Assessment of exposure and DNA damage from second-hand smoke using potential biomarker in urine: cigarettes and heated tobacco products.

Second-hand smoke exposure is an established cause of several adverse health effects. Tobacco smoke exposure in the environment has been improved by the WHO Framework Convention on Tobacco Control. However, concerns have been raised regarding the health effects of heated tobacco products. Analysis of tobacco smoke biomarkers is critical for assessing the health effects of second-hand tobacco smoke exposure. In this study, nicotine metabolites (nicotine, cotinine, trans-3'-hydroxycotinine) and carcinogenic 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol were analysed in the urine of non-smokers with or without passive exposure to cigarettes and heated tobacco products. In addition, 7-methylguanine and 8-hydroxy-2'-deoxyguanosine were simultaneously measured as DNA damage markers. The results revealed higher levels of urinary nicotine metabolites and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol in participants exposed to second-hand tobacco smoke (both cigarettes and heated tobacco products) at home. In addition, the urinary levels of 7-methylguanine and 8-hydroxy-2'-deoxyguanosine tended to be higher in the second-hand tobacco smoke-exposed group. The urinary levels of nicotine metabolites and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol were high in workplaces with no protection against passive smoking. These biomarkers will be useful for evaluating passive exposure to tobacco products.

Relationship of airflow limitation severity with work productivity reduction and sick leave in a Japanese working population.

BACKGROUND: The aim of this study was to reveal the association between airflow limitation (AL) severity and reduction with work productivity as well as use of sick leave among Japanese workers. METHODS: This cross-sectional study included 1,378 workers who underwent a lung function test during a health checkup at the Japanese Red Cross Kumamoto Health Care Center. AL was defined as forced expiratory volume in 1 second/forced vital capacity of <0.7. Workers completed a questionnaire on productivity loss at work and sick leave. The quality and quantity of productivity loss at work were measured on a ten-point scale indicating how much work was actually performed on the previous workday. Participants were asked how many days in the past 12 months they were unable to work because of health problems. Logistic regression analysis was used to assess the associations between AL severity and the quality and quantity of productivity loss at work as well as use of sick leave. RESULTS: Compared with workers without AL, workers with moderate-to-severe AL showed a significant productivity loss (quality: odds ratio [OR] =2.04, 95% confidence interval [CI]: 1.12-3.71, P=0.02 and quantity: OR =2.19, 95% CI: 1.20-4.00, P=0.011) and use of sick leave (OR =2.69, 95% CI: 1.33-5.44, P=0.006) after adjusting for sex, age, body mass index, smoking status, hypertension, hyperglycemia, dyslipidemia, sleep duration, work hours per day, and workplace smoking environment. CONCLUSION: AL severity was significantly associated with work productivity loss and use of sick leave. Our findings suggested that early intervention in the subjects with AL at the workforce might be beneficial for promoting work ability.

Prevalence of airflow limitation on medical check-up in Japanese subjects.

The prevalence and mortality of chronic obstructive pulmonary disease (COPD) is expected to increase in the future throughout the world. Little data is available on the prevalence of airflow limitation in Japan, especially on medical check-up. The purpose of this study was to assess the prevalence of airflow limitation in Japanese subjects during medical check-ups. The study subjects were 13,534 Japanese subjects (8,583 males and 4,951 females) aged 40-69 years who underwent medical check-ups at the Japanese Red Cross Kumamoto Health Care Center. Pulmonary function data were analyzed according to smoking habits in each age group. The spirometric criteria for diagnosis of airflow limitation were forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 70%. The severity of COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. People with a medical diagnosis of asthma or individuals who had other pulmonary diseases were excluded from a diagnosis of COPD. The prevalence of airflow limitation was 7.0% in all subjects, 9.1% in males and 3.3% in females. Using the GOLD system, the prevalence of mild, moderate, severe and very severe airflow limitation was 7.06, 1.92, 0.10 and 0.00%, respectively, in males. In females, the prevalence of mild, moderate, severe and very severe airflow limitation was 2.67, 0.63, 0.02 and 0.00%, respectively. Only 10 cases with airflow limitation reported a previous diagnosis of COPD. These results suggest that screening spirometry during medical check-ups can identify many COPD patients not aware of this disease and highlight the need for enhanced screening efforts, intervention and treatment.

Emphysema detected by lung cancer screening with low-dose spiral CT: prevalence, and correlation with smoking habits and pulmonary function in Japanese male subjects.

OBJECTIVE: Screening with low-dose spiral CT is a promising new tool for early lung cancer detection. A study was undertaken to assess the prevalence of emphysema detected by CT screening, and to assess the correlation between the extent of emphysema and the severity defined according to the recently published Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. METHODS: After informed consent, CT screening and pulmonary function tests were performed on 615 men between the ages of 40 and 69. Severity of emphysema was assessed visually. Only the pulmonary function data for male subjects were analysed because there were too few female subjects with emphysema. RESULTS: Emphysema was detected in 30.5% of current smokers, 14.1% of former smokers and 3.0% of non-smokers. In male current smokers, airflow obstruction (FEV(1)/FVC < 0.7) was seen in 18.1% of subjects with mild emphysema, and in 33.3% of subjects with moderate emphysema. FEV(1) values were less than 80% of the predicted normal in 8.5% of subjects with mild emphysema, and 28.6% of subjects with moderate emphysema. The percentage of male subjects with emphysema equivalent to GOLD stage 0 was 90.0% for subjects in their 40s, 82.5% for those in their 50s, and 68.2% for those in their 60s. CONCLUSION: A considerable percentage of the subjects with emphysema as detected by CT screening had GOLD stage 0. CT screening assists in detecting early-stage emphysema.

Effect of smoking on FEV decline in a cross-sectional and longitudinal study of a large cohort of Japanese males.

OBJECTIVE: The effects of cigarette smoking and smoking cessation on age-related pulmonary function decline was assessed in both cross-sectional and longitudinal studies. METHODOLOGY: In the cross-sectional study, pulmonary function data from 11,875 healthy asymptomatic males, aged between 35 and 74, were analysed and correlated with their smoking history and age. In the longitudinal study, changes in pulmonary function were monitored over a 5-year period in 1888 healthy males. RESULTS: The cross-sectional study showed that the difference in FEV(1) between male never smokers and current smokers was small at a younger age but increased with age. A beneficial effect on FEV(1) decline was observed in those who ceased smoking, even within the previous 12 months. Longitudinally, current smokers showed a more rapid decline in FEV(1) over the 5-year period than non-smokers. Those who ceased smoking had lower rates of decline in FEV(1) than those who continued to smoke. CONCLUSION: These results indicate that cigarette smoking is associated with a reduction in pulmonary function, and that smoking cessation has a beneficial effect on FEV(1) decline. Provision of a smoking cessation program for all smokers, especially those showing a rapid decline of FEV(1), should be considered as an important strategy to prevent progression of COPD.