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1.
Public Health ; 187: 24-35, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32889229

RESUMO

OBJECTIVE: This study aims to further quantify evidence of the association between exposure to indoor air pollution (IAP), tobacco smoke etc., on the one hand and the risk of contracting tuberculosis (TB) on the other. STUDY DESIGN: This was a systematic review and meta-analysis of articles published between June 2014 and February 2020 in PubMed, Web of Science, among others. METHODS: We only included studies that controlled for confounders, screened both the exposed and unexposed study participants, and passive smoking studies that limited the study population to non-smokers. Quality of studies was assessed using the Newcastle-Ottawa scale. The analysis was conducted using STATA, and pooled effect sizes were calculated using the random-effects model, and heterogeneity was tested for using the Cochran Q test and I2 statistic. RESULTS: A total of 26 articles were included in the final analysis. There was an increased risk of contracting TB among people exposed to IAP (risk ratio [RR] = 1.68, 95% confidence interval [CI] 1.108-2.542). We also observed a two-fold increase in the risk of contracting TB from exposure to secondhand tobacco smoke (RR = 2.15, 95%CI 1.419-3.242). Tobacco smoking doubled the risk of contracting TB (RR = 2.67, 95%CI 2.017-3.527). Furthermore, studies that used microbiological tests showed a higher RR compared to those that used other TB diagnostic methods. CONCLUSION: Exposure to IAP and secondhand tobacco smoke increases the risk of contracting TB. Various disease prevention campaigns should include IAP awareness and encourage a shift to cleaner sources of energy.

2.
Environ Sci Pollut Res Int ; 27(24): 29856-29866, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32483718

RESUMO

Exposure to secondhand smoke (SHS) in the workplace has led many workplaces to set up smoke-free policies to protect non-smoking employees. Although smoke-free workplaces are pervasive, the intensity of the practice is questionable. The purpose of this review is to identify the pooled prevalence estimate of secondhand smoke at smoke-free workplaces and the factors associated with SHS exposure at the workplace despite existing smoke-free policies. Fourteen studies (total 7458 employees) were identified from Pubmed, ScienceDirect, Cinahl, Scopus, and Web of Science from inception to December 2017. Results indicate that despite the existence of smoke-free policies at the workplace, 14 studies reported exposure to secondhand smoke. The pooled prevalence of the SHS exposure was 0.29 (95% CI = 0.23 to 0.36) (P < 0.001). Male young adults working in the hospitality industry are likely to report exposure to secondhand smoke at the smoke-free workplace. While most of the selected studies show the exposure of SHS within the smoking ban workplace, only two studies reported no exposure to secondhand smoke after implementation of smoke-free policies. Although the smoking ban policy at the workplace has been introduced, there are still a number of employees being affected by secondhand smoke. This indicates that there is still a gap of knowledge, attitude, and practice of non-smokers in strengthening the smoke-free policy at the workplace.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Local de Trabalho , Humanos , Masculino , Prevalência , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-31861215

RESUMO

Enabling parents to create a smoke-free home is one of the key ways that children's exposure to second-hand smoke (SHS) can be reduced. Smoke-free home interventions have largely targeted mothers who smoke, and there is little understanding of the barriers and facilitators that fathers experience in creating a smoke-free home. Systematic searches combining terms for fathers, homes, and SHS exposure were run in April 2019 in Web of Science's Citation Indices, PsycINFO, and PubMed for English-language studies published since 2008. The searches identified 980 records for screening, plus 66 records from other sources. Twelve studies reported in 13 papers were included in this scoping review. Eight of the studies were conducted in Asian countries (five in China, one in India, one in Japan, and one in Iran), three were conducted in Canada, and one in Turkey. Findings were extracted in verbatim text for thematic analysis. The review identified that attitudes and knowledge, cultural and social norms, gender power relations, and shifting perceptions and responsibilities related to fatherhood can impact on fathers' views of their role in relation to creating and maintaining a smoke-free home. There were too few published studies that had assessed smoke-free home interventions with fathers to draw conclusions regarding effective approaches. Research is clearly needed to inform our understanding of fathers' roles, successes and challenges in creating and maintaining a smoke-free home, so that father-inclusive rather than mother-led interventions can be developed to benefit entire households and improve gender equity as well as health.


Assuntos
Pai/psicologia , Poluição por Fumaça de Tabaco/análise , Adulto , Criança , Características da Família , Feminino , Humanos , Masculino , Mães
4.
BMC Public Health ; 19(1): 1071, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395051

RESUMO

BACKGROUND: Household smoke-free home rules cannot fully protect nonsmokers from secondhand smoke (SHS) if they live in multi-unit housing (MUH). Instead, property-level smoke-free policies are needed to prevent SHS incursion into apartment units and to keep common areas smoke-free. Smoke-free policies are usually at the discretion of property management companies and owners within the context of market-rate and privately-owned affordable housing in the U.S. METHODS: Semi-structured interviews on the policy development, implementation and enforcement experiences of 21 different privately-owned affordable housing management companies were conducted with representatives from properties in North Carolina and Georgia who had established smoke-free policies before 2016. RESULTS: The decision to adopt was typically made by corporate leadership, board members, owners or property managers, with relatively little resident input. Policy details were influenced by property layout, perceptions of how best to facilitate compliance and enforcement, and cost of creating a designated smoking area. Policies were implemented through inclusion in leases, lease addenda or house rules with 6 months' notice most common. Participants thought having a written policy, the norms and culture of the housing community, public norms for smoke-free environments, and resident awareness of the rules and their consequences, aided with compliance. Violations were identified through routine inspections of units and resident reporting. Resident denial and efforts to hide smoking were shared as challenges to enforcement, along with a perception that concrete evidence would be needed in eviction court and that simply the smell of SHS was insufficient evidence of violation. Over half had terminated leases or evicted residents due to violations of the smoke-free policy. The most common benefits cited were reduced turnover cost and time, and lower vacancy rates. CONCLUSIONS: Understanding the smoke-free policy process in privately-owned affordable housing can help practitioners encourage policies within subsidized housing contexts. The study identified salient benefits (e.g., reduced cost, time, and vacancies) that can be highlighted when encouraging MUH partners to adopt policies. Additionally, study findings provide guidance on what to consider when designing smoke-free policies (e.g., layout, costs), and provide insights into how to enhance compliance (e.g., resident awareness) and manage enforcement (e.g., routine inspections).


Assuntos
Habitação/organização & administração , Setor Privado , Política Antifumo , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Idoso , Custos e Análise de Custo , Feminino , Georgia , Habitação/economia , Habitação/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Pesquisa Qualitativa , Adulto Jovem
5.
Environ Pollut ; 254(Pt B): 113036, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31465899

RESUMO

Ambient air pollution (AAP) is recognized a cardiovascular risk factor and lipid profile dysregulation seems to be one of the potential mediators involved. However, results from epidemiologic research on the association between exposure to AAP and altered lipid profile have been inconsistent. This study aims to systematically review and meta-analyse epidemiologic evidence on the association between exposure to ambient air pollutants (particulate matter, nitrogen oxides, sulphur dioxide, ozone, carbon monoxide, back carbon) and lipid profile parameters (Total cholesterol; High-Density Lipoprotein Cholesterol; Low-Density Lipoprotein Cholesterol; TG-Triglycerides) or dyslipidaemia. Systematic electronic literature search was performed in PubMed, Web of Science and Scopus databases (last search on 24th May 2019) using keywords related to the exposure (ambient air pollutants) and to the outcomes (lipid profile parameters/dyslipidaemia). Qualitative and quantitative information of the studies were extracted and fixed or random-effects models were used to obtain a pooled effect estimate per each pollutant/outcome combination. 22 studies were qualitatively analysed and, from those, 3 studies were quantitatively analysed. Particulate matters were the most studied pollutants and a considerable heterogeneity in air pollution assessment methods and outcomes definitions was detected. Age, obesity related measures, tobacco consumption, sex and socioeconomic factors were the most frequent considered variables for confounding adjustment in the models. In a long-term exposure scenario, we found a 3.14% (1.36%-4.95%) increase in TG levels per 10 µg/m3 PM10 increment and a 4.24% (1.37%-7.19%) increase in TG levels per 10 µg/m3 NO2 increment. No significant associations were detected for the remaining pollutant/outcome combinations. Despite the few studies included in the meta-analysis, our study suggests some epidemiologic evidence supporting the association between PM10 and NO2 exposures and increased TG levels. Due to the very low level of evidence, more studies are needed to clarify the role of lipid profile dysregulation as a mediator on the AAP adverse cardiovascular effects.


Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/análise , Lipídeos/análise , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Monóxido de Carbono/análise , Poluentes Ambientais/análise , Feminino , Humanos , Masculino , Óxidos de Nitrogênio/análise , Ozônio/análise , Material Particulado/análise , Fatores Socioeconômicos , Dióxido de Enxofre/análise
6.
Medicine (Baltimore) ; 98(28): e16454, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305478

RESUMO

OBJECTIVE: Tobacco smoke contains carcinogens known to damage somatic and germ cells. In this study, we investigated the effect of tobacco smoking on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML). METHODS: Information about tobacco smoking exposures of the mother before, during, and after pregnancy was collected via PubMed, Embase, and Web of Science databases through November 5, 2018. We performed to evaluate the association between smoking exposure and the risk of childhood ALL and AML. Study selection, data abstraction, and quality assessment were performed by 2 independent reviewers. Random effects models were used to obtain summary odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Nineteen case-control studies of childhood leukemia (age < 15 years) conducted in 9 countries from 1974 to 2018. Maternal smoking exposures did not a significant association with childhood ALL (OR = 1.004, 95% CI 0.953-1.058, P = .881) and AML (OR = 0.92, 95% CI 0.815-1.038, P = .177) during exposure time windows. However, there was an association with paternal smoking and ALL (OR = 1.15, 95% CI 1.038-1.275, P = .007). Paternal smoking in AML showed there was no association with smoking exposures and childhood AML (OR = 1.133, 95% CI 0.943-1.362, P = .181). Next, maternal daily cigarettes consumption showed no associations with ALL (OR = 1.08, 95% CI 1.000-1.168, P = .051) during pregnancy. No association with maternal daily smoking and AML (OR = 0.909, 95% CI 0.682-1.211, P = .514). Paternal daily cigarettes consumption was associated with increased risks of childhood ALL (OR = 1.200, 95% CI 1.112-1.302, P = .000). The higher consumption of paternal smoking (more than 10 per day) was significantly related to childhood ALL. Paternal daily smoking consumption also was related to AML (OR = 1.242, 95% CI 1.031-1.496, P = .022). CONCLUSION: Maternal smoking before, during, or after pregnancy was not associated with childhood ALL or AML. However, paternal smoking was related to a significantly elevated risk of childhood ALL during pregnancy, but not for AML. Maternal daily smoking consumption was not associated with ALL or AML during pregnancy. The higher consumption of paternal smoking were, the higher the risk of childhood ALL or AML.


Assuntos
Leucemia Mieloide Aguda/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Criança , Feminino , Humanos , Fatores de Risco
7.
PLoS One ; 14(6): e0217845, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31173615

RESUMO

BACKGROUND: Understanding patterns of socio-economic inequalities in tobacco consumption is key to design targeted public health policies for tobacco control. This study examines socio-economic inequalities in smoking and involuntary exposure to tobacco smoke between 2005 and 2013. METHODS: Data were derived from the Argentine National Risk Factors Surveys, conducted in 2005, 2009, and 2013. Two inequality measures were calculated: the age-adjusted prevalence ratio (PR) and the disparity index (DI). Educational level, household income per consumer unit and employment status were used as proxies for socio-economic status (SES). Generalized linear models were used in the analysis. RESULTS: Prevalence of smoking decreased from 29.7% to 25.1% between 2005 and 2013, mainly in women (p<0.001). Despite the overall prevalence reduction, socio-economic inequalities in smoking persisted. For both men and women, the DI was moderately high for smoking (14.47%-33.06%) across the three surveys. In men, the PR indicated a higher smoking prevalence for lower educational levels and lower household income throughout the analyzed period. In women, unlike previous years, the 2013 survey showed disparity related to unemployment. Involuntary exposure to tobacco smoke in 2013 was associated with educational level and household income, with lower involuntary exposure among those with higher SES. CONCLUSIONS: While overall smoking rates have decreased in Argentina, socio-economic disparities related to tobacco smoking persist. Comprehensive tobacco control programs targeted to address these inequalities are essential in developing strategies to reduce health disparities in tobacco-related diseases.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Tabaco/efeitos adversos , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Classe Social , Uso de Tabaco/efeitos adversos , Uso de Tabaco/epidemiologia , Adulto Jovem
8.
Int J Tuberc Lung Dis ; 23(4): 412-421, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31064619

RESUMO

OBJECTIVES To examine: 1) whether exposure to secondhand smoke (SHS) at home is associated with symptoms of self-reported illness among mother-child pairs (MCPs); and 2) the relationship between low socio-economic status and SHS exposure and the role these play as obstacles to the reduction of risk of illness in MCPs. METHOD A cross-sectional study was conducted in Rajshahi District, Bangladesh, from May to July 2017. A total of 541 MCPs were interviewed. RESULTS The prevalence of SHS exposure at home in our sample data was 49.0%. SHS exposure was found to be associated with a higher likelihood of any self-reported rhinitis, any respiratory symptoms and any reproductive health problems among mothers. SHS exposure in children was found to be associated with a higher likelihood of any self-reported rhinitis and food sensitisation, any respiratory symptoms and otitis media. Our findings also suggested that although SHS had an independently adverse effect on MCPs, wealth moderated the likelihood of illness. CONCLUSIONS MCPs who were both poor and exposed to SHS were uniquely disadvantaged in terms of their poor health conditions than MCPs who were wealthier and exposed to SHS. .


Assuntos
Exposição Ambiental/efeitos adversos , Pobreza/estatística & dados numéricos , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Adulto , Bangladesh/epidemiologia , Pré-Escolar , Estudos Transversais , Exposição Ambiental/economia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Prevalência , Fatores de Risco , Autorrelato , Fatores Socioeconômicos , Poluição por Fumaça de Tabaco/economia , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-30991759

RESUMO

Previous studies have suggested an association between secondhand smoke (SHS) exposure and risk of depressive symptoms. However, it remains unclear whether there is a dose-response relationship. The effect estimates were pooled using fixed-effect or random-effect models based on homogeneity analysis. The dose-response meta-analysis was performed by linear and non-linear regression. Subgroup analyses were conducted to explore the possible sources of heterogeneity. Twenty-four studies were included in this meta-analysis. SHS exposure was significantly associated with increased odds of depressive symptoms (odds ratio (OR) = 1.32, 95% confidence interval (CI) 1.25-1.39). For SHS exposure expressed as an ordinal variable, the dose-response meta-analysis revealed a monotonically increasing relationship between SHS exposure and depressive symptoms. A similar dose-response relationship was observed for SHS exposure expressed as a continuous variable (OR = 1.57, 95% CI = 1.26-1.87). Our findings suggest that SHS exposure is associated with increasing odds of depressive symptoms in a dose-response manner.


Assuntos
Depressão/epidemiologia , Poluição por Fumaça de Tabaco/análise , Depressão/induzido quimicamente , Relação Dose-Resposta a Droga , Humanos , Prevalência , Fatores de Risco
10.
NPJ Prim Care Respir Med ; 29(1): 12, 2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31028270

RESUMO

Approximately three billion individuals are exposed to household air pollution (HAP) from the burning of biomass fuels worldwide. Household air pollution is responsible for 2.9 million annual deaths and causes significant health, economic and social consequences, particularly in low- and middle-income countries. Although there is biological plausibility to draw an association between HAP exposure and respiratory diseases, existing evidence is either lacking or conflicting. We abstracted systematic reviews and meta-analyses for summaries available for common respiratory diseases in any age group and performed a literature search to complement these reviews with newly published studies. Based on the literature summarized in this review, HAP exposure has been associated with acute respiratory infections, tuberculosis, asthma, chronic obstructive pulmonary disease, pneumoconiosis, head and neck cancers, and lung cancer. No study, however, has established a causal link between HAP exposure and respiratory disease. Furthermore, few studies have controlled for tobacco smoke exposure and outdoor air pollution. More studies with consistent diagnostic criteria and exposure monitoring are needed to accurately document the association between household air pollution exposure and respiratory disease. Better environmental exposure monitoring is critical to better separate the contributions of household air pollution from that of other exposures, including ambient air pollution and tobacco smoking. Clinicians should be aware that patients with current or past HAP exposure are at increased risk for respiratory diseases or malignancies and may want to consider earlier screening in this population.

11.
Artigo em Inglês | MEDLINE | ID: mdl-31010129

RESUMO

Secondhand smoke (SHS), a common environmental exposure factor, has become a serious public health problem. Metabolic syndrome is another worldwide clinical challenge. Our study tried to determine the age differences in the relationship between SHS and the risk of metabolic syndrome. Studies were searched in PubMed and Web of Science from 11 November to 30 November 2018. Eighteen studies were finally included based on inclusion and exclusion criteria. The relationship between SHS and the risk indicators of metabolic syndrome was analyzed. The weighted mean difference (WMD) of fasting plasma glucose (FPG), insulin, body mass index (BMI), and waist circumference (WC), and the standard mean difference (SMD) of total cholesterol, triglycerides, and low- and high-density lipoprotein-cholesterol (LDL-C, HDL-C) were calculated in a meta-analysis. SHS was positively associated with the level of insulin and WC. According to the subgroup analysis based on age difference, SHS was positively associated with FPG in the upper age group, and positively associated with LDL-C and negatively associated with HDL-C in the lower age group. BMI showed a more obvious positive correlation in the adults group than in the children and the teenagers group. In conclusion, the association of metabolic syndrome with SHS varies with age. When exposed to SHS, older people may be more susceptible to glucose metabolic disorder, but younger people may be more susceptible to lipid metabolic disorder.


Assuntos
Envelhecimento/metabolismo , Síndrome Metabólica/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Adulto , Fatores Etários , Glicemia/análise , Índice de Massa Corporal , Criança , HDL-Colesterol/sangue , Humanos , Insulina/sangue , Resistência à Insulina , Metabolismo dos Lipídeos , Síndrome Metabólica/sangue , Síndrome Metabólica/etiologia , Obesidade/sangue , Obesidade Abdominal/etiologia , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura
12.
Environ Sci Pollut Res Int ; 26(13): 12648-12661, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30903465

RESUMO

Ambient air pollution is nowadays one of the most crucial contributors to deteriorating health status worldwide. The components of air pollution include PM2.5 and PM10, NO2, SO2, CO, O3, and organic compounds. They are attributed to several health outcomes, for instance, cardiovascular diseases (CVD), respiratory diseases, birth outcomes, neurologic diseases, and psychiatric diseases. The objective of this study is to evaluate the association between different ambient air pollutants and the above-mentioned health outcomes. In this systematic review, a total of 76 articles was ultimately selected from 2653 articles, through multiple screening steps by the aid of a set of exclusion criteria as non-English articles, indoor air pollution assessment, work-related, occupational and home-attributed pollution, animal studies, tobacco smoking effects, letters to editors, commentaries, animal experiments, reviews, case reports and case series, out of 19,862 published articles through a systematic search in PubMed, Web of Science, and Scopus. Then, the associations between air pollution and different health outcomes were measured as relative risks and odds ratios. The association between air pollutants, PM2.5 and PM10, NO2, SO2, CO, O3, and VOC with major organ systems health was investigated through the gathered studies. Relative risks and/or odds ratios attributed to each air pollutant/outcome were ultimately reported. In this study, a thorough and comprehensive discussion of all aspects of the contribution of ambient air pollutants in health outcomes was proposed. To our knowledge up to now, there is no such comprehensive outlook on this issue. Growing concerns in concert with air pollution-induced health risks impose a great danger on the life of billions of people worldwide. Should we propose ideas and schemes to reduce ambient air pollutant, there will be dramatic reductions in the prevalence and occurrence of health-threatening conditions.


Assuntos
Poluição do Ar/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Exposição Ambiental/efeitos adversos , Doenças do Sistema Nervoso/epidemiologia , Doenças Respiratórias/epidemiologia , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Exposição Ambiental/análise , Feminino , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Neoplasias/epidemiologia , Neoplasias/etiologia , Doenças do Sistema Nervoso/etiologia , Material Particulado/efeitos adversos , Material Particulado/análise , Gravidez , Resultado da Gravidez , Doenças Respiratórias/etiologia
13.
J Alzheimers Dis ; 70(s1): S145-S163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30775976

RESUMO

BACKGROUND: Both air pollution and dementia are current and growing global issues. There are plausible links between exposure to specific air pollutants and dementia. OBJECTIVE: To systematically review the evidence base with respect to the relationship between air pollution and later cognitive decline and dementia. METHODS: Medline, Embase, and PsychINFO® were searched from their inception to September 2018, for publications reporting on longitudinal studies of exposure to air pollution and incident dementia or cognitive decline in adults. Studies reporting on exposure to tobacco smoke including passive smoking or on occupational exposure to pollutants were excluded. Using standard Cochrane methodology, two readers identified relevant abstracts, read full text publications, and extracted data into structured tables from relevant papers, as defined by inclusion and exclusion criteria. Papers were also assessed for validity. CRD42018094299Results:From 3,720 records, 13 papers were found to be relevant, with studies from the USA, Canada, Taiwan, Sweden, and the UK. Study follow-up ranged from one to 15 years. Pollutants examined included particulate matter ≤2.5 µ (PM2.5), nitrogen dioxide (NO2), nitrous oxides (NOx), carbon monoxide (CO), and ozone. Studies varied in their methodology, population selection, assessment of exposure to pollution, and method of cognitive testing. Greater exposure to PM2.5, NO2/NOx, and CO were all associated with increased risk of dementia. The evidence for air pollutant exposure and cognitive decline was more equivocal. CONCLUSION: Evidence is emerging that greater exposure to airborne pollutants is associated with increased risk of dementia.

14.
BMC Public Health ; 19(1): 195, 2019 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-30764804

RESUMO

BACKGROUND: In low-income countries such as Nepal, indoor air pollution (IAP), generated by the indoor burning of biomass fuels, is the top-fourth risk factor driving overall morbidity and mortality. We present the first assessment of geographic and socio-economic determinants of the markers of IAP (specifically fuel types, cooking practices, and indoor smoking) in a nationally-representative sample of Nepalese households. METHODS: Household level data on 11,040 households, obtained from the 2016 Nepal Demographic and Health Survey, were analyzed. Binary logistic regression analyses were conducted to assess the use of fuel types, indoor cooking practices, indoor smoking and IAP with respect to socio-economic indicators and geographic location of the household. RESULTS: More than 80% of the households had at least one marker of IAP: 66% of the household used unclean fuel, 45% did not have a separate kitchen to cook in, and 43% had indoor smoking. In adjusted binary logistic regression, female and educational attainment of household's head favored cleaner indoor environment, i.e., using clean fuel, cooking in a separate kitchen, not smoking indoors, and subsequently no indoor pollution. In contrast, households belonging to lower wealth quintile and rural areas did not favor a cleaner indoor environment. Households in Province 2, compared to Province 1, were particularly prone to indoor pollution due to unclean fuel use, no separate kitchen to cook in, and smoking indoors. Most of the districts had a high burden of IAP and its markers. CONCLUSIONS: Fuel choice and clean indoor practices are dependent on household socio-economic status. The geographical disparity in the distribution of markers of IAP calls for public health interventions targeting households that are poor and located in rural areas.


Assuntos
Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Biomassa , Culinária/métodos , Culinária/estatística & dados numéricos , Países em Desenvolvimento , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Pobreza , Fatores de Risco , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adulto Jovem
15.
J Affect Disord ; 245: 918-927, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30699877

RESUMO

BACKGROUND: Globally about 30% of adult women and 40% of children are exposed to secondhand smoke (SHS) from active smokers. SHS exposure of pregnant women has been associated with postpartum depression. Unexposed women in pregnancy had lower rates of postpartum depression than women exposed to SHS. This systematic review aimed to determine the association of depressive symptoms and exposure to SHS in nonsmoking pregnant women. METHOD: The case-controlled, cross-sectional, and cohort studies with a comparison group were included. Studies including women who had smoking history during pregnancy were excluded. The comprehensive electronic databases, CINAHL, EMBASE, and Medline were searched. RESULT: Of the 2777 records screened, seven studies were included in the review for data extraction. The bias of studies was assessed using the RoBANS. We synthesized two studies that showed depressive symptoms at any time during pregnancy and postpartum significantly increased (ORs = 1.77 [95% CI = 1.12 - 2.79]; p = 0.01; I2 = 28%, 4103 women, two studies), and significantly increased the odds of antenatal suicidal ideation in SHS exposed women (ORs = 1.75 [95% CI = 1.14 - 2.70]; p = 0.01; I2 = 51%, 2670 women, two studies). Lack of studies from counties with the highest smoking rates was a limitation. CONCLUSIONS: SHS exposure during pregnancy showed a significant increase in the odds of depressive symptoms. Furthermore, research is required to clarify to association between SHS and depression.


Assuntos
Depressão Pós-Parto/epidemiologia , Depressão/epidemiologia , Complicações na Gravidez/epidemiologia , Ideação Suicida , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Estudos de Casos e Controles , Estudos Transversais , Depressão/psicologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , não Fumantes , Gravidez , Complicações na Gravidez/psicologia , Gestantes/psicologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-30609776

RESUMO

There are health consequences to exposure to secondhand smoke (SHS). About two-thirds of children in China live with at least one person, usually a parent, who smokes at home. However, none of the reviews of interventions for reducing SHS have targeted children in China. The purpose of this study was to review the effectiveness of interventions for reducing parental SHS exposure at home among children in China. We searched various electronic databases for English and Chinese publications appearing between 1997 and 2017. Thirteen relevant studies were identified. Common strategies used in intervention groups were non-pharmacological approaches such as counseling plus self-help materials, and attempting to persuade fathers to quit smoking. Family interactions and follow-up sessions providing counseling or using text messages could be helpful to successful quitting. Several encouraging results were observed, including lower cotinine levels in children (n = 2), reduced tobacco consumption (n = 5), and increased quit rates (n = 6) among parents. However, the positive effects were not sustained 3~6 months after the interventions. Self-reported quitting without bio-chemical validation was the most common outcome measure. A study design using biochemical validations, a longer follow-up period, and targeting all people living with children in the same household is recommended.


Assuntos
Exposição Ambiental/prevenção & controle , Poluição por Fumaça de Tabaco , Criança , China , Habitação , Humanos , Pais , Fumar Tabaco/prevenção & controle
18.
Nicotine Tob Res ; 21(11): 1462-1472, 2019 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-29986089

RESUMO

INTRODUCTION: A systematic review was conducted to evaluate the impact of public smoking bans on social inequalities in children's secondhand smoke (SHS) exposure at home. METHODS: Five databases were electronically searched for articles on children's SHS exposure at home related to public smoking bans. In addition, the gray literature and German public health journals were considered. Search was restricted to English and German publications. Of 3037 records screened, 25 studies fulfilled the inclusion criteria by either measuring SHS exposure before and after public smoking ban introduction or by comparing exposure between regions with and without smoke-free legislation. Studies were further examined whether they additionally reported on impacts on social inequalities in SHS exposure. Information on children's SHS exposure at home in relation to smoke-free legislation were extracted by one reviewer and checked for accuracy by a second reviewer. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity (PRISMA-E) guidelines for equity-focused systematic reviews, the PROGRESS-Plus framework was applied to data extraction and analysis with focus on social inequalities in SHS exposure. Results were visualized by a harvest plot. RESULTS: Eight studies gave results on the impact of public smoking bans on social inequalities in children's SHS exposure. Whereas only one study indicated widening of the social gap in exposure, seven studies showed no impact or a reduction of social inequalities in exposure. CONCLUSIONS: First evidence on short-term impact of public smoking bans does not support the assumption of intervention-generated inequalities in children's SHS exposure at home. Future studies should focus on long-term equity impacts of smoke-free legislation. IMPLICATIONS: There are substantial social inequalities in children's SHS exposure in many countries. Both hypotheses on the effect of smoke-free legislation on children's SHS exposure at home, the displacement hypothesis and the social diffusion hypothesis, did not take social inequalities into account. Up to now, only few studies analyzed the effects of smoke-free legislation on social inequalities in children's SHS exposure at home. Public smoking bans had overall no negative impact on social inequalities in children's SHS exposure at home. More consistent reporting of absolute and relative inequalities is needed to comprehensively assess equity impact of smoke-free legislation.


Assuntos
Bem-Estar da Criança , Política Antifumo , Marginalização Social , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Poluição do Ar em Ambientes Fechados/prevenção & controle , Criança , Pré-Escolar , Feminino , Saúde Global , Humanos , Lactente , Recém-Nascido , Masculino , Poluição por Fumaça de Tabaco/legislação & jurisprudência
19.
Am J Prev Med ; 56(2): 281-287, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30553690

RESUMO

INTRODUCTION: The purpose of this study is to estimate healthcare utilization and healthcare costs due to secondhand smoke exposure at home for children in the U.S. METHODS: Using data from the 2000, 2005, and 2010 U.S. National Health Interview Surveys, the authors analyzed the association between secondhand smoke exposure at home and utilization of three types of healthcare services (hospital nights, emergency room visits, and doctor visits) for children aged 3-14 years (N=16,860). A zero-inflated Poisson regression model was used to control for sociodemographic characteristics and the number of months without health insurance. The authors determined excess healthcare utilization attributable to secondhand smoke exposure at home for children and then estimated annual secondhand smoke-attributable healthcare costs as the product of annual excess healthcare utilization and unit costs obtained from the 2014 Medical Expenditures Panel Survey. This study was conducted from 2016 to 2018. RESULTS: The prevalence of secondhand smoke exposure at home for children in 2000, 2005, and 2010 was 25.0%, 12.3%, and 9.1%, respectively. Secondhand smoke exposure at home was positively associated with emergency room visits, but was not significantly associated with nights at the hospital or doctor visits for children. Secondhand smoke exposure at home for children resulted in an excess of 347,156 emergency room visits in 2000, 124,412 visits in 2005, and 101,570 visits in 2010, which amounted to $215.1 million, $77.1 million, and $62.9 million in excess annual healthcare costs (2014 dollars) in 2000, 2005, and 2010, respectively. CONCLUSIONS: Although U.S. healthcare costs attributable to secondhand smoke exposure at home for children are declining, interventions to reduce secondhand smoke exposure at home for children are still needed to reduce the economic burden attributable to secondhand smoke exposure.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Habitação/legislação & jurisprudência , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Política Antifumo/economia , Poluição por Fumaça de Tabaco/economia , Adolescente , Criança , Pré-Escolar , Serviço Hospitalar de Emergência/economia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Habitação/estatística & dados numéricos , Humanos , Masculino , Visita a Consultório Médico/economia , Visita a Consultório Médico/estatística & dados numéricos , Política Antifumo/legislação & jurisprudência , Fumar/efeitos adversos , Fumar/epidemiologia , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Estados Unidos/epidemiologia
20.
Nicotine Tob Res ; 21(9): 1172-1180, 2019 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-30060241

RESUMO

INTRODUCTION: Tobacco has been known to contain radioactive polonium and lead for 50 years but the literature is divided as to the public health significance. I review the data on tobacco radioactivity and its internalization by smokers. METHODS: Data sources: Reports of lead-210 and polonium-210 content of tobacco leaf, cigarettes, cigarette smoke, and human respiratory tissues, published between 1964 and September 2017. Study selection: Any identified study that reported values for lead-210 and polonium-210 content. Data extraction: Data quality was addressed by comparative review of analytic methods. RESULTS: The data about radiation content of tobacco and smoke are robust. Early reports suggesting microsievert lifetime doses of inhaled radioactivity to smokers were not borne out. The results remain sensitive to pharmacological assumptions around absorption and redistribution of inhaled radionuclides, and radiobiological assumptions about interaction with human tissues. CONCLUSIONS: Literature on tobacco radioactivity has not fully contended with pharmacological and radiobiological uncertainty, and is therefore divided as to health significance. This does much to explain regulatory inaction over the last half century. Before radiation safety law can offer a vehicle for tobacco control, more must be learnt about the pharmacology and radiobiology of inhaled radionuclides in tobacco smoke. IMPLICATIONS: This work makes it apparent that the study of tobacco smoke radioactivity has been scientifically stagnant for the last 40 years. The field cannot advance until we improve understanding of the pharmacology and radiobiology of inhaled radionuclides in tobacco smoke. Despite this, a subset of contemporary authors is still suggesting individual health risks about 1000 times higher than can be supported by internationally accepted models.


Assuntos
Radioisótopos de Chumbo/análise , Polônio/análise , Radioatividade , Poluição por Fumaça de Tabaco/análise , Fumar Tabaco , Humanos , Radioisótopos de Chumbo/efeitos adversos , Pulmão/efeitos dos fármacos , Pulmão/efeitos da radiação , Polônio/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Fumar Tabaco/efeitos adversos
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