Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

NIOSHTIC-2 Publications Search

Search Results

Environmental tobacco smoke and adult asthma. The impact of changing exposure status on health outcomes.

Authors
Eisner-MD; Yelin-EH; Henke-J; Shiboski-SC; Blanc-PD
Source
Am J Respir Crit Care Med 1998 Jul; 158(1):170-175
NIOSHTIC No.
20024645
Abstract
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.
Keywords
Bronchial-asthma; Psychological-factors; Demographic-characteristics; Smoking; Age-factors; Sex-factors; Racial-factors; Respiratory-system-disorders; Pulmonary-system-disorders; Tobacco-smoke; Occupational-exposure
Contact
Paul D. Blanc, M.D., MSPH, 350 Parnassus Ave, Suite 609, San Francisco, CA 94143-0924
CODEN
AJCMED
Publication Date
19980701
Document Type
Journal Article
Email Address
blanc@itsa.ucsf.edu
Funding Amount
372965
Funding Type
Grant
Fiscal Year
1998
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-003480
Issue of Publication
1
ISSN
1073-449X
Priority Area
Research Tools and Approaches: Social and Economic Consequences
Source Name
American Journal of Respiratory and Critical Care Medicine
State
CA
Performing Organization
University of California, Cardiovascular Research Institute, San Francisco, California
TOP