Aggarwal A N, Gupta Dheeraj, Sharma C P, Jindal S K
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2004 Jan;119(1):18-23.
BACKGROUND & OBJECTIVES: Exposure to environmental tobacco smoke (ETS) can lead to airflow limitation, similar to that seen in smokers. However, the effects have not been conclusively proven. In the present study an attempt was made to characterize the effect of ETS exposure at home on airflow mechanics in asymptomatic healthy women.
Fifty women volunteers with no apparent health related problem, exposed to household ETS (group I), and 50 age-matched women not exposed (group II) were studied. Vital capacity (VC), forced expiratory flow in first second (FEV1), FEV1/VC ratio, peak expiratory flow (PEF), maximal midexpiratory flow (FEF(25-75%)), airway resistance (R(aw)) and specific airway conductance (sG(aw)) were measured, and compared between the two groups. Conditional logistic and linear regression analysis were done to assess contribution of household ETS exposure to decreased lung function.
FEV1 and PEF values were marginally lower among women in group I (mean difference 0.13 l and 0.20 l/sec respectively). FEF(25-75%), R(aw) and sG(aw) were significantly impaired in this group. Ten (20.0%) women in group I and five (10.0%) in group II had abnormal R(aw) (adjusted odds ratio 6.72, 95% confidence limits 1.15-39.42), while eight (16.0%) women in group I and one (2.0%) in group II had abnormal sG(aw) (adjusted odds ratio 21.08, 95% confidence limits 1.30-341.05). Cumulative life time ETS exposure was, not significantly related to a reduction in FEV1, VC, PEF, FEF(25-75%), R(aw) or sG(aw) after adjustments for potential confounders.
INTERPRETATION & CONCLUSION: Exposure to household ETS resulted in subtle impairment of airflow mechanics in asymptomatic women, possibly attributed to small airway narrowing. Further investigations are required to study the progression of this impairment with time.
接触环境烟草烟雾（ETS）可导致气流受限，类似于吸烟者的情况。然而，其影响尚未得到确凿证实。在本研究中，试图描述在家中接触ETS对无症状健康女性气流力学的影响。
对50名无明显健康相关问题且接触家庭ETS的女性志愿者（I组）和50名年龄匹配的未接触者（II组）进行研究。测量两组的肺活量（VC）、第1秒用力呼气流量（FEV1）、FEV1/VC比值、呼气峰值流量（PEF）、最大呼气中期流量（FEF(25 - 75%)）、气道阻力（R(aw)）和比气道传导率（sG(aw)），并进行比较。采用条件逻辑回归和线性回归分析来评估家庭ETS暴露对肺功能下降的影响。
I组女性的FEV1和PEF值略低（平均差异分别为0.13升和0.20升/秒）。该组的FEF(25 - 75%)、R(aw)和sG(aw)明显受损。I组中有10名（20.0%）女性和II组中有5名（10.0%）女性的R(aw)异常（调整后的优势比为6.72，95%置信区间为1.15 - 39.42），而I组中有8名（16.0%）女性和II组中有1名（2.0%）女性的sG(aw)异常（调整后的优势比为21.08，95%置信区间为1.30 - 341.05）。在对潜在混杂因素进行调整后，累积终生ETS暴露与FEV1、VC、PEF、FEF(25 - 75%)、R(aw)或sG(aw)的降低无显著相关性。
接触家庭ETS导致无症状女性的气流力学出现细微损害，可能归因于小气道狭窄。需要进一步研究来探讨这种损害随时间的进展情况。
