OBJECTIVE : The aim of this study was to investigate
the association between eczema ever (EE) and current
eczema symptoms (ES) in relation to exposure to
environmental tobacco smoke (ETS).
DESIGN : A cross-sectional study using the
International Study of Asthma and Allergies in
SETTING : 16 schools were randomly selected from two
neighbourhoods situated in Ekurhuleni Metropolitan
Municipality, Gauteng Province, South Africa.
PARTICIPANTS : From a total population of 3764 school
children aged 12–14 years, 3468 completed the
questionnaire (92% response rate). A total of 3424
questionnaires were included in the final data analysis.
PRIMARY OUTCOME : The prevalence of EE and current
ES was the primary outcome in this study.
RESULTS : Data were analysed using Multilevel Logistic
Regression Analysis (MLRA). The likelihood of EE was increased by exposure to ETS at home (OR 1.30 95%
CI 1.01 to 1.67) and at school (OR 1.26 95% CI 1.00
to 1.60). The likelihood of EE was lower for males (OR
0.66 95% CI 0.51 to 0.84). The likelihood of ES was
increased by ETS at home (OR 1.93 95% CI 1.43 to
2.59) and school (1.44 95% CI 1.09 to 1.90). The
likelihood of ES was again lower for males (OR 0.56
95% CI 0.42 to 0.76). Smoking by mother/female
guardian increased the likelihood of EE and ES,
however, this was not significant in the multivariate
CONCLUSIONS : Symptoms of eczema were positively
associated with exposure to ETS at home and school.
The results support the hypothesis that ETS is an
important factor in understanding the occurrence of