Bridevaux Pierre-Olivier, Cornuz Jacques, Gaspoz Jean-Michel, Burnand Bernard, Ackermann-Liebrich Ursula, Schindler Christian, Leuenberger Philippe, Rochat Thierry, Gerbase Margaret W
Division of Pulmonary Medicine, University Hospitals of Geneva, 24 rue Micheli-du-Crest, 1211, Geneva, Switzerland.
Arch Intern Med. 2007 Dec 10;167(22):2516-23. doi: 10.1001/archinte.167.22.2516.
Although secondhand smoke (SHS) has been linked with various respiratory conditions and symptoms, its association with health-related quality of life (HRQOL) is unknown.
A cross-sectional study was performed of 2500 never smokers in Switzerland who participated in the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults and completed a 36-Item Short Form Health Survey (SF-36) in 2002. Using linear regression models adjusting for confounders, we measured the association between HRQOL and moderate or high SHS exposure (< or =3 h/d or >3 h/d) compared with no SHS exposure. Data from men and women were analyzed separately and further stratified by source of SHS (home, workplace, and public spaces).
After adjustments, SHS was associated with reduced scores in all SF-36 domains. High SHS exposure predicted a greater reduction in HRQOL. Compared with nonexposed women, those with high SHS exposure at home had significantly lower scores on the physical functioning (-7.8, P < .001), role physical (-10.5, P = .02), bodily pain (-9.2, P = .01), and social functioning (-8.1, P = .007) domains. Exposed men had lower scores for the role physical domain (-20.0, P < .001) and a trend toward lower scores in other domains. In women, exposure to SHS at home was associated with a stronger negative effect on HRQOL than at work and in public spaces.
Secondhand smoke is associated with reduced HRQOL, more significantly so in women. Exposure to SHS at home and high levels of exposure are associated with lower SF-36 scores, suggesting a dose-response relationship.
尽管二手烟（SHS）已与多种呼吸道疾病和症状相关联，但其与健康相关生活质量（HRQOL）的关联尚不清楚。
对瑞士2500名从不吸烟的成年人进行了一项横断面研究，这些人参与了瑞士成人空气污染与肺部疾病队列研究，并于2002年完成了一份36项简短健康调查问卷（SF-36）。我们使用线性回归模型对混杂因素进行调整，比较了与无二手烟暴露相比，中度或高度二手烟暴露（<或=3小时/天或>3小时/天）与健康相关生活质量之间的关联。对男性和女性的数据分别进行分析，并根据二手烟来源（家庭、工作场所和公共场所）进一步分层。
调整后，二手烟与SF-36所有领域的得分降低相关。高二手烟暴露预示着健康相关生活质量的更大下降。与未暴露的女性相比，在家中暴露于高二手烟的女性在身体功能（-7.8，P<.001）、角色身体（-10.5，P=.02）、身体疼痛（-9.2，P=.01）和社会功能（-8.1，P=.007）领域的得分显著更低。暴露的男性在角色身体领域得分较低（-20.0，P<.001），在其他领域有得分降低的趋势。在女性中，在家中暴露于二手烟对健康相关生活质量的负面影响比在工作场所和公共场所更强。
二手烟与健康相关生活质量降低有关，在女性中更为显著。在家中暴露于二手烟以及高暴露水平与较低的SF-36得分相关，表明存在剂量反应关系。
