Directly measured secondhand smoke exposure and COPD health outcomes

被引：50

作者：

Eisner M.D. ^{[1
,2
,3
]}

Balmes J. ^{[1
,2
,3
]}

Yelin E.H. ^{[1
,4
]}

Katz P.P. ^{[1
,4
]}

Hammond S.K. ^{[5
]}

Benowitz N. ^{[1
,6
]}

Blanc P.D. ^{[1
,2
,3
]}

机构：

[1] Department of Medicine, University of California San Francisco, San Francisco, CA 94113-0924

[2] Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA 94113-0924

[3] Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA 94113-0924

[4] Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94113-0920

[5] School of Public Health, University of California, Berkeley, CA

[6] Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California San Francisco, San Francisco, CA 94143-1220

来源：

BMC Pulmonary Medicine | / 6卷 / 1期

关键词：

Chronic Obstructive Pulmonary Disease; Nicotine; Cotinine; Chronic Obstructive Pulmonary Disease Severity; Physical Health Status;

D O I：

10.1186/1471-2466-6-12

中图分类号：

学科分类号：

摘要：

Background: Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD), secondhand smoke (SHS) exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods: We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL), and dyspnea measured at one year follow-up. Results: The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9) and dyspnea (1.0 pts; 95% CI 0.4 to 1.7) after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054), disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063), and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p < 0.05), although the confidence intervals did not always exclude the no effect level. Conclusion: Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking. © 2006 Eisner et al; licensee BioMed Central Ltd.

引用

共 43 条

[1]

The Health Consequences of Smoking: A Report to the Surgeon General, (1971)

[2]

Eisner M.D., Balmes J., Katz P.P., Trupin L., Yelin E.H., Blanc P.D., Lifetime environmental tobacco smoke exposure and the risk of chronic obstructive pulmonary disease, Environ Health, 4, 1, (2005)

[3]

Balmes J., Becklake M., Blanc P., Henneberger P., Kreiss K., Mapp C., Milton D., Schwartz D., Toren K., Viegi G., American Thoracic Society Statement: Occupational contribution to the burden of airway disease, Am J Respir Crit Care Med, 167, 5, pp. 787-797, (2003)

[4]

Trupin L., Earnest G., San Pedro M., Balmes J.R., Eisner M.D., Yelin E., Katz P.P., Blanc P.D., The occupational burden of chronic obstructive pulmonary disease, Eur Respir J, 22, 3, pp. 462-469, (2003)

[5]

Coultas D.B., Health effects of passive smoking. 8. Passive smoking and risk of adult asthma and COPD: An update, Thorax, 53, 5, pp. 381-387, (1998)

[6]

Garcia-Aymerich J., Farrero E., Felez M.A., Izquierdo J., Marrades R.M., Anto J.M., Risk factors of readmission to hospital for a COPD exacerbation: A prospective study, Thorax, 58, 2, pp. 100-105, (2003)

[7]

Eisner M.D., Environmental tobacco smoke exposure and pulmonary function among adults in NHANES III: Impact on the general population and adults with current asthma, Environ Health Perspect, 110, 8, pp. 765-770, (2002)

[8]

Eisner M.D., Katz P.P., Yelin E.H., Hammond S.K., Blanc P.D., Measurement of environmental tobacco smoke exposure among adults with asthma, Environmental Health Perspectives, 109, 8, pp. 809-814, (2001)

[9]

Eisner M.D., Yelin E.H., Katz P.P., Earnest G., Blanc P.D., Exposure to indoor combustion and adult asthma outcomes: Environmental tobacco smoke, gas stoves, and woodsmoke, Thorax, 57, 11, pp. 973-978, (2002)

[10]

Ostro B.D., Lipsett M.J., Mann J.K., Wiener M.B., Selner J., Indoor air pollution and asthma. Results from a panel study, Am J Respir Crit Care Med, 149, 6, pp. 1400-1406, (1994)

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