成年期二手烟暴露与欧洲社区呼吸健康调查 20 年随访期间下呼吸道健康的关系。
Second-hand smoke exposure in adulthood and lower respiratory health during 20 year follow up in the European Community Respiratory Health Survey.
机构信息
Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
出版信息
Respir Res. 2019 Feb 14;20(1):33. doi: 10.1186/s12931-019-0996-z.
BACKGROUND
Early life exposure to tobacco smoke has been extensively studied but the role of second-hand smoke (SHS) for new-onset respiratory symptoms and lung function decline in adulthood has not been widely investigated in longitudinal studies. Our aim is to investigate the associations of exposure to SHS in adults with respiratory symptoms, respiratory conditions and lung function over 20 years.
METHODS
We used information from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations of SHS exposure with respiratory health (asthma symptom score, asthma, chronic bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationships between SHS exposure and lung function levels and decline.
RESULTS
Reported exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (1990-1994) and 7.1% after the 20-year follow-up (2008-2011). On average 2.4% of the study participants were not exposed at the first, but were exposed at the third examination. An increase in SHS exposure over time was associated with doctor-diagnosed asthma (odds ratio (OR): 2.7; 95% confidence interval (95%-CI): 1.2-5.9), chronic bronchitis (OR: 4.8; 95%-CI: 1.6-15.0), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.2-2.9) and dyspnoea (OR: 2.7; 95%-CI: 1.1-6.7) compared to never exposed to SHS. Associations between increase in SHS exposure and incidence of COPD (OR: 2.0; 95%-CI: 0.6-6.0) or lung function (β: - 49 ml; 95%-CI: -132, 35 for FEV and β: - 62 ml; 95%-CI: -165, 40 for FVC) were not apparent.
CONCLUSION
Exposure to second-hand smoke may lead to respiratory symptoms, but this is not accompanied by lung function changes.
背景
早期接触烟草烟雾已被广泛研究，但二手烟（SHS）对成年人新发呼吸道症状和肺功能下降的作用在纵向研究中尚未得到广泛研究。我们的目的是调查成年人接触 SHS 与 20 年内呼吸道症状、呼吸道疾病和肺功能的关系。
方法
我们使用了来自欧洲社区呼吸健康调查 I-III 中 26 个中心的 3011 名成年人的信息，他们在所有三次调查中均为从不吸烟或前吸烟者。使用广义线性混合效应模型分析 SHS 暴露与呼吸道健康（哮喘症状评分、哮喘、慢性支气管炎、COPD）之间的关系，模型调整了混杂因素（包括性别、年龄、吸烟状况、社会经济地位和过敏敏化）。使用线性混合效应模型，并进一步调整身高，评估 SHS 暴露与肺功能水平和下降之间的关系。
结果
报告的 SHS 暴露在所有 26 个研究中心随时间下降。基线（1990-1994 年）时 SHS 暴露的患病率为 38.7%，20 年随访（2008-2011 年）后为 7.1%。平均有 2.4%的研究参与者在第一次检查时未暴露，但在第三次检查时暴露。随着时间的推移，SHS 暴露的增加与医生诊断的哮喘（比值比（OR）：2.7；95%置信区间（95%-CI）：1.2-5.9）、慢性支气管炎（OR：4.8；95%-CI：1.6-15.0）、哮喘症状评分（计数比（CR）：1.9；95%-CI：1.2-2.9）和呼吸困难（OR：2.7；95%-CI：1.1-6.7）有关，与从未接触过 SHS 的人相比。SHS 暴露增加与 COPD（OR：2.0；95%-CI：0.6-6.0）或肺功能（β：-49ml；95%-CI：-132，35 为 FEV 和 β：-62ml；95%-CI：-165，40 为 FVC）的发生率之间没有明显关联。
结论
接触二手烟可能会导致呼吸道症状，但不会导致肺功能变化。
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