LUNG-CANCER AND EXPOSURE TO TOBACCO-SMOKE IN THE HOUSEHOLD
LUNG-CANCER AND EXPOSURE TO TOBACCO-SMOKE IN THE HOUSEHOLD
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DOI：
10.1056/nejm199009063231003
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发表时间：
1990-09-06
影响因子：
158.5
通讯作者：
MCKNEALLY, MF
中科院分区：
文献类型：
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作者：
JANERICH, DT;THOMPSON, WD;MCKNEALLY, MF
背景：被动吸烟与肺癌的关系具有重要的公共卫生意义。以前的一些研究表明，在家庭中暴露于环境烟草烟雾可能导致肺癌，但其他人没有发现任何影响。配偶吸烟一直是最常用的衡量这种接触的标准。研究方法：为了确定肺癌是否与家庭内暴露于烟草烟雾有关，我们对191例组织学确诊的原发性肺癌患者进行了一项基于人群的病例对照研究，这些患者从不吸烟，并对相同数量的从不吸烟的非肺癌患者进行了研究。一生的居住史，包括暴露于环境烟草烟雾的信息进行了汇编和分析。暴露是以“吸烟者年数”衡量的，即每个居住地的年数乘以家庭中的吸烟者人数。结果如下：在儿童和青少年时期，家庭暴露于25年或更长的吸烟年限使肺癌风险增加一倍（比值比，2.07; 95%置信区间，1.16至3.68）。大约15%的从未吸烟的对照组受试者报告了这一水平的暴露。在儿童和青少年时期，家庭接触少于25个吸烟年不会增加肺癌的风险。暴露于配偶的吸烟，平均占家庭总暴露量的三分之一以下，与风险增加无关。结论：回忆偏差和其他方法学问题的可能性可能会影响环境烟草烟雾病例对照研究的结果。尽管如此，我们关于生命早期暴露的研究结果表明，非吸烟者中约有17%的肺癌可归因于儿童和青少年时期高水平的吸烟暴露。
Background: The relation between passive smoking and lung cancer is of great public health importance. Some previous studies have suggested that exposure to environmental tobacco smoke in the household can cause lung cancer, but others have found no effect. Smoking by the spouse has been the most commonly used measure of this exposure. Methods: In order to determine whether lung cancer is associated with exposure to tobacco smoke within the household, we conducted a population-based case-control study of 191 patients with histologically confirmed primary lung cancer who had never smoked and an equal number of persons without lung cancer who had never smoked. Lifetime residential histories including information on exposure to environmental tobacco smoke were compiled and analyzed. Exposure was measured in terms of "smoker-years," determined by multiplying the number of years in each residence by the number of smokers in the household. Results: Household exposure to 25 or more smoker-years during childhood and adolescence doubled the risk of lung cancer (odds ratio, 2.07; 95 percent confidence interval, 1.16 to 3.68). Approximately 15 percent of the control subjects who had never smoked reported this level of exposure. Household exposure of less than 25 smoker-years during childhood and adolescence did not increase the risk of lung cancer. Exposure to a spouse''s smoking, which constituted less than one third of total household exposure on average, was not associated with an increase in risk. Conclusions: The possibility of recall bias and other methodologic problems may influence the results of case-control studies of environmental tobacco smoke. Nonetheless, our findings regarding exposure during early life suggest that approximately 17 percent of lung cancers among nonsmokers can be attributed to high levels of exposure to cigarette smoke during childhood and adolescence.