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公共场所吸烟立法禁令前后酒吧工作人员的呼吸道症状、肺功能及炎症标志物

Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places.

作者信息

Menzies Daniel, Nair Arun, Williamson Peter A, Schembri Stuart, Al-Khairalla Mudher Z H, Barnes Martyn, Fardon Tom C, McFarlane Lesley, Magee Gareth J, Lipworth Brian J

机构信息

Asthma and Allergy Research Group, Department of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland.

出版信息

JAMA. 2006 Oct 11;296(14):1742-8. doi: 10.1001/jama.296.14.1742.

Abstract

CONTEXT

Scotland prohibited smoking in confined public places on March 26, 2006.

OBJECTIVE

To investigate the association of smoke-free legislation with symptoms, pulmonary function, and markers of inflammation of bar workers.

DESIGN, SETTING, AND PARTICIPANTS: This prospective observational study was conducted in Tayside, Scotland from February-June 2006. One hundred five nonasthmatic and asthmatic nonsmoking bar workers were initially enrolled, of whom 77 completed the study per protocol.

MAIN OUTCOME MEASURES

Respiratory and sensory symptoms, spirometry measurements, serum cotinine levels, peripheral inflammatory cell count, asthma quality-of-life scores, and exhaled nitric oxide levels were evaluated before and after introduction of the smoking ban.

RESULTS

For the per-protocol analysis, the percentage of bar workers with respiratory and sensory symptoms decreased from 79.2% (n = 61) before the smoke-free policy to 53.2% (n = 41) (total change, -26%; 95% confidence interval [CI], -13.8% to -38.1%; P<.001) and 46.8% (n = 38) (-32.5%; 95% CI, -19.8% to -45.2%; P<.001) 1 and 2 months afterward. Forced expiratory volume in the first second increased from 96.6% predicted to 104.8% (change, 8.2%; 95% CI, 3.9% to 12.4%; P<.001) and then 101.7% (change, 5.1%; 95% CI, 2.1% to 8.0%; P = .002), and serum cotinine levels decreased from 5.15 ng/mL to 3.22 ng/mL (change, -1.93 ng/mL; 95% CI, -2.83 to -1.03 ng/mL; P<.001) and then 2.93 ng/mL (-2.22 ng/mL; 95% CI, -3.10 to -1.34 ng/mL; P<.001). The total white blood cell and neutrophil count was reduced from 7610 to 6980 cells/microL at 2 months (-630 cells/muL; 95% CI, -1010 to -260 cells/microL; P = .002) and from 4440 to 4030 cells/microL (-410 cells/microL; 95% CI, -740 to -90 cells/microL; P = .03), respectively. Asthmatic bar workers also had less airway inflammation, with a reduction in exhaled nitric oxide from 34.3 parts per billion (ppb) to 27.4 ppb 1 month after the ban (0.8-fold change; 95% CI, 0.67 to 0.96 ppb; P = .04), and Juniper quality-of-life scores increased from 80.2 to 87.5 points (7.3 points; 95% CI, 0.1 to 14.6 points; P = .049).

CONCLUSIONS

Smoke-free legislation was associated with significant early improvements in symptoms, spirometry measurements, and systemic inflammation of bar workers. Asthmatic bar workers also had reduced airway inflammation and improved quality of life.

摘要

背景

2006年3月26日,苏格兰禁止在封闭公共场所吸烟。

目的

调查无烟立法与酒吧工作人员的症状、肺功能及炎症标志物之间的关联。

设计、场所和参与者:这项前瞻性观察性研究于2006年2月至6月在苏格兰泰赛德进行。最初招募了105名非哮喘且不吸烟的酒吧工作人员,其中77名按照方案完成了研究。

主要观察指标

在实施吸烟禁令前后,评估呼吸和感觉症状、肺功能测定、血清可替宁水平、外周炎症细胞计数、哮喘生活质量评分及呼出一氧化氮水平。

结果

对于符合方案分析,有呼吸和感觉症状的酒吧工作人员比例从无烟政策实施前的79.2%(n = 61)降至1个月后的53.2%(n = 41)(总变化,-26%;95%置信区间[CI],-13.8%至-38.1%;P<.001)和2个月后的46.8%(n = 38)(-32.5%;95%CI,-19.8%至-45.2%;P<.001)。第1秒用力呼气量从预测值的96.6%增至104.8%(变化,8.2%;95%CI,3.9%至12.4%;P<.001),随后为101.7%(变化,5.1%;95%CI,2.1%至8.0%;P =.002),血清可替宁水平从5.15 ng/mL降至3.22 ng/mL(变化,-。

1.93 ng/mL;95%CI,-2.83至-1.03 ng/mL;P<.001),随后为2.93 ng/mL(-2.22 ng/mL;95%CI,-3.10至-1.34 ng/mL;P<.001)。2个月时白细胞和中性粒细胞总数分别从7610降至6980个/微升(-630个/微升;95%CI,-1010至-260个/微升;P =.002)和从4440降至4030个/微升(-410个/微升;95%CI,-740至-90个/微升;P =.03)。哮喘酒吧工作人员的气道炎症也减轻,禁令实施1个月后呼出一氧化氮从34.3十亿分之一(ppb)降至27.4 ppb(0.8倍变化;95%CI,0.67至0.96 ppb;P =.04),杜松生活质量评分从80.2分增至87.5分(7.3分;95%CI,0.1至14.6分;P =.049)。

结论

无烟立法与酒吧工作人员的症状、肺功能测定及全身炎症的显著早期改善相关。哮喘酒吧工作人员的气道炎症也减轻,生活质量得到改善。

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