ArticlesEffect of passive smoking on respiratory symptoms, bronchial responsiveness, lung function, and total serum IgE in the European Community Respiratory Health Survey: a cross-sectional study
Introduction
Passive smoking is widespread and causes exposure to many potent respiratory irritants.1, 2 In children, parental smoking is associated with respiratory symptoms and poorer lung function.3 The consequences of involuntary exposure to tobacco smoke have not been studied as extensively in adults as in children.4 Some studies have found that passive smoking in adulthood increases the risk and severity of asthma and respiratory symptoms.5, 6, 7 Several studies have indicated that involuntary exposure to tobacco in adults results in significant impairment of lung function.8, 9, 10 Passive smoking has also been associated with increased serum concentrations of total IgE.11, 12
Between 1990 and 1994, information on variation in asthma prevalence, known or suspected risk factors for atopy and asthma, and the management of asthma were collected in the European Community Respiratory Health Survey (ECRHS).13 The association between passive smoking and respiratory symptoms and asthma has so far been analysed in only one ECRHS study, which was based on data from the Swedish part of the survey; passive smoking in the workplace was found to increase the risk of symptomatic asthma in the workplace and asthma-related work disability.14
The aim of this analysis was to study the effect of passive smoking on respiratory symptoms, bronchial responsiveness, lung function, and total serum IgE in the ECRHS.
Section snippets
Population
The methods of the ECRHS have been described elsewhere.13 Participating centres selected an area defined by existing administrative boundaries with a population of at least 150 000. When possible, an appropriate local sampling frame was used to select randomly at least 1500 men and 1500 women, aged 20–44 years. In stage I, the ECRHS screening questionnaire was sent to participants. It asked about symptoms suggesting asthma, the use of medication for asthma, and the presence of hay-fever and
Results
The analysis included data from 36 centres in 16 countries. No data on bronchial responsiveness were available for two of the centres (Cardiff and Tartu). Altogether we included 3486 men and 4396 women (mean age 32·7 years [range 20–48]) who had never smoked. Of the 7882 questionnaire respondents included, spirometry was done for 6655, IgE measurements for 5985, and methacholine challenge for 5403. Data on occupational exposures in the current or last-held job were available from 30 of the 36
Discussion
The main findings in this investigation of adults who had never smoked are that reported passive smoking was common in all centres. However, the prevalence of passive smoking in the workplace varied more than 20-fold, with high rates in southern and central Europe and lower rates in New Zealand, Australia, the USA, and Sweden. Passive smoking increased the likelihood of experiencing respiratory symptoms and was also related to increased bronchial responsiveness. We found a positive association
References (34)
- et al.
A population based study on occupational asthma in Europe and other industrialised countries
Lancet
(1999) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
Cigarette smoke-sensitive asthma: challenge studies
J Allergy Clin Immunol
(1988) - et al.
Passive cigarette smoke-challenge studies: increase in bronchial hyperreactivity
J Allergy Clin Immunol
(1992) - et al.
The association of smoking and sensitisation to common environmental allergens: results from the European Community Respiratory Health Survey
J Allergy Clin Immunol
(1999) - et al.
Exposure of the US population to environmental tobacco smoke: the Third National Health and Nutrition Examination Survey, 1988 to 1989
JAMA
(1996) - et al.
Assessment of multiple markers of environmental tobacco smoke (ETS) in controlled steady-state atmospheres in a dynamic test chamber
Am Ind Hyg Assoc J
(1992) - et al.
Health effects of passive smoking 10: summary of effects of parental smoking on the respiratory health of children and implications for research
Thorax
(1999) Health effects of passive smoking 8: passive smoking and risk of adult asthma and COPD
Thorax
(1998)- et al.
Asthma related to occupational and ambient air pollutant in nonsmokers
J Occup Med
(1993)
Passive smoking exposure in adults and chronic respiratory symptoms (SAPALDIA Study)
Am J Respir Crit Care Med
Adult-onset asthma is associated with self-reported mold or environmental tobacco smoke exposures in the home
Allergy
Effect of passive smoking on the pulmonary function of adults
Thorax
Exposure-response relationship between passive smoking and adult pulmonary function
Am J Respir Crit Care Med
The effect of environmental tobacco smoke exposure on lung function in a longitudinal study of British adults
Epidemiology
The Po river delta respiratory epidemiological survey: an analysis of factors related to level of total serum IgE
Eur Respir J
Relationship of active and passive smoking to total IgE in adults of the Epidemiological study of the genetics and environment of asthma, bronchial hyperresponsiveness and atopy (EGEA)
Am J Respir Crit Care Med
Cited by (0)
Members listed at the end of the paper