1 Center for Environmental and Respiratory Health Research.
Am J Respir Crit Care Med. 2013 Oct 1;188(7):776-82. doi: 10.1164/rccm.201304-0773OC.
Identification of the subpopulation especially susceptible to the adverse effects of second-hand smoke exposure (SHS) would be useful for preventive actions and interventions.
To investigate whether asthmatic heredity indicates susceptibility to the effects of SHS on the risk of adult-onset asthma.
A population-based incident case-control study of clinically defined adult-onset asthma and randomly drawn control subjects (adults 21-63 yr old) from a geographically defined area in South Finland. After excluding current and ex-smokers there were 226 cases and 450 disease-free control subjects.
Our outcome measure was new adult-onset asthma. Parental asthma and recent SHS had a synergistic effect on the risk of asthma, the adjusted odds ratio being 1.97 (95% confidence interval, 1.12-3.45) for SHS; 2.64 (1.65-4.24) for parental asthma; and 12.69 (3.44-46.91) for their joint effect (relative excess risk due interaction, 9.08 [-0.22 to 43.18]). Synergistic effect followed a dose-dependent pattern with both recent and cumulative SHS exposures, with relative excess risk due interaction for parental asthma and over 100 SHS cigarette-years of 6.17 (0.57-19.16).
This is the first study showing that individuals with asthmatic heredity have a considerably increased risk of adult-onset asthma when exposed to SHS. SHS exposure has dose-dependent synergism with family history of asthma, the joint effect being stronger with higher exposure levels. Avoiding SHS could be an important preventive measure for reducing the risk of adult-onset asthma among those with asthmatic heredity. Asking about family history of asthma is a useful tool for identifying these susceptible individuals in clinical and preventive settings.
识别特别容易受到二手烟暴露（SHS）不良影响的亚群对于预防措施和干预措施将是有用的。
研究哮喘遗传是否表明易受 SHS 对成人发病哮喘风险的影响。
一项基于人群的临床定义的成人发病哮喘的病例对照研究，以及来自芬兰南部地理定义区域的随机抽取的无病对照（21-63 岁成人）。排除当前和以前的吸烟者后，有 226 例病例和 450 例无病对照。
我们的结局测量是新的成人发病哮喘。父母哮喘和最近的 SHS 对哮喘的风险有协同作用，调整后的比值比为 1.97（95%置信区间，1.12-3.45）为 SHS；2.64（1.65-4.24）为父母哮喘；以及 12.69（3.44-46.91）为其联合效应（交互归因超额风险，9.08 [-0.22 至 43.18]）。协同作用呈剂量依赖性模式，最近和累积 SHS 暴露均有协同作用，父母哮喘和超过 100 支 SHS 香烟年的交互归因超额风险为 6.17（0.57-19.16）。
这是第一项表明，暴露于 SHS 时，具有哮喘遗传的个体发生成人发病哮喘的风险显著增加的研究。SHS 暴露与家族哮喘史呈剂量依赖性协同作用，暴露水平越高，联合作用越强。避免 SHS 可能是减少具有哮喘遗传的个体发生成人发病哮喘风险的重要预防措施。询问哮喘家族史是在临床和预防环境中识别这些易感个体的有用工具。
