Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2023 Aug 21;13(1):13605. doi: 10.1038/s41598-023-40058-z.
Exposure to second-hand smoke (SHS) is prevalent in many countries, but the problem's scope is poorly understood globally, especially in developing countries. We aimed to estimate SHS exposure and its national and subnational burden of diseases in Iran, the second-largest country in the Middle East, during 2009-2020. The burden of diseases from SHS was estimated as disability-adjusted life years (DALYs) for adolescents (10-18) year's non-smokers. Using comparative risk assessment methodologies, the calculations were based on disease-specific relative risk estimates with national and subnational SHS exposure data, and the uncertainty and sensitivity analysis was performed. The results of study showed that the trend of exposure to SHS is increasing in Iran. The highest DALY was related to lower respiratory infection (LRI), asthma, and otitis media, respectively. The national average asthma burden (DALY/100,000) has increased from 17.4 (11.8_23.9) in 2009 to 21.3 (13.9_30) in 2020, LRI decreased from 25.8 (21.5_30.2) to 19.8 (16.7_23.1), and national average burden of otitis media (DALY/100,000) has increased from 3.1(1.9_4.6) to 3.9(2.4_5.6). The increasing trend of otitis media and asthma DALYs attributable to SHS exposure in Iran requires more attention from policymakers to protect the population.
二手烟（SHS）暴露在许多国家都很普遍，但全球范围内对该问题的范围了解甚少，特别是在发展中国家。我们旨在估计 2009-2020 年期间伊朗（中东第二大国家）的 SHS 暴露情况及其国家和次国家疾病负担。青少年（10-18 岁）非吸烟者的 SHS 暴露造成的疾病负担以伤残调整生命年（DALY）衡量。使用比较风险评估方法，计算基于特定疾病的相对风险估计值，结合国家和次国家 SHS 暴露数据，并进行不确定性和敏感性分析。研究结果表明，伊朗 SHS 暴露的趋势呈上升趋势。最高的 DALY 与下呼吸道感染（LRI）、哮喘和中耳炎有关。国家平均哮喘负担（DALY/100000）从 2009 年的 17.4（11.8_23.9）增加到 2020 年的 21.3（13.9_30），LRI 从 25.8（21.5_30.2）降至 19.8（16.7_23.1），国家平均中耳炎负担（DALY/100000）从 3.1（1.9_4.6）增加到 3.9（2.4_5.6）。伊朗 SHS 暴露导致中耳炎和哮喘 DALY 呈上升趋势，这需要政策制定者更加关注，以保护人口。
