Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study

Yin, Peng; Jiang, CQ; Cheng, Kar Keung; Lam, TH; Lam, KH; Miller, '; Zhang, WS; Thomas, G. Neil; Adab, Peymané

doi:10.1016/s0140-6736(07)61378-6

Cited by 251 publications

(186 citation statements)

References 27 publications

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“…Although SHS exposure has been associated with worse COPD health and greater risk of COPD exacerbations (35,36), it did not likely explain our findings. We showed a consistent association with PM 2.5 and NO 2 concentrations with poor respiratory health in homes where SHS exposure was relatively low.…”

Section: Discussionmentioning

confidence: 59%

In-Home Air Pollution Is Linked to Respiratory Morbidity in Former Smokers with Chronic Obstructive Pulmonary Disease

Hansel¹,

McCormack²,

Belli³

et al. 2013

Am J Respir Crit Care Med

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Rationale: The effect of indoor air pollutants on respiratory morbidity among patients with chronic obstructive pulmonary disease (COPD) in developed countries is uncertain. Objectives: The first longitudinal study to investigate the independent effects of indoor particulate matter (PM) and nitrogen dioxide (NO 2 ) concentrations on COPD morbidity in a periurban community. Methods: Former smokers with COPD were recruited and indoor air was monitored over a 1-week period in the participant's bedroom and main living area at baseline, 3 months, and 6 months. At each visit, participants completed spirometry and questionnaires assessing respiratory symptoms. Exacerbations were assessed by questionnaires administered at clinic visits and monthly telephone calls. Measurements and Main Results: Participants (n ¼ 84) had moderate or severe COPD with a mean FEV 1 of 48.6% predicted. The mean (6 SD) indoor PM 2.5 and NO 2 concentrations were 11.4 6 13.3 µg/m 3 and 10.8 6 10.6 ppb in the bedroom, and 12.2 6 12.2 µg/m 3 and 12.2 6 11.8 ppb in the main living area. Increases in PM 2.5 concentrations in the main living area were associated with increases in respiratory symptoms, rescue medication use, and risk of severe COPD exacerbations. Increases in NO 2 concentrations in the main living area were independently associated with worse dyspnea. Increases in bedroom NO 2 concentrations were associated with increases in nocturnal symptoms and risk of severe COPD exacerbations. Conclusions: Indoor pollutant exposure, including PM 2.5 and NO 2 , was associated with increased respiratory symptoms and risk of COPD exacerbation. Future investigations should include intervention studies that optimize indoor air quality as a novel therapeutic approach to improving COPD health outcomes.Keywords: indoor air; chronic obstructive pulmonary disease; particulate matter; nitrogen dioxide; exacerbations Chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States and the fifth leading cause worldwide, is expected to become increasingly prevalent in upcoming decades (1, 2). Most COPD is caused by environmental exposures; in developed countries, this exposure is primarily cigarette smoke. After COPD begins, evidence indicates that it can be worsened by other environmental exposures. For example, outdoor particulate matter (PM) concentrations have been associated with an increase in COPD hospitalizations and mortality (3, 4). Similarly, outdoor nitrogen dioxide (NO 2 ) exposure has been linked to worse COPD morbidity, including higher rates of exacerbations (4-6).Although substantial evidence shows that outdoor air pollutants impact COPD, there is much less evidence for the impact of indoor air on COPD, especially in developed countries. Although the Global Initiative for Chronic Obstructive Lung Disease guidelines identify indoor air pollution resulting from burning wood and other biomass fuels as a major risk factor for COPD (7), exposures under these conditions are two to three orders of magnitude higher ...

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Section: Discussionmentioning

confidence: 59%

In-Home Air Pollution Is Linked to Respiratory Morbidity in Former Smokers with Chronic Obstructive Pulmonary Disease

Hansel¹,

McCormack²,

Belli³

et al. 2013

Am J Respir Crit Care Med

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“…To prevent contamination, all subjects received a unique identifier, which was used to barcode all items including the questionnaires, blood tubes and cryovials. The 1996 volunteers received a full medical checkup including measurement of blood pressure, obesity indices (body mass index (BMI), waist and hip circumferences, percentage body fat), 1 lung function (forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), 6 physical function measures (2.5 m get-up-and-go, left and right hand grip strength), chest X-ray and a range of vascular disease surrogate markers as described in Table 1.…”

Section: Physical Examinationmentioning

confidence: 99%

“…These include lifestyle factors such as the maintenance of traditional cuisine and minimal consumption of tobacco products and alcohol in women, and psychosocial factors such as traditional belief in the need for a diet that balances Yin (cold/dark) and Yang (hot/bright) foods and offsets such imbalance in the body or the health benefits of obesity, which in developing countries is advantageous to help overcome childhood infections, including diarrhoeal disease. 1,6 Such a legacy means this population is an ideal setting to assess, both crosssectionally and longitudinally, the impact of rapid economic development on health determinants.…”

Section: Introductionmentioning

confidence: 99%

“…This cohort can therefore help not only to assess determinants of disease within the Chinese setting, but also to provide supportive data in Western settings where a hypothesis may not be adequately assessed. We have already utilized this in the assessment of passive smoking on chronic obstructive pulmonary disease 6 and napping on diabetes and the metabolic syndrome. The low rate of smoking in women, yet high prevalence in men, enabled a much clearer picture of the contribution of passive smoking, 6 which can often be confounded by the residual effects of active smoking in Caucasian populations.…”

Section: Introductionmentioning

confidence: 99%

“…We have already utilized this in the assessment of passive smoking on chronic obstructive pulmonary disease 6 and napping on diabetes and the metabolic syndrome. The low rate of smoking in women, yet high prevalence in men, enabled a much clearer picture of the contribution of passive smoking, 6 which can often be confounded by the residual effects of active smoking in Caucasian populations. Likewise, in China napping is a very common and widely accepted practice and not, as in many Western settings, a response to tiredness resulting from disease or ageing that might otherwise confound the observation.…”

Section: Introductionmentioning

confidence: 99%

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An overview of the Guangzhou Biobank Cohort Study–Cardiovascular Disease Subcohort (GBCS-CVD): a platform for multidisciplinary collaboration

et al. 2009

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The Guangzhou Biobank Cohort Study (GBCS, n ¼ 30 519, age X50 years) was established to examine the effects of genetic and environmental influences on health problems and chronic disease development. Guangzhou is undergoing massive economic development, but from a baseline that had remained unchanged for millennia. The Cardiovascular Disease Subcohort (GBCS-CVD) consists of 2000 participants who have been intensively phenotyped including a range of surrogate markers of vascular disease, including carotid artery intima-media thickness, cerebral artery stenoses, arterial stiffness, ankle-to-brachial blood pressure index and albuminuria, as well as coagulatory and inflammatory markers. Plasma and leukocytes are stored in liquid nitrogen for future studies. Preliminary demographic data show the female volunteers are younger than the male ones, but present with greater levels of adiposity including central obesity (31 vs 16%). Women had more body fat (33 vs 24%) and associated levels of adipokines. Despite this, body mass index and hip circumferences were similar, which contrasts with Caucasian populations. Men had more physician-diagnosed vascular disease (6.1 vs 2.5%), hypertension (42 vs 34%) and hyperglycaemia (36.6 vs 29.6%) than the women, but were less insulin resistant. In men, smoking (40 vs 2%) and drinking alcohol (67 vs 50%) was more common and they also had lower energy expenditures. The genotype distributions of the 15 typed single nucleotide polymorphisms were all in HardyWeinberg equilibrium. This article describes the rationale and methodology for the study. Given the comprehensive characterization of demographic and psychosocial determinants and biochemistry, the study provides a unique platform for multidisciplinary collaboration in a highly dynamic setting.

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Secondhand Smoke and Infectious Disease in Adults: A Global Women's Health Concern

Benowitz

2010

Arch Intern Med

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Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study

Cited by 251 publications

References 27 publications

In-Home Air Pollution Is Linked to Respiratory Morbidity in Former Smokers with Chronic Obstructive Pulmonary Disease

In-Home Air Pollution Is Linked to Respiratory Morbidity in Former Smokers with Chronic Obstructive Pulmonary Disease

An overview of the Guangzhou Biobank Cohort Study–Cardiovascular Disease Subcohort (GBCS-CVD): a platform for multidisciplinary collaboration

Secondhand Smoke and Infectious Disease in Adults: A Global Women's Health Concern

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