Wichmann Margarete A, Cruickshanks Karen J, Nondahl David M, Chappell Richard, Klein Barbara E K, Klein Ronald, Fischer Mary E
University of Wisconsin, School of Medicine and Public Health, Department of Population Health Sciences, Madison, WI 53726-2397, USA.
WMJ. 2013 Apr;112(2):53-7.
Environmental tobacco smoke (ETS) exposure has been associated with adverse health outcomes. Our goal was to determine if ETS exposure changed between 1998-2000 and 2003-2005 among participants in the population-based Epidemiology of Hearing Loss Study.
ETS exposure was ascertained using a cotinine-validated questionnaire at the 5-year (1998-2000) and 10-year follow-up examinations (2003-2005). Non-smoking participants with data from both visits were included (n=1898; ages 53-96 years at 5-yr follow-up). McNemar's test was used to test differences in ETS exposure overall and in 3 settings: home, work, and social settings. Generalized estimating equations (GEE) were used for multivariate logistic regression models of exposure.
The proportion of nonsmokers with no or little ETS exposure increased from 80% to 88% (P< 0.0001). The percent living in a home with no indoor smokers increased from 94% to 97% (P<0.0001). The percent reporting no exposure at work increased from 91% to 95% (P<0.0001). The percent reporting the lowest frequency of social exposure increased from 65% to 77% (P<0.0001). In the GEE model, age was inversely associated with overall ETS exposure (Odds Ratio [OR] per 5 yr= 0.87, 95% CI= 0.81, 0.94), as was education (OR for college vs < high school=0.25, 95% CI=0.16, 0.37), female gender (ORI= 0.41, 95% CI= 0.33, 0.51), and later examination period (OR =0.62, 95% CI= 0.53, 0.73); current employment was positively associated with exposure (OR=1.44, 95% CI=1.14, 1.83).
Between the late 1990s and the mid-2000s, ETS exposure in older adults decreased. Decreasing exposures suggest there may be future declines in ETS-related adverse health outcomes.
环境烟草烟雾（ETS）暴露与不良健康后果相关。我们的目标是确定在基于人群的听力损失流行病学研究的参与者中，1998 - 2000年至2003 - 2005年期间ETS暴露是否发生了变化。
在5年随访（1998 - 2000年）和10年随访检查（2003 - 2005年）时，使用经可替宁验证的问卷确定ETS暴露情况。纳入两次访视均有数据的非吸烟参与者（n = 1898；5年随访时年龄为53 - 96岁）。采用McNemar检验来检验总体ETS暴露以及在家庭、工作场所和社交场所这三种环境中的ETS暴露差异。广义估计方程（GEE）用于暴露的多变量逻辑回归模型。
无或几乎无ETS暴露的非吸烟者比例从80%增加到88%（P < 0.0001）。居住在无室内吸烟者家庭中的比例从94%增加到97%（P < 0.0001）。报告在工作场所无暴露的比例从91%增加到95%（P < 0.0001）。报告社交暴露频率最低的比例从65%增加到77%（P < 0.0001）。在GEE模型中，年龄与总体ETS暴露呈负相关（每5年的优势比[OR] = 0.87，95%置信区间[CI] = 0.81，0.94），教育程度也是如此（大学学历与高中以下学历相比的OR = 0.25，95% CI = 0.16，0.37），女性（OR = 0.41，95% CI = 0.33，0.51）以及较晚的检查时期（OR = 0.62，95% CI = 0.53，0.73）也呈负相关；当前就业与暴露呈正相关（OR = 1.44，95% CI = 1.14，1.83）。
在20世纪90年代末至21世纪中期，老年人的ETS暴露有所下降。暴露的减少表明与ETS相关的不良健康后果未来可能会减少。
