Recent findings by a group of Italian investigators led by Francesco Forastiere of the Agency of Public Health in Rome, Italy, add new fuel to the firestorm of debate about the effects of exposure to environmental tobacco smoke, or ETS [EHP 108:1171-1177]. The focus of their study was to compare the characteristics of two subsets of nonsmoking adult women in four areas of Italy: those who were exposed to ETS through their husbands' smoking and those who were not exposed, being married to nonsmokers. Specifically, they sought to evaluate whether the risk factors associated with cardiovascular and pulmonary diseases and lung cancer occurred differently among the exposed and unexposed women, possibly indicating that adverse health effects attributed to ETS exposure might instead be caused by other factors shared by the women married to smokers. Although they did identify some sociodemographic and dietary differences between the two groups of women, the scientists say their results do not support earlier claims that ETS-exposed people more frequently exhibit other risk factors for cardiovascular and pulmonary disease than nonexposed people.
The researchers collected voluminous data from each of the 1,938 women, who had participated earlier in a cross-sectional epidemiologic study of the role of air pollution on respiratory conditions. The women were asked to fill out two self-administered questionnaires. The first questionnaire gathered demographic information and answers to questions about many relevant variables, including ETS exposure, exposure to toxic substances at work, family medical history, personal medical history, physical exercise habits, and other preventive behaviors. The second questionnaire was used to assess the women's dietary habits.
Each woman was also given a thorough medical examination, and contributed urine and blood samples. The urine samples were used to confirm the subjects' reported nonsmoking status and to help quantify ETS exposure. Blood samples underwent laboratory analysis to determine concentrations of cholesterol, vitamins, and antioxidants in order to assess diet and overall health.
Sophisticated statistical analysis led to some interesting comparative results between the two groups. The women married to smokers were found to be less educated than the women married to nonsmokers. They also tended to live in more crowded dwellings, were significantly less likely to eat cooked or fresh vegetables more than once a day, and had significantly higher urine cotinine concentrations due to ETS exposure. Aside from these factors--which the researchers concluded were unsurprising given that smoking in Italy occurs more frequently among men of lower socioeconomic status (as well as among women of higher status)--both groups were remarkably similar.
The investigators state that there were no significant differences between the two groups that would imply increased risk factors among the ETS-exposed women other than the exposure to ETS itself. After controlling for various factors in their data analysis, the researchers conclude that women married to smokers do not differ significantly from women married to nonsmokers. That assertion bolsters previous research suggesting that the deleterious health effects attributed to ETS exposure do not in fact arise from other causes.
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|Publication:||Environmental Health Perspectives|
|Date:||Dec 1, 2000|
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