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      Atopic dermatitis is associated with active and passive cigarette smoking in adolescents

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          Abstract

          Objective

          The relationship between passive smoking and atopic dermatitis has previously been reported, but few studies have simultaneously evaluated the association of atopic dermatitis with active and passive smoking.

          Methods

          The relationships between atopic dermatitis and active and passive smoking were evaluated in Korean adolescents. We used a large, representative, population-based survey (The Korea Youth Risk Behavior Web-based Survey) conducted in 2011 and 2012. Active smoking was classified into 3 groups (0 days, 1–19 days, and ≥ 20 days/month). Passive smoking was categorized into 3 groups (0 days, 1–4 days, and ≥ 5 days/week). Atopic dermatitis diagnosed by a medical doctor either during the past 1 month or during the participant’s lifetime was surveyed. Age, sex, obesity status, region of residence, economic level, and parental educational level of the participants were adjusted as confounders. Adjusted odds ratios (AORs) and 95% confidence intervals (CI) were calculated using multiple logistic regression analysis with complex sampling.

          Results

          A total of 6.8% (10,020/135,682) of the participants reported atopic dermatitis during the last 12 months. Active smoking was significantly associated with atopic dermatitis (previous 12 months) (AOR [95% CI] of smoking ≥ 20 days/month = 1.18 [1.07–1.29]; 1–19 days/month = 1.11 [0.99–1.23], P = 0.002). Passive smoking was also related to atopic dermatitis (previous 12 months) (AOR [95% CI] of smoking ≥ 5 days/week = 1.12 [1.05–1.20]; 1–4 days/week = 1.08 [1.03–1.13], P < 0.001).

          Conclusion

          Atopic dermatitis was significantly associated with active and passive smoking in Korean adolescents.

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          Most cited references17

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          Independent association of various smoking characteristics with markers of systemic inflammation in men. Results from a representative sample of the general population (MONICA Augsburg Survey 1994/95).

          Aim of the study was to investigate the association between various markers of systemic inflammation and a detailed history of smoking in a large representative sample of the general population. The effects of chronic smoking on white blood cell (WBC) count, fibrinogen, albumin, plasma viscosity (PV), and high-sensitivity C-reactive protein (CRP) were measured in 2305 men and 2211 women, age 25-74 years, participating in the third MONICA Augsburg survey 1994/95. In men, current smokers showed statistically significantly higher values for WBC count, fibrinogen, PV, and CRP, compared to never smokers, with intermediate, but only slightly increased values for ex-smokers and for occasional smokers. No consistent associations were seen with albumin. Duration of smoking was positively associated with markers of inflammation as were pack-years of smoking. Conversely, duration of abstinence from smoking was inversely related to these markers. Except for WBC count, no such associations were found in women. Data from this large representative population show strong associations between smoking and various markers of systemic inflammation in men. They also show that cessation of smoking is associated with a decreased inflammatory response, which may represent one mechanism responsible for the reduced cardiovascular risk in these subjects.
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            Validity of self-reported height, weight, and body mass index of the Korea Youth Risk Behavior Web-based Survey questionnaire.

            Self-reported anthropometric values, such as height and weight, are used to calculate body mass index (BMI) and assess the prevalence of obesity among adolescents. The aim of this study was to evaluate the validity of self-reported height, weight, and BMI of the Korea Youth Risk Behavior Web-based Survey questionnaire. A convenience sample of 137 middle school students and 242 high school students completed a self-administered questionnaire in 2008. Body height and weight were directly measured after self-reported values were obtained from the questionnaire survey. Sensitivity, specificity, and kappa statistics were computed in order to evaluate the validity of the prevalence of obesity (BMI ≥ 95th percentile or ≥ 25 kg/m(2)) based on self-reported data. Self-reported weight and BMI tended to be underestimated. Self-reported height tended to be overestimated among middle school females and high school males. Obese adolescents tended to underestimate their weight and BMI and overestimate their height more than non-obese adolescents. The prevalence estimate of obesity based on self-reported data (10.6%) was lower than that based on directly measured data (15.3%). The estimated sensitivity of obesity based on self-reported data was 69.0% and the specificity was 100.0%. The value of kappa was 0.79 (95% confidence interval, 0.70-0.88). This study demonstrated that self-reported height and weight may lead to the underestimation of BMI and consequently the prevalence of obesity. These biases should be taken into account when self-reported data are used for monitoring the prevalence and trends of obesity among adolescents nationwide.
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              The effect of environmental tobacco smoke on eczema and allergic sensitization in children.

              The negative impact of environmental tobacco smoke (ETS) on airway diseases in children is well known. Whether there is an effect on atopic eczema is not clear. To determine the impact of ETS on atopic eczema, allergic sensitization and allergic airway diseases in 1669 school beginners. The prevalence of atopy-related health outcomes was assessed by questionnaire, dermatological examination, skin prick testing and specific immunoglobulin E measurement. Exposure assessments were based on measurement of cotinine [expressed as cotinine to creatine ratio (CCR)] in spot urine samples (n = 1220) together with questionnaire and interview data on smoking behaviour of the parents. In the total study group, prevalence of atopic eczema diagnosed on examination was significantly associated with urinary CCR values. The odds ratio (OR) and 95% confidence interval (CI), calculated for an increase of 100 ng mg-1 CCR was 1.97 (95% CI 1.23-3.16). The prevalence of skin manifestations according to questionnaire data as well as a history of asthma, wheezing, and hay fever were positively although not significantly associated with ETS exposure. When genetically predisposed children (defined by the presence of parental atopy) were compared with children whose parents had no atopy, the ORs of allergic outcome variables were generally higher in the first group. In the group of predisposed children, significant associations with urinary CCR were found for allergic sensitization against house dust mites as measured by skin prick test (OR 3.10, 95% CI 1.63-5.90). Children are at a higher risk of developing an atopic eczema when exposed to ETS and genetically predisposed children are at higher risk of developing a sensitization against house dust mites.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysis
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                1 November 2017
                2017
                : 12
                : 11
                : e0187453
                Affiliations
                [1 ] Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
                [2 ] Department of Statistics, Hallym University, Chuncheon, Korea
                [3 ] Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
                Centre for Addiction and Mental Health, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-1655-9549
                Article
                PONE-D-17-09157
                10.1371/journal.pone.0187453
                5665603
                29091936
                7311b439-bef6-4dfe-a415-225ec65ad448
                © 2017 Kim et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 March 2017
                : 19 October 2017
                Page count
                Figures: 1, Tables: 3, Pages: 11
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100003725, National Research Foundation of Korea;
                Award ID: NRF-2015-R1D1A1A01060860
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100002632, Hallym University;
                Award ID: HURF-2016-38
                Award Recipient :
                Funded by: Korea ministry of environment
                Award ID: 2016001360009
                Award Recipient :
                This work was supported in part by a research grant (NRF-2015-R1D1A1A01060860) from the National Research Foundation (NRF) of Korea, a Research Grant funded by Hallym University Sacred Heart Hospital (HURF-2016-38), and a Korea Ministry of Environment (MOE) as "The Environmental Health Action Program"(2016001360009). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Custom metadata
                The data underlying this study are third party data that are available to qualified researchers from Korean Youth Risk Behaviour Web-based Survey (KYRBWS). Interested researchers may apply for access to these data by contacting KYRBWS directly ( https://yhs.cdc.go.kr/new/, tel: +82-43-719-7474,7471). The authors do not have any special access to these data and confirm that interested researchers may apply for access to these data in the manner described.

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