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Li Q, Yamamoto R, Shinzawa M, Otsuki N, Matsumura Y, Nakamura Y, Mizui M, Matsui I, Sakaguchi Y, Shinomiya H, Ishibashi C, Adachi H, Nakanishi K, Nagatomo I. Short sleep duration and smoking initiation in university students: a retrospective cohort study. Sleep Breath 2024; 28:1839-1846. [PMID: 38637352 DOI: 10.1007/s11325-024-03014-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/05/2024] [Accepted: 02/23/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE The aim of this study was to clarify an association between short sleep duration and smoking initiation. METHODS Participants eligible for this retrospective cohort study were university students who were admitted to a single national university in Japan between 2007 and 2015. Baseline sleep duration and smoking status were measured using general questionnaires at health checkups at admission. During a 6-year observation period, smoking initiation was assessed using general questionnaires at annual health checkups. Cox proportional hazards models adjusted for clinically relevant factors were used to assess the association between sleep duration and smoking initiation. RESULTS Of 17,493 men, including 540, 5,568, 8,458, 2,507, and 420 men with sleep duration of < 5, 5-6, 6-7, 7-8, and ≥ 8 h, respectively, smoking initiation was observed in 16.1%, 12.5%, 11.2%, 10.0%, and 11.7%, respectively, during a median observation period of 3.0 years. Men with shorter sleep duration were at a higher risk of smoking initiation (adjusted hazard ratio 1.49 [95% confidence interval 1.19-1.85], 1.11 [1.01-1.22], 1.00 [reference], 0.92 [0.80-1.06], and 1.00 [0.75-1.34], respectively). Of 8,880 women, including 267, 3,163, 4,220, and 1,230 women with sleep duration of < 5, 5-6, 6-7, and ≥ 7 h, respectively, smoking initiation was observed in 4.9%, 2.3%, 2.0%, and 2.2%, respectively, during a median observation period of 3.0 years. A similar dose dependent association was ascertained in women (2.50 [1.39-4.49], 1.18 [0.86-1.62], 1.00 [reference], and 1.22 [0.79-1.89], respectively). CONCLUSION This study clarified that university students with short sleep duration were vulnerable to smoking initiation.
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Affiliation(s)
- Qinyan Li
- Laboratory of Behavioral Health Promotion, Department of Health Promotion Medicine, Graduate School of Medicine, Osaka University, Toyonaka, Japan
| | - Ryohei Yamamoto
- Laboratory of Behavioral Health Promotion, Department of Health Promotion Medicine, Graduate School of Medicine, Osaka University, Toyonaka, Japan.
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan.
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan.
| | - Maki Shinzawa
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Naoko Otsuki
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
| | - Yuichiro Matsumura
- Laboratory of Behavioral Health Promotion, Department of Health Promotion Medicine, Graduate School of Medicine, Osaka University, Toyonaka, Japan
| | - Yuko Nakamura
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
| | - Masayuki Mizui
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Isao Matsui
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yusuke Sakaguchi
- Department of Inter-Organ Communication Research in Kidney Diseases, Graduate School of Medicine, Osaka University, Suita, 565-0871, Japan
| | - Haruki Shinomiya
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
| | - Chisaki Ishibashi
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
| | - Kaori Nakanishi
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
| | - Izumi Nagatomo
- Health and Counseling Center, Osaka University, 1-17 Machikaneyamacho, Toyonaka, Osaka, 560-0043, Japan
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Tehrani AM, Berijani N, Hajiketabi S, Samadi M. Tracking bioaerosol exposure among municipal solid waste workers using hematological and inflammatory biomarkers. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 352:124124. [PMID: 38723706 DOI: 10.1016/j.envpol.2024.124124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/20/2024] [Accepted: 05/07/2024] [Indexed: 06/06/2024]
Abstract
High levels of bioaerosols may exist in the air of municipal solid waste (MSW) management facilities, constituting a significant occupational hazard for workers. In this study, we investigated the potential association between exposure to bioaerosols and inflammatory biomarkers among municipal solid waste workers (MSWWs) at both the landfill site and the municipal solid waste transfer station (MSWTS), in comparison to a control group without exposure. Air sampling was conducted at six points around the landfill, two points at the MSWTS, and one point in a public park (as a control area) during the spring and summer of 2019. The results of our study revealed that airborne pathogens were highly prevalent at the sampling points, especially in the active zone and leachate collection pond. Aspergillus species were the predominant fungal species detected in this study, with the highest occurrence observed for Aspergillus flavus (83.3%), Aspergillus niger, and Aspergillus fumigatus (75.0%). Furthermore, Staphylococcus species accounted for over 75% of the total bacterial bioaerosols detected across all study areas. The blood test results of workers revealed a significant increase in platelets (PLT), immunoglobulin G (IgG), white blood cells (WBC), neutrophils, basophils, and high-sensitivity C-reactive protein (hs-CRP) compared to the control group. Conversely, platelet distribution width (PDW), mean platelet volume (MPV), and platelet-large cell ratio (P-LCR) in the exposed subjects exhibited a decreasing trend compared to the control group. These findings suggest a potential association between exposure to bioaerosols, particularly in the vicinity of open dumpsites, and elevated levels of hematologic and inflammatory markers in circulation. Furthermore, the influence of smoking status and confounding factors appears to be significant in both the control and exposure groups.
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Affiliation(s)
- Ashraf Mazaheri Tehrani
- Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran; Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Sajjad Hajiketabi
- Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran; Student Research Committee, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammadtaghi Samadi
- Research Center for Health Sciences, Department of Environmental Health Engineering, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
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Yan YY, Ye F, Ho MH, Yeung KCY, Lee JJ. Biomarkers of Waterpipe Tobacco Smoke Exposure: A Systematic Review and Meta-Analysis. Nicotine Tob Res 2024; 26:655-662. [PMID: 38157415 DOI: 10.1093/ntr/ntad262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/01/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The prevalence of waterpipe tobacco smoking is increasing globally. Biomarkers of waterpipe tobacco smoke (WTS) exposure are less studied. AIMS AND METHODS To identify the types of biomarkers of WTS exposure and estimate changes in biomarker concentrations pre- to post-WTS exposure. PubMed, Embase, Web of Science, CINAHL Plus, PsycINFO, and Cochrane Library were searched for studies up to April 24, 2023. The types of biomarkers were identified. Random-effects models were used to estimate changes in biomarker concentrations pre- to post-WTS exposure. RESULTS Seventy-three studies involving 3755 participants exposed to WTS (49% male, mean age: 24.8 years) and 11 types of biomarkers of WTS exposure were identified. The biomarkers included tobacco alkaloids, expired carbon monoxide (eCO), carboxyhemoglobin (COHb), tobacco-specific nitrosamines, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), heavy metals, unmetabolized VOCs, unmetabolized PAHs, furan metabolites, and heterocyclic aromatic amines. Compared with pre-WTS exposure, eCO (breath; mean difference [MD] 27.00 ppm; 95% confidence interval [CI]: 20.91 to 33.08), COHb (blood; MD 4.30%; 95%CI: 2.57 to 6.03), COHb (breath; MD 7.14%; 95%CI: 4.96 to 9.31), nicotine (blood; MD 8.23 ng/mL; 95%CI: 6.27 to 10.19), and cotinine (urine; MD 110.40 ng/mL; 95%CI: 46.26 to 174.54) significantly increased post-WTS exposure. CONCLUSIONS Biomarkers of WTS exposure were systematically identified. The similarity between the biomarkers of WTS exposure and those of cigarette smoke and higher concentrations of some biomarkers post-WTS exposure underscore the need for further research on applying biomarkers in surveillance, interventions, and regulations to mitigate the harms of waterpipe tobacco smoking. IMPLICATIONS This study provides the first comprehensive overview of biomarkers investigated and available for assessing WTS exposure and their concentration changes in the human body. Researchers can use biomarkers such as eCO, COHb, nicotine, and cotinine to measure the health risks associated with WTS exposure and objectively evaluate the effectiveness of public health interventions aimed at reducing waterpipe tobacco smoking. Public health policymaking can also be informed through increased biomarker concentrations following WTS exposure, to implement regulations and public health education campaigns on limiting or preventing waterpipe tobacco smoking.
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Affiliation(s)
- Yong Yang Yan
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Fen Ye
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Mu-Hsing Ho
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | | | - Jung Jae Lee
- LKS Faculty of Medicine, School of Nursing, University of Hong Kong, Hong Kong SAR, China
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Kunno J, Luangwilai T, Pimviriyakul P, Sematong S, Supawattanabodee B, Kuratong S, Robson MG. Active smoking in urban households: An association between urinary cotinine metabolite level and serum eGFR concentration. Tob Induc Dis 2024; 22:TID-22-59. [PMID: 38586496 PMCID: PMC10996036 DOI: 10.18332/tid/186071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Smoking stands as a primary contributor to preventable deaths globally and is linked to an increased risk of developing kidney failure and other diseases. A few studies have focused on the negative correlation between serum cotinine and estimated glomerular filtration rate (eGFR), indicating decreased kidney function. This study investigated the associations between urinary cotinine metabolite concentration and serum eGFR among active smokers in urban households. METHODS This was a cross-sectional study of active smokers in urban households' community Bangkok, Thailand from January to April 2023. The study involved 85 participants aged ≥18 years who were active smokers. Both urinary cotinine and serum eGFR concentrations were used as biomarkers. Independent sample t-tests were used to compare the urinary cotinine metabolite based on differences in the characteristic variable. We used multiple linear regression to test the association between cotinine metabolite and characteristics variables. Spearman's analysis was used to test the correlation between cotinine metabolite and eGFR concentration. RESULTS The association between urinary cotinine metabolite and serum eGFR concentration decreased with increasing cotinine concentrations (r= -0.223, p=0.041), suggesting a decline in kidney function. However, this study found no significant difference between urinary cotinine metabolite and characteristic variables (p>0.05). Additionally, those who smoked for ≥10 years (117.40 ± 89.80 ng/mL), smoked ≥10 cigarettes per day (117.40 ± 89.80 ng/mL) and used conventional cigarettes (124.53 ± 115.10 ng/mL). The results of the multiple linear regression models analysis indicated that those who were smokers for ≥10 years (β=0.076; 95% CI: -31.575-59.715) and those who were smoked ≥10 cigarettes/day (β=0.126; 95% CI: -65.636-18.150) were not associated with urinary cotinine metabolite level. CONCLUSIONS This study shows that the urinary cotinine metabolite level is associated with serum eGFR concentration among active smokers in urban households. The current study suggests that clinical identification and a prospective cohort study are needed before robust conclusions about how tobacco affects kidney efficiency.
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Affiliation(s)
- Jadsada Kunno
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Titaporn Luangwilai
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Panu Pimviriyakul
- Department of Biochemistry, Faculty of Science, Kasetsart University, Bangkok, Thailand
| | - Saowanee Sematong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Busaba Supawattanabodee
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Sathit Kuratong
- Department of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Mark Gregory Robson
- School of Environmental and Biological Sciences, Rutgers University, New Brunswick, United States
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Wang X, Liu X, O'Donnell MJ, McQueen M, Sniderman A, Pare G, Hankey GJ, Rangarajan S, Chin SL, Rao-Melacini P, Ferguson J, Xavier D, Zhang H, Liu L, Pais P, Lopez-Jaramillo P, Damasceno A, Langhorne P, Rosengren A, Dans AL, Elsayed A, Avezum A, Mondo C, Judge C, Diener HC, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Nilanont Y, Yusuf S. Tobacco use and risk of acute stroke in 32 countries in the INTERSTROKE study: a case-control study. EClinicalMedicine 2024; 70:102515. [PMID: 38516107 PMCID: PMC10955659 DOI: 10.1016/j.eclinm.2024.102515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
Background Smoking is a major risk factor for the global burden of stroke. We have previously reported a global population attributable risk (PAR) of stroke of 12.4% associated with current smoking. In this study we aimed to explore the association of current tobacco use with different types of tobacco exposure and environmental tobacco smoke (ETS) exposure on the risk of stroke and stroke subtypes, and by regions and country income levels. Methods The INTERSTROKE study is a case-control study of acute first stroke and was undertaken with 13,462 stroke cases and 13,488 controls recruited between January 11, 2007 and August 8, 2015 in 32 countries worldwide. Association of risk of tobacco use and ETS exposure were analysed with overall stroke, ischemic and intracerebral hemorrhage (ICH), and with TOAST etiological stroke subtypes (large vessel, small vessel, cardioembolism, and undetermined). Findings Current smoking was associated with an increased risk of all stroke (odds ratio [OR] 1.64, 95% CI 1.46-1.84), and had a stronger association with ischemic stroke (OR 1.85, 95% CI 1.61-2.11) than ICH (OR 1.19 95% CI 1.00-1.41). The OR and PAR of stroke among current smokers varied significantly between regions and income levels with high income countries (HIC) having the highest odds (OR 3.02 95% CI 2.24-4.10) and PAR (18.6%, 15.1-22.8%). Among etiological subtypes of ischemic stroke, the strongest association of current smoking was seen for large vessel stroke (OR 2.16, 95% CI 1.63-2.87) and undetermined cause (OR 1.97, 95% CI 1.55-2.50). Both filtered (OR 1.73, 95% CI 1.50-1.99) and non-filtered (OR 2.59, 95% CI 1.79-3.77) cigarettes were associated with stroke risk. ETS exposure increased the risk of stroke in a dose-dependent manner, exposure for more than 10 h per week increased risk for all stroke (OR 1.95, 95% CI 1.69-2.27), ischemic stroke (OR 1.89, 95% CI 1.59-2.24) and ICH (OR 2.00, 95% CI 1.60-2.50). Interpretation There are significant variations in the magnitude of risk and PAR of stroke according to the types of tobacco used, active and ETS exposure, and countries with different income levels. Specific strategies to discourage tobacco use by any form and to build a smoke free environment should be implemented to ease the global burden of stroke. Funding The Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Swedish Research Council, Swedish Heart and Lung Foundation, The Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland, and through unrestricted grants from several pharmaceutical companies with major contributions from Astra Zeneca, Boehringer Ingelheim (Canada), Pfizer (Canada), MERCK, Sharp and Dohme, Swedish Heart and Lung Foundation, UK Chest, and UK Heart and Stroke.
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Affiliation(s)
- Xingyu Wang
- Beijing Hypertension League Institute, Beijing, China
- National Genetic Resources Research Center, National Research Institute for Family Planning, Beijing, China
| | - Xin Liu
- Beijing Hypertension League Institute, Beijing, China
- National Genetic Resources Research Center, National Research Institute for Family Planning, Beijing, China
| | - Martin J. O'Donnell
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
- NUI Galway, Galway, Ireland
| | - Matthew McQueen
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | | | - Guillaume Pare
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Graeme J. Hankey
- St John's Medical College and Research Institute, Bangalore, India
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Siu Lim Chin
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Purnima Rao-Melacini
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | | | - Denis Xavier
- Fundacion Oftalmologica de Santander-Clinica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
| | - Hongye Zhang
- Beijing Hypertension League Institute, Beijing, China
| | - Lisheng Liu
- Beijing Hypertension League Institute, Beijing, China
| | - Prem Pais
- St John's Medical College and Research Institute, Bangalore, India
| | - Patricio Lopez-Jaramillo
- Fundacion Oftalmologica de Santander-Clinica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
| | | | - Peter Langhorne
- Glasgow Royal Infirmary, University of Glasgow, Glasgow, Scotland, UK
| | - Annika Rosengren
- Sahlgrenska Academy and University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Antonio L. Dans
- College of Medicine, University of Philippines, Manila, Philippines
| | | | - Alvaro Avezum
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Charles Mondo
- Uganda Heart Institute, Mulago Hospital, Kampala, Uganda
| | | | | | | | | | - Nana Pogosova
- National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | | | - Romana Iqbal
- Department of Medicine, Aga Khan University Hospitals in Karachi, Pakistan
| | - Rafael Diaz
- Estudios Clinicos Latinoamerica, Rosario, Argentina
| | - Khalid Yusoff
- UCSI University, Cheras, Kuala Lumpur 56000, Malaysia
| | - Afzalhussein Yusufali
- Hatta Hospital, Dubai Health Authority/Dubai Medical College, Dubai, United Arab Emirates
| | - Aytekin Oguz
- Istanbul Medeniyet Üniversitesi, Istanbul, Turkey
| | | | - Fernando Lanas
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Okechukwu S. Ogah
- Division of Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
| | - A. Ogunniyi
- Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
| | | | | | | | | | | | - Yongchai Nilanont
- Neurology Division, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - INTERSTROKE Investigators
- Beijing Hypertension League Institute, Beijing, China
- National Genetic Resources Research Center, National Research Institute for Family Planning, Beijing, China
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
- NUI Galway, Galway, Ireland
- McGill University Health Centre, Montreal, QC, Canada
- St John's Medical College and Research Institute, Bangalore, India
- Fundacion Oftalmologica de Santander-Clinica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
- Eduardo Mondlane University, Maputo, Mozambique
- Glasgow Royal Infirmary, University of Glasgow, Glasgow, Scotland, UK
- Sahlgrenska Academy and University Hospital, University of Gothenburg, Gothenburg, Sweden
- College of Medicine, University of Philippines, Manila, Philippines
- Al Shaab Teaching Hospital, Khartoum, Sudan
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
- Uganda Heart Institute, Mulago Hospital, Kampala, Uganda
- Department of Neurology, University Hospital, Essen, Germany
- Institute of Psychiatry and Neurology, Warsaw, Poland
- National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- Department of Medicine, Aga Khan University Hospitals in Karachi, Pakistan
- Estudios Clinicos Latinoamerica, Rosario, Argentina
- UCSI University, Cheras, Kuala Lumpur 56000, Malaysia
- Hatta Hospital, Dubai Health Authority/Dubai Medical College, Dubai, United Arab Emirates
- Istanbul Medeniyet Üniversitesi, Istanbul, Turkey
- Department of Cardiology, Hospital Luis Vernaza, Guayaquil, Ecuador
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Division of Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
- Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Universidad Peruana Cayetano Heredia, Lima, Peru
- University of Split, Croatia
- Rush Alzheimer Disease Research Center in Chicago, Chicago, IL, USA
- University of Limpopo, Pretoria, South Africa
- Neurology Division, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Biderafsh A, Rahimi foroushani A, Nedjat S. Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life? SAGE Open Med 2024; 12:20503121231220216. [PMID: 38357404 PMCID: PMC10865937 DOI: 10.1177/20503121231220216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/20/2023] [Indexed: 02/16/2024] Open
Abstract
Objective This study aimed to determine the association between adolescent socioeconomic status (father's education and adolescent subjective socioeconomic status) and adult quality of life and the mediation roles of adult socioeconomic status, social capital and lifestyle (physical activity and exposure to smoke) among the "Tehran University of Medical Sciences Employees Cohort (TEC) Study" participants. Method Data of 4455 participants were derived from the Tehran University of Medical Sciences Employees Cohort (TEC) Study. In this study, the World Health Organization quality of life-BREF, the World Bank's Integrated and the International Physical Activity Questionnaire were used. Data were analyzed with structural equation modeling using SPSS Amos 24.0 program. Results The mean age of the participants was 42.31 years (SD: 8.37) and most of the subjects were female (60.7%). Correlation analysis results revealed that, quality of life had a significant and positive association with adolescent subjective socioeconomic status (r = 0.169, p < 0.01) and father's education (r = 0.091, p < 0.01). A mediation model testing the direct relationship between adolescent socioeconomic status and adult socioeconomic status and quality of life, showed a positive relationship between adolescent subjective socioeconomic status (β = 0.229, p < 0.001) and father's education (β = 0.443, p < 0.001) with adult socioeconomic status. Adult socioeconomic status was positively related to quality of life (β = 0.205, p < 0.001). Adult socioeconomic status mediated the relationship between adolescent subjective socioeconomic status (β = 0.047, p < 0.01) and father's education (β = 0.091, p < 0.01) with quality of life. While adult socioeconomic status fully mediated the relationship between the father's education and quality of life, it partially mediated the adolescent subjective socioeconomic status-quality of life association. Other variables such as social capital and lifestyle did not have mediator role in a mediation model. Conclusion This study provides the evidence for the role of adult socioeconomic status as a partial mediator between adolescent subjective socioeconomic status and quality of life. Therefore, there are several unknown mediators other than adult socioeconomic status that need to be explored in future studies.
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Affiliation(s)
- Azam Biderafsh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Zettergren A, Sompa S, Palmberg L, Ljungman P, Pershagen G, Andersson N, Lindh C, Georgelis A, Kull I, Melen E, Ekström S, Bergstrom A. Assessing tobacco use in Swedish young adults from self-report and urinary cotinine: a validation study using the BAMSE birth cohort. BMJ Open 2023; 13:e072582. [PMID: 37438074 DOI: 10.1136/bmjopen-2023-072582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES Studies on health effects of tobacco often rely on self-reported exposure data, which is subjective and can lead to misclassification. The aim of this study was to describe the prevalence of cigarette smoking, snus and e-cigarette use, as well as to validate self-reported tobacco use among young adults in Sweden. METHOD Participants of a population-based Swedish cohort (n=3052), aged 22-25 years, assessed their tobacco use in a web questionnaire. Urinary cotinine was analysed in a subsample of the study population (n=998). The agreement between self-reported tobacco use and urinary cotinine was assessed using Cohen's Kappa coefficient (κ) at a cut-off level of 50 ng/mL. RESULTS Patterns of tobacco use differed between men and women. Among men, 20.0% reported daily snus use, 5.8% daily cigarette smoking and 5.6% any e-cigarette use. In contrast, 3.2% of the women reported daily snus use, 9.0% daily cigarette smoking and 2.4% any e-cigarette use. Among the tobacco use categories, daily snus users had the highest levels of cotinine. Of reported non-tobacco users, 3.5% had cotinine levels above the cut-off, compared with 68.0% among both occasional cigarette smokers and snus users, 67.5% among all e-cigarette users and 94.7% and 97.8% among daily cigarette smokers and snus users, respectively. Agreement between self-reported tobacco use and urinary cotinine was classified as strong for daily use of cigarettes (κ=0.824) and snus (κ=0.861), while moderate to weak for occasional smoking (κ=0.618), occasional snus use (κ=0.573) and any e-cigarette use (κ=0.576). CONCLUSIONS We found high validity of self-reported tobacco use in our study population, particularly for daily tobacco use. Further, we found that daily snus users were exposed to high levels of cotinine. Together with previous findings, our results indicate good validity of self-reported tobacco use among young adults.
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Affiliation(s)
- Anna Zettergren
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shanzina Sompa
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lena Palmberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Inger Kull
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Anna Bergstrom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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8
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Tabatabaei Z, Baghapour MA, Hoseini M, Fararouei M, Abbasi F, Baghapour M. Assessing BTEX concentrations emitted by hookah smoke in indoor air of residential buildings: health risk assessment for children. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1653-1665. [PMID: 34900296 PMCID: PMC8617227 DOI: 10.1007/s40201-021-00721-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/07/2021] [Indexed: 05/24/2023]
Abstract
Hookah smoke is one of the major indoor sources of Volatile Organic Compounds (VOCs), including Benzene, Toluene, Ethylbenzene, and Xylenes (BTEX). The present study aimed to investigate potential exposure to BTEX compounds among primary school children whose parents smoked hookah at home. BTEX concentrations in indoor air were measured in 60 residential buildings of Khesht, southwestern Iran (case = 30 and control = 30). Target compounds were sampled by charcoal tubes, and the samples were then analyzed by GC-FID. Monte Carlo simulation was used to assess the carcinogenic and non-carcinogenic risks of BTX exposure for the children aged 7-13 years. The concentrations of benzene (7.19 ± 3.09 vs. 0.82 ± 0.5 μg/m3), toluene (1.62 ± 0.69 vs. 0.3 ± 0.22 μg/m3), and xylenes (2.9 ± 1.66 vs. 0.31 ± 0.22 μg/m3) were considerably higher in the indoor air of the case houses compared with the control houses (p < 0.05). The Incremental Lifetime Cancer Risk (ILCR) of benzene for non-smoking and smoking houses were estimated 1.8 × 10-6 and 15 × 10-6, respectively, exceeding the recommendations of the World Health Organization (WHO) and the Environmental Protection Agency (EPA) (1 × 10-6). Moreover, Hazard Quotients (HQs) of all BTX compounds were < 1. The indoor benzene concentration was significantly influenced by the floor at which families lived and type of the kitchen. In order to prevent children's exposure to BTX emitted by hookah, banning indoor smoking is the only way to eliminate these compounds in the indoor air.
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Affiliation(s)
- Zeynab Tabatabaei
- Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Baghapour
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hoseini
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariba Abbasi
- Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Melika Baghapour
- Department of Biology, Faculty of Science, York University, Toronto, Canada
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9
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Janjani H, Nabizadeh R, Kashani H, Shamsipour M, Aghaei M, Yunesian M. Spatiotemporal variability of exposure to secondhand smoke in Iran during 2009-2020: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:46838-46851. [PMID: 34245414 DOI: 10.1007/s11356-021-15273-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
The present study aimed to provide a systematic review of studies on the prevalence of secondhand smoke (SHS) exposure in the Iran population as a serious indoor health hazard. A literature review of studies that considered SHS exposure, available in multiple electronic databases including Web of Science, PubMed, and Scopus published 2009-2020 in English and two Persian databases (SID and Magiran), was carried out following the PRISMA recommendations. A total of 55 studies were included based on the inclusion and exclusion criteria and the quality assessment. The results showed no specific decrease in the prevalence of exposure to secondhand smoke in Iran; however, it appeared that the exposure has been increasing. Distribution of studies in terms of age group revealed that most studies (38%) investigated adults (more than 18 years old), while 34% of the studies considered less than 18 years of age group and a single article considered infants (6-24 months). Based on the present study results, a large population of Iran was exposed to SHS. Moreover, based on Iran's STEPs 2016 (Stepwise Non-communicable Diseases Risk Factors Survey in Iran) study, the overall prevalence of SHS exposure at home (57.5%) was higher than in workplaces (49.2%). The results of the present study recommended that protection measures should be comprehensive in terms of exposure places, and since the exposure prevalence in some provinces was higher than the others, it is especially important to consider the local measures and cultural aspects in SHS control programs.
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Affiliation(s)
- Hosna Janjani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Aghaei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
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10
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Hadei M, Shahsavani A, Hopke PK, Naseri S, Yazdanbakhsh A, Sadani M, Mesdaghinia A, Yarahmadi M, Rahmatinia M, Fallah S, Emam B, Kermani M, Jaafarzadeh N, Alipour M, Hassanzadeh V, Bazzazpour S, Nazari SSH. A systematic review and meta-analysis of human biomonitoring studies on exposure to environmental pollutants in Iran. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 212:111986. [PMID: 33540338 DOI: 10.1016/j.ecoenv.2021.111986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/09/2021] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
Population exposure to environmental contaminants can be precisely observed through human biomonitoring studies. The present study aimed to systematically review all the biomonitoring studies conducted in Iran on some selected carcinogen environmental pollutants. In this systematic review study, 11 carcinogen agents were selected including arsenic, cadmium, chromium, nickel, lindane, benzene, trichloroethylene (TCE), pentachlorophenol (PCP), radon-222, radium-224, - 226, - 228, and tobacco smoke. The Web of Science, PubMed, and Scopus databases were searched for peer-reviewed articles published in English. After several screening steps, data were extracted from the studies. Meta-analyses (a random-effect model using the DerSimonian-Laired method) were performed only for the biomarkers with more than three eligible articles, including cadmium in blood and breast milk, and arsenic in breast milk. Methodological quality of the studies was assessed using the Newcastle-Ottawa Quality Assessment Scale adapted for cross-sectional studies. Of the 610 articles found in the database search, 30 studies were eligible for qualitative review, and 13 were included in the meta-analysis (cadmium in blood (n = 3), cadmium in breast milk (n = 6), and arsenic in breast milk (n = 4)). The overall pooled average concentrations (95% CI) of cadmium in blood, cadmium in breast milk, and arsenic in breast milk were 0.11 (95% CI: 0.08, 0.14), 5.38 (95% CI: 3.60, 6.96), and 1.42 (95% CI: 1.02, 1.81) µg/L, respectively. These values were compared with the biomarker concentrations in other countries and health-based guideline values. This study showed that there is a need for comprehensive action plans to reduce the exposure of general population to these environmental contaminants.
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Affiliation(s)
- Mostafa Hadei
- Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Shahsavani
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Philip K Hopke
- Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY 13699, USA
| | - Simin Naseri
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Yazdanbakhsh
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Sadani
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Masoumeh Rahmatinia
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sevda Fallah
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahaaran Emam
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nemat Jaafarzadeh
- Department of Environmental Health Engineering, School of Public Health, Ahvaz University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Alipour
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vajihe Hassanzadeh
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahriyar Bazzazpour
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Saeed Hashemi Nazari
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Moridzadeh M, Dehghani S, Rafiee A, Hassanvand MS, Dehghani M, Hoseini M. Assessing BTEX exposure among workers of the second largest natural gas reserve in the world: a biomonitoring approach. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:44519-44527. [PMID: 32770338 DOI: 10.1007/s11356-020-10379-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
Urinary benzene, toluene, ethylbenzene, and xylenes (BTEX) can be used as a reliable biomarker of exposure to these pollutants. This cross-sectional study aimed to employ biomonitoring to assess BTEX exposure among South Pars Gas Field (SPGF) workers in Assaluyeh, Iran. Forty employees who were working on the site were recruited as the case group. Besides, 31 administrative employees were recruited as the control group. Pre-shift and post-shift spot urine samples were collected from the subjects in the case group, while the subjects in the control group provided mid-morning urine samples. Overall, 111 urine samples, including 80 samples from the case group and 31 samples from the controls, were collected. Gas chromatography-mass spectrometry (GC/MS) was used to determine the urinary levels of BTEX compounds. The median urinary levels of benzene, toluene, ethylbenzene, m,p-xylene, and o-xylene in the post-shift samples of the exposed group were 1.24, 2.28, 0.5, 1.32, and 1.5 μg/l, respectively. Significant differences were observed in urinary BTEX levels among smokers and non-smokers in both studied groups (p < 0.05). Accordingly, the median urinary BTEX concentrations in smokers were 2 to 6.5 times higher than the corresponding values in non-smoker subjects. Smoking status was the only predictor of the urinary BTEX concentration. Our findings revealed that refinery workers are exposed to significant levels of BTEX compounds. Considering the health risks associated with BTEX exposure for refinery workers, implementation of suitable control strategies, such as using appropriate personal protective equipment and improving on-site ventilation systems, are recommended reducing their exposure to BTEX via the inhalation.
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Affiliation(s)
- Mehdi Moridzadeh
- Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samaneh Dehghani
- Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mansooreh Dehghani
- Department of Environmental Health, Research Center for Health Sciences, Institute of Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hoseini
- Department of Environmental Health, Research Center for Health Sciences, Institute of Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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12
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Fernandes AG, Santos LN, Pinheiro GP, da Silva Vasconcellos D, de Oliva ST, Fernandes BJ, Couto RD. Urinary Cotinine as a Biomarker of Cigarette Smoke Exposure: A Method to Differentiate Among Active, Second-Hand, and Non-Smoker Circumstances. ACTA ACUST UNITED AC 2020. [DOI: 10.2174/1875318302010010060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective:
To review the literature on the use of urinary cotinine as a biological marker of cigarette smoke exposure.
Methods:
Narrative review of original and review articles on the topic of interest, published in Portuguese or English by June 2018, and selected in the following online databases: PubMed and Virtual Health Library (VHL).
Results:
Urinary cotinine is usually the recommended biomarker to estimate exposure to cigarette smoke, and can be used alone or, preferably, in association with questionnaires. Different analytical techniques can be used to quantify urinary cotinine and are differently performed because of urine sample interfering factors.
Conclusion:
The precise classification of smoking status is essential. It is advisable to use objective measurements regarding smoking habits since self-reported smoking may not always represent the true smoking status of the individual, particularly in groups that are more vulnerable to omitting the information of questionnaries, in addition, it has possible biases of memory. The accurate assessment of smoking is crucial to improve clinical management and counseling for different diseases as well as the establishment of preventive strategies. So, the use of urinary cotinine as a biomarker of cigarette smoke exposure seems to be a suitable assay to distinguish non-smokers from passive and active smokers.
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13
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Pakzad R, Nedjat S, Yaseri M, Salehiniya H, Mansournia N, Nazemipour M, Mansournia MA. Effect of Smoking on Breast Cancer by Adjusting for Smoking Misclassification Bias and Confounders Using a Probabilistic Bias Analysis Method. Clin Epidemiol 2020; 12:557-568. [PMID: 32547245 PMCID: PMC7266328 DOI: 10.2147/clep.s252025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose The aim of this study was to determine the association between smoking and breast cancer after adjusting for smoking misclassification bias and confounders. Methods In this case–control study, 1000 women with breast cancer and 1000 healthy controls were selected. Using a probabilistic bias analysis method, the association between smoking and breast cancer was adjusted for the bias resulting from misclassification of smoking secondary to self-reporting as well as a minimally sufficient adjustment set of confounders derived from a causal directed acyclic graph (cDAG). Population attributable fraction (PAF) for smoking was calculated using Miettinen’s formula. Results While the odds ratio (OR) from the conventional logistic regression model between smoking and breast cancer was 0.64 (95% CI: 0.36–1.13), the adjusted ORs from the probabilistic bias analysis were in the ranges of 2.63–2.69 and 1.73–2.83 for non-differential and differential misclassification, respectively. PAF ranges obtained were 1.36–1.72% and 0.62–2.01% using the non-differential bias analysis and differential bias analysis, respectively. Conclusion After misclassification correction for smoking, the non-significant negative-adjusted association between smoking and breast cancer changed to a significant positive-adjusted association.
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Affiliation(s)
- Reza Pakzad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- School of Public Health, Birjand University of Medical Sciences, Birjand, South Khorasan, Iran
| | - Nasrin Mansournia
- Department of Endocrinology, AJA University of Medical Sciences, Tehran, Iran
| | - Maryam Nazemipour
- Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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14
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Gehricke JG, Gevorkian J, Stehli A, Alejo SD, Dawson M, Kopelevich A. Discrepancies in the Validity of Self-Reported Cigarette Smoking in Adults With and Without ADHD. J Dual Diagn 2019; 15:177-183. [PMID: 31156069 PMCID: PMC6711780 DOI: 10.1080/15504263.2019.1620399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) is associated with an increased smoking prevalence and impairments in executive function, which may negatively affect the validity of self-reported smoking rates. This study compares the utility of self-reported smoking with salivary cotinine in adult smokers and nonsmokers with and without ADHD. Methods: Participants (N = 82) were adult smokers and nonsmokers with and without ADHD (n = 35 ADHD and n = 47 controls) from an observational study. Odds ratios (ORs) for accuracy of self-reported smoking compared to salivary cotinine were calculated using diagnosis (ADHD vs. control), gender, age, education, employment, and number of cigarettes per day as predictors. Post-hoc analysis stratified sensitivity, specificity, and accuracy of self-reported smoking in individuals with ADHD and without ADHD. Results: The initial analysis identified education as a significant independent predictor of odds of accuracy, OR = 6.22, p = .013, after adjusting for diagnosis, gender, age, employment, and cigarettes per day. Post-hoc analysis revealed that sensitivity, specificity, and accuracy of self-reported smoking was 100% for individuals with ADHD who had more than high school education compared to those with high school or less, which was 83.3%, 45.5%, and 65.2%, respectively. Self-reported smoking of control participants with greater than a high school education had a sensitivity of 85.7%, a specificity of 91.7%, and an accuracy of 88.5%. Control participants with a high school or lower education had a sensitivity of 54.6%, a specificity of 90%, and an accuracy of 71.4% for their self-reported smoking. Conclusions: Individuals with ADHD and high school or lower education showed the lowest specificity and accuracy in their self-reported smoking, which may affect documented smoking prevalence rates. This is a secondary analysis of data collected as part of a clinical trial registered as NCT00915798 at www.clinicaltrials.gov .
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Affiliation(s)
- Jean-G Gehricke
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Jonathan Gevorkian
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Annamarie Stehli
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Sharina Dyan Alejo
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Meghan Dawson
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Alexei Kopelevich
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
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15
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Hoseini M, Nabizadeh R, Delgado-Saborit JM, Rafiee A, Yaghmaeian K, Parmy S, Faridi S, Hassanvand MS, Yunesian M, Naddafi K. Environmental and lifestyle factors affecting exposure to polycyclic aromatic hydrocarbons in the general population in a Middle Eastern area. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 240:781-792. [PMID: 29778814 DOI: 10.1016/j.envpol.2018.04.077] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study was to investigate environmental and lifestyle factors affecting exposure to PAHs in the general population in a large city of the Middle East (Tehran) by measuring urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) and establishing relationships between PAHs exposure and related factors. Urine samples were collected from 222 randomly chosen subjects who were living in the urban area of Tehran, Iran. Subjects were required to complete a detailed questionnaire aimed to document their personal and sociodemographic information, activities, cooking-related appliances, smoking history/exposure, and consumed foodstuff. Identification and quantification of six OH-PAHs was carried out using a gas chromatography with mass spectrometry (GC-MS). The geometric means for 1-OHP, 1-NAP, 2-NAP, 2-FLU, 9-FLU, and 9-PHE for whole population study were 310, 1220, 3070, 530, 330, and 130 ng/g creatinine, respectively. The two naphthalene metabolites contributed on average 77% of the total concentration of six measured OH-PAHs, followed by the 2-FLU, 1-OHP, 9-FLU, and 9-PHE. The most important predictors of urinary PAHs were consumption of grilled/barbecued foods, smoking, and exposure to environmental tobacco smoking. Water pipe smoking was linked to urinary OH-PAH metabolite in a dose-response function. Residential traffic was also related with OH-PAH metabolite concentrations. Other factors including gender, age, exposure to common house insecticides, open burning, and candle burning were found to be statistically associated with the urinary levels of some OH-PAHs. High exposure to PAHs among general population in Middle Eastern large cities and its associated health implications calls for public health measures to reduce PAHs exposure.
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Affiliation(s)
- Mohammad Hoseini
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Nabizadeh
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Juana Maria Delgado-Saborit
- ISGlobal Barcelona Institute for Global Health, Barcelona Biomedical Research Park, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, United Kingdom
| | - Ata Rafiee
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Yaghmaeian
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Parmy
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sasan Faridi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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16
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Mojahed K, Navidian A. The Effect of Motivational Interviewing on Craving and Dependence on Hookah in Suburban Pregnant Women in South East of Iran. Issues Ment Health Nurs 2018; 39:693-699. [PMID: 29847190 DOI: 10.1080/01612840.2018.1445325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hookah smoking during pregnancy is a health concern which requires effective interventions. Thus, the authors have aimed to evaluate the effect of motivational interviewing on craving and dependence on hookah in pregnant women (n = 140) addicted to hookah who reside in the outskirts of Zahedan, a city in southeast of Iran. The subjects were selected using the convenience sampling and randomly divided into either the control or intervention group. The intervention group received five motivational interviewing group sessions about hookah smoking withdrawal, whereas the control group was given the conventional recommendations for quitting hookah. Data were collected after 8 weeks during the post intervention period using Hookah Craving Test and Hookah Addiction Severity Index. Next, they were analyzed using independent t-test, paired t-test, and analysis of covariance (ANCOVA). After the motivational interviewing intervention, the independent t-test indicated a significant difference between the intervention and control groups in terms of the mean score of hookah craving (P = 0.0001). Moreover, ANCOVA, with control of the effect of pretest and duration of hookah addiction, demonstrated a significant difference between the two groups regarding the mean score of hookah dependence after the intervention (P = 0.0001). Motivational interviewing had a significant positive impact on decreased hookah craving and dependence (two indices of withdrawal). Therefore, healthcare providers are recommended to incorporate motivational interviewing-based education into prenatal care programs to promote the chance of hookah smoking withdrawal.
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Affiliation(s)
- Kheirolnesa Mojahed
- a Department of Midwifery , Zahedan University of Medical Sciences , Zahedan , Iran
| | - Ali Navidian
- b Pregnancy Health Research Center , Zahedan University of Medical Sciences , Zahedan , Iran
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17
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Rafiee A, Delgado-Saborit JM, Gordi E, Quémerais B, Kazemi Moghadam V, Lu W, Hashemi F, Hoseini M. Use of urinary biomarkers to characterize occupational exposure to BTEX in healthcare waste autoclave operators. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 631-632:857-865. [PMID: 29727996 DOI: 10.1016/j.scitotenv.2018.03.090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 05/12/2023]
Abstract
Urinary benzene, toluene, ethylbenzene, and xylenes (BTEX) can be used as a reliable biomarker of exposure to these pollutants. This study was aimed to investigate the urinary BTEX concentration in operators of healthcare waste (HCW) autoclaves. This cross-sectional study was conducted in selected hospitals in Tehran, Iran between April and June 2017. Twenty operators (as the case group) and twenty control subjects were enrolled in the study. Personal urine samples were collected at the beginning and end of the work shift. Urinary BTEX were measured by a headspace gas chromatography-mass spectrometry (GC/MS). A detailed questionnaire was used to gather information from subjects. Results showed that the median of urinary benzene, toluene, ethylbenzene, m-p xylene, and o-xylene levels in the exposed group were 3.26, 3.36, 0.84, 3.94 and 4.48 μg/L, respectively. With the exception of ethylbenzene, subjects in the exposed group had significantly higher urinary BTEX levels than control group (p < 0.05). Urinary BTEX concentrations in the exposed case group were 2.5-fold higher than in the control group. There was a significant relationship between the amount of generated waste per day and the urinary BTEX in the exposed group. Smoking status and type of autoclave used were also identified as predictors of urinary BTEX concentrations. The healthcare waste treatment autoclaves can be considered as a significant BTEX exposure source for operators working with these treatment facilities. The appropriate personal protection equipment and control measures capable in reducing BTEX exposure should be provided to HCW workers to reduce their exposures to BTEX.
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Affiliation(s)
- Ata Rafiee
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Juana Maria Delgado-Saborit
- ISGlobal Barcelona Institute for Global Health, Barcelona Biomedical Research Park, Barcelona, Spain; Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Elham Gordi
- Young Researchers and Elite Club, Roudehen Branch, Islamic Azad University, Roudehen, Iran
| | | | | | - Wenjing Lu
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Fallah Hashemi
- Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hoseini
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Biomonitoring-based exposure assessment of benzene, toluene, ethylbenzene and xylene among workers at petroleum distribution facilities. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2018; 149:19-25. [PMID: 29145162 DOI: 10.1016/j.ecoenv.2017.10.070] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/23/2017] [Accepted: 10/31/2017] [Indexed: 01/09/2023]
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19
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Walabyeki J, Adamson J, Buckley HL, Sinclair H, Atkin K, Graham H, Whitaker K, Wardle J, Macleod U. Experience of, awareness of and help-seeking for potential cancer symptoms in smokers and non-smokers: A cross-sectional study. PLoS One 2017; 12:e0183647. [PMID: 28846706 PMCID: PMC5573210 DOI: 10.1371/journal.pone.0183647] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 08/08/2017] [Indexed: 01/27/2023] Open
Abstract
Background Presenting to primary care with potential cancer symptoms is contingent on one’s ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms. Methods Smokers and non-smokers aged over 50 from Yorkshire general practice lists were sent a postal questionnaire asking about symptoms, consulting and awareness of cancer symptoms. Data were analysed using STATA14. Results Response rate after one reminder was 30.5% (1205/3954). Smoking status was associated with experience of cough (p<0.001), breathlessness (p = 0.002) and tiredness (p = 0.004) with smokers (25.8% of population) more likely than never-smokers (53.6% of population) to experience all three symptoms (cough OR = 2.56;95%CI[1.75–3.75], breathlessness OR = 2.39;95%CI[1.43–4.00], tiredness OR = 1.57;95%CI[1.12–2.19]). Smoking status was associated with awareness of breathlessness as a potential cancer symptom (p = 0.035) and consulting for cough (p = 0.011) with smokers less likely to consult than never-smokers (OR = 0.37;95% CI[0.17–0.80]). Conclusion Our findings suggest that current smokers are more likely to experience cough, breathlessness and tiredness, but are less likely to consult for cough than never-smokers. To increase cancer awareness and promote consulting among smokers, innovative interventions improving symptom recognition and empowering smokers to seek help are required.
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Affiliation(s)
- Julie Walabyeki
- Hull York Medical School, University of Hull, Hull, United Kingdom
- * E-mail:
| | - Joy Adamson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Hannah L. Buckley
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Helena Sinclair
- Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Karl Atkin
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Hilary Graham
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Katriina Whitaker
- School of Health Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Jane Wardle
- Health Behaviour Research Centre, University College London, London, United Kingdom
| | - Una Macleod
- Hull York Medical School, University of Hull, Hull, United Kingdom
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