Air Pollution and Lung Diseases in Adults) Team. Int Arch Allergy Immunol 111: 396–402.

58. MinY-G, JungH-W, KimHS, ParkSK, YooKY (1997) Prevalence and risk factors for perennial allergic rhinitis in Korea: results of a nationwide survey. Clin Otolaryngol 22: 139–144.

59. SiracusaA, MarabiniA, SensiL, BacoccoliR, RipandelliA, et al. (1997) Prevalence of asthma and rhinitis in Perugia, Italy. Monaldi Arch Chest Dis 52: 434–439.

60. AustinJB, RussellG (1997) Wheeze, cough, atopy, and indoor environment in the Scottish Highlands. Arch Dis Child 76: 22–26.

61. FarooqiIS, HopkinJM (1998) Early childhood infection and atopic disorder. Thorax 53: 927–32.

62. LamTH, ChungSF, BetsonCL, WongCM, HedleyAJ (1998) Respiratory symptoms due to active and passive smoking in junior secondary school students in Hong Kong. Int J Epidemiol 27: 41–48.

63. PonsonbyAL, CouperD, DwyerT, CarmichaelA (1998) Cross sectional study of the relation between sibling number and asthma, hay fever, and eczema. Arch Dis Child 79: 328–333.

64. MontefortS, LenickerHM, CarunaS, Agius MuscatH (1998) Asthma, rhinitis and eczema in Maltese 13–15 year-old schoolchildren – prevalence, severity and associated factors [ISAAC]. International Study of Asthma and Allergies in Childhood. Clin Exp Allergy 28: 1089–1099.

65. DuhmeH, WeilandSK, RudolphP, WienkeA, KramerA, et al. (1998) Asthma and allergies among children in West and East Germany: a comparison between Münster and Greifswald using the ISAAC phase I protocol. International Study of Asthma and Allergies in Childhood. Eur Respir J 11: 840–847.

66. BurrML, AndersonHR, AustinJB, HarkinsLS, KaurB, et al. (1999) Respiratory symptoms and home environment in children: a national survey. Thorax 54: 27–32.

67. DotterudLK, FalkES (1999) Atopic disease among adults in northern Russia, an area with heavy air pollution. Acta Derm Venereol 79: 448–450.

68. KeleşN, IlicaliC, DeğerK (1999) The effects of different levels of air pollution on atopy and symptoms of allergic rhinitis. Am J Rhinol 13: 185–190.

69. PlaschkePP, JansonC, NorrmanE, BjörnssonE, EllbjärS, et al. (2000) Onset and remission of allergic rhinitis and asthma and the relationship with atopic sensitization and smoking. Am J Respir Crit Care Med 162: 920–924.

70. ZacharasiewiczA, ZidekT, HaidingerG, WaldhorT, VutucC (2000) Symptoms suggestive of atopic rhinitis in children aged 6–9 years and the indoor environment. Allergy 55: 945–950.

71. UptonMN, McConnachieA, McSharryC, HartCL, SmithGD, et al. (2000) Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring. BMJ 321: 88–92.

72. OzdemirN, UçgunI, MetintasS, KolsuzM, MetintasM (2000) The prevalence of asthma and allergy among university freshmen in Eskisehir, Turkey. Respir Med 94: 536–541.

73. HjernA, HedbergA, HaglundB, RosénM (2001) Does tobacco smoke prevent atopic disorders? A study of two generations of Swedish residents. Clin Exp Allergy 31: 908–914.

74. JansonC, ChinnS, JarvisD, ZockJP, TorénK, et al. (2001) Effect of passive smoking on respiratory symptoms, bronchial responsiveness, lung function, and total serum IgE in the European Community Respiratory Health Survey: a cross-sectional study. Lancet 358: 2103–2109.

75. SimpsonBM, CustovicA, SimpsonA, HallamCL, WalshD, et al. (2001) NAC Manchester asthma and allergy study (NACMAAS): risk factors for asthma and allergic disorders in adults. Clin Exp Allergy 31: 391–399.

76. DotterudLK, OdlandJO, FalkES (2001) Atopic diseases among schoolchildren in Nikel, Russia, an Arctic area with heavy air pollution. Acta Derm Venereol 81: 198–201.

77. KalyoncuAF, DemirAU, OzcakarB, BozkurtB, ArtvinliM (2001) Asthma and allergy in Turkish university students: Two cross-sectional surveys 5 years apart. Allergol Immunopathol (Madr) 29: 264–271.

78. LeeSI, ShinMH, LeeHB, LeeJS, SonBK, et al. (2001) Prevalences of symptoms of asthma and other allergic diseases in Korean children: a nationwide questionnaire survey. J Korean Med Sci 16: 155–164.

79. StaziMA, SampognaF, MontaganoG, GrandolfoME, CouilliotMF, et al. (2002) Early life factors related to clinical manifestations of atopic disease but not to skin-prick test positivity in young children. Pediatr Allergy Immunol 13: 105–112.

80. PeroniDG, PiacentiniGL, AlfonsiL, ZermanL, Di BlasiwP, et al. (2003) Rhinitis in pre-school children: prevalence, association with allergic diseases and risk factors. Clin Exp Allergy 33: 1349–1354.

81. Barraza VillarrealA, Sanín AguirreLH, Téllez RojoMM, Lacasaña NavarroM, RomieuI (2003) Risk factors for asthma in school children from Ciudad Juárez, Chihuahua. J Asthma 40: 413–423.

82. MonteilMA, JosephG, Chang KitC, WheelerG, AntoineRM (2004) Smoking at home is strongly associated with symptoms of asthma and rhinitis in children of primary school age in Trinidad and Tobago. Rev Panam Salud Publica 16: 193–198.

83. LeeSL, WongW, LauYL (2004) Increasing prevalence of allergic rhinitis but not asthma among children in Hong Kong from 1995 to 2001 (Phase 3 International Study of Asthma and Allergies in Childhood). Pediatr Allergy Immunol 15: 72–78.

84. KrämerU, LemmenCH, BehrendtH, LinkE, SchäferT, et al. (2004) The effect of environmental tobacco smoke on eczema and allergic sensitization in children. Br J Dermatol 150: 111–118.

85. DemirAU, KarakayaG, BozkurtB, SekerelBE, KalyoncuAF (2004) Asthma and allergic diseases in schoolchildren: third cross-sectional survey in the same primary school in Ankara, Turkey. Pediatr Allergy Immunol 15: 531–538.

86. MiyakeY, YuraA, IkiM (2004) Cross-sectional study of allergic disorders in relation to familial factors in Japanese adolescents. Acta Paediatr 93: 380–385.

87. Annesi-MaesanoI, OryszczynMP, RaherisonC, KopferschmittC, PauliG, et al. (2004) Increased prevalence of asthma and allied diseases among active adolescent tobacco smokers after controlling for passive smoking exposure. A cause for concern? Clin Exp Allergy 34: 1017–1023.

88. DeS, FentonJE, JonesAS, ClarkeRW (2005) Passive smoking, allergic rhinitis and nasal obstruction in children. J Laryngol Otol 119: 955–957.

89. ToppR, ThefeldW, WichmannHE, HeinrichJ (2005) The effect of environmental tobacco smoke exposure on allergic sensitization and allergic rhinitis in adults. Indoor Air 15: 222–227.

90. MaziakW, KennethD, WardKD, RastamS, MzayekF, et al. (2005) Extent of exposure to environmental tobacco smoke (ETS) and its dose-response relation to respiratory health among adults. Respir Res 6: 13.

91. MiyakeY, MiyamotoS, OhyaY, SasakiS, MatsunagaI, et al. (2005) Association of active and passive smoking with allergic disorders in pregnant Japanese women: baseline data from the Osaka Maternal and Child Health Study. Ann Allergy Asthma Immunol 94: 644–651.

92. BugianiM, CarossoA, MiglioreE, PiccioniP, CorsicoA, et al. (2005) ISAYA (ECRHS Italy) Study Group. Allergic rhinitis and asthma comorbidity in a survey of young adults in Italy. Allergy 60: 165–70.

93. ObiharaCC, MaraisBJ, GieRP, PotterP, BatemanED, et al. (2005) The association of prolonged breastfeeding and allergic disease in poor urban children. Eur Respir J 25: 970–977.

94. StrumylaiteL, KregzdyteR, VaitkaitieneE (2005) Pasyvus rukymas ir vaiku kvepavimo sutrikimai [Passive smoking and respiratory health of children]. Medicina (Kaunas) 41: 348–354.

95. LundVJ, PreziosiP, HercbergS, HamoirM, DubreuilC, et al. (2006) Yearly incidence of rhinitis, nasal bleeding, and other nasal symptoms in mature women. Rhinology 44: 26–31.

96. KurosakaF, NakataniY, TeradaT, TanakaA, IkeuchiH, et al. (2006) Current cat ownership may be associated with the lower prevalence of atopic dermatitis, allergic rhinitis, and Japanese cedar pollinosis in schoolchildren in Himeji, Japan. Pediatr Allergy Immunol 17: 22–28.

97. SakarA, YorganciogluA, DincG, YukselH, CelikP, et al. (2006) The prevalence of asthma and allergic symptoms in Manisa, Turkey (A western city from a country bridging Asia and Europe). Asian Pac J Allergy Immunol 24: 17–25.

98. HoSY, LamTH, ChungSF, LamTP (2007) Cross-sectional and prospective associations between passive smoking and respiratory symptoms at the workplace. Ann Epidemiol 17: 126–131.

99. HorakE, MorassaB, UlmerbH (2007) Association between environmental tobacco smoke exposure and wheezing disorders in Austrian preschool children. Swiss Med Wkly 137: 608–613.

100. EbbertJO, CroghanIT, SchroederDR, MurawskiJ, HurtRD (2007) Association between respiratory tract diseases and secondhand smoke exposure among never smoking flight attendants: a cross-sectional survey. Environ Health 6: 28.

101. TanakaK, MiyakeY, ArakawaM, SasakiS, OhyaY (2007) Prevalence of asthma and wheeze in relation to passive smoking in Japanese children. Ann Epidemiol 17: 1004–1010.

102. ZuraimiMS, ThamKW, ChewFT, OoiPL, DavidK (2008) Home exposures to environmental tobacco smoke and allergic symptoms among young children in Singapore. Int Arch Allergy Immunol 146: 57–65.

103. FoliakiS, Annesi-MaesanoI, Tuuau-PotoiN, WaqatakirewaL, ChengS, et al. (2008) Risk factors for symptoms of childhood asthma, allergic rhinoconjunctivitis and eczema in the Pacific: an ISAAC Phase III study. Int J Tuberc Lung Dis 12: 799–780.

104. GómezR, TeijeiroA, ZernottiM, CanonicaG, MimessiG, et al. (2008) Smoking is a risk factor for having rhinitis in adolescents. Allergy 63: 419.

105. KabirZ, ManningPJ, HolohanJ, KeoganS, GoodmanPG, et al. (2009) Second-hand smoke exposure in cars and respiratory health effects in children. Eur Respir J 34: 629–633.

106. BrescianiniS, BrunettoB, IacovacciP, D'IppolitoC, AlbertiG, et al. (2009) Prevalence of self-perceived allergic diseases and risk factors in Italian adolescents. Pediatr Allergy Immunol 20: 578–84.

107. MusharrafiehU, Al-SahabB, ZaitounF, El-HajjMA, RamadanF, et al. (2009) Prevalence of asthma, allergic rhinitis and eczema among Lebanese adolescents. J Asthma 46: 382–87.

108. González-DíazSN, Del Río-NavarroBE, Pietropaolo-CienfuegosDR, Escalante-DomínguezAJ, García-AlmarazRG, et al. (2010) Factors associated with allergic rhinitis in children and adolescents from northern Mexico: International Study of Asthma and Allergies in Childhood Phase IIIB. Allergy Asthma Proc 31: 53–62.

109. Bedolla-BarajasM, Cuevas-RíosG, García-BarbozaE, Barrera-ZepedaAT, Morales-RomeroJ (2010) Prevalencia y factores asociados a la rinitis alérgica en escolares de Ciudad Guzmán, Mexico. [Prevalence and factors associated to allergic rhinitis among schoolchildren of Ciudad Guzmán, Mexico] Rev Invest Clin 62: 244–251.

110. WangHY, PizzichiniMM, BeckerAB, DuncanJM, FergusonAC, et al. (2010) Disparate geographic prevalences of asthma, allergic rhinoconjunctivitis and atopic eczema among adolescents in five Canadian cities. Pediatr Allergy Immunol 21: 867–877.

111. VlaskiE, StavricK, SeckovaL, KimovskaM, IsjanovskaR (2011) Do household tobacco smoking habits influence asthma, rhinitis and eczema among 13–14 year-old adolescents? Allergol Immunopathol 39: 39–44.

112. VirkkulaP, LiukkonenK, SuomalainenAK, AronenET, KirjavainenT, et al. (2011) Parental smoking, nasal resistance and rhinitis in children. Acta Paediatr 100: 1234–1238.

113. HåkanssonK, von BuchwaldC, ThomsenSF, ThyssenJP, BackerV, et al. (2011) Nonallergic rhinitis and its association with smoking and lower airway disease: a general population study. Am J Rhinol Allergy 25: 25–29.

114. ChenBY, ChanCC, HanYY, WuHP, GuoYL (2012) The risk factors and quality of life in children with allergic rhinitis in relation to seasonal attack patterns. Paediatr Perinat Epidemiol 26: 146–155.

115. PeñarandaA, AristizabalG, GarciaE, VasquezC, Rodriguez-MartinezCE, et al. (2012) Allergic rhinitis and associated factors in schoolchildren from Bogota, Colombia. Rhinology 50: 122–128.

116. TanakaK, MiyakeY, ArakawaM (2012) Smoking and prevalence of allergic disorders in Japanese pregnant women: baseline data from the Kyushu Okinawa Maternal and Child Health Study. Environ Health 11: 15.

117. MontefortS, EllulP, MontefortM, CaruanaS, GrechV, et al. (2012) The effect of cigarette smoking on allergic conditions in Maltese children (ISAAC). Pediatr Allergy Immunol 23: 472–478.

118. MitchellEA, BeasleyR, KeilU, MontefortS, OdhiamboJ, et al. (2012) The association between tobacco and the risk of asthma, rhinoconjunctivitis and eczema in children and adolescents: analyses from Phase Three of the ISAAC programme. Thorax 67: 941–949.

119. MillsCM, SrivastavaED, HarveyIM, SwiftGL, NewcombeRG, et al. (1994) Cigarette smoking is not a risk factor in atopic dermatitis. Int J Dermatol 33: 33–34.

120. YangCY, ChengMF, HsiehYL (2000) Effects of indoor environmental factors on risk for atopic eczema in a subtropical area. J Toxicol Environ Health A 61: 245–253.

121. PurvisDJ, ThompsonJM, ClarkPM, RobinsonE, BlackPN, et al. (2005) Risk factors for atopic dermatitis in New Zealand children at 3.5 years of age. Br J Dermatol 152: 742–749.

122. HaileamlakA, DagoyeD, WilliamsH, VennAJ, HubbardR, et al. (2005) Early life risk factors for atopic dermatitis in Ethiopian children. J Allergy Clin Immunol 115: 370–376.

123. SebõkB, SchneiderI, HarangiF (2006) Primary Care Paediatricians in Baranya County. Familiar and environmental factors influencing atopic dermatitis in the childhood. J Eur Acad Dermatol Venereol 20: 418–422.

124. MiyakeY, TanakaK, ArakawaM (2011) IL13 genetic polymorphisms, smoking, and eczema in women: a case-control study in Japan. BMC Med Genet 12: 142.

125. BurrML, MiskellyFG, ButlandBK, MerrettTG, Vaughan-WilliamsE (1989) Environmental factors and symptoms in infants at high risk of allergy. J Epidemiol Community Health 43: 125–132.

126. ZeigerRS, HellerS (1995) The development and prediction of atopy in high-risk children: follow-up at age seven years in a prospective randomized study of combined maternal and infant food allergen avoidance. J Allergy Clin Immunol 95: 1179–1190.

127. OlesenAB, EllingsenAR, OlesenH, JuulS, Thestrup-PedersenK (1997) Atopic dermatitis and birth factors: historical follow up by record linkage. BMJ 314: 1003–1008.

128. BergmannRL, DiepgenTL, KussO, BergmannKE, KujatJ, et al. (2002) Breastfeeding duration is a risk factor for atopic eczema. Clin Exp Allergy 32: 205–209.

129. KerkhofM, KoopmanLP, van StrienRT, WijgaA, SmitHA, et al. (2003) Risk factors for atopic dermatitis in infants at high risk of allergy: the PIAMA study. Clin Exp Allergy 33: 1336–1341.

130. LinnebergA, SimonsenJB, PetersenJ, StensballeLG, BennCS (2006) Differential effects of risk factors on infant wheeze and atopic dermatitis emphasize a different etiology. J Allergy Clin Immunol 117: 184–189.

131. LerbaekA, KyvikKO, RavnH, MennéT, AgnerT (2007) Incidence of hand eczema in a population-based twin cohort: genetic and environmental risk factors. Br J Dermatol 157: 552–557.

132. NoakesP, TaylorA, HaleJ, BrecklerL, RichmondP, et al. (2007) The effects of maternal smoking on early mucosal immunity and sensitization at 12 months of age. Pediatr Allergy Immunol 18: 118–127.

133. SariachviliM, DrosteJ, DomS, WieringaM, VellingaA, et al. (2007) Is breast feeding a risk factor for eczema during the first year of life? Pediatr Allergy Immunol 18: 410–417.

134. TanakaK, MiyakeY, SasakiS, OhyaY, HirotaY, et al. (2008) Maternal smoking and environmental tobacco smoke exposure and the risk of allergic diseases in Japanese infants: the Osaka Maternal and Child Health Study. J Asthma 45: 833–838.

135. BöhmeM, KullI, BergströmA, WickmanM, NordvallL, et al. (2010) Parental smoking increases the risk for eczema with sensitization in 4-year-old children. J Allergy Clin Immunol 125: 941–943.

136. JedrychowskiW, PereraF, MaugeriU, Mrozek-BudzynD, MillerRL, et al. (2011) Effects of prenatal and perinatal exposure to fine air pollutants and maternal fish consumption on the occurrence of infantile eczema. Int Arch Allergy Immunol 155: 275–281.

137. EdmanB (1988) Palmar eczema: a pathogenetic role for acetylsalicylic acid, contraceptives and smoking? Acta Derm Venereol 68: 402–407.

138. VolkmerRE, RuffinRE, WiggNR, DaviesN (1995) The prevalence of respiratory symptoms in South Australian preschool children. II. Factors associated with indoor air quality. J Paediatr Child Health 31: 116–120.

139. LissGM, SussmanGL, DealK, BrownS, CividinoM, et al. (1997) Latex allergy: epidemiological study of 1351 hospital workers. Occup Environ Med 54: 335–342.

140. SchäferT, DirschedlP, KunzB, RingJ, UberlaK (1997) Maternal smoking during pregnancy and lactation increases the risk for atopic eczema in the offspring. J Am Acad Dermatol 36: 550–556.

141. LinnebergA, NielsenNH, MennéT, MadsenF, JørgensenT (2003) Smoking might be a risk factor for contact allergy. J Allergy Clin Immunol 111: 980–984.

142. MontnemeryP, NihlénU, Göran LöfdahlC, NybergP, SvenssonA (2003) Prevalence of self-reported eczema in relation to living environment, socio-economic status and respiratory symptoms assessed in a questionnaire study. BMC Dermatol 3: 4.

143. YemaneberhanH, FlohrC, LewisSA, BekeleZ, ParryE, et al. (2004) Prevalence and associated factors of atopic dermatitis symptoms in rural and urban Ethiopia. Clin Exp Allergy 34: 779–785.

144. HeudorfU, SchümannM, AngererJ, ExnerM (2005) Dermal and bronchial symptoms in children: are they caused by PAH containing parquet glue or by passive smoking? Int Arch Occup Environ Health 78: 655–662.

145. MontnemeryP, NihlénU, LöfdahlCG, NybergP, SvenssonA (2005) Prevalence of hand eczema in an adult Swedish population and the relationship to risk occupation and smoking. Acta Derm Venereol 85: 429–432.

146. DotterudLK, Smith-SivertsenT (2007) Allergic contact sensitization in the general adult population: a population-based study from Northern Norway. Contact Dermatitis 56: 10–15.

147. Al-SahabB, AtouiM, MusharrafiehU, ZaitounF, RamadanF, et al. (2008) Epidemiology of eczema among Lebanese adolescents. Int J Public Health 53: 260–267.

148. ErginS, OzşahinA, ErdoğanBS, AktanS, ZencirM (2008) Epidemiology of atopic dermatitis in primary schoolchildren in Turkey. Pediatr Dermatol 25: 399–401.

149. Suárez-VarelaM, García-MarcosL, KoganMD, Llopis GonzálezA, Martínez GimenoA, et al. (2008) Parents' smoking habit and prevalence of atopic eczema in 6–7 and 13–14 year-old schoolchildren in Spain. ISAAC phase III. Allergol Immunopathol (Madr) 36: 336–442.

150. AttwaE, el-LaithyN (2009) Contact dermatitis in car repair workers. J Eur Acad Dermatol Venereol 23: 138–145.

151. MedingB, AlderlingM, AlbinM, BrismanJ, WrangsjöK (2009) Does tobacco smoking influence the occurrence of hand eczema? Br J Dermatol 160: 514–518.

152. LipińskaKI, ElgalalA, KunaP (2009) Epidemiologia atopowego zapalenia skory w populacji ogolnej mieszkancow wojewodztwa lodzkiego [Epidemiology of atopic dermatitis in general population of Lodz province's citizens]. Pneumonol Alergol Pol 77: 145–151.

153. XepapadakiP, ManiosY, LiarigkovinosT, GrammatikakiE, DouladirisN, et al. (2009) Association of passive exposure of pregnant women to environmental tobacco smoke with asthma symptoms in children. Pediatr Allergy Immunol 20: 423–429.

154. RöhrlK, StenbergB (2010) Lifestyle factors and hand eczema in a Swedish adolescent population. Contact Dermatitis 62: 170–176.

155. ThyssenJP, LinnebergA, MennéT, NielsenNH, JohansenJD (2010) The effect of tobacco smoking and alcohol consumption on the prevalence of self-reported hand eczema: a cross-sectional population-based study. Br J Dermatol 162: 619–626.

156. MedingB, AlderlingM, WrangsjöK (2010) Tobacco smoking and hand eczema: a population-based study. Br J Dermatol 163: 752–756.

157. YangYW, ChenYH, HuangYH (2011) Cigarette smoking may modify the risk of depression in eczema among adults: a preliminary study using NHANES 2005–2006. J Eur Acad Dermatol Venereol 25: 1048–1053.

158. CivelekE, SahinerUM, YükselH, BozAB, OrhanF, et al. (2011) Prevalence, burden, and risk factors of atopic eczema in schoolchildren aged 10–11 years: a national multicenter study. J Investig Allergol Clin Immunol 21: 270–277.

159. Dei-CasP, AcuñaMK, Dei-CasI (2011) Atopic dermatitis in children: a comparative survey among 2 age groups. Rev Chil Pediatr 82: 410–418.

160. ApfelbacherCJ, DiepgenTL, SchmittJ (2011) Determinants of eczema: population-based cross-sectional study in Germany. Allergy 66: 206–213.

161. ParkH, KimK (2011) Association of blood mercury concentrations with atopic dermatitis in adults: a population-based study in Korea. Environ Res 111: 573–578.

162. BerglindIA, AlderlingM, MedingB (2011) Life-style factors and hand eczema. Br J Dermatol 165: 568–575.

163. BreunigJA, de AlmeidaHLJr, DuquiaRP, SouzaPR, StaubHL (2012) Scalp seborrheic dermatitis: prevalence and associated factors in male adolescents. Int J Dermatol 51: 46–49.

164. YiO, KwonHJ, KimH, HaM, HongSJ, et al. (2012) Effect of environmental tobacco smoke on atopic dermatitis among children in Korea. Environ Res 113: 40–45.

165. RönmarkEP, EkerljungL, LötvallJ, WennergrenG, RönmarkE, et al. (2012) Eczema among adults: prevalence, risk factors and relation to airway diseases. Results from a large-scale population survey in Sweden. Br J Dermatol 166: 1301–1308.

166. Kavaliūnas A (2011) Padidėjusio jautrumo maisto produktams ir alergijos maistui paplitimas tarp Vilniaus miesto gyventoju˛ [The prevalence of adverse reactions to food and food allergy among Vilnius city (Lithuania) inhabitants] [dissertation]. Vilnius: Institute of Public Health, Vilnius University.

167. KuligM, LuckW, LauS, NiggemannB, BergmannR, et al. (1999) Effect of pre- and postnatal tobacco smoke exposure on specific sensitization to food and inhalant allergens during the first 3 years of life. Multicenter Allergy Study Group, Germany. Allergy 54: 220–228.

168. DubakienėR, ŠurkienėG, StukasR, Pirmaitytė-VileskoJ, KavaliūnasA (2008) Food allergies among 5th–9th grade schoolchildren in Vilnius (Lithuania). Ekologija 54: 1–4.

169. TaylorB, WadsworthJ, GoldingJ, ButlerN (1983) Breast feeding, eczema, asthma, and hayfever. J Epidemiol Community Health 37: 95–99.

170. ButlandBK, StrachanDP, LewisS, BynnerJ, ButlerN, et al. (1997) Investigation into the increase in hay fever and eczema at age 16 observed between the 1958 and 1970 British birth cohorts. BMJ 315: 717–721.

171. ArshadSH, StevensM, HideDW (1993) The effect of genetic and environmental factors on the prevalence of allergic disorders at the age of two years. Clin Exp Allergy 23: 504–511.

172. BiaginiJM, LeMastersGK, RyanPH, LevinL, ReponenT, et al. (2006) Environmental risk factors of rhinitis in early infancy. Pediatr Allergy Immunol 17: 278–284.

173. RehDD, LinSY, ClippSL, IraniL, AlbergAJ, et al. (2009) Secondhand tobacco smoke exposure and chronic rhinosinusitis: a population-based case-control study. Am J Rhinol Allergy 23: 562–567.

174. MerrettTG, BurrML, ButlandBK, MerrettJ, MiskellyFG, et al. (1988) Infant feeding and allergy: 12-month prospective study of 500 babies born into allergic families. Ann Allergy 61: 13–20.

175. Dei-CasI, Dei-CasP, AcuñaK (2009) Atopic dermatitis and risk factors in poor children from Great Buenos Aires, Argentina. Clin Exp Dermatol 34: 299–303.

176. WangIJ, HsiehWS, WuKY, GuoYL, HwangYH, et al. (2008) Effect of gestational smoke exposure on atopic dermatitis in the offspring. Pediatr Allergy Immunol 19: 580–586.

177. DotterudLK, OdlandJØ, FalkES (2004) Atopic dermatitis and respiratory symptoms in Russian and northern Norwegian school children: a comparison study in two arctic areas and the impact of environmental factors. J Eur Acad Dermatol Venereol 18: 131–136.

178. DotterudLK, OdlandJO, FalkES (2000) Atopic diseases among adults in the two geographically related arctic areas Nikel, Russia and Sør-Varanger, Norway: possible effects of indoor and outdoor air pollution. J Eur Acad Dermatol Venereol 14: 107–111.

179. KuligM, LuckW, WahnU (1999) The association between pre- and postnatal tobacco smoke exposure and allergic sensitization during early childhood. Multicentre Allergy Study Group, Germany. Hum Exp Toxicol 18: 241–244.

180. MiyakeY, OhyaY, TanakaK, YokoyamaT, SasakiS, et al. (2007) Home environment and suspected atopic eczema in Japanese infants: the Osaka Maternal and Child Health Study. Pediatr Allergy Immunol 18: 425–432.

181. ThyssenJP, JohansenJD, MennéT, NielsenNH, LinnebergA (2010) Effect of tobacco smoking and alcohol consumption on the prevalence of nickel sensitization and contact sensitization. Acta Derm Venereol 90: 27–33.

182. BarbeeRA, HalonenM, KaltenbornWT, BurrowsB (1991) A longitudinal study of respiratory symptoms in a community population sample. Correlations with smoking, allergen skin-test reactivity, and serum IgE. Chest 99: 20–26.

183. ThomsenSF, UlrikCS, PorsbjergC, BackerV (2006) Early life exposures and risk of atopy among Danish children. Allergy Asthma Proc 27: 110–114.

184. LarssonML, MagnusonA, MontgomerySM (2005) Parental smoking and allergic sensitization in offspring defined by skin prick testing. Pediatr Allergy Immunol 16: 449–452.

185. LiptayS, BauerCP, GrüblA, FranzR, EmmrichP (1991) Atopieentwicklung in der fruhen Kindheit–Pradisponierende Faktoren [Development of atopic disease in early childhood–predisposing factors]. Monatsschr Kinderheilkd 139: 130–135.

186. WittigHJ, McLaughlinET, LeiferKL, BelloitJD (1978) Risk factors for the development of allergic disease: analysis of 2,190 patient records. Ann Allergy 41: 84–88.

187. LinnebergA, NielsenNH, MadsenF, FrølundL, DirksenA, et al. (2001) Smoking and the development of allergic sensitization to aeroallergens in adults: a prospective population-based study. The Copenhagen Allergy Study. Allergy 56: 328–332.

188. ZetterströmO, OstermanK, MachadoL, JohanssonSG (1981) Another smoking hazard: raised serum IgE concentration and increased risk of occupational allergy. BMJ 283: 1215–1217.

189. BråbäckL, KjellmanNI, SandinA, BjörksténB (2001) Atopy among schoolchildren in northern and southern Sweden in relation to pet ownership and early life events. Pediatr Allergy Immunol 12: 4–10.

190. RaherisonC, Pénard-MorandC, MoreauD, CaillaudD, CharpinD, et al. (2008) Smoking exposure and allergic sensitization in children according to maternal allergies. Ann Allergy Asthma Immunol 100: 351–357.

191. BakosN, SchöllI, SzalaiK, KundiM, UntersmayrE, et al. (2006) Risk assessment in elderly for sensitization to food and respiratory allergens. Immunol Lett 107: 15–21.

192. Harris-RobertsJ, RobinsonE, WaterhouseJC, BillingsCG, ProctorAR, et al. (2009) Sensitization to wheat flour and enzymes and associated respiratory symptoms in British bakers. Am J Ind Med 52: 133–140.

193. TsunodaK, OhtaY, ShinogamiM, SodaY (1995) Does passive smoking affect the incidence of nasal allergies? Am J Public Health 85: 1019–1020.

194. JeebhayMF, RobinsTG, MillerME, BatemanE, SmutsM, et al. (2008) Occupational allergy and asthma among salt water fish processing workers. Am J Ind Med 51: 899–910.

195. AngioniAM, FanciulliG, CorchiatC (1989) Frequency of and risk factors for allergy in primary school children: results of a population Survey. Paediatr Perinat Epidemiol 3: 248–255.

196. FrankP, MorrisJ, HazellM, LinehanM, FrankT (2006) Smoking, respiratory symptoms and likely asthma in young people: evidence from postal questionnaire surveys in the Wythenshawe Community Asthma Project (WYCAP). BMC Pulm Med 6: 10.

197. GuedesHTV, SouzaLSF (2009) Exposure to maternal smoking in the first year of life interferes in breast-feeding protective effect against the onset of respiratory allergy from birth to 5 yr. Pediatr Allergy Immunol 20: 30–34.

198. StaikūnieneJ, SakalauskasR (2003) Ziedadulkiu sukelto alerginio rinito ir bronchu astmos imunologines savybes bei rizikos veiksniai [The immunological parameters and risk factors for pollen-induced allergic rhinitis and asthma]. Medicina (Kaunas) 39: 244–253.

199. DubakienėR, VaicekauskaitėD, ŽidanavičiūtėJ, JoneliūnienėI, DrąsutienėG, et al. (2006) Human ecology studies: the role of environmental factors in pregnancy. Ekologija 4: 18–21.

200. WoodsRK, AbramsonM, RavenJM, BaileyM, WeinerJM, et al. (1998) Reported food intolerance and respiratory symptoms in young adults. Eur Respir J 11: 151–155.

201. HuangSW (2007) Follow-up of children with rhinitis and cough associated with milk allergy. Pediatr Allergy Immunol 18: 81–85.

202. PegasPN, AlvesCA, ScottoMG, EvtyuginaMG, PioCA, et al. (2011) Factores de risco e prevalencia de asma e rinite em criancas em idade escolar em Lisboa [Risk factors and prevalence of asthma and rhinitis among schoolchildren in Lisbon]. Rev Port Pneumol 17: 109–116.

203. GustafssonD, AnderssonK, FagerlundI, KjellmanNI (1996) Significance of indoor environment for the development of allergic symptoms in children followed up to 18 months of age. Allergy 51: 789–795.

204. HagendorensMM, BridtsCH, LauwersK, van NuijsS, EboDG, et al. (2005) Perinatal risk factors for sensitization, atopic dermatitis and wheezing during the first year of life (PIPO study). Clin Exp Allergy 35: 733–740.

205. LucasA, BrookeOG, ColeTJ, MorleyR, BamfordMF (1990) Food and drug reactions, wheezing, and eczema in preterm infants. Arch Dis Child 65: 411–415.

206. VesseyMP, PainterR, PowellJ (2000) Skin disorders in relation to oral contraception and other factors, including age, social class, smoking and body mass index. Findings in a large cohort study. Br J Dermatol 143: 815–820.

207. GirolomoniG, AbeniD, MasiniC, SeraF, AyalaF, et al. (2003) The epidemiology of atopic dermatitis in Italian schoolchildren. Allergy 58: 420–425.

208. DubakieneR, RudzevicieneO, ButieneI, SezaiteI, PetronyteM, et al. (2012) Studies on early allergic sensitization in the Lithuanian birth cohort. Sci World J 2012: 909524.

209. MitchellEA, StewartAW (2001) ISAAC Phase One Study Group (2001) International Study of Asthma and Allergy in Childhood. The ecological relationship of tobacco smoking to the prevalence of symptoms of asthma and other atopic diseases in children: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur J Epidemiol 17: 667–673.

210. The Global Youth Tobacco Survey Collaborative Group (2002) Tobacco use among youth: a cross country comparison. Tob Control 11: 252–270.

211. KingK, MartynenkoM, BergmanMH, LiuYH, WinickoffJP, et al. (2009) Family composition and children's exposure to adult smokers in their homes. Pediatrics 123: e559–64.

212. Centers for Disease Control and Prevention (2007) Exposure to secondhand smoke among students aged 13–15 years-worldwide, 2000–2007. MMWR 56: 497–500.

213. Rothman KJ (1986) Modern epidemiology. Boston: Little, Brown and Co. p.39.

214. US Department of Health and Human Services (2007) Children and secondhand smoke exposure. Excerpts from The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

215. US Department of Health and Human Services (1986) The Health Consequences of Involuntary Smoking. A Report of the Surgeon General. Rockville (Maryland): US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health.

216. Pérez-RíosM, SchiaffinoA, LópezMJ, NebotM, GalánI, et al. (2013) Questionnaire-based second-hand smoke assessment in adults. Eur J Public Health 23: 763–767.

217. WahnU (2000) What drives the allergic march? Allergy 55: 591–599.