[P4179] Burden of second-hand-smoke (SHS) in persistent asthmatic children

Second-hand-smoke (SHS) appears to lead to higher severity of asthma in childhood. The aim of this study was to evaluate if SHS affects the severity of asthma in a series of asthmatic children followed at the IBIM Pulmonary and Allergy Paediatric Clinic and investigated through standardized questionnaire and spirometry. Statistical analysis was performed with SPSS release 19. 95 (44.81%) SHS exposed (SHSe) and 117 (55.18%) SHS non exposed (SHSne) were analysed, aged 9.17±2.65 and 9.16±2.83, respectively. Exposure to maternal smoke in pregnancy was found only in SHSe (p<0.0001). With regard to SHSne, SHSe showed lower percentage of exclusive breast feeding (51.6% vs 67.5%, p=0.018), paternal history of rhinitis (17% vs 29,1%, p=0.041), whereas they showed higher BMI (Kg/m2)(20.56±4.83 vs 18.89±4.51, p=0.010), previous multitrigger wheezing (67.2% vs 50%, p=0.047), recurrent otitis (>=4/life) (15.8% vs 9.5%, p=0.166) and Lower Respiratory Infections (46.3% vs 35%, p=0.096), and current exposure to pet (31.6% vs 15.4%, p<0.005). With regard to SHSne intermittent asthmatics, SHSe persistent asthmatics showed lower FEV1(%Pred) 87.14±13.90 vs 99.09±10.03(p<0.0001); FVC (%Pred) 93.28±15.46 vs 99.16±10.89 (p=0.033); FEV1/FVC (%Pred) 93.28±15.46 vs 99.59±6.26 (p=0.0001);FEF25-75(%Pred)72.20±19.16 vs 94.80±19.14 (p<0.0001), higher number (>=2) of severe exacerbations in the last 12 months (p=0.005).For the latter, by regression logistic model, paternal history of rhinitis and maternal smoke in pregnancy were the only significant risk factors (OR=8.54, 95%CI 2.36-30.88, p<0,001 and OR=2.58, 95%CI 0.74-8.96, P=0,133, respectively. In conclusion, SHSe in persistent asthmatic children is associated with uncontrolled asthma.