Background: While early life exposure to tobacco products are extensively studied, the role of second-hand smoke (SHS) for new onset respiratory symptoms and lung function decline in adulthood is not well investigated in longitudinal studies. The aim of the present study is to investigate over 20 years the associations of exposure to SHS in adults with respiratory symptoms and diseases, as well as lung function. Methods: Data were analysed from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations between SHS exposure and respiratory health (asthma symptom score, asthma, bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationship between SHS exposure and lung function levels and decline. Results: Exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (beginning 1991) and 7.1% in the 20 year follow-up (beginning 2008). An increase in SHS exposure over time (2.4%) was associated with doctor-diagnosed asthma (odds ratio (OR): 2.66; 95% confidence interval (95%-CI): 1.20-5.91), chronic bronchitis (OR: 4.84; 95%-CI: 1.56-14.97), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.24-2.91) and dyspnoea (OR: 2.73; 95%-CI: 1.11-6.71) compared to never exposed to SHS. Significant associations between increase in SHS exposure and COPD (OR: 1.95; 95%-CI: 0.63-6.04) as well as lung function (β: -49 ml; 95%-CI: -132, 35 for FEV1 and β: -62 ml; 95%-CI: -165, 41 for FVC) were not detected. Conclusion: Exposure to second-hand smoke is associated with increased risks of asthma, chronic bronchitis and asthma symptoms, but not with chronic obstructive pulmonary disease.
Second-hand smoke exposure in adulthood and lower respiratory health during 20 year follow up in the European Community Respiratory Health Survey
Roberto Bono;
2019-01-01
Abstract
Background: While early life exposure to tobacco products are extensively studied, the role of second-hand smoke (SHS) for new onset respiratory symptoms and lung function decline in adulthood is not well investigated in longitudinal studies. The aim of the present study is to investigate over 20 years the associations of exposure to SHS in adults with respiratory symptoms and diseases, as well as lung function. Methods: Data were analysed from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations between SHS exposure and respiratory health (asthma symptom score, asthma, bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationship between SHS exposure and lung function levels and decline. Results: Exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (beginning 1991) and 7.1% in the 20 year follow-up (beginning 2008). An increase in SHS exposure over time (2.4%) was associated with doctor-diagnosed asthma (odds ratio (OR): 2.66; 95% confidence interval (95%-CI): 1.20-5.91), chronic bronchitis (OR: 4.84; 95%-CI: 1.56-14.97), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.24-2.91) and dyspnoea (OR: 2.73; 95%-CI: 1.11-6.71) compared to never exposed to SHS. Significant associations between increase in SHS exposure and COPD (OR: 1.95; 95%-CI: 0.63-6.04) as well as lung function (β: -49 ml; 95%-CI: -132, 35 for FEV1 and β: -62 ml; 95%-CI: -165, 41 for FVC) were not detected. Conclusion: Exposure to second-hand smoke is associated with increased risks of asthma, chronic bronchitis and asthma symptoms, but not with chronic obstructive pulmonary disease.
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