二手烟暴露与从不吸烟者 10 年（2002-2012 年）心血管疾病发病风险：ATTICA 队列研究。

Exposure to second hand smoke and 10-year (2002-2012) incidence of cardiovascular disease in never smokers: The ATTICA cohort study.

机构信息

Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.

Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; University of Canberra, Faculty of Health, Canberra, Australia; University of La Trobe, College of Science, Health & Engineering, Melbourne, Australia.

出版信息

Int J Cardiol. 2019 Nov 15;295:29-35. doi: 10.1016/j.ijcard.2019.07.065. Epub 2019 Jul 23.

DOI:10.1016/j.ijcard.2019.07.065

PMID:31375335

Abstract

BACKGROUND

Despite WHO Framework Convention of Tobacco Control (FCTC) adoption, effective implementation of national smoking bans remains pending in several countries. This study quantified the association of second hand smoke (SHS) exposure and 10-year cardiovascular disease (CVD) among never smokers in such settings.

METHODS

In 2001-2002, a sample of 1514 males and 1528 females (range: 18-89 years old) were randomly selected in Greece. Frequency and duration of SHS exposure (i.e. exposure extending >30 min/day) within the home and/or workplace were assessed by interview. Following a 10-year follow-up period (2002-2012), incidence of non-fatal and fatal CVD (ICD-10) was evaluated among n = 2020 participants. The analytic study sample consisted of all never smokers (n = 910).

RESULTS

Despite national smoking ban implementation (2009), 44.6% (n = 406) of never smokers reported SHS exposure. While SHS exposed never smokers exhibited a more favorable profile of CVD-related risk factors at baseline, they subsequently developed similar 10-year CVD incidence rates, at a younger mean age (p = 0.001), than their non-exposed counterparts. Following adjustment for several lifestyle and clinical factors, SHS exposed never smokers exhibited a two-fold elevated 10-year CVD risk (adj. HR: 2.04, 95% CI: 1.43-2.92), particularly among women (adj. HR: 2.45, 95% CI: 1.45-4.06). SHS exposure accounted for 32% excess Population Attributable Risk (PAR) for 10-year CVD events in never smokers, with highest rates (PAR: 52%) being among those exposed in the workplace.

CONCLUSION

The prevention of SHS associated CVD and related healthcare costs mandates additional strategies for securing the effective implementation of comprehensive WHO FCTC based national smoking bans.

摘要

背景

尽管世界卫生组织《烟草控制框架公约》（FCTC）已经通过，但在一些国家，有效的国家禁烟令的实施仍未得到落实。本研究旨在量化此类环境下二手烟（SHS）暴露与从未吸烟者 10 年内心血管疾病（CVD）之间的关联。

方法

在 2001-2002 年，在希腊随机抽取了 1514 名男性和 1528 名女性（年龄范围：18-89 岁）作为样本。通过访谈评估了家庭和/或工作场所内 SHS 暴露的频率和持续时间（即每天暴露时间超过 30 分钟）。在 10 年的随访期间（2002-2012 年），评估了 n=2020 名参与者中发生的非致命性和致命性 CVD（ICD-10）的情况。分析研究样本由所有从未吸烟者（n=910）组成。

结果

尽管实施了国家禁烟令（2009 年），但仍有 44.6%（n=406）的从未吸烟者报告了 SHS 暴露。尽管 SHS 暴露的从未吸烟者在基线时表现出更有利的 CVD 相关风险因素特征，但他们随后以更年轻的平均年龄（p=0.001）发展出相似的 10 年 CVD 发病率。在调整了多种生活方式和临床因素后，暴露于 SHS 的从未吸烟者发生 10 年 CVD 的风险增加了一倍（调整后的 HR：2.04，95%CI：1.43-2.92），尤其是女性（调整后的 HR：2.45，95%CI：1.45-4.06）。SHS 暴露导致从未吸烟者 10 年内 CVD 事件的人群归因风险增加了 32%（额外的人群归因风险：52%），其中在工作场所暴露的人群风险最高（额外的人群归因风险：52%）。