Rando-Matos Yolanda, Pons-Vigués Mariona, López María José, Córdoba Rodrigo, Ballve-Moreno José Luis, Puigdomènech-Puig Elisa, Benito-López Vega Estíbaliz, Arias-Agudelo Olga Lucía, López-Grau Mercè, Guardia-Riera Anna, Trujillo José Manuel, Martin-Cantera Carlos
Centre d'Atenció Primària (CAP) Florida Nord. Gerència d'Àmbit d'Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.
Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
PLoS One. 2017 Jul 31;12(7):e0181035. doi: 10.1371/journal.pone.0181035. eCollection 2017.
The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations.
Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment.
A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36%) than for asthma (5-31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies.
Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.
本系统评价和荟萃分析旨在综合科学论文中关于无烟立法对所有人群呼吸系统疾病以及感觉和呼吸道症状（咳嗽、咳痰、眼红、流涕）影响的现有证据。
进行系统评价和荟萃分析。于1995年1月至2015年2月期间在PubMed、EMBASE、Cochrane图书馆、Scopus、科学引文索引和谷歌学术数据库中进行检索。纳入标准为：1）关于无烟立法的原创性科学研究；2）收集立法前后的数据；3）评估对呼吸和感觉结果的影响。由两名评审员独立进行标题和摘要筛选、从全文文章中提取数据以及方法学质量评估。
共识别出1606篇论文。筛选出50篇论文，其中26篇与症状相关（23篇涉及工人）。大多数结果显示出现这些症状的人群百分比显著下降，尤其是在采取综合措施的场所及禁令实施后的即刻时期（头六个月内）。4篇（50%）关于肺功能的论文报告呼气参数有一些显著改善。在评估哮喘住院情况的17篇论文中，13篇描述有显著下降，慢性阻塞性肺疾病住院情况的显著下降幅度（范围为1 - 36%）低于哮喘（5 - 31%）。6项关于不同呼吸系统疾病的研究结果存在差异，4篇关于死亡率的论文报告亚组中有显著下降。23项（46%）研究存在低偏倚风险。
无烟立法似乎在短期内改善了工人的呼吸和感觉症状（在综合无烟立法中对感觉症状的总体影响更大），对哮喘住院率也有一定程度的改善。
