American Journal of EPIDEMIOLOGY Volume 161 Number 5 March 1, 2005 Copyright © 2005 by The Johns Hopkins Bloomberg School of Public Health Sponsored by the Society for Epidemiologic Research Published by Oxford University Press EDITORIAL Please Read the Following Paper and Write This Way! After dealing with many wordy manuscripts submitted to the American Journal of Epidemiology and badgering authors to shorten them, I was delighted to receive the 2,164word paper by Lewis et al. (1) that is published in this issue. If you are an aspiring author of epidemiologic papers, please read their paper, which is a model of conciseness and clarity. It has been my experience that, on average, the British write and speak more clearly, using fewer and shorter words than Americans. However, American English can be both clear and simple, and we would like to see more examples of good writing from epidemiologists of all nationalities. Regrettably, since my editorial, “Be Kind to Your Reader,” was published in 1990 (2), as a whole the manuscripts we receive have not improved. Shorter papers provide at least two advantages. First, they are less apt to be taxing or sleep-inducing to us decisionmaking editors and our readers. Although our official limit is 4,000 words, one member of our editorial board has commented that papers with over 3,000 words are often boring. I agree. Second, we have a strict fixed limit on published pages. Therefore, if papers were shorter, we would not have to turn down so many good submissions. Unfortunately, current epidemiologists’ tendency toward wordiness seems to have extended to grant writing. In the “good old days,” our applications were funded when we listed our specific aims in a few sentences or phrases. Now, my younger colleagues are wary of submitting a grant in which specific aims do not also contain a sales pitch and occupy a whole page. They also fear that, if they clearly describe their study in 16 pages rather than all or almost all of the 25-page limit imposed by the National Institutes of Health, many peer reviewers will take a dim view of the application. Many of us complain that we are short of time to do all that is required of us and all that we would like to do. Since reading of epidemiologic papers is an important consumer of our time, let’s do ourselves a favor and write succinctly. REFERENCES 1. Lewis SA, Antoniak M, Venn AJ, et al. Secondhand smoke, dietary fruit intake, road traffic exposures, and the prevalence of asthma: a cross-sectional study in young children. Am J Epidemiol 2005;161:406–11. 2. Friedman GD. Be kind to your reader. Am J Epidemiol 1990;132:591–3. Gary D. Friedman, Editor American Journal of Epidemiology 405 Am J Epidemiol 2005;161:405 American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved Vol. 161, No. 5 Printed in U.S.A. DOI: 10.1093/aje/kwi059 ORIGINAL CONTRIBUTIONS Secondhand Smoke, Dietary Fruit Intake, Road Traffic Exposures, and the Prevalence of Asthma: A Cross-Sectional Study in Young Children S. A. Lewis1, M. Antoniak1, A. J. Venn2, L. Davies3, A. Goodwin3, N. Salfield3, J. Britton2, and A. W. Fogarty1 1 Division of Respiratory Medicine, University of Nottingham, Nottinghan, United Kingdom. Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom. 3 Public Health Group, Department of Health, Government Office East Midlands, Nottingham, United Kingdom. 2 Received for publication August 23, 2004; accepted for publication November 19, 2004. The authors have investigated the independent effects of exposure to secondhand smoke, road vehicle traffic, and dietary fruit intake in a cross-sectional study of asthma in young children. They surveyed all children aged 4–6 years in 235 schools in the East Midlands and East of England regions of the United Kingdom in 2003. Data on respiratory symptoms, diagnoses and treatment, smoking in the home, and dietary fruit intake were collected by parental questionnaire. A geographic information system was used to map postcodes and determine the distance of the home from the nearest main road. Responses were obtained from 11,562 children. Wheeze in the past year and physician-diagnosed asthma were reported by 14.1% and 18.2%, respectively. Both of these outcomes were more common in children who lived with a smoker, and the prevalence of asthma increased with the number of smokers in the home. Asthma prevalence was not associated with proximity of the home to a main road or with dietary fruit intake. The authors conclude that, of the potential risk factors considered in this study, preventing secondhand smoke exposure may be the most effective way of preventing asthma. asthma; diet; public health; tobacco smoke pollution; vehicle emissions Exposures to secondhand tobacco smoke, road vehicle traffic, and diet are some of the most prevalent modifiable risk factors for asthma in children. The effect of parental smoking on wheezing illness and diagnosed asthma in children is well established (1, 2), but evidence that these outcomes are more common in children living close to a main road (3–5) has not been confirmed in all studies (6, 7). Several dietary factors have been linked to asthma (8), and one of the most consistent observations is of an inverse association with fruit intake (9–13). The National Schools Fruit Scheme is a government initiative that aims to provide each child aged 4–6 years with free fruit in school every day by winter 2004. As part of an evaluation of the health benefits of this scheme, we have taken the opportunity to investigate the relative importance of fruit intake, exposure to secondhand smoke, and road vehicle traffic in determining the prevalence of asthma in over 11,000 children. MATERIALS AND METHODS Participants comprised all eligible children attending a sample of schools in two regions of England, the East Midlands and Eastern Region, in the summer 2003 term, before commencement of the National School Fruit Scheme. We contacted a random sample of 225 schools in each region, with the aim of recruiting 125 in each region, and distributed a short questionnaire to parents of all children aged 4–6 years. We included questions relating to wheeze and eczema, based on standard wording from the International Study of Asthma and Allergies in Childhood (14). We also asked about asthma diagnosed by a physician and whether the child had a reliever or steroid inhaler for asthma and, if so, how many puffs he or she had used in the past week. The questionnaires were scanned and entered into a database (Document Capture Company, Wembley, United Correspondence to Dr. Sarah Lewis, Division of Respiratory Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, United Kingdom (e-mail: Sarah.Lewis@nottingham.ac.uk). 406 Am J Epidemiol 2005;161:406–411 Passive Smoking, Diet, Vehicle Emissions, and Asthma 407 TABLE 1. Distribution of asthma outcomes by age, sex, local education authority area, Townsend Index, and presence of eczema, United Kingdom, 2003 Physiciandiagnosed asthma (%)† Frequency (no.) % Wheeze in past year (%)* Male 5,835 50.5 16.5 21.1 18.7 Female 5,711 49.5 11.6 15.2 13.2
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