Passive Smoking Exposure: A Risk Factor for Chronic Bronchitis and Asthma in Adults?

doi:10.1378/chest.122.3.1086

Chest

Volume 122, Issue 3, September 2002, Pages 1086-1090

https://doi.org/10.1378/chest.122.3.1086 Get rights and content

Objective

The effects of passive smoke exposure on respiratory health are still under debate. Therefore, we examined the risk of respiratory symptoms related to passive smoke exposure among German adults within the European Community Respiratory Health Survey.

Methods

The questionnaire data of the population-based sample (n = 1,890) were analyzed. Multiple logistic regression models were carried out for current asthma (asthma symptoms or medication), chronic bronchitis (cough with phlegm for ≥ 3 months per year), and wheezing as dependent variables, and self-reported exposure to passive smoke at home and at the workplace as independent variables after adjusting for city, age, gender, active smoking, and socioeconomic status as well as occupational exposure to dusts and/or gases.

Results

The relative odds for chronic bronchitis were significantly higher in subjects reporting involuntary tobacco smoke exposure in the workplace (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.16 to 3.11). Likewise, the adjusted OR for asthma was slightly elevated (OR, 1.51; 95% CI, 0.99 to 2.32). The risk of chronic bronchitis (OR, 3.07; 95% CI, 1.56 to 6.06), asthma (OR, 2.06; 95% CI, 1.07 to 3.97), and wheezing (OR, 2.12; 95% CI, 1.25 to 3.58) increased significantly with a daily exposure of > 8 h.

Conclusion

The control of passive smoke exposure in the workplace might reduce the risk of respiratory symptoms independently of exposure to other airborne contaminants.

Section snippets

Subjects

Within the European Community Respiratory Health Survey, a population-based, cross-sectional survey including 55 centers in 23 countries,²³ a representative sample of 4,500 subjects in Hamburg, Germany, and 4,990 subjects in Erfurt, Germany, who were 20 to 44 years of age was obtained from the offices of the population census. In stage I of the study, a one-page screening questionnaire was mailed to all subjects (response rate, 76.8%). All eligible subjects in Hamburg (n = 4,090) and a random

Results

The study population in its relationship to passive smoking exposure is described in Table 1. Most participants reporting involuntary tobacco smoke exposure were exposed at home and at the workplace (62.9%), with a mean (± SD) duration of 5 ± 4 h per day. Subjects reporting passive smoke exposure were less likely to have a higher educational level and to live in Erfurt. Furthermore, they were more likely to be exposed to gases and/or mine dusts at the workplace. Additionally, subjects with

Discussion

In this study, involuntary tobacco smoke exposure, especially in the workplace, was associated with the prevalence of respiratory symptoms in young adults even after adjustment for occupational exposure. The risk estimates increased significantly with the increasing duration of daily exposure to second-hand smoke.

Our study has several strengths. Since it is a population-based survey, it reflects the prevalence of respiratory symptoms as well as the exposure to ETS exposure in the general

Acknowledgment

The authors thank C. Ramin, G. Schmudde, U. Willenbrock, S. Pirstat, A. Schneider, G. Wo¨lke, and E. Beck for their help with the manuscript.

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Smoking is one significant global health care problems, that not only affects the users but also endangers the health of people inhaling the smoke (passive smoking/secondhand smoke). The serum level of IL-18, an important regulator of inherent and acquired immune response, is affected by cigarette smoking. The aim of this study was to evaluate the effect of secondhand smoke (SHS) exposure on IL-18 serum level in non-smoker adults.
In a case-control study, using easy sampling method, 76 non-smokers who were exposed to cigarette smoke for at least 1 h daily during the past year were considered as exposure group, while 76 of their companions without exposure to cigarette smoke (after matching age) were considered as non-exposure group. Serum IL-18 levels were measured for all participants and finally compared between the two groups using Chi-square test. P value < 0.05 was considered to be statistically significant.
The exposure and non-exposure groups included 58 (76.3%) and 25 (32.9%) males, respectively (P < 0.001). The mean ± SD of age for the exposure and non-exposure groups was 35.42 ± 10.37 and 38.47 ± 12.49 years, respectively (P = 0.102). There was no significant difference between the mean serum levels of IL-18 in the exposure (54.81 ± 57.03 ng/ml) and non-exposure (41.49 ± 42.14 ng/ml) groups (P = 0.104).
The exposure to secondhand smoke has no significant effect on serum level of IL-18 in exposed adult individuals. However, more studies with larger sample sizes on different populations are required to confirm these results.
Burden of disease from second-hand tobacco smoke exposure at home among adults from European Union countries in 2017: an analysis using a review of recent meta-analyses
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Smoke-free legislation reduced second-hand smoke (SHS) exposure in public places, and indirectly promoted private smoke-free settings. Nevertheless, a large proportion of adults is still exposed to SHS at home. The aim of this paper is to quantify the burden of disease due to home SHS exposure among adults in the 28-European Union (EU) countries for year 2017.
The burdens by gender from lung cancer, chronic obstructive pulmonary disease (COPD), breast cancer, ischemic heart disease (IHD), stroke, asthma, and diabetes were estimated in an original research analysis using the comparative risk assessment method. Relative risks of death/diseases by gender for adults exposed to SHS at home compared to not exposed ones were estimated updating existing meta-analyses. Prevalence of home SHS exposure by gender was estimated using a multiple imputation procedure based on Eurobarometer surveys. Data on mortality and disability adjusted life years (DALYs) were obtained from the Global Burden of Disease, Injuries and Risk Factors Study.
In 2017, 526,000 DALYs (0.36% of total DALYs) and 24,000 deaths (0.46% of total deaths) were attributable to home SHS exposure in the 28-EU countries, mainly from COPD and IHD. South-Eastern EU countries showed the highest burden, with proportion of DALYs/deaths attributable to SHS exposure on total higher than 0.50%/0.70%, whereas northern EU-countries showed the lowest burden, with proportions of DALYs/deaths lower than 0.25%/0.34%.
The burden from SHS exposure is still significant in EU countries. More could be done to raise awareness of the health risks associated with SHS exposure at home.
Asthma in the Elderly
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Citation Excerpt :
It is advisable to recommend that elderly asthma patients avoid, to the extent possible, exertion or exercise outside when levels of air pollution are high. Long-term passive cigarette smoke exposure has been linked to new-onset asthma in children and adults, as well as to the worsening of asthma symptoms, decreased lung function, and greater use of health services in those with preexisting asthma.93,94 The third cornerstone of asthma care is pharmacologic therapy.89,95
Plant-Based Diets and Asthma
2017, Vegetarian and Plant-Based Diets in Health and Disease Prevention
Asthma is characterized by chronic airway inflammation, which can be prevented and alleviated by factors including the common cold, inhaled allergens, tobacco smoke, exercise, and mental stress. Increased asthma prevalence is related to environmental exposures and lifestyle changes, particularly in diet. Healthy dietary patterns including plant-based diets are associated with low asthma prevalence, good asthma control, good lung function, and low asthma exacerbation. Plant-based diets, especially raw vegetable diets, may have antioxidant, antiinflammatory, and immunomodulatory effects against asthma, resulting in beneficial effects for prevention and control of asthma.
Medico-social aspects of patients with bronchial asthma
2015, Kontakt
Citation Excerpt :
But another study by Chaudhuri et al. [105], did not record any significant difference. Passive smoking in the workplace or at home (in particular above 8 h per day) is associated with an increase of respiratory symptoms (wheezing) in young adults, leading to the onset of bronchial asthma or chronic obstructive pulmonary disease [106]. According to Broekeman et al. [107], an increased sputum correlated with a significantly higher number of goblet cells, presents mucus-positive epithelium, thicker thickness of the epithelium in smoking of asthmatics.
In the past three decades, there was a visible increase regarding asthma prevalence and allergic diseases all around the world, especially in countries with a Western lifestyle, so called westernization. Bronchial asthma affects the quality of life of asthmatic and his family. The health determinants have an impact on the onset and development of bronchial asthma. The cause of an allergy is a combination of 50% of genetic factors and an additional 50% involving environmental factors. The onset and development of atopy and asthma is dependent on many factors, such as environmental factors (indoor and outdoor air pollution, domestic animals, allergens, tobacco smoke, hormones, endotoxins) and personal factors (gender, smoking, obesity, food, diet, breastfeeding, development of lungs). There is confirmation of major association of asthma with low birth weight, mothers’ family background, which interacts with socio-economic status. The development of asthma affects increased intake of sodium, decreased intake of fruit, vegetables and fish. A positive effect has the intake of coffee (caffeine) and vitamin C. Exposure to harmful substances has been associated with workplace factors (occupational asthma), residential housing and lifestyle habits, which depend on social status. It was discovered, that there is an association between asthma and being overweight as well. Maternal stress during pregnancy, stress in the family, maternal anxiety, lack of functioning within family, may also be a trigger for the onset and development of asthma. Poorly controlled bronchial asthma increases direct and indirect health care costs, limits asthmatics at work as well as in their daily life. Precautions and stabilization of this disease can also insure the knowledge of the various medico-social aspects of patients with bronchial asthma.
Passive smoking exposure is associated with increased risk of COPD in never smokers
2014, Chest
Passive smoking, or environmental tobacco smoke (ETS), is a risk factor for lung cancer, cardiovascular disease, and childhood asthma, but a relationship with COPD has not been fully established. Our aim was to study ETS as a risk factor for COPD in never smokers.
Data from three cross-sectional studies within the Obstructive Lung Disease in Northern Sweden (OLIN) database were pooled. Of the 2, 182 lifelong never smokers, 2, 118 completed structured interviews and spirometry of acceptable quality. COPD was defined according to the GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria using postbronchodilator spirometry. The association of COPD with ETS in single and multiple settings was calculated by multivariate logistic regression adjusting for known risk factors for COPD.
COPD prevalence was associated with increased ETS exposure: 4.2% (no ETS), 8.0% (ETS ever at home), 8.3% (ETS at previous work), and 14.7% (ETS ever at home and at both previous and current work), test for trend P = .003. Exclusion of subjects aged ≥ 65 years and subjects reporting asthma yielded similar results. ETS in multiple settings, such as ever at home and at both previous and current work, was strongly associated to COPD (OR, 3.80; 95% CI, 1.29-11.2).
In this population-based sample of never smokers, ETS was independently associated with COPD. The association was stronger for ETS in multiple settings. ETS in multiple settings was, after age, the strongest risk factor for COPD and comparable to personal smoking of up to 14 cigarettes/d in comparable materials. The findings strongly advocate measures against smoking in public places.

View all citing articles on Scopus

This article is part of the MD thesis of Kerstin Bu¨sching.

This study has been supported by a grant from the Bundesministerium fu¨r Forschung und Technologie.

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Chest

Occupational and Environmental Lung DiseasePassive Smoking Exposure: A Risk Factor for Chronic Bronchitis and Asthma in Adults?

Objective

Methods

Results

Conclusion

Section snippets

Subjects

Results

Discussion

Acknowledgment

Atmos Environ

J Allergy Clin Immunol

Chest

Lancet

Social class, smoking and the severity of respiratory symptoms in the general population

J Epidemiol Community Health

Passive smoking exposure in adults and chronic respiratory symptoms (SAPALDIA Study): Swiss Study on Air Pollution and Lung Diseases in Adults, SAPALDIA Team

Am J Respir Crit Care Med

SenatskommissionzurPru¨funggesundheitsscha¨dlicherArbeitsstoffederDeutschenForschungsgemeinschaft. Passivrauchen

Verordnung u¨ber Arbeitssta¨tten, 2001

Passive smoking and adults: new evidence for adverse effects

Am J Respir Crit Care Med

Environmental tobacco smoke, indoor allergens, and childhood asthma

Environ Health Perspect

Health effects of passive smoking: 3. Parental smoking and prevalence of respiratory symptoms and asthma in school age children

Thorax

Health effects of passive smoking: 6. Parental smoking and childhood asthma; longitudinal and case-control studies

Thorax

Influence of parental smoking on respiratory symptoms during the first decade of life: the Tucson Children's Respiratory Study

Am J Epidemiol

Environmental tobacco smoke exposure and asthma in adults

Environ Health Perspect

Health effects of exposure to environmental tobacco smoke

Tob Control

Relationships of active and passive smoking to total IgE in adults of the Epidemiological Study of the Genetics and Environment of Asthma, Bronchial Hyperresponsiveness, and Atopy (EGEA)

Am J Respir Crit Care Med

Occupational and Environmental Lung Disease
Passive Smoking Exposure: A Risk Factor for Chronic Bronchitis and Asthma in Adults?