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Hashemi-Aghdam MR, Shafiee G, Ebrahimi M, Ejtahed HS, Yaseri M, Motlagh ME, Qorbani M, Heshmat R, Kelishadi R. Trend of passive smoking and associated factors in Iranian children and adolescents: the CASPIAN studies. BMC Public Health 2022; 22:603. [PMID: 35351076 PMCID: PMC8962519 DOI: 10.1186/s12889-022-13045-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 03/22/2022] [Indexed: 01/19/2023] Open
Abstract
Background It is well documented that, similar to active smokers, passive smokers are also at an increased risk of developing non-communicable diseases, and it could impose high financial costs on the healthcare system. This study aimed to evaluate the trend of passive smoking and related determinants during the three phases of a school-based surveillance program. Methods This is a secondary study using the national data obtained from three phases of the surveillance program entitled The Childhood and Adolescence Surveillance and Prevention of Adult Noncommunicable Disease (CASPIAN) study, conducted from 2008 to 2014 on Iranian children and adolescents living in urban and rural areas of 30 provinces in Iran. Participants were selected by cluster multistage sampling method. Results Overall, the study participants consisted of 33,288 students (50.5% boys) with a mean (± SD) age of 12.8 ± 3.2 years. The passive smoking rate was significantly increased from 35.6% in 2008 to 43.2% in 2015 among children and adolescents. According to the multivariate logistic regression, father’s university education, mother’s employment, life satisfaction, and socioeconomic status had a protective role regarding second-hand smoke exposure. In contrast, the father’s self-employment had a positive role in increasing the rate of passive smoking. Conclusion Considering the increasing trend of passive smoking and its considerable adverse health effects, it is necessary to implement large-scale public interventions to reduce the rate and hazards of exposure to tobacco smoke.
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Deguen S, Vasseur P, Kihal-Talantikite W. [Societal inequalities and the urban exposome: Social origins for different exposures]. Med Sci (Paris) 2022; 38:75-80. [PMID: 35060890 DOI: 10.1051/medsci/2021149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Today, many epidemiological studies have proved the adverse health consequences of environmental exposure. For instance, air pollution exposure is recognized to be related with respiratory and cardiovascular diseases as well as adverse pregnancy outcomes. Noise nuisances are also known to increase cardiovascular diseases and to disturb the sleeping quality. Inversely, the access and availability of various resources, as parks, green spaces, and playgrounds positively affect health, psychological and physical well-being, and favorable health behaviors. In this present literature review, we will focus on the urban dimension of exposome, defined by Robinson et al. as the accumulation of all urban settings favorable or unfavorable to health, from the time of life in utero [1].
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Affiliation(s)
- Séverine Deguen
- École des hautes études en santé publique (EHESP), 15 avenue du Professeur Léon Bernard, 35043 Rennes Cedex, France - Sorbonne Université, UPMC Univ Paris 6, Inserm, Institut Pierre Louis d'épidémiologie et de santé publique (UMRS 1136), Département d'épidémiologie sociale, 75646 Paris Cedex 13, France
| | - Pauline Vasseur
- École des hautes études en santé publique (EHESP), 15 avenue du Professeur Léon Bernard, 35043 Rennes Cedex, France
| | - Wahida Kihal-Talantikite
- Laboratoire image ville environnement (LIVE), UMR 7362 CNRS, université de Strasbourg, 67000 Strasbourg, France
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Ferguson L, Taylor J, Davies M, Shrubsole C, Symonds P, Dimitroulopoulou S. Exposure to indoor air pollution across socio-economic groups in high-income countries: A scoping review of the literature and a modelling methodology. ENVIRONMENT INTERNATIONAL 2020; 143:105748. [PMID: 32629198 PMCID: PMC7903144 DOI: 10.1016/j.envint.2020.105748] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 05/20/2023]
Abstract
Disparities in outdoor air pollution exposure between individuals of differing socio-economic status is a growing area of research, widely explored in the environmental health literature. However, in developed countries, around 80% of time is spent indoors, meaning indoor air pollution may be a better proxy for personal exposure. Building characteristics - such as build quality, volume and ventilation - and occupant behaviour, mean indoor air pollution may also vary across socio-economic groups, leading to health inequalities. Much of the existing literature has focused on inequalities in exposure to outdoor air pollution, and there is thus a lack of an evidence base reviewing data for indoor environments. In this study, a scoping review of the literature on indoor air pollution exposures across different socio-economic groups is performed, examining evidence from both monitoring and modelling studies in the developed world. The literature was reviewed, identifying different indoor pollutants, definitions for socio-economic status and pre- and post- housing interventions. Based on the review, the study proposes a modelling methodology for evaluating the effects of environmental policies on different socio-economic populations. Using a sample size calculation, obstacles in obtaining sufficiently large samples of monitored data are demonstrated. A modelling framework for the rapid quantification of daily home exposure is then outlined as a proof of concept. While significant additional research is required to examine inequalities in indoor exposures, modelling approaches may provide opportunities to quantify exposure disparities due to housing and behaviours across populations of different socio-economic status.
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Affiliation(s)
- Lauren Ferguson
- UCL Energy Institute, Bartlett School of Environment, Energy and Resources, University College London, UK; Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK; Air Quality & Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Science and Innovation Campus, Chilton, UK.
| | - Jonathon Taylor
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK
| | - Clive Shrubsole
- Air Quality & Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Science and Innovation Campus, Chilton, UK
| | - Phil Symonds
- Institute for Environmental Design and Engineering, Bartlett School of Environment, Energy and Resources, University College London, UK
| | - Sani Dimitroulopoulou
- Air Quality & Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Science and Innovation Campus, Chilton, UK
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Phetphum C, Noosorn N. Prevalence of secondhand smoke exposure at home and associated factors among middle school students in Northern Thailand. Tob Induc Dis 2020; 18:11. [PMID: 32165877 PMCID: PMC7057047 DOI: 10.18332/tid/117733] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/30/2020] [Accepted: 02/01/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION One-third of youths in Thailand will be exposed to secondhand smoke (SHS) from family members who are smokers. This research aims to study the prevalence of and factors associated with SHS exposure at home among middle school students in Northern Thailand. METHODS This study used a cross-sectional survey. The sample was 780 middle school students in Northern Thailand. A self-administered questionnaire was used for data collection and analyses were performed using a chi-squared test and multiple logistic regression. RESULTS Of the respondents, 46.8% reported that they had been exposed to SHS at home. The main SHS sources were from fathers (45.4%), relatives (24.1%), siblings (12.4%), mothers (3.3%), and neighbours and guests (14.8%). The factors associated with SHS exposure at home included: household members who were smokers (OR=7.43; 95% CI: 5.17–10.68; p<0.001), home without a smoke-free rule (OR=3.40; 95% CI: 1.85–6.24; p<0.001), household members who were alcohol drinkers (OR=2.29; 95% CI: 1.59–3.30; p<0.001), and living in homes with ≤3 rooms (OR=1.79; 95% CI: 1.21–2.63; p=0.003). CONCLUSIONS Thai student’s exposure to SHS at home is high, especially when household members smoke and they live in a home without a smoke-free rule. Our findings highlight the need for policies and interventions to establish smoke-free homes.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Narongsak Noosorn
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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Kuntz B, Lampert T. Smoking and Passive Smoke Exposure Among Adolescents in Germany. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 113:23-30. [PMID: 26857509 DOI: 10.3238/arztebl.2016.0023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 08/24/2015] [Accepted: 08/24/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Children and adolescents are the most important target group for smoking prevention and non-smoker protection measures (smoke-free legislation). In this article, we discuss trends over time and differences between social groups with regard to smoking and passive smoke exposure among adolescents in Germany. METHODS The data evaluated in this article were collected in two different study periods of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), namely, 2003-2006 and 2009-2012. Adolescents aged 11 to 17 were asked about their smoking behavior and passive smoke exposure (6812 and 5258 respondents in the two study periods, respectively). Their social status was rated with an index based on information supplied by the adolescents' parents about their level of education, occupation, and income. RESULTS The prevalence of smoking among adolescents fell in approximately six years from 20.4% to 12.0% (p< 0.001), and that of daily smoking from 13.3% to 5.4% (p<0.001). The percentage of non-smokers who spent time several days per week, or every day, in rooms where other persons were smoking declined from 35.1% to 18.8% (p<0.001). The lower the respondents' social status, the more likely they were to smoke daily and to have regular passive exposure to smoking. CONCLUSION The findings suggest that the measures implemented in recent years to protect adolescents from the health risks of active and passive smoking have been beneficial independently of the adolescents' social backgrounds.
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Affiliation(s)
- Benjamin Kuntz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin
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Kelishadi R, Shahsanai A, Qorbani M, Ardalan G, Poursafa P, Heshmat R, Motlagh ME. Exposure to Hookah and Cigarette Smoke in Children and Adolescents According to Their Socio-Economic Status: The CASPIAN-IV Study. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e3036. [PMID: 27781078 PMCID: PMC5065706 DOI: 10.5812/ijp.3036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/23/2015] [Accepted: 12/16/2015] [Indexed: 11/16/2022]
Abstract
Background Exposure to smoking or passive smoking is one of serious health problems especially in the pediatric age group. Objectives To compare the prevalence and determinants of passive smoking in a nationally representative sample of Iranian children and adolescents according to their socioeconomic status (SES). Materials and Methods This nationwide study was conducted in 2011 - 2012 among 14880 students aged 6 - 18 years, living in 30 provinces in Iran. Exposure to the smoke of hookah or cigarette was documented by using validated questionnaires. Possible influencing factors were determined and the frequency of passive smoking was compared according to the regional and familial SES. Results Participants consisted of 13,486 children and adolescents including 49.2% girls and 75.6% urban inhabitants (90.6% participation rate). The mean age of participants was 12.47 ± 3.36 years. Overall, 43.87% of them (44.07% of boys and 43.66% of girls) were exposed to second hand smoke at home. Exposures to hookah or cigarette smoke at home were respectively reported in 21.46% and 34.49% of participants. The prevalence of passive smoking was lower in children of families with higher SES level, but higher in high SES regions of the country than in low SES ones, and ranged from 39.2% in the region with lowest SES to 49.05% in the highest SES region. Higher education levels of fathers and mothers were significantly associated with lower frequency of passive smoking. Conclusions Exposure to second hand smoke is a major problem among Iranian children and adolescents. Low family SES and low parental education increased the frequency of passive smoking. Appropriate public health education and legislation for smoke free home as well as family-centered counseling should be strengthened.
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Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Armindokht Shahsanai
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Mostafa Qorbani
- Department of Community Medicine, Alborz University of Medical Sciences, Karaj, IR Iran
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Gelayol Ardalan
- Bureau of Population, Youth and School Health, Ministry of Health and Medical Education, Tehran, IR Iran
| | - Parinaz Poursafa
- Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Diseases, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Ramin Heshmat
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Esmaeil Motlagh
- Bureau of Population, Youth and School Health, Ministry of Health and Medical Education, Tehran, IR Iran
- Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Mohammad Esmaeil Motlagh, Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-9122995592, Fax: +98-2181450007, E-mail:
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Asikainen A, Carrer P, Kephalopoulos S, Fernandes EDO, Wargocki P, Hänninen O. Reducing burden of disease from residential indoor air exposures in Europe (HEALTHVENT project). Environ Health 2016; 15 Suppl 1:35. [PMID: 26961383 PMCID: PMC4895703 DOI: 10.1186/s12940-016-0101-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND The annual burden of disease caused indoor air pollution, including polluted outdoor air used to ventilate indoor spaces, is estimated to correspond to a loss of over 2 million healthy life years in the European Union (EU). Based on measurements of the European Environment Agency (EEA), approximately 90 % of EU citizens live in areas where the World Health Organization (WHO) guidelines for air quality of particulate matter sized < 2.5 mm (PM2.5) are not met. Since sources of pollution reside in both indoor and outdoor air, selecting the most appropriate ventilation strategy is not a simple and straightforward task. METHODS A framework for developing European health-based ventilation guidelines was created in 2010-2013 in the EU-funded HEALTHVENT project. As a part of the project, the potential efficiency of control policies to health effects caused by residential indoor exposures of fine particulate matter (PM2.5), outdoor bioaerosols, volatile organic compounds (VOC), carbon oxide (CO) radon and dampness was estimated. The analysis was based on scenario comparison, using an outdoor-indoor mass-balance model and varying the ventilation rates. Health effects were estimated with burden of diseases (BoD) calculations taking into account asthma, cardiovascular (CV) diseases, acute toxication, respiratory infections, lung cancer and chronic obstructive pulmonary disease (COPD). RESULTS The quantitative comparison of three main policy approaches, (i) optimising ventilation rates only; (ii) filtration of outdoor air; and (iii) indoor source control, showed that all three approaches are able to provide substantial reductions in the health risks, varying from approximately 20 % to 44 %, corresponding to 400 000 and 900 000 saved healthy life years in EU-26. PM2.5 caused majority of the health effects in all included countries, but the importance of the other pollutants varied by country. CONCLUSIONS The present modelling shows, that combination of controlling the indoor air sources and selecting appropriate ventilation rate was the most effective to reduce health risks. If indoor sources cannot be removed or their emissions cannot be limited to an accepted level, ventilation needs to be increased to remove remaining pollutants. In these cases filtration of outdoor air may be needed to prevent increase of health risks.
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Affiliation(s)
- Arja Asikainen
- Department of Health Protection, National Institute for Health and Welfare, Neulaniementie 4, 70210, Kuopio, Finland.
| | - Paolo Carrer
- Department of Occupational Health, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy.
| | | | | | - Pawel Wargocki
- Technical University of Denmark, International Centre for Indoor Environment and Energy, DTU Civil Engineering, 2800 Kps, Lyngsby, Denmark.
| | - Otto Hänninen
- Department of Health Protection, National Institute for Health and Welfare, Neulaniementie 4, 70210, Kuopio, Finland.
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Park S, Lim S, Kim J, Lee H, June KJ. Socioeconomic disparities in household secondhand smoke exposure among non-smoking adolescents in the Republic of Korea. Glob Public Health 2015; 12:1104-1121. [PMID: 26654579 DOI: 10.1080/17441692.2015.1117119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This nationally representative study examined (a) gender and age differences in household secondhand smoke exposure (HSHSE) and (b) associations between socioeconomic status (SES) and HSHSE among non-smoking Korean adolescents. Two subsamples were analysed: males (n = 25,648) and females (n = 30,240). The HSHSE measures were incidence of HSHSE (yes/no) and number of days of HSHSE (1-7 days); the SES measures were parental education, perceived economic status, and family wealth. For the first aim, chi-square test, t-test, and bivariate negative binomial regression analysis were performed; For the second aim, multivariate logistic regression and negative binomial regression analyses were performed. The incidence and number of days of HSHSE were significantly higher among females (32.35% and 3.48 days) than males (26.83% and 3.08 days). The HSHSE incidence was significantly higher among younger adolescents (23.32% to 31.08% of males and 26.58% to 37.03% of females). Lower SES was associated with (a) greater odds of HSHSE (odds ratio: 1.12-1.58 among males and 1.19-1.85 among females) and (b) greater incidence rates of HSHSE (incidence rate ratio: 1.05-1.17 among males and 1.10-1.14 among females). Efforts should be made to decrease HSHSE among adolescents, particularly low-SES youth.
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Affiliation(s)
- Sunhee Park
- a College of Nursing Science, East-West Nursing Research Institute , Kyung Hee University , Seoul , Republic of Korea
| | - Sungwon Lim
- b Research Institute of Health Sciences , Korea University , Seoul , Republic of Korea
| | - Junghee Kim
- c Department of Nursing, Graduate School , Kyung Hee University , Seoul , Republic of Korea
| | - Haein Lee
- c Department of Nursing, Graduate School , Kyung Hee University , Seoul , Republic of Korea
| | - Kyung Ja June
- d Department of Nursing , Soonchunhyang University , Cheonan , Republic of Korea
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Predictors of children's secondhand smoke exposure at home: a systematic review and narrative synthesis of the evidence. PLoS One 2014; 9:e112690. [PMID: 25397875 PMCID: PMC4232519 DOI: 10.1371/journal.pone.0112690] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/10/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Children's exposure to secondhand smoke (SHS) has been causally linked to a number of childhood morbidities and mortalities. Over 50% of UK children whose parents are smokers are regularly exposed to SHS at home. No previous review has identified the factors associated with children's SHS exposure in the home. AIM To identify by systematic review, the factors which are associated with children's SHS exposure in the home, determined by parent or child reports and/or biochemically validated measures including cotinine, carbon monoxide or home air particulate matter. METHODS Electronic searches of MEDLINE, EMBASE, PsychINFO, CINAHL and Web of Knowledge to July 2014, and hand searches of reference lists from publications included in the review were conducted. FINDINGS Forty one studies were included in the review. Parental smoking, low socioeconomic status and being less educated were all frequently and consistently found to be independently associated with children's SHS exposure in the home. Children whose parents held more negative attitudes towards SHS were less likely to be exposed. Associations were strongest for parental cigarette smoking status; compared to children of non-smokers, those whose mothers or both parents smoked were between two and 13 times more likely to be exposed to SHS. CONCLUSION Multiple factors are associated with child SHS exposure in the home; the best way to reduce child SHS exposure in the home is for smoking parents to quit. If parents are unable or unwilling to stop smoking, they should instigate smoke-free homes. Interventions targeted towards the socially disadvantaged parents aiming to change attitudes to smoking in the presence of children and providing practical support to help parents smoke outside the home may be beneficial.
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