Risk factors for childhood respiratory disease. The effect of host factors and home environmental exposures.

Standardized respiratory disease questionnaires (ATS-DLD-78-C) were completed by the parents of 4,071 children 5 to 14 yr of age, and risk factors for respiratory symptoms were evaluated by logistic analysis. Younger age, male sex, and lower socioeconomic status (SES) were independent risk factors for most respiratory symptoms and illnesses. All respiratory outcomes were significantly more prevalent in children with a physician's diagnosis of asthma. Asthma was more prevalent in male (4.5%) than in female (2.6%) children, and the greater prevalence of most respiratory symptoms in males did not persist in children with the same asthma status. Children whose questionnaires were completed by their fathers were reported to have significantly fewer respiratory symptoms than children with mother-completed questionnaires. We postulate that fathers underreport symptoms for their children. A positive parental history of allergy or respiratory illness was an independent predictor of respiratory symptoms and illnesses in the children. Chest illness before 2 yr of age and chest illness in the past year showed a significant positive linear trend with the number of parental smokers, and these effects of passive smoking were confirmed in the logistic analysis. The use of gas cooking stoves, inversely associated with SES, was not an independent risk factor for any respiratory symptoms or illnesses.