Korean J Fam Pract. 2018; 8(4): 565-569  https://doi.org/10.21215/kjfp.2018.8.4.565
Association between Environmental Tobacco Smoke and Helicobacter pylori Infection in Children and Adolescents: The United States National Health and Nutritional Examination Survey 1999-2000
Young Il Kim, Hyun Woo Kim*, Jung Hyun Kim, Dong Won Lee, Ji Hoon Jung, Sang Hyun Cho, Sun Whan Kim, Seung Jin Jung, Byung Shik Cho, Jae Hyun Youn
Department of Family Medicine, Hana General Hospital, Cheongju, Korea
Hyun Woo Kim Tel: +82-43-230-6555, Fax: +82-43-230-5300 E-mail: jamesinfm@gmail.com ORCID: http://orcid.org/0000-0002-3217-1432
Received: July 6, 2017; Revised: September 1, 2017; Accepted: September 7, 2017; Published online: August 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Although the prevalence of Helicobacter pylori infection has been assessed in the National Health and Nutritional Examination Survey(NHANES), its possible relation with environmental tobacco smoke (ETS) has not been fully explored in children and adolescents. This study aimed to examine whether exposure to ETS is associated with H. pylori infection in children and adolescents.
Methods: We used cross-sectional data from the 1999–2000 NHANES and analyzed the data of 2,975 persons who were aged between 3 and 19 years and did not have smoking histories. ETS exposure levels were measured based on serum cotinine levels. The status of H. pylori infection was evaluated using the immunoglobulin G enzyme linked immunosorbent assay.
Results: Univariate analysis showed that ETS exposure levels were correlated with the prevalence of H. pylori infection. However, after controlling for all possible confounders, the association of ETS with H. pylori infection was not statistically significant.
Conclusion: There was a positive correlation between ETS and H. pylori infection in children and adolescents. Socioeconomic factors might further explain this relationship. Additional studies are required.
Keywords: Tobacco Smoke Pollution; Helicobacter pylori; Nutrition Surveys
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