Al-Zoughool Mustafa, Pintos Javier, Richardson Lesley, Parent Marie-Élise, Ghadirian Parviz, Krewski Daniel, Siemiatycki Jack
McLaughlin Center of Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.
Environ Health. 2013 Dec 18;12:112. doi: 10.1186/1476-069X-12-112.
The objective of the present study was to examine the association between environmental tobacco smoke (ETS) and risk of lung cancer among never smokers, defined as subjects who smoked less than 100 cigarettes in their lifetime.
We conducted a population-based case-control study on lung cancer in Montreal, Canada (1996-2000) including 1,203 cases and 1513 controls. The present analysis is restricted to the 44 cases and 436 population controls who reported never smoking and completed the questionnaire on lifetime ETS exposure. Collected information included duration and intensity of exposure from multiple sources: inside home (parents, spouses, roommates and any other co-resident) and outside homes (in vehicles, social settings, and workplace). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated between ETS and lung cancer, adjusting for age, sex, socioeconomic status (SES), and proxy respondent.
Overall there was no association between ETS cumulative exposure from all sources (measured in pack-years) and lung cancer: OR = 0.98 (95%CI: 0.40-2.38), comparing upper with lower tertiles of exposure. While there were no elevated ORs associated with ever having lived with parents who smoked (OR = 0.62; 95%CI: 0.32-1.21) or with spouses who smoked (OR = 0.39; 95%CI: 0.18-0.85), ETS exposure from sources outside homes was associated with a slight, although non-significant increased risk: OR = 2.30 (95%CI: 0.85-6.19) for the upper 50% exposed. There were no clear differences in ORs by age at exposure to ETS or by histologic type of tumour, though numbers of subjects in subgroup analyses were too small to provide reliable estimates.
No clear association between lifetime ETS exposure from all sources and increased risk of lung cancer was found in the current study.
本研究的目的是调查环境烟草烟雾（ETS）与终生吸烟少于100支的从不吸烟者患肺癌风险之间的关联。
我们在加拿大蒙特利尔开展了一项基于人群的肺癌病例对照研究（1996 - 2000年），包括1203例病例和1513例对照。目前的分析仅限于44例报告从不吸烟且完成了关于终生ETS暴露问卷的病例以及436例人群对照。收集的信息包括来自多个来源的暴露持续时间和强度：家庭内部（父母、配偶、室友及其他同住者）和家庭外部（车辆内、社交场合及工作场所）。在调整年龄、性别、社会经济地位（SES）和代理应答者后，估计ETS与肺癌之间的比值比（OR）和95%置信区间（CI）。
总体而言，来自所有来源的ETS累积暴露（以包年衡量）与肺癌之间无关联：比较暴露的上三分位数与下三分位数时，OR = 0.98（95%CI：0.40 - 2.38）。虽然与曾经与吸烟的父母同住（OR = 0.62；95%CI：[0.32 - 1.21]）或与吸烟的配偶同住（OR = 0.39；95%CI：[0.18 - 0.85]）无升高的OR，但家庭外部来源的ETS暴露与轻微但不显著增加的风险相关：暴露最高的50%人群的OR = 2.30（95%CI：0.85 - 6.19）。按接触ETS时的年龄或肿瘤组织学类型划分，OR无明显差异，尽管亚组分析中的受试者数量过少，无法提供可靠估计。
在本研究中，未发现所有来源的终生ETS暴露与肺癌风险增加之间存在明确关联。
