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Cough  2006 

Chronic productive cough in school children: prevalence and associations with asthma and environmental tobacco smoke exposure

DOI: 10.1186/1745-9974-2-11

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We performed a cross sectional survey of 2397 Seattle middle school students, 11–15 years old, using written and video respiratory-symptom questionnaires. We defined CPC as – daily cough productive of phlegm for at least 3 months out of the year; current asthma as – yes to "Have you had wheezing or whistling in your chest in the past 12 months?" and yes in the past year to any of the four video wheezing/asthma video scenarios; and ETS exposure as exposed to tobacco smoke at least several hours each day. We used multilogistic regression to examine relationships between CPC, asthma, and ETS exposure and included in the model the potentially confounding variables race, gender, and allergic rhinitis.The prevalence of CPC was 7.2%. Forty-seven percent (82/173) of children with CPC met criteria for current asthma, while only 10% (214/2224) of those without CPC had current asthma. Current asthma had the strongest associated with CPC, odds ratio (OR) 6.4 [95% CI 4.5–9.0], and ETS was independently associated with both CPC, OR 2.7 [1.8–4.1] and asthma, OR 2.7 [1.5–4.7].In a population of young teenagers, CPC was strongly associated with report of current asthma symptoms and also with ETS exposure. This suggests that asthma and ETS exposure may contribute to CPC in children. However, this study was not designed to determine whether asthma was the actual cause of CPC in this population of children.Asthma is a recognized cause of persistent cough in both adults [1,2] children [3], but cough productive of sputum for more than three months out of the year, referred to as chronic productive cough (CPC), is not considered common in children with asthma. The NHLBI guidelines do not discuss productive cough as a separate sign [4], and little is known about the prevalence of CPC and its causes in children.Chronic productive cough is a hallmark of the rare conditions cystic fibrosis, ciliary dysmotility, and bronchiectasis, but it is possible that asthma and ETS exposure lead to CPC as


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