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The aim of this study was to obtain quantitative information from published data on the association between environmental tobacco smoke (ETS) exposure and the prevalence of serious lower respiratory tract infections (LRTI) in infancy and early childhood. We identified 21 relevant publications on the relation between ETS and the prevalence of serious LRTI by reviewing reference lists in relevant reports and by conducting manual and computer searches (Medline database; Dissertation abstracts index of Xerox University Microfilms) of published reports between 1966 and 1995. Thirteen studies were included in a quantitative overview using random effects modeling to derive pooled odds ratios. Sensitivity analyses were conducted to test the decision rules used in extracting odds ratio data. The results of community and hospital studies are broadly consistent and show that the child of a parent who smokes is at approximately twice the risk of having a serious respiratory tract infection in early life that requires hospitalization. This association was pronounced in children younger than age two and diminished after the age of two. The combined odds ratio for hospitalization for lower respiratory tract infections in infancy or early childhood is 1.93 (95% CI 1.66-2.25); the combined odds ratio of prevalence of serious LRTI at age less than 2 years, between 0 and 6 years, and between 3 and 6 years were 1.71 (95% CI 1.33-2.20); 1.57 (1.28-1.91), and 1.25 (0.88-1.78), respectively. There was no evidence of heterogeneity across the studies in these combined odds ratios. We conclude that this meta-analysis provides strong evidence that exposure to ETS causes adverse respiratory health outcomes such as either a serious LRTI or hospitalization for LRTI. New public health campaigns are urgently needed to discourage smoking in the presence of young children.

A high proportion of adult Chinese living in New South Wales were born elsewhere, most commonly in China. Mortality among these males from 1969-78 was due mainly to ischaemic heart disease (IHD) cancer and cerbrovascular disease. Females showed a similar general pattern. Chinese males had double the risk of dying from cerebrovascular death, but death rates from IHD were similar to those of the Australian population, although the risk of IHD was significantly lower in Chinese females. Male Chinese had significantly higher rates for cancers of the nasopharynx, lung, intestines and rectum, and stomach and liver, whereas females had a significantly higher risk for cancers of the lung and stomach. Mortality patterns were similar to those for United States Chinese. Apart from cancer, relatively little is known about the causes of death in China. Crude death rates only are available for very broad categories of causes of death. Most of our information on Chinese general mortality comes from studies of migrants, or their descendants overseas, mainly in South-East Asia and the USA. In the latter more detailed studies have been made of cancer mortality and cancer incidence than of other causes. The purpose of our study was to describe mortality in Chinese, born in China, and dying in the state of New South Wales from 1969-78.