A systematic review and meta-analysis was conducted of studies investigating the association between secondhand tobacco smoke (SHTS) and middle ear disease (MED) in children. MEDLINE, EMBASE, and CAB abstracts (through December 2010) and reference lists were searched. Sixty-one epidemiological studies of children assessing the effect of SHTS on outcomes of MED were included. Articles were reviewed and the data were extracted and synthesized by two researchers. Living with a smoker was associated with an increased risk of MED in children by an odds ratio (OR) of 1.62 (95% CI: 1.33-1.97) for maternal postnatal smoking and by 1.37 (95% CI: 1.25-1.50) for any household member smoking. Prenatal maternal smoking (OR: 1.11; 95% CI: 0.93-1.31) and paternal smoking (OR: 1.24; 95% CI: 0.98-1.57) were associated with a nonsignificant increase in the risk of MED. The strongest effect was on the risk of surgery for MED, where maternal postnatal smoking increased the risk by an OR of 1.86 (95% CI: 1.31-2.63) and paternal smoking by 1.83 (95% CI: 1.61-2.07). The authors concluded that exposure to SHTS, particularly to smoking by the mother, significantly increases the risk of MED in childhood. Arch Pediatr Adolesc Med. 2011 Sep 5. PMID: 21893640.
