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Secondary exposure to inhaled tobacco products
Örebro University, School of Health and Medical Sciences.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Även andra individer än rökaren kan påverkas av tobaksrökning. Syftet med denna avhandling var att undersöka några sådana effekter. Studierna omfattar såväl passiv rökning som exponering under graviditet. Mer specifikt handlar studierna om:

· Exponering för passiv rökning under barndomen och samband med luftvägssymtom och allergi senare i livet.

· Passiv rökning i vuxen ålder och samband med luftvägssymtom.

· Exponering hos serveringspersonal och effekter av lagstiftning mot tobaksrökning.

· Rökning under graviditet och kontroll och koordination av handrörelser hos barn.

Passiv rökning i barndomen hade en koppling till ökad risk för astma och allergi. Passiv rökning hos vuxna var kopplat till förekomst av andnings- och luftvägssymtom på ett dosberoende vis. Besvär i andningsvägar och slemhinnor minskade avsevärt hos icke rökande serveringspersonal efter rökförbudet på restauranger som infördes den 1 juni 2005.

Mammans rökning under graviditet var kopplad till nedsatt handkontroll och handkoordination hos avkomman. Sambandet var tydligast för vänsterhanden och pojkarnas handfunktion påverkades betydligt mer än flickornas. Fynden stödjer att rökning under graviditet kan påverka nervsystemets utveckling i negativ riktning.

Ett flertal oönskade effekter kan således drabba dem som är nära rökare under någon period i livet och resultaten understryker vikten av att förebygga sådan exponering.

Abstract [en]

Secondary exposure to inhaled tobacco products can influence the human body in a variety of ways. The aim of this thesis was to investigate a variety of health effects of secondary exposure to inhaled tobacco products. The research encompassed both airborne and in utero exposures. Specific investigations included:

· Childhood exposure to environmental tobacco smoke (ETS) and associations with respiratory symptoms and allergic sensitization.

· Adult exposure to ETS and exacerbation of respiratory symptoms

· Workplace exposure to ETS and associations with respiratory symptoms

· The influence of smoke-free workplace legislation on respiratory symptoms

· In utero exposure and associations with physical control and coordination at age 11 years

Environmental tobacco smoke during childhood was shown to be associated with an increased risk of asthma and allergic sensitization. Environmental tobacco smoke exposure in adult non-smokers was associated with a dose-dependent increase in the prevalence of respiratory symptoms. The frequency of respiratory and sensory symptoms in hospitality workers declined substantially in non-smokers following the introduction of smoke-free legislation. Maternal smoking during pregnancy was associated with poorer physical control and coordination among offspring, particularly in the left – usually non-dominant- hand and most pronounced in boys, consistent with an adverse influence on neurological development.

These findings help to characterize several adverse outcomes associated with secondary exposure to inhaled tobacco products and emphasise the importance of preventing such exposures.

Place, publisher, year, edition, pages
Örebro: Örebro universitet , 2008. , p. 72
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 23
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-2519ISBN: 978-91-7668-635-5 (print)OAI: oai:DiVA.org:oru-2519DiVA, id: diva2:136352
Public defence
2008-11-21, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 14:00
Opponent
Supervisors
Available from: 2008-10-20 Created: 2008-10-20 Last updated: 2017-10-18Bibliographically approved
List of papers
1. Environmental tobacco smoke exposure during childhood is associated with increased prevalence of asthma in adults
Open this publication in new window or tab >>Environmental tobacco smoke exposure during childhood is associated with increased prevalence of asthma in adults
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2001 (English)In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 120, no 3, p. 711-717Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To examine if exposure to environmental tobacco smoke (ETS) during childhood has an impact on asthma prevalence in adults, and to identify the amount of nuisance from ETS and other lower airway irritants (LAWIs) in a city population.

DESIGN: A postal survey.

SETTING: The municipality of Orebro, Sweden.

PARTICIPANTS: A total of 8,008 randomly selected inhabitants aged 15 to 69 years.

MEASUREMENTS: Exposures, airway symptoms, and respiratory history were assessed using a questionnaire.

RESULTS: The response rate was 84%. In never-smokers with childhood ETS exposure, the prevalence of physician-diagnosed asthma was 7.6% vs 5.9% in nonexposed subjects (p = 0.036). In never-smokers without a family history of asthma, the prevalence of physician-diagnosed asthma in subjects reporting childhood ETS exposure was 6.8% vs 3.8% in nonexposed subjects (p < 0.001). Subjects with childhood ETS exposure were more likely to start smoking in adulthood. The prevalence of ever-smokers was 54.5% vs 33.8% (p < 0.0001) in nonexposed subjects. ETS was the most commonly reported LAWI in the total sample (21%), followed by exercise in cold air (20%), dust (19%), exercise (16%), perfume (15%), cold air (12%), pollen (10%), and pets (8%). All LAWIs were more frequently reported by women.

CONCLUSIONS: Childhood exposure to ETS is associated with an increased prevalence of asthma among adult never-smokers, especially in nonatopic subjects. Children exposed to ETS are also more likely to become smokers. ETS is as a major LAWI.

National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-15588 (URN)10.1378/chest.120.3.711 (DOI)
Available from: 2011-05-17 Created: 2011-05-17 Last updated: 2017-12-11Bibliographically approved
2. Parental smoking and allergic sensitization in offspring defined by skin prick testing
Open this publication in new window or tab >>Parental smoking and allergic sensitization in offspring defined by skin prick testing
2005 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 16, no 5, p. 449-452Article in journal (Refereed) Published
Abstract [en]

Investigations of parental smoking during childhood and allergic sensitization have produced contradictory results, but this may be because of variations in the definition of allergy and other influences. We investigated associations of parental smoking with an objective measure of allergy, skin prick testing (SPT), and considered associations with maternal and paternal smoking, independently of each other. A stratified random sample, aged 22-74 yr, of 720 Swedish FinEsS-study members were skin prick tested for 15 allergens. Subjects with at least one positive SPT were defined as atopic. Data on childhood exposures, including parental smoking, were collected by structured interview. Logistic regression used atopy as the dependent variable. After adjustment, paternal smoking was statistically significantly associated with an increased risk and maternal smoking a non-statistically significant decreased risk in offspring, with odds ratios (and 95% confidence intervals) of 1.48 (1.04-2.10) and 0.73 (0.48-1.12), respectively. Analysis of families with a non-smoking mother produced an odds ratio for paternal smoking of 1.61 (1.09-2.37). The negative association between maternal smoking and atopy may not operate through passive smoke exposure and could conceal a significant increased risk associated with passive exposure to tobacco smoke in childhood.

National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-15589 (URN)10.1111/j.1399-3038.2005.00247.x (DOI)16101940 (PubMedID)
Available from: 2011-05-17 Created: 2011-05-17 Last updated: 2017-12-11Bibliographically approved
3. Passive smoking and respiratory symptoms in the FinEsS Study
Open this publication in new window or tab >>Passive smoking and respiratory symptoms in the FinEsS Study
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2003 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 21, no 4, p. 672-676Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to examine the relationship between reported environmental tobacco smoke (ETS) exposure and respiratory symptoms. In 1996, a postal questionnaire was randomly distributed in three areas of Estonia to a population-based sample, of which 4,995 females and 1,822 males had never smoked. The main outcome measures were current respiratory symptoms and the amount of reported ETS exposure outside the home. ETS exposure at home was more common in females (31% versus 19%), while exposure outside of the home was more common in males (53% versus 7%). Females reported more symptoms from tobacco smoke than males (37.7% versus 21.6%). If ETS exposure outside of the home exceeded 5 h daily, the risk for wheeze (odds ratio (OR) 2.67, 95% confidence interval (CI) 1.98-3.61) and physician-diagnosed asthma (OR 1.79, 1.02-3.16) were increased. ETS exposure outside of the home was shown to be strongly related to almost all respiratory symptoms in a dose/response manner. ETS exposure at home did not show significantly elevated ORs for any respiratory symptoms. This study shows that females seem to be more troubled by environmental smoke exposure than males and provides further evidence of the serious health hazards associated with environmental smoke exposure. Indeed, the findings of this study support a ban on smoking in the workplace and public areas.

National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-15590 (URN)10.1183/​09031936.03.00033702 (DOI)12762355 (PubMedID)
Available from: 2011-05-17 Created: 2011-05-17 Last updated: 2017-12-11Bibliographically approved
4. Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden: before and after the implementation of a smoke-free law
Open this publication in new window or tab >>Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden: before and after the implementation of a smoke-free law
2008 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 4, p. 267-277Article in journal (Refereed) Published
Abstract [en]

Objectives This study attempted to identify changes in exposure to environmental tobacco smoke, as well as symptoms and attitudes among hospitality workers after the introduction of extended smoke-free workplace legislation.

Methods A total of 37 volunteers working in bingo halls and casinos (gaming workers) and 54 bars and restaurant employees (other workers) in nine Swedish communities participated in the study. Altogether 71 of 91 persons (14 daily smokers and 57 nonsmokers) participated in both the preban baseline survey and the follow-up 12 months after the ban. Exposure to environmental tobacco smoke, smoking habits, respiratory and sensory symptoms, and attitudes towards the ban were recorded, and spirometry was carried out.

Results The frequency of reported respiratory and sensory symptoms was approximately halved among the nonsmokers in both occupational groups after the introduction of the ban. Initially 87% had exposure to environmental tobacco smoke that was over the nicotine cut-off level chosen to identify possible health risk (<0.5 µg/m3), while, after the ban, it was only 22%, a relative risk of 0.25 (95% confidence interval 0.15–0.41). The risk decreased in both occupational groups, but gaming workers experienced the highest preban exposure levels. Attitudes towards the legislation were largely positive, particularly after the ban. However, there was no notable change in lung function, and there was no notable reduction in the number of cigarettes consumed by smokers.

Conclusions The introduction of smoke-free legislation was associated with a substantial reduction in respiratory and sensory symptoms, as well as reduced exposure to environmental tobacco smoke at work, particularly among gaming workers.

Place, publisher, year, edition, pages
Helsingfors: Institutet för arbetshygien, 2008
Keywords
Attitude to Health, Cotinine/urine, Female, Gambling, Humans, Male, Occupational Exposure/adverse effects/analysis/*prevention & control, Public Policy, Respiratory Tract Diseases/epidemiology/etiology, Restaurants, Smoking/*legislation & jurisprudence, Spirometry, Sweden/epidemiology, Tobacco Smoke Pollution/adverse effects/analysis/*prevention & control
National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Research subject
Social Medicine; Medicine
Identifiers
urn:nbn:se:oru:diva-3755 (URN)18815714 (PubMedID)
Available from: 2009-01-05 Created: 2009-01-05 Last updated: 2018-01-13Bibliographically approved
5. Does maternal smoking during pregnancy influence physical control and coordination among offspring?
Open this publication in new window or tab >>Does maternal smoking during pregnancy influence physical control and coordination among offspring?
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-15591 (URN)
Available from: 2011-05-17 Created: 2011-05-17 Last updated: 2017-10-17Bibliographically approved

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Larsson, Matz

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