Environmental Tobacco Smoke and Adult Asthma. The Impact of Changing Exposure Status on Health Outcomes

Details

• Personal Author:
  Blanc PD ; Eisner MD ; Henke J ; Shiboski SC ; Yelin EH
• Description:
  The effect of environmental tobacco smoke (ETS) exposure on adults with asthma has not been well characterized. In a prospective cohort study of 451 nonsmoking adults with asthma, we evaluated the impact of ETS exposure on asthma severity, health status, and health care utilization over 18 mo. There were 129 subjects (29%; 95% CI, 25-33%) who reported regular ETS exposure, falling into three categories: exposure at baseline but none at follow-up (n = 43, 10%), no baseline exposure and new exposure at follow-up (n = 56, 12%), and exposure at both baseline and follow-up (n = 30, 7%). In cross-sectional analyses, subjects with baseline ETS exposure had greater severity-of-asthma scores (score difference, 1.7; 95% CI, 0. 2-3.1), worse asthma-specific quality of life scores (score difference, 3.5; 95% CI, 0.03-7.0), and worse scores on the Medical Outcomes Study SF-36 physical component summary (score difference, 3. 0; 95% CI, 0-6.0) than unexposed subjects. They also had greater odds of emergency department visits (odds ratio [OR] = 2.1; 95% CI, 1.2-3.5), urgent physician visits (OR = 1.9; 95% CI, 1.1-3.3), and hospitalizations (OR = 1.9; 95% CI, 1.02-3.6). In longitudinal follow-up, subjects reporting ETS cessation showed improvement in severity-of-asthma scores (score reduction, -3.2; 95% CI, -4.4 to -2. 0) and physical component summary scores (score increase, 5.3; 95% CI, 2.6-8.1). Environmental tobacco smoke cessation decreased the odds of emergency department visits (OR = 0.4; 95% CI, 0.2-0.97) and hospitalizations (OR = 0.2; 95% CI, 0.04-0.97) after adjustment for covariates. Environmental tobacco smoke initiation was associated with greater asthma severity only in subjects with high-level (>= 3 h/wk) exposure (score increase, 1.4; 95% CI, 0.03-2.7). In conclusion, self-reported ETS exposure is associated with greater asthma severity, worse health status, and increased health care utilization in adults with asthma. [Description provided by NIOSH]
• Subjects:
  Age Factors Asthma Asthma, Occupational Demography Mental Health Occupational Exposure Occupational Health Race Factors Respiratory Tract Diseases Safety Sex Characteristics Smoke Smokers Tobacco Products

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• Keywords:
  Age-factors Bronchial-asthma Demographic-characteristics Occupational-exposure Psychological-factors Pulmonary-system-disorders Racial-factors Respiratory-system-disorders Sex-factors Smoking Tobacco-smoke

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  170-175
• Volume:
  158
• Issue:
  1
• NIOSHTIC Number:
  nn:20024645
• Citation:
  Am J Respir Crit Care Med 1998 Jul; 158(1):170-175
• Contact Point Address:
  Paul D. Blanc, M.D., MSPH, 350 Parnassus Ave, Suite 609, San Francisco, CA 94143-0924
• Email:
  blanc@itsa.ucsf.edu
• Federal Fiscal Year:
  1998
• NORA Priority Area:
  Research Tools and Approaches: Social and Economic Consequences
• Performing Organization:
  University of California, Cardiovascular Research Institute, San Francisco, California
• Peer Reviewed:
  True
• Start Date:
  19970930
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• End Date:
  20010929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3786574e497d17cfa81bbde23d9a79291bb4bbfffc10111ee5ca2c08c9d47acd6d24b56adee1da4f748a8e8ca96abb27a322fb03def71808f589461f8a1393f6
• Download URL:
  https://stacks.cdc.gov/view/cdc/196340/cdc_196340_DS1.pdf
• File Type:
  [PDF - 57.87 KB ]