Environmental tobacco smoke exposure, urine CC-16 levels, and asthma outcomes among Chinese children

Background Previous studies have shown the relationship between club cell secretory protein (Clara) (CC-16) and respiratory diseases. However, few studies have explored the associations between urine CC-16 levels and environmental tobacco smoke (ETS) exposure in children. The objective of this study was to evaluate whether ETS exposure is associated with CC-16 when stratified by asthma status. Methods In our study, CC-16 was measured on 537 children aged 9-15 from northeast China in 2011-2012 using the Human Clara Cell Protein ELISA kits. Doctor-diagnosed asthma was defined as having ever been diagnosed with asthma by a physician. The relationship between ETS exposure and urine CC-16 level was assessed using linear regression. Results When stratified by asthma status, a negative association between ETS exposure and urine CC-16 was observed after adjusting for the effects of the related covariates, with an adjusted β coefficient [P value] = -0.31 [0.006] in the first 2 years of life and with an adjusted β coefficient [P value] = -0.68 [0.004] in the first 2 years of life and current. Conclusions Our study shows long-term exposure to ETS was associated with urinary CC-16 among children without asthma.