Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Ciber de Epidemidemiología y Salud Pública, CIBEResp, Madrid, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, IDIS, Santiago de Compostela, Spain.
Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Facultad de Medicina, Universidad Cooperativa de Colombia, Colombia; Fundación Carolina, Colombia.
Arch Bronconeumol. 2023 May;59(5):305-310. doi: 10.1016/j.arbres.2023.02.017. Epub 2023 Mar 10.
Exposure to environmental tobacco smoke (ETS) is associated with increased mortality and morbidity. The objective of this study was to estimate the impact of ETS exposure in Spain on mortality in 2020 in the population aged 35 years and over.
A method of estimating attributable mortality (AM) based on the prevalence of ETS exposure was applied. Prevalence data were obtained from a representative study conducted in Spain and the relative risks were derived from a meta-analysis. AM point estimates are presented along with 95% confidence intervals (95% CI), calculated using a bootstrap naive procedure. AM, both overall and by smoking habit, was estimated for each combination of sex, age group, and cause of death (lung cancer and ischemic heart disease). A sensitivity analysis was performed.
A total of 747 (95% CI 676-825) deaths were attributable to ETS exposure, of which 279 (95% CI 256-306) were caused by lung cancer, and 468 (95% CI 417-523) by ischemic heart disease. Three-quarters (75.1%) of AM occurred in men and 60.9% in non-smokers. When chronic obstructive pulmonary disease and cerebrovascular disease are included, the burden of AM is estimated at 2242 deaths.
ETS exposure is associated with 1.5% of all deaths from lung cancer and ischemic heart disease in the population aged 35 and over. These data underline the need for health authorities to focus on reducing exposure to ETS in all settings and environments.
接触环境烟草烟雾（ETS）与死亡率和发病率的增加有关。本研究的目的是估计 2020 年 ETS 暴露对西班牙 35 岁及以上人群死亡率的影响。
应用基于 ETS 暴露流行率的归因死亡率（AM）估算方法。流行率数据来自西班牙进行的一项代表性研究，相对风险来自荟萃分析。使用bootstrap naive 程序计算并呈现 AM 点估计值及其 95%置信区间（95%CI）。按性别、年龄组和死因（肺癌和缺血性心脏病）对每种吸烟习惯进行了总体和 AM 估计。进行了敏感性分析。
共有 747 例（95%CI 676-825）死亡归因于 ETS 暴露，其中 279 例（95%CI 256-306）归因于肺癌，468 例（95%CI 417-523）归因于缺血性心脏病。75.1%的 AM 发生在男性，60.9%发生在非吸烟者中。当包括慢性阻塞性肺疾病和脑血管疾病时，估计 AM 的负担为 2242 例死亡。
ETS 暴露与 35 岁及以上人群中 1.5%的肺癌和缺血性心脏病死亡有关。这些数据强调了卫生当局需要关注在所有环境和场所减少 ETS 暴露。
