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Nolder KA, Anderson KG. Effects of acute and chronic nicotine administration on probability discounting. Behav Pharmacol 2023; 34:468-476. [PMID: 37668161 DOI: 10.1097/fbp.0000000000000753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Nicotine use is a continuing public health concern. Smokers are more likely to make risky or maladaptive decisions compared to nonsmokers, so the relation between nicotine and risky choice warrants further investigation. Risky choice can be operationally defined as the choice for a larger, uncertain reinforcer over a smaller, certain reinforcer and can be assessed through a probability-discounting procedure. Acute nicotine administration has been shown to alter risky choice, but because the everyday smoker uses nicotine repeatedly, more research on chronic administration is needed and would allow for assessment of tolerance or sensitization of any effects. The present study examined effects of acute and repeated nicotine administration on probability discounting. Sprague-Dawley rats were used as subjects and the probability-discounting task involved discrete-trial choices between a small, certain reinforcer and a larger, uncertain reinforcer. The probability of larger-reinforcer delivery decreased across blocks within each session. Acute nicotine (0.1-1.0 mg/kg) administration dose-dependently increased risky choice, increased lose-stay ratios (a measure of response perseveration), and decreased reinforcement frequency. Tolerance to nicotine's effects on larger-reinforcer choice was observed after repeated 1.0 mg/kg nicotine administration. The results of the present study add to the existing literature that acute nicotine administration increases risky choice and demonstrates that tolerance to this effect develops after chronic exposure to the drug. Possible behavioral mechanisms behind this effect are discussed, as are suggestions for future research on nicotine and risky choice.
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Affiliation(s)
- Katya A Nolder
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
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Hori A, Inoue Y, Kuwahara K, Kunugita N, Akter S, Nishiura C, Kinugawa C, Endo M, Ogasawara T, Nagahama S, Miyamoto T, Tomita K, Yamamoto M, Nakagawa T, Honda T, Yamamoto S, Okazaki H, Imai T, Nishihara A, Sasaki N, Uehara A, Murakami T, Shimizu M, Eguchi M, Kochi T, Konishi M, Kashino I, Yamaguchi M, Nanri A, Kabe I, Mizoue T, Dohi S. Smoking and Long-Term Sick Leave in a Japanese Working Population: Findings of the Japan Epidemiology Collaboration on Occupational Health Study. Nicotine Tob Res 2021; 23:135-142. [PMID: 31679035 PMCID: PMC7789951 DOI: 10.1093/ntr/ntz204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/30/2019] [Indexed: 12/28/2022]
Abstract
Background Few studies have investigated the association between tobacco smoking and sick leave (SL) in Japan. Methods We followed 70 896 workers aged 20–59 years (60 133 males, 10 763 females) between April 2012 and March 2017. A Cox proportional hazards model was used to investigate the associations between smoking (smoking status and intensity) and long-term SL (ie, SL lasting ≥30 consecutive days). Cause-specific analyses were also conducted. Results A total of 1777 people took long-term SL during a follow-up of 307 749 person years. Compared with never-smokers, current smokers were at a higher risk of long-term SL (hazard ratio [HR] = 1.32; 95% confidence interval [CI] = 1.19 to 1.48). Cause-specific analyses revealed that current smoking was associated with a higher risk of SL due to all physical disorders (HR = 1.44, 95% CI = 1.22 to 1.69), cancer (HR = 1.49, 95% CI = 1.10 to 2.01), cardiovascular disease (CVD; HR = 2.16, 95% CI = 1.31 to 3.55), and injuries/external causes (HR = 1.83, 95% CI = 1.31 to 2.58). Former smokers were at a higher risk of SL due to cancer at a borderline significance level (HR = 1.38, 95% CI = 0.99 to 1.92). Low-intensity smoking (ie, 1–10 cigarettes smoked per day) was associated with all-cause SL, SL due to CVD, and SL due to injuries/external causes compared with never-smokers. Conclusion In a large cohort of working-age Japanese, smoking was associated with a greater risk of long-term SL. Greater effort is needed to mitigate disease burden associated with smoking at workplace in Japan. Implications Our study contributes to the literature on the association between smoking and SL in several ways. First, the study was conducted among a Japanese working population. While the association has been extensively studied in Western setting, few attempts have been made elsewhere. Second, cause-specific analyses were undertaken in our study. Third, we paid attention to the effect of low-intensity smoking on SL given that there is growing evidence of an elevated health risk associated with low-intensity smoking.
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Affiliation(s)
- Ai Hori
- Department of Global Public Health, University of Tsukuba, Ibaraki Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Naoki Kunugita
- School of Health Sciences, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shamima Akter
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chihiro Nishiura
- Department of Safety and Health, Tokyo Gas Co., Ltd., Tokyo, Japan
| | | | - Motoki Endo
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Naoko Sasaki
- Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan
| | | | - Taizo Murakami
- Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan
| | - Makiko Shimizu
- East Japan Works (Keihin), JFE Steel Corporation, Kanagawa, Japan
| | | | | | - Maki Konishi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ikuko Kashino
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Miwa Yamaguchi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akiko Nanri
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
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Abstract
OBJECTIVE To determine the impact of smoking on intensive care unit (ICU) outcomes in patients who underwent operative fixation for spine trauma. DESIGN Retrospective cohort study. SETTING Single academic level I trauma center. PATIENTS One hundred eighty-one consecutive surgical spine trauma patients from January 2010 to December 2014 requiring ICU stay. INTERVENTION Patients with smoking history compared to patients with no previous smoking history. MAIN OUTCOME MEASUREMENTS ICU length of stay, postoperative complications. RESULTS There were 297 spine trauma patients identified, of which 181 had an ICU stay (61%). There were 96 patients in the smoker cohort (53%) and 85 in the nonsmoker cohort (47%). On univariate analysis, the smoking cohort had a significantly longer ICU length of stay (11.0 ± 12.0 days vs. 8.01 ± 7.98 days, P = 0.046). Adjusting for confounders, smoking (beta: 3.99, P = 0.023), age ≥65 years (beta: 7.61, P = 0.001), body mass index ≥30 (beta: 4.47, P = 0.010), and American Spinal Injury Association Impairment Scale (beta: -1.39, P = 0.013) were independently associated with increased ICU length of stay. Smoking was not significantly associated with pneumonia (P = 0.238) or adult respiratory distress syndrome (P = 0.387) on multivariate analysis. CONCLUSIONS A history of smoking, older age, obesity, and increasing American Spinal Injury Association Impairment Scale was independently associated with increased ICU length of stay in patients with surgical spine trauma. This study highlights the health care burden of smoking in the trauma population and may help physicians triage scarce ICU resources. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Stimulant drugs are associated with violent and penetrating trauma. Am J Emerg Med 2019; 37:645-650. [DOI: 10.1016/j.ajem.2018.06.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 11/20/2022] Open
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The relationship between motor vehicle collisions and cigarette smoking in Ontario: Analysis of CAMH survey data from 2002 to 2016. Prev Med Rep 2018; 13:327-331. [PMID: 30792948 PMCID: PMC6369270 DOI: 10.1016/j.pmedr.2018.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/21/2018] [Accepted: 12/24/2018] [Indexed: 11/20/2022] Open
Abstract
Research has shown that tobacco users have an increased risk of collisions compared to nonsmokers. Studies from 1967 through 2013 documented a crude relative risk of collision involvement of about 1.5 among smokers compared to nonsmokers. In January 2009, in response to concerns about the health risks associated with potentially high concentrations of secondhand smoke resulting from smoking in vehicles, the provincial government in Ontario, Canada, introduced legislation restricting smoking in vehicles where children and adolescents are present. We examined the association between reported smoking and involvement in a motor vehicle collision in a large representative sample of adult drivers in Ontario, Canada, from 2002 and 2016, with particular focus on 2002-2008 and 2010-2016, periods before and after the legislation. Data are based on the Centre for Addiction and Mental Health (CAMH) Monitor. Among licensed drivers, prevalence of self-reported collision involvement within the past year for 2002-2008 was 9.39% among those who currently smoked compared to 7.08% of nonsmokers. Following implementation of the legislation, for 2010-2016, the prevalence of collisions for smokers was 7.01% and for nonsmokers was 6.02%. The overall difference for both smokers and nonsmokers between the two time periods was statistically significant; however, the difference between the two groups for the pre-legislation period was significant even after adjusting for potential confounders, while post legislation the difference was not significant. Prior to the legislation, the prevalence of collision was higher among smokers than nonsmokers; following the introduction of the legislation the prevalence was similar for the two groups.
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Gathecha GK, Ngaruiya C, Mwai W, Kendagor A, Owondo S, Nyanjau L, Kibogong D, Odero W, Kibachio J. Prevalence and predictors of injuries in Kenya: findings from the national STEPs survey. BMC Public Health 2018; 18:1222. [PMID: 30400906 PMCID: PMC6219001 DOI: 10.1186/s12889-018-6061-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Injuries are becoming an increasingly important public health challenge globally, and are responsible for 9% of deaths. Beyond their impact on health and well-being, fatal and non-fatal injuries also affect social and economic development for individuals concerned. Kenya has limited data on the magnitude and factors associated with injuries. This study sought to determine the magnitude and risk factors for injuries in Kenya and to identify where the largest burden lies. METHODS A national population-based household survey was conducted from April-June 2015 among adults age 18-69 years. A three-stage cluster sample design was used to select clusters, households and eligible individuals based on WHO guidelines. We estimated the prevalence of injuries, identified factors associated with injuries and the use of protective devices/practices among road users. Multivariate logistic regression was used to identify potential factors associated with injuries. RESULTS A total of 4484 adults were included in the study. Approximately 15% had injuries from the past 12 months, 60.3% were males. Four percent of the respondents had been injured in a road traffic crash, 10.9% had experienced unintentional injuries other than road traffic injuries while 3.7% had been injured in violent incidents. Among drivers and passengers 12.5% reported always using a seatbelt and 8.1% of the drivers reported driving while drunk. The leading causes of injuries other than road traffic crashes were falls (47.6%) and cuts (34.0%). Males (p = 0.001), age 18-29 (p < 0.05) and smokers (p = 0.001) were significantly more likely to be injured in a road traffic crash. A higher social economic status (p = 0.001) was protective against other unintentional injuries while students had higher odds for such types of injuries. Heavy episodic drinking (p = 0.001) and smoking (p < 0.05) were associated with increased likelihood of occurrence of a violent injury. CONCLUSIONS Our study found that male, heavy episodic drinkers, current smokers and students were associated with various injury types. Our study findings highlight the need to scale up interventions for injury prevention for specific injury mechanisms and target groups. There is need for sustained road safety mass media campaigns and strengthened enforcement on helmet wearing, seatbelt use and drink driving.
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Affiliation(s)
| | - Christine Ngaruiya
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT USA
| | - Wilfred Mwai
- Division of Non Communicable Diseases, Ministry of Heath, Nairobi, Kenya
| | - Ann Kendagor
- Division of Non Communicable Diseases, Ministry of Heath, Nairobi, Kenya
| | - Scholastica Owondo
- Division of Non Communicable Diseases, Ministry of Heath, Nairobi, Kenya
| | - Loise Nyanjau
- Division of Non Communicable Diseases, Ministry of Heath, Nairobi, Kenya
| | - Duncan Kibogong
- Directorate of Road Safety, National Transport and Safety Authority, Nairobi, Kenya
| | - Wilson Odero
- Faculty of Medicine, Maseno University, Kisumu, Kenya
| | - Joseph Kibachio
- Division of Non Communicable Diseases, Ministry of Heath, Nairobi, Kenya
- The Institute of Global Health, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
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Choi KC, Kim SA, Kim NR, Shin MH. Association between Smoking and Unintentional Injuries among Korean Adults. Chonnam Med J 2018; 54:184-189. [PMID: 30288375 PMCID: PMC6165918 DOI: 10.4068/cmj.2018.54.3.184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/08/2018] [Accepted: 08/10/2018] [Indexed: 11/21/2022] Open
Abstract
Using a cross-sectional representative national survey, we evaluated the relationship between cigarette smoking and unintentional injuries among Korean adults. We used data from the 2009 Korean Community Health Survey. Smoking status was defined as never smokers, ex-smokers, and current smokers. Current smokers were categorized into light daily smokers (1–10 cigarettes/day), moderate daily smokers (11–20 cigarettes/day), or heavy daily smokers (≥21 cigarettes/day). We used the Poisson regression model with a robust variance estimation to estimate prevalence rate ratios (PRR) and corresponding 95% confidence interval (95% CI). After adjusting for demographic characteristics, socioeconomic variables, lifestyle variables, and health status variables, former smokers (PRR, 1.19, 95% CI 1.11–1.28), light daily smokers (PRR 1.22, 95% CI 1.13–1.32), moderate daily smokers (PRR 1.33, 95% CI 1.24–1.42), and heavy daily smokers (PRR 1.40, 95% CI 1.25–1.57) had an increased risk for unintentional injuries compared with non-smokers. In conclusion, cigarette smoking is associated with unintentional injuries in a dose-response manner in Korean adults. The findings suggest that community smoking cessation programs may reduce morbidity and mortality from unintentional injuries.
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Affiliation(s)
- Kyu-Chul Choi
- Department of Emergency Medicine, Hwasun Chonnam National University Hospital, Hwasun, Korea
| | - Sun A Kim
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Nu Ri Kim
- Chonnam Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
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Wu D, Yang T, Cottrell RR, Zhou H, Feng X. Prevalence and behavioural associations of unintentional injuries among Chinese college students: a 50-University population-based study. Inj Prev 2018; 25:52-59. [PMID: 30194259 DOI: 10.1136/injuryprev-2018-042751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/13/2018] [Accepted: 08/09/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the prevalence, demographic characteristics and behavioural correlates of unintentional injuries among Chinese college students. METHODS A cross-sectional multistage survey sampling process was conducted among 11 770 undergraduates from 50 universities in China. Students were asked to report different types of unintentional injuries that required medical attention from a doctor over the past year. The χ² test and multiple logistic regression analysis were used to identify factors associated with these injuries. RESULTS The overall unintentional injury prevalence was 47.9% (95% CI 47.6% to 48.2%). Most injuries occurred at sport venues (24.0%), following by home/dormitory injuries (20.5%) and traffic injuries (13.0%). Some behavioural factors exhibiting significant associations with overall unintentional injuries were: sleeping less than 7 hours (OR=1.32, 95% CI 1.27 to 1.37), smoking (OR=1.28, 95% CI 1.23 to 1.32), alcohol consumption (OR=1.74, 95% CI 1.69 to 1.78) and heavy internet use (OR=1.60, 95% CI 1.52 to 1.67). Male students were more likely to be involved in traffic and sport injuries than female students. Students majoring in non-medical fields had a higher risk of sport and home injuries than students majoring in medical fields. Those who drank alcohol, slept less than 7 hours or who reported heavy internet use were more likely to experience all types of injuries than students who did not participate in these behaviours. Finally, students who smoked had a higher likelihood of traffic and sport injuries than non-smoking students. CONCLUSIONS A substantial number of college students reported injuries in the past year, and several key behavioural factors were associated with injuries. These findings could be beneficial for the design, implementation and assessment of injury intervention programme with college students. Based on these findings, policy implications for unintentional injury prevention and control were also considered.
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Affiliation(s)
- Dan Wu
- Department of Psychology/Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, China
| | - Tingzhong Yang
- Center for Tobacco Control Research and Department of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China .,Injury Control Research Center, West Virginia University, Morgantown, West Virginia, USA
| | - Randall R Cottrell
- Public Health Studies Program, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Huan Zhou
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueying Feng
- The First Affiliated Hospital, Zhejiang University, Hangzhou, China
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Brooks RD, Grier T, Dada EO, Jones BH. The Combined Effect of Cigarette Smoking and Fitness on Injury Risk in Men and Women. Nicotine Tob Res 2018; 21:1621-1628. [DOI: 10.1093/ntr/nty155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/23/2018] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Prior studies have identified cigarette smoking and low fitness as independent risk factors for injury; however, no studies have evaluated the combined effect of cigarette smoking and fitness on injury risk.
Objective
To evaluate the combined effect of cigarette smoking and fitness on injury risk in men and women.
Design
This is a secondary analysis of data collected from US Army recruits (n = 2000) during basic combat training within the United States in 2007. Physical training and fitness, cigarette smoking, and prior injury data were obtained from questionnaires, whereas demographic and injury data were obtained from medical and basic combat training unit records. Chi-squared tests were used to assess differences in injury risk by fitness level and cigarette smoking. Relative risk values were calculated with 95% confidence intervals.
Results
The primary findings showed that smokers experienced 20%–30% higher risk of injury than nonsmokers. In addition, higher aerobic and muscular fitness was generally not protective against injury between least fit and more fit smokers. However, higher fitness was protective against injury between least and more fit nonsmokers, with least fit nonsmokers being 30%–50% more likely to experience an injury than fit nonsmokers.
Conclusion
This study revealed that higher aerobic and muscular fitness was not protective against injury among smokers; however, it was protective against injury among nonsmokers. Further implementation of smoking cessation programs may be beneficial for military and civilian personnel who are required to be physically fit in order to carry out their job responsibilities.
Implications
Male and female smokers experienced significantly higher risk of injury than nonsmokers. Although higher fitness is protective against injury in nonsmokers, the protective effect of fitness is lost among smokers. In an attempt to reduce injury risk among military and emergency personnel, smoking cessation programs should be further implemented among both more fit and less fit smokers.
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Affiliation(s)
- Raina D Brooks
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, MD
| | - Tyson Grier
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, MD
| | - Esther O Dada
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, MD
| | - Bruce H Jones
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, MD
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Lee W, Lee S, Kim J, Kim J, Kim YK, Kim K, Won JU, Roh J, Yoon JH. Relationship Between Exposure to Second-Hand Smoke in the Workplace and Occupational Injury in the Republic of Korea. Ann Work Expo Health 2017; 62:41-52. [PMID: 29267948 DOI: 10.1093/annweh/wxx089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 10/04/2017] [Indexed: 11/13/2022] Open
Abstract
Background Most studies in the field of smoking exposure in the workplace linked to occupational safety have only focused on active smoking. Few studies have reported that exposure to second-hand smoke in the workplace is a possible factor increasing the risk of occupational injury without considering occupational characteristics. The aim of this study was to determine the association between occupational injury and level of exposure to second-hand smoke at the workplace among Korean workers, after taking into account occupational characteristics. Method Using data from the third Korean Working Conditions Survey, levels of exposure to second-hand smoke were categorized as none, moderate, and high. We investigated the influence of exposure to second-hand smoke on occupational injury using logistic regression analysis with stratification by sex, smoking status, smoke-free policy in the workplace, and occupational characteristics. Occupational characteristics (occupational classification, working schedule, length of working day, and co-exposure to occupational hazards in the workplace) were stratified and analyzed using logistic regression models to estimate the risk of occupational injury linked to exposure to second-hand smoke. Results Among all participants, there was a significant dose-dependent association between risk of occupational injury and level of exposure level to second-hand smoke. After stratification by sex and smoking status, there was a significant association between risk of occupational injury and exposure level to second-hand smoke. Moreover, there was a significant relationship between exposure to second-hand smoke in the workplace and occupational injury, depending on the smoking-free policy at workplace (odds ratio [OR] in completely non-smoking workplace, 4.23; OR in non-smoking workplace with separate smoking area, 2.98; OR in smoking workplace 2.84). Additionally, there was a significant relationship between risk of occupational injury and exposure to second-hand smoke after stratification by occupational classification, working schedule, long working hours, and co-exposure to hazards in the workplace. Discussion There was a dose-response relationship between occupational injury and exposure to second-hand smoke, even after stratification to reduce the impact of various potential confounders and after taking into account occupational characteristics. These findings provide greater insight into the effects of exposure to second-hand smoke on the working population and may direct further research and policy-making in this field.
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Affiliation(s)
- Wanhyung Lee
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Incheon Worker's Health Center, Incheon, Republic of Korea
| | - Seunghyun Lee
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Jeonghoon Kim
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Republic of Korea.,Department of Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jihyun Kim
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Incheon Worker's Health Center, Incheon, Republic of Korea
| | - Yeong-Kwang Kim
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Incheon Worker's Health Center, Incheon, Republic of Korea
| | - Kyoosang Kim
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Republic of Korea.,Department of Occupational Environmental Medicine, Seoul Medical Center, Seoul, Republic of Korea
| | - Jong-Uk Won
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Incheon Worker's Health Center, Incheon, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jaehoon Roh
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Incheon Worker's Health Center, Incheon, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea.,Incheon Worker's Health Center, Incheon, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Ryu E, Juhn YJ, Wheeler PH, Hathcock MA, Wi CI, Olson JE, Cerhan JR, Takahashi PY. Individual housing-based socioeconomic status predicts risk of accidental falls among adults. Ann Epidemiol 2017. [PMID: 28648550 DOI: 10.1016/j.annepidem.2017.05.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Accidental falls are a major public health concern among people of all ages. Little is known about whether an individual-level housing-based socioeconomic status measure is associated with the risk of accidental falls. METHODS Among 12,286 Mayo Clinic Biobank participants residing in Olmsted County, Minnesota, subjects who experienced accidental falls between the biobank enrollment and September 2014 were identified using ICD-9 codes evaluated at emergency departments. HOUSES (HOUsing-based Index of SocioEconomic Status), a socioeconomic status measure based on individual housing features, was also calculated. Cox regression models were utilized to assess the association of the HOUSES (in quartiles) with accidental fall risk. RESULTS Seven hundred eleven (5.8%) participants had at least one emergency room visit due to an accidental fall during the study period. Subjects with higher HOUSES were less likely to experience falls in a dose-response manner (hazard ratio: 0.58; 95% confidence interval: 0.44-0.76 for comparing the highest to the lowest quartile). In addition, the HOUSES was positively associated with better health behaviors, social support, and functional status. CONCLUSIONS The HOUSES is inversely associated with accidental fall risk requiring emergency care in a dose-response manner. The HOUSES may capture falls-related risk factors through housing features and socioeconomic status-related psychosocial factors.
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Affiliation(s)
- Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Young J Juhn
- Asthma Epidemiology Research Unit and Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Philip H Wheeler
- Asthma Epidemiology Research Unit and Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | | | - Chung-Il Wi
- Asthma Epidemiology Research Unit and Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Paul Y Takahashi
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN.
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12
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Rommel A, Varnaccia G, Lahmann N, Kottner J, Kroll LE. Occupational Injuries in Germany: Population-Wide National Survey Data Emphasize the Importance of Work-Related Factors. PLoS One 2016; 11:e0148798. [PMID: 26859560 PMCID: PMC4747528 DOI: 10.1371/journal.pone.0148798] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/22/2016] [Indexed: 12/12/2022] Open
Abstract
Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand the occurrence of occupational injuries, sociodemographic factors and work- and health-related factors are tested simultaneously. Thus, the present analysis aims to develop a comprehensive epidemiological model that facilitates the explanation of varying injury rates in the workplace. The representative phone survey German Health Update 2010 provides information on medically treated occupational injuries sustained in the year prior to the interview. Data were collected on sociodemographics, occupation, working conditions, health-related behaviors, and chronic diseases. For the economically active population (18-70 years, n = 14,041), the 12-month prevalence of occupational injuries was calculated with a 95% confidence interval (CI). Blockwise multiple logistic regression was applied to successively include different groups of variables. Overall, 2.8% (95% CI 2.4-3.2) of the gainfully employed population report at least one occupational injury (women: 0.9%; 95% CI 0.7-1.2; men: 4.3%; 95% CI 3.7-5.0). In the fully adjusted model, male gender (OR 3.16) and age 18-29 (OR 1.54), as well as agricultural (OR 5.40), technical (OR 3.41), skilled service (OR 4.24) or manual (OR 5.12), and unskilled service (OR 3.13) or manual (OR 4.97) occupations are associated with higher chances of occupational injuries. The same holds for frequent stressors such as heavy carrying (OR 1.78), working in awkward postures (OR 1.46), environmental stress (OR 1.48), and working under pressure (OR 1.41). Among health-related variables, physical inactivity (OR 1.47) and obesity (OR 1.73) present a significantly higher chance of occupational injuries. While the odds for most work-related factors were as expected, the associations for health-related factors such as smoking, drinking, and chronic diseases were rather weak. In part, this may be due to context-specific factors such as safety and workplace regulations in high-income countries like Germany. This assumption could guide further research, taking a multi-level approach to international comparisons.
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Affiliation(s)
- Alexander Rommel
- Robert Koch Institute, Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Gianni Varnaccia
- Robert Koch Institute, Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Nils Lahmann
- Charité-Universitätsmedizin Berlin, Institute of Health Sciences Education and Nursing, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Lars Eric Kroll
- Robert Koch Institute, Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101, Berlin, Germany
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Zhao J, Pachanee CA, Yiengprugsawan V, Seubsman SA, Sleigh A. Smoking, smoking cessation, and 7-year mortality in a cohort of Thai adults. Popul Health Metr 2015; 13:30. [PMID: 26512212 PMCID: PMC4624360 DOI: 10.1186/s12963-015-0062-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 10/03/2015] [Indexed: 01/31/2023] Open
Abstract
Background Smoking is a strong risk factor for mortality in both the developed and the developing world. However, there is still limited research to examine the impact of smoking cessation and mortality in middle-income Southeast Asian populations. Methods We use longitudinal data from a large Thai cohort of adult Open University students residing nationwide, linked with official death records to assess the association of smoking status and mortality risks during a 7-year follow-up. The log-rank test was used to evaluate the statistical probability of differential survival according to baseline smoking status. Multivariate hazard ratios (HR) were reported for smoking status and all-cause and cause-specific mortality. Results From 2005 baseline to 2012, current smokers were more likely to die than cohort members who ceased smoking and never smokers (1.9 vs 1.3 vs 0.6 %, p < 0.05). The hazard of all-cause mortality increased with the daily amount of cigarette consumption among both current and former smokers. Cause of death analyses showed that current male smokers had a significantly increased risk of cardiovascular disease related mortality (HR 3.9 [95 % CI 1.8–8.1]). Former male smokers had a moderate increase in risk of dying from cardiovascular diseases compared to never smokers (HR 1.6 [95 % CI 0.7–3.4]). Current male smokers between 2005 and 2009 experienced highest subsequent mortality hazards during the period 2009–2012 compared to never smokers (HR 2.1 [95 % CI 1.4–3.4]). The higher risk of dying reduced if people quit smoking during the 2005–2009 follow-up period (HR 1.5 [95 % CI 0.7–3.3]). Risk for mortality fell even further among long-term quitters (HR 1.4 [95 % CI 0.9–2.2]). Conclusion Among a large nationwide cohort of Thai adults, current smokers were at a significantly and substantially higher risk of all-cause mortality, especially cardiovascular-related mortality. The higher risk of dying fell if people quit smoking and the risk for mortality was even lower among long-term quitters. Promotion of smoking cessation will contribute substantially to the reduction in avoidable mortality in Thailand.
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Affiliation(s)
- Jiaying Zhao
- National Centre for Epidemiology and Population Health and Global Health Division, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Cha-Aim Pachanee
- International Health and Policy Program, Bureau of Policy and Strategy, Ministry of Public Health, Nonthaburi, Thailand
| | - Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health and Global Health Division, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Sam-Ang Seubsman
- National Centre for Epidemiology and Population Health and Global Health Division, Research School of Population Health, The Australian National University, Canberra, Australia ; School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian Sleigh
- National Centre for Epidemiology and Population Health and Global Health Division, Research School of Population Health, The Australian National University, Canberra, Australia
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Chen VCH, Kuo CJ, Wang TN, Lee WC, Chen WJ, Ferri CP, Tsai D, Lai TJ, Huang MC, Stewart R, Ko YC. Suicide and Other-Cause Mortality after Early Exposure to Smoking and Second Hand Smoking: A 12-Year Population-Based Follow-Up Study. PLoS One 2015. [PMID: 26222448 PMCID: PMC4519334 DOI: 10.1371/journal.pone.0130044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The association between smoking and suicide is still controversial, particular for early life cigarette smoking exposure. Few studies have investigated this association in adolescents using population-based cohorts, and the relationship with second hand smoking (SHS) exposure has not been addressed. Methods and Findings In this study, we followed a large population-based sample of younger people to investigate the association between smoking, SHS exposure and suicide mortality. Between October 1995 and June 1996, 162,682 junior high school students ages 11 to 16 years old living in a geographic catchment area in Taiwan were enrolled and then followed till December 2007 (1,948,432 person-years) through linkage to the National Death Certification System. Participants who were currently smoking at baseline had a greater than six-fold higher suicide mortality than those who did not smoke (29.5 vs. 4.8 per 100,000 person-years, p<0.001) as well as higher natural mortality (33.7 vs. 10.3 per 100,000 person-years, p<0.001). After controlling for gender, age, parental education, asthma, allergic rhinitis, and alcohol consumption, the adjusted hazard ratios for suicide were 3.69 (95% CI 1.85-7.39) in current smokers, and 1.47 (95% CI 0.94-2.30) and 2.83 (95% CI 1.54-5.20) respectively in adolescents exposed to SHS of 1-20 cigarettes and >20 cigarettes/per day. The estimated depression-adjusted odds ratio did not change substantially. The population attributable fractions for suicide associated with smoking and heavy SHS exposure (>20 cigarettes/per day) were 9.6% and 10.6%, respectively. Conclusions This study showed evidence of excess suicide mortality among young adults exposed to active or passive early life cigarette smoking.
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Affiliation(s)
- Vincent Chin-Hung Chen
- Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital and Chang Gung University, Chiayi, Taiwan
- Department of Psychiatry, Chung San Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsu-Nai Wang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (YCK); (TNW)
| | - Wen-Chung Lee
- Institue of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wei J. Chen
- Institue of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Cleusa P. Ferri
- Universidade Federal de São Paulo-Psychobiology Department, São Paulo, Brazil
| | - Duujian Tsai
- School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Te-Jen Lai
- Department of Psychiatry, Chung San Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Meng-Chuan Huang
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Robert Stewart
- King’s College London (Institute of Psychiatry), London, United Kingdom
| | - Ying-Chin Ko
- Environment-Omics-Diseases Research Center, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
- * E-mail: (YCK); (TNW)
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Xiao H, Stoecklin-Marois M, Li CS, McCurdy SA, Schenker M. Cohort study of physical activity and injury among Latino farm workers. Am J Ind Med 2015; 58:737-45. [PMID: 25943698 DOI: 10.1002/ajim.22460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2015] [Indexed: 11/06/2022]
Abstract
INTRODUCTION This study characterized physical activity and its association with injury among Latino farm workers. METHODS An interviewer-administered questionnaire was used to collect baseline and follow-up data on 843 and 640 Latino farm workers, respectively. Participants were 18-55 years old, engaged in farm work and residing in Mendota, CA at baseline interview. The questionnaire assessed self-reported physical activity and risk of injury. RESULTS The 12 month prevalence of injury decreased from 9.0% at baseline to 6.9% at follow up interview. In GEE models adjusted for age, follow-up time, gender, smoking, income and years working in agriculture, poor/fair self-assessed health status (OR = 1.82, 95% CI: 1.18-2.82) and 2-3 hr per day of sitting/watching TV/using a computer (OR = 0.50, 95% CI: 0.30-0.83) were significantly associated with injury. CONCLUSIONS Physical activity was not associated with injury in this population. Efforts to reduce injuries should focus on known risk factors such as poor health status.
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Affiliation(s)
- Hong Xiao
- Department of Public Health Sciences; School of Medicine; University of California; Davis California
| | - Maria Stoecklin-Marois
- Department of Public Health Sciences; School of Medicine; University of California; Davis California
| | - Chin-Shang Li
- Department of Public Health Sciences; School of Medicine; University of California; Davis California
| | - Stephen A. McCurdy
- Department of Public Health Sciences; School of Medicine; University of California; Davis California
| | - Marc Schenker
- Department of Public Health Sciences; School of Medicine; University of California; Davis California
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KIM HC, LAMICHHANE DK, JUNG DY, KIM HR, CHOI EH, OH SS, KANG HT, RHEE KY, CHANG SJ. Association of active and passive smoking with occupational injury in manual workers: a cross-sectional study of the 2011 Korean working conditions survey. INDUSTRIAL HEALTH 2015; 53:445-453. [PMID: 26051290 PMCID: PMC4591137 DOI: 10.2486/indhealth.2015-0011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 05/21/2015] [Indexed: 06/04/2023]
Abstract
This study was conducted to investigate the relationship of active and passive smoking with occupational injury among manual workers. Data from the 2011 Korean Working Conditions Survey were analyzed for 12,507 manual workers aged ≥15 yr. Overall, 60.4% of men and 5.8% of women were current smokers. The prevalence of injury was higher among never smokers who were exposed to secondhand smoke (SHS) (7.7% in men and 8.1% in women) than current smokers (4.2% in men and 4.1% in women). After controlling for potential confounders, in men, compared to those who never smoked and were not exposed to SHS, people who never smoked and were exposed to SHS (adjusted odds ratio (aOR)=3.7, 2.2-6.4) and current smokers (aOR=2.5, 1.6-3.8) were more likely to experience injury. Among women, the aORs of occupational injury were 8.4 (4.2-16.7) for never smoking women with occasional exposure to SHS and 3.5 (95% CI: 1.4-8.7) for current smokers, in comparison to never smoking women who were never exposed to SHS at work (reference group). The present study suggests that exposure to SHS is a possible risk factor of occupational injury for never smoking men and women.
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Affiliation(s)
- Hwan-Cheol KIM
- Department of Occupational and Environmental Medicine, School
of Medicine, Inha University, Republic of Korea
| | - Dirga Kumar LAMICHHANE
- Department of Social and Preventive Medicine, School of
Medicine, Inha University, Republic of Korea
| | - Dal-Young JUNG
- Department of Social and Preventive Medicine, School of
Medicine, Inha University, Republic of Korea
| | - Hyoung-Ryoul KIM
- Department of Occupational and Environmental Medicine,
College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Eun-Hee CHOI
- Institute of Lifestyle Medicine, Wonju College of Medicine,
Yonsei University, Republic of Korea
| | - Sung-Soo OH
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
| | - Hee-Tae KANG
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
| | - Kyung-Yong RHEE
- Occupational Safety and Health Research Institute, KOSHA,
Republic of Korea
| | - Sei-Jin CHANG
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
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17
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Molero Y, Lichtenstein P, Zetterqvist J, Gumpert CH, Fazel S. Varenicline and risk of psychiatric conditions, suicidal behaviour, criminal offending, and transport accidents and offences: population based cohort study. BMJ 2015; 350:h2388. [PMID: 26037950 PMCID: PMC4452930 DOI: 10.1136/bmj.h2388] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine associations between varenicline and the incidence of a range of adverse outcomes. DESIGN Population based cohort study using within person analyses to control for confounding by indication. SETTING Whole population of Sweden. PARTICIPANTS 7,917,436 people aged 15 and over, of whom 69,757 were treated with varenicline between 2006 and 2009. MAIN OUTCOME MEASURES Incidence of new psychiatric conditions, suicidal behaviour, suspected and convicted criminal offending, transport accidents, and suspected and convicted traffic offences. RESULTS In the whole population, 337,393 new psychiatric conditions were diagnosed during follow-up. In addition, 507,823 suspected and 338,608 convicted crimes, 40,595 suicidal events, 124,445 transport accidents, and 99,895 suspected and 57,068 convicted traffic crimes were recorded. Within person analyses showed that varenicline was not associated with significant hazards of suicidal behaviour, criminal offending, transport accidents, traffic offences, or psychoses. However, varenicline was associated with a small increase in the risk of anxiety conditions (hazard ratio 1.23, 95% confidence interval 1.01 to 1.51) and mood conditions (1.31, 1.06 to 1.63), which was only seen in people with pre-existing psychiatric disorders. CONCLUSIONS Concerns that varenicline is associated with an increased risk of many adverse outcomes, including suicidality and accidents, are not supported in this observational study. The small increase in risk of two psychiatric conditions in people with pre-existing psychiatric disorders needs to be confirmed using other research designs.
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Affiliation(s)
- Yasmina Molero
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm
| | - Johan Zetterqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm
| | - Clara Hellner Gumpert
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
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Yiengprugsawan V, Berecki-Gisolf J, Bain C, McClure R, Seubsman SA, Sleigh AC. Predictors of injury mortality: findings from a large national cohort in Thailand. BMJ Open 2014; 4:e004668. [PMID: 24902726 PMCID: PMC4054638 DOI: 10.1136/bmjopen-2013-004668] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
OBJECTIVE To present predictors of injury mortality by types of injury and by pre-existing attributes or other individual exposures identified at baseline. DESIGN 5-year prospective longitudinal study. SETTING Contemporary Thailand (2005-2010), a country undergoing epidemiological transition. PARTICIPANTS Data derived from a research cohort of 87 037 distance-learning students enrolled at Sukhothai Thammathirat Open University residing nationwide. MEASURES Cohort members completed a comprehensive baseline mail-out questionnaire in 2005 reporting geodemographic, behavioural, health and injury data. These responses were matched with national death records using the Thai Citizen ID number. Age-sex adjusted multinomial logistic regression was used to calculate ORs linking exposure variables collected at baseline to injury deaths over the next 5 years. RESULTS Statistically significant predictors of injury mortality were being male (adjustedOR 3.87, 95% CI 2.39 to 6.26), residing in the southern areas (AOR 1.71, 95% CI 1.05 to 2.79), being a current smoker (1.56, 95% CI 1.03 to 2.37), history of drunk driving (AOR 1.49, 95% CI 1.01 to 2.20) and ever having been diagnosed for depression (AOR 1.91, 95% CI 1.00 to 3.69). Other covariates such as being young, having low social support and reporting road injury in the past year at baseline had moderately predictive AORs ranging from 1.4 to 1.6 but were not statistically significant. CONCLUSIONS We complemented national death registration with longitudinal data on individual, social and health attributes. This information is invaluable in yielding insight into certain risk traits such as being a young male, history of drunk driving and history of depression. Such information could be used to inform injury prevention policies and strategies.
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Affiliation(s)
- Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Christopher Bain
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
- Genetics and Population Health Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Roderick McClure
- Monash Injury Research Institute, Monash University, Melbourne, Australia
| | - Sam-ang Seubsman
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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Denney JT, He M. The social side of accidental death. SOCIAL SCIENCE RESEARCH 2014; 43:92-107. [PMID: 24267755 DOI: 10.1016/j.ssresearch.2013.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 09/05/2013] [Accepted: 09/18/2013] [Indexed: 06/02/2023]
Abstract
Mortality from unintentional injuries, or accidents, represents major and understudied causes of death in the United States. Epidemiological studies show social factors, such as socioeconomic and marital status, relate with accidental death. But social theories posit a central role for social statuses on mortality risk, stipulating greater relevance for causes of death that have been medically determined to be more preventable than others. These bodies of work are merged to examine deaths from unintentional injuries using 20years of nationally representative survey data, linked to prospective mortality. Results indicate that socially disadvantaged persons were significantly more likely to die from the most preventable and equally likely to die from the least preventable accidental deaths over the follow-up, compared to their more advantaged counterparts. This study extends our knowledge of the social contributors to a leading cause of death that may have substantial implications on overall disparities in length of life.
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Affiliation(s)
- Justin T Denney
- Rice University, Department of Sociology, MS-28, 6100 Main St., Houston, TX 77005, United States.
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20
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Martínez-Sánchez JM, Gallus S, Lugo A, Fernández E, Invernizzi G, Colombo P, Pacifici R, La Vecchia C. Smoking while driving and public support for car smoking bans in Italy. Tob Control 2012; 23:238-43. [DOI: 10.1136/tobaccocontrol-2012-050700] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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21
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Elias W, Assy N, Elias I, Toledo T, Yassin M, Bowirrat A. The detrimental danger of Water-Pipe (Hookah) transcends the hazardous consequences of general health to the driving behavior. J Transl Med 2012; 10:126. [PMID: 22709610 PMCID: PMC3477070 DOI: 10.1186/1479-5876-10-126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/23/2012] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To determine whether the consumption of tobacco used in Water-Pipe by drivers increases the risk of a motor vehicle collision as a consequence of hypoxia. DESIGN Analytical case-control study. DATA SOURCES Seventy exclusive Water-Pipe smokers (Experimental Group--EG)--mean age ± SD: 29.47 ± 10.45 years; mean number of weekly WPS, (6.9 ± 3.7); mean duration of WPS (WPS) is (7.5 ± 2.1 years)--and thirty non-smoker (Control Group--CG; mean age ± SD: 36.33 ± 13.92 years) were recruited during 2011 from two Arab villages located in the Galilee, northern Israel. METHODS We performed a case-control study exclusively among Water-Pipe smokers with an appropriate non smokers control group. Demographic questionnaire, Pulse Oxymeter for blood oxygenation measure and a driver simulator for measuring various participants driving behaviors were utilized. Statistical analysis for analyzing the different variables, Pearson's x2 analysis for the comparison of categorical variables, continuous variable is compared using Student's t-test and for testing the correlation between the different variables and bivariate correlation analysis were applied. RESULTS In the (EG) following WPS, we observed increase in the pulse rate--from 80 to 95 (t = 11.84, p < 0.05) and decrease in saturation level from 97.9 to 97.32, the decrease is statistically significant (t = 3.01, p < 0.05) versus no change in (CG). An increased number of accidents among EG (OR is 1.333 with CI of 1.008-1.776), while in CG, an insignificantly decrease (t = 3.08, p < 0.05). In EG an increase in centerline crossings (OR is 1.306 with CI of 1.016-1.679), also the total time not being within the lane was increased and the estimated (OR: 1.329; CI: 1.025-1.722). WPS increases the number of accidents by 33% and Hypoxia can cause driving behavioral turbulences. CONCLUSION The results show that WPS has a significant impact on driving behavior and on the risk of being involved in road accidents and causing driving to become riskier and less careful and stable. To the best of our knowledge, this is the first time such relationships have been tested. After WPS the total number of traffic accidents and driving violations increase. The results show a significant increase in the pulse rate immediately after WPS with a decrease in the saturation rate (the level of blood oxygenation); these changes continue half an hour after WPS.
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Affiliation(s)
- Wafa Elias
- The Ran Naor Road Safety Research Center, Technion, Haifa, Israel
| | | | | | - Tomer Toledo
- Civil and Environmental Engineering, Technion, Haifa, Israel
| | | | - Abdalla Bowirrat
- EMMS Nazareth-The Nazareth Hospital, Nazareth, Zip code: 16100, Israel
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22
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Hitchman SC, Guignard R, Nagelhout GE, Mons U, Beck F, van den Putte B, Crone M, de Vries H, Hyland A, Fong GT. Predictors of car smoking rules among smokers in France, Germany and the Netherlands. Eur J Public Health 2012; 22 Suppl 1:17-22. [PMID: 22294780 DOI: 10.1093/eurpub/ckr200] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND As exposure to tobacco smoke pollution (TSP) has been identified as a cause of premature death and disease in non-smokers, and studies have demonstrated that smoking in cars produces high levels of TSP, this study will investigate smokers' rules for smoking in their cars, and predictors of car smoking rules, including potentially modifiable correlates. METHODS Data were drawn from nationally representative samples of current smokers from the International Tobacco Control Policy Evaluation Project surveys in France (2007), Germany (2007), and the Netherlands (2008). Smokers in France and Germany were asked about smoking rules in their cars, and smokers in the Netherlands were asked about smoking rules in cars carrying children. RESULTS In France and Germany, 59% and 52% of smokers respectively, allowed smoking in their cars. In the Netherlands, 36% of smokers allowed smoking in cars carrying children. Predictors of allowing smoking in cars included: being a daily vs. non-daily smoker, being younger vs. older age, having no (young) children in the home, being a heavier smoker, and allowing smoking in the home. In the Netherlands, smokers who agreed that TSP is dangerous to non-smokers were less likely to allow smoking in cars carrying children. CONCLUSION Overall, a sizeable proportion of smokers allowed smoking in their cars across the three countries. Media campaigns with information about the dangers of TSP may increase the adoption of smoke-free cars. These media campaigns could target smokers who are most likely to allow smoking in cars.
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Affiliation(s)
- Sara C Hitchman
- Department of Psychology, University of Waterloo, Waterloo, Canada.
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Rumberger JS, Hollenbeak CS. Potential Costs and Benefits of Statewide Smoking Cessation in Pennsylvania. J Smok Cessat 2012. [DOI: 10.1375/jsc.5.2.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AbstractObjectives:To determine whether the cost of a statewide smoking cessation program in Pennsylvania could be justified by the benefits.Methods:A cost-benefit analysis of statewide access to smoking cessation programs. We compared three treatment alternatives, with and without counselling: nicotine replacement therapy, bupropion and varenicline.Results:While the retail price of a pack of cigarettes in Pennsylvania is on average US$4.72, the combined medical costs and productivity losses in Pennsylvania attributable to each pack of cigarettes sold are approximately US$23.78 per pack of cigarettes. The ratio of benefits to cost varied from US$0.97 to US$2.76 saved per dollar spent on smoking cessation programs, depending upon the type of intervention.Conclusions:For most smoking cessation treatments, the benefits of a statewide smoking cessation program in Pennsylvania would greatly outweigh its costs.
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The impact of smoking on complications after operatively treated ankle fractures--a follow-up study of 906 patients. J Orthop Trauma 2011; 25:748-55. [PMID: 21886001 DOI: 10.1097/bot.0b013e318213f217] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study on patients with operatively treated ankle fractures aimed to investigate the impact of smoking on postoperative complications and especially deep wound infections. DESIGN Cohort study with prospective follow-up. SETTING University-associated teaching hospital with advanced trauma care. PATIENTS A consecutive series of patients (n = 906) operatively treated for an acute ankle fracture during a 3-year period was identified. For the analysis, the patients were categorized as nonsmokers (n = 721) and smokers (n = 185). Data were collected from the department database and completed with a review of the patients' medical charts. MAIN OUTCOME MEASURES Postoperative complications. RESULTS Follow-up data at 6 weeks were available for 98.2% of the patients. Postoperative complications of any kind (30.1% versus 20.3%, P = 0.005) as well as deep wound infections (4.9% versus 0.8%, P < 0.001) were more common among smokers than nonsmokers. Multivariable analyses showed that smokers had six times higher odds of developing a deep infection compared with nonsmokers. A more complicated fracture, associated diabetes mellitus, and unsatisfactory operative fracture reduction also enhanced the risk of postoperative complications. CONCLUSIONS We conclude that cigarette smoking increases the risk of postoperative complications in patients operatively treated for an ankle fracture. Smoking is a considerable risk factor. Therefore, physicians, nurses, and other healthcare professionals should strive to support patients to stop smoking while still under acute treatment.
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Curto A, Martínez-Sánchez JM, Fernández E. Tobacco consumption and secondhand smoke exposure in vehicles: a cross-sectional study. BMJ Open 2011; 1:e000418. [PMID: 22119753 PMCID: PMC3225587 DOI: 10.1136/bmjopen-2011-000418] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 10/31/2011] [Indexed: 11/29/2022] Open
Abstract
Objectives To estimate the prevalence of tobacco consumption and secondhand smoke (SHS) exposure in private cars, commercial vehicles and taxis in the city of Barcelona in Spain. Design setting and participants We carried out an observational cross-sectional study in 2011. We selected a systematic sample of 2442 private cars, commercial vehicles and taxis on 40 public roads regulated by traffic lights in all 10 districts of Barcelona. We calculated the prevalence rates and 95% CIs of smoking and SHS exposure in cars, and the corresponding ORs adjusting for the potential confounding variables. Results The prevalence of tobacco consumption was 5.5% (95% CI 4.6% to 6.4%) and was greater for commercial vehicles (9.8%; 95% CI 7.1% to 12.5%). The prevalence of SHS exposure was 5.2% (95% CI 3.8% to 6.6%) and 2.2% (95% CI 0.5% to 3.9%) of passengers under 14 years of age were exposed to SHS in vehicles. Conclusions This study highlights the need to promote public health measures aimed at reducing tobacco consumption in vehicles, especially in the presence of children, as well as enforcement of the current Spanish law against smoking in commercial vehicles and taxis.
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Affiliation(s)
- Ariadna Curto
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jose M Martínez-Sánchez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain
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Thornley S, Kool B, Robinson E, Marshall R, Smith GS, Ameratunga S. Alcohol and risk of admission to hospital for unintentional cutting or piercing injuries at home: a population-based case-crossover study. BMC Public Health 2011; 11:852. [PMID: 22070787 PMCID: PMC3247204 DOI: 10.1186/1471-2458-11-852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 11/09/2011] [Indexed: 11/30/2022] Open
Abstract
Background Cutting and piercing injuries are among the leading causes of unintentional injury morbidity in developed countries. In New Zealand, cutting and piercing are second only to falls as the most frequent cause of unintentional home injuries resulting in admissions to hospital among people aged 20 to 64 years. Alcohol intake is known to be associated with many other types of injury. We used a case-crossover study to investigate the role of acute alcohol use (i.e., drinking during the previous 6 h) in unintentional cutting or piercing injuries at home. Methods A population-based case-crossover study was conducted. We identified all people aged 20 to 64 years, resident in one of three regions of the country (Greater Auckland, Waikato and Otago), who were admitted to public hospital within 48 h of an unintentional non-occupational cutting or piercing injury sustained at home (theirs or another's) from August 2008 to December 2009. The main exposure of interest was use of alcohol in the 6-hour period before the injury occurred and the corresponding time intervals 24 h before, and 1 week before, the injury. Other information was collected on known and potential confounders. Information was obtained during face-to-face interviews with cases, and through review of their medical charts. Results Of the 356 participants, 71% were male, and a third sustained injuries from contact with glass. After adjustment for other paired exposures, the odds ratio for injury after consuming 1 to 3 standard drinks of alcohol during the 6-hour period before the injury (compared to the day before), compared to none, was 1.77 (95% confidence interval 0.84 to 3.74), and for four or more drinks was 8.68 (95% confidence interval 3.11 to 24.3). Smokers had higher alcohol-related risks than non-smokers. Conclusions Alcohol consumption increases the odds of unintentional cutting or piercing injury occurring at home and this risk increases with higher levels of drinking.
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Affiliation(s)
- Simon Thornley
- Section of Epidemiology & Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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Rumberger JS, Hollenbeak CS. Potential Costs and Benefits of Statewide Smoking Cessation in Pennsylvania. J Smok Cessat 2011. [DOI: 10.1375/jsc.6.1.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AbstractObjectives:To determine whether the cost of a statewide smoking cessation program in Pennsylvania could be justified by the benefits.Methods:A cost-benefit analysis of statewide access to smoking cessation programs. We compared three treatment alternatives, both with and without counselling: nicotine replacement therapy, bupropion and varenicline.Results:While the retail price of a pack of cigarettes in Pennsylvania is on average US$4.72, the combined medical costs and productivity losses in Pennsylvania attributable to each pack of cigarettes sold are approximately US$23.78 per pack of cigarettes. The ratio of benefits to cost varied from US$0.97 to US$2.76 saved per dollar spent on smoking cessation programs, depending upon the type of intervention.Conclusions:For most smoking cessation treatments, the benefits of a statewide smoking cessation program in Pennsylvania would greatly outweigh its costs.
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Saadat S, Karbakhsh M. Association of waterpipe smoking and road traffic crashes. BMC Public Health 2010; 10:639. [PMID: 20969795 PMCID: PMC2978152 DOI: 10.1186/1471-2458-10-639] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Accepted: 10/23/2010] [Indexed: 11/21/2022] Open
Abstract
Background The purpose of this research was to examine whether waterpipe smokers experience increased risk of motor vehicle crashes. Methods In a telephone survey, a random sample of Iranian drivers were asked to report their age, gender, vehicle age, whether their vehicles were equipped with anti-lock braking system (ABS), average daily drive time (DDT), whether they smoked cigarette or waterpipe, whether they had diabetes mellitus (DM), number of traffic crashes during the last calendar year and whether the crash involved a pedestrian or another vehicle. Results A total of 2070 motor vehicle owners with the mean age of 41.6 ± 11.45 were interviewed. The annual incidence of Road Traffic Crashes (RTC) was 14.9%; 14.0% involved a collision/s with other vehicles and 0.9% with pedestrians. There was an association between the RTC and male gender, DDT, being a cigarette smoker, being a waterpipe smoker and DM in univariable analysis. The association between RTC and being a waterpipe smoker and also cigarette smoker was significant in multivariable analysis after adjustment for DDT. Conclusions Being waterpipe and/or cigarette smoker and DDT were the independent predictors of the number of traffic crashes in Poisson regression model. If the increased risk of RTC among waterpipe or cigarette smokers is seen in other studies, it would be beneficial to promote tobacco cessation and control strategies through injury prevention initiatives.
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Affiliation(s)
- Soheil Saadat
- Sina Trauma Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Clarke DE, Eaton WW, Petronis KR, Ko JY, Chatterjee A, Anthony JC. Increased risk of suicidal ideation in smokers and former smokers compared to never smokers: evidence from the Baltimore ECA follow-up study. Suicide Life Threat Behav 2010; 40:307-18. [PMID: 20822357 PMCID: PMC2936702 DOI: 10.1521/suli.2010.40.4.307] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The incidence rate of suicidal ideation among current and former smokers versus never smokers is not known. In this study, the age-adjusted incidence of suicidal ideation was highest among current smokers, followed by former, then never smokers. The adjusted hazard for suicide ideation was 2.22 (95%CI = 1.48, 3.33) and 1.19 (95%CI = 0.78, 1.82) for current and former smokers, respectively, compared to never smokers. Results indicate that current smokers have increased risks of suicidal ideation above and beyond the risk for never and former smokers regardless of age, gender, history of depressive disorder or anxiety symptoms, and alcohol abuse/dependence. Smoking cessation might be beneficial for some suicide prevention efforts.
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Affiliation(s)
- Diana E. Clarke
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD
| | - William W. Eaton
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD
| | | | - Jean Y. Ko
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD
| | | | - James C. Anthony
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, Department of Epidemiology, Michigan State University, East Lansing, MI
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Do YK, Park K. Local governments' dependence on tobacco tax revenue: a deterrent to tobacco control in the Republic of Korea. Bull World Health Organ 2009; 87:692-9. [PMID: 19784449 PMCID: PMC2739912 DOI: 10.2471/blt.08.056051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Revised: 12/20/2008] [Accepted: 01/04/2009] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To investigate, in the Republic of Korea, whether local governments' participation in an anti-smoking programme supported by the National Health Promotion Fund in 2002-2003 was related to the percentage of local tax revenue comprised by the tobacco consumption tax (TCT). METHODS Using financial and administrative data on 163 municipalities, the authors estimated logit models of local governments' participation in the anti-smoking programme as a function of the proportion of local tax revenue that came from the TCT and a set of control variables, namely local socioeconomic characteristics and the size of the staff in the local public health centre (PHC). FINDINGS Local governments that derived a greater percentage of their local tax revenue from the TCT, particularly those that ranked in the upper fourth in terms of this percentage, were less likely to participate in the anti-smoking programme. Insufficient staff in the PHC was also found to be associated with lower participation in the anti-smoking programme. CONCLUSION Local governments' dependence on revenue from the TCT may be a deterrent to tobacco control in the Republic of Korea.
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Affiliation(s)
- Young Kyung Do
- Walter H Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, CA 94305-6055, United States of America.
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Schenker MB, Pinkerton KE, Mitchell D, Vallyathan V, Elvine-Kreis B, Green FHY. Pneumoconiosis from agricultural dust exposure among young California farmworkers. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:988-94. [PMID: 19590695 PMCID: PMC2702418 DOI: 10.1289/ehp.0800144] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 02/25/2009] [Indexed: 05/11/2023]
Abstract
BACKGROUND Agricultural workers are exposed to airborne pollutants, including organic and inorganic (mineral) dusts. OBJECTIVES Lung autopsy specimens from consecutive coroner's cases of Hispanic males in Fresno County, California, (n = 112) were obtained to determine whether mineral dust exposure in agricultural work leads to pneumoconiosis. METHODS The left lung was fixed by inflation. We evaluated airway and parenchymal pathology using standardized diagnostic criteria and semiquantitative grading schemata, including the grading of small airways for fibrosis and birefringent mineral dust particles. We analyzed lung dust burden on a subset of 37 lungs following bleach digestion, using scanning electron microscopy (SEM), X-ray spectrometry (XRS) and image analysis, and by X-ray diffraction for crystalline silica (CSi). Farmworkers comprised 51.5% and nonfarmworkers 48.5% of the samples. RESULTS Proximal airways demonstrated little mineral dust accumulation, but membranous and respiratory bronchioles had wall thickening, remodeling, and inflammation associated with carbonaceous and mineral dust deposition. These changes were independently associated with agricultural work, cigarette smoking, and increased age. Mineral dust small airways disease, pneumoconiosis (macules and nodules), and pathologic changes consistent with chronic bronchitis, emphysema, and interstitial fibrosis predominated in farmworkers compared with nonfarmworkers. CSi, determined gravimetrically, and aluminum silicate particles, determined by SEM/XRS, were increased in the lungs of farmworkers compared with nonfarmworkers and were significantly (p < 0.05) associated with small airway disease and pneumoconiosis. CONCLUSION Mineral dust exposure is associated with increased small airway disease and pneumoconiosis among California farmworkers; however, the clinical significance and natural history of these changes remains to be determined.
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Affiliation(s)
- Marc B Schenker
- Department of Public Health Sciences, University of California at Davis, Davis, California 95616, USA.
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Tsai SP, Wen CP, Chan HT, Chiang PH, Tsai MK, Cheng TYD. The effects of pre-disease risk factors within metabolic syndrome on all-cause and cardiovascular disease mortality. Diabetes Res Clin Pract 2008; 82:148-56. [PMID: 18757109 DOI: 10.1016/j.diabres.2008.07.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 06/02/2008] [Accepted: 07/13/2008] [Indexed: 11/24/2022]
Abstract
The metabolic syndrome has been criticized for being "polluted with the inclusion of frank "diseases" with "pre-diseases". We assessed the effect of a single and a combination of "pre-disease" risk factors of metabolic syndrome on the overall and cardiovascular disease (CVD) mortality. These pre-disease risk factors included pre-diabetes, pre-hypertension, overweight and borderline hypertriglycerdemia and were defined as: fasting glucose at 110-125 mg/dL, systolic blood pressure at 120-139 mmHg, body mass index at 25-29.9 kg/m(2) and serum triglyceride at 150-199 mg/dL, respectively. The metabolic syndrome in this paper was based on the version defined by the ATP III. The cohort consisted of 35,259 adults (>==40 years) with a medium follow-up of 15 years. Relative risks (RRs) for all-causes, CVD and "CVD plus diabetes" mortality were calculated with the Cox proportional hazards model. Prevalence of the pre-disease risk factors (40.2%) was nearly four times larger than the metabolic syndrome (10.6%). Individual pre-disease risk factor was associated with significant increases of 13% and 67% (pre-diabetes), 22% and 62% (pre-hypertension), 23% and 32% (overweight) and 17% and 46% (borderline hypertriglyceridemia) on all-cause and "CVD plus diabetes" mortality, respectively. Smoking had comparable risks as "pre-diseases", and, as such, should also be considered as the fifth "pre-disease". Like metabolic syndrome, each "Pre-disease" is a major and significant risk factor for all cause and cardiovascular mortality, but unlike metabolic syndrome, the definition or clinical follow up of "Pre-disease" is simple and straightforward. Recognizing each of the four "pre-disease" as a clinical entity, a hitherto sub-clinical status but involving significantly increased mortality, can alert and justify early intervention through changing lifestyle and modifying biologic risk factors.
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Affiliation(s)
- Shan Pou Tsai
- University of Texas, School of Public Health, Houston, TX, USA
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Iacobelli N, Gallus S, Petridou E, Zuccaro P, Colombo P, Pacifici R, La Vecchia C, Negri E. Smoking behaviors and perceived risk of injuries in Italy, 2007. Prev Med 2008; 47:123-6. [PMID: 18501413 DOI: 10.1016/j.ypmed.2008.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Revised: 04/01/2008] [Accepted: 04/08/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Apart from cancer, cardiovascular and respiratory diseases, smoking is associated with an increased risk of accidents and injuries. Many of these can be accounted for by dangerous smoking behaviors such as smoking in bed or while driving. We estimated therefore the prevalence of these hazardous smoking behaviors and the perceived risk of accidents associated with them in Italy. METHODS Data were derived by a survey on smoking on 3057 subjects, representative of the Italian population aged > or =15 years. Specific questions were included on prevalence and risk perception of smoking while driving or in bed. RESULTS Of all current smokers (23.5% of the Italian population), 12% reported smoking while in bed, 69% reported smoking while driving a car, and 17% reported smoking while driving a motorcycle. Predictors of smoking while driving were younger age, male sex, and being a heavy smoker. Of the total population, 81% reported that smoking while driving increased the risk of accident, but public perception was lower in men, the young, current smokers, and among the subjects engaging in these behaviors. About 7% of car injuries in Italy could involve a subject who smokes while driving. CONCLUSION Efforts should be taken, therefore, to disseminate knowledge about the smoking behaviors associated to high risk of injuries.
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Affiliation(s)
- Nick Iacobelli
- Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, 20156 Milan, Italy
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Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Public Health Nutr 2008; 12:497-506. [PMID: 18547457 DOI: 10.1017/s1368980008002802] [Citation(s) in RCA: 391] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To assess whether overweight Asians, assessed on the basis of WHO criteria, are at greater mortality risk than overweight Caucasians, and to determine whether alternative cut-off points (BMI = 23.0-24.9 kg/m2 for overweight and BMI >or= 25.0 kg/m2 for obesity) suggested by the WHO Western Pacific Regional Office are appropriate. DESIGN The cohort was followed prospectively until the end of 2001. All-cause and CVD mortality risks of the overweight and obese group, relative to the reference group (BMI = 18.5-24.9 or 18.5-22.9 kg/m2), were assessed using Cox regression analysis, adjusting for age, smoking and gender. Excess deaths were estimated with a method proposed by the US Centers for Disease Control and Prevention. SETTING National Health Interview Survey (NHIS 2001) and a middle-aged perspective cohort in Taiwan. SUBJECTS Subjects comprised 36 386 civil servants and school teachers, aged 40 years and older, who underwent a medical examination during 1989-1992. RESULTS In the WHO-defined overweight group, Asians showed a significant increase in all-cause mortality risk compared with Caucasians. Asians showed risks equivalent to Caucasians' at lower BMI (around 5 units). Every unit of BMI increase, at 25.0 kg/m2 or above, was associated with a 9 % increase in relative mortality risk from all causes. Applying a cut-off point of 25.0 kg/m2 for obesity would result a prevalence of 27.1 %, while the traditional WHO cut-off point of 30.0 kg/m2 yielded obesity prevalence of 4.1 %. Excess deaths due to obesity accounted for 8.6 % of all deaths and 21.1 % of CVD deaths, based on the alternative cut-offs. CONCLUSIONS In this Asian population, significant mortality risks started at BMI >or= 25.0 kg/m2, rather than at BMI >or= 30.0 kg/m2. The study supports the use of BMI >or= 25.0 kg/m2 as a new cut-off point for obesity and BMI = 23.0-24.9 kg/m2 for overweight. The magnitude of obesity-attributable deaths has been hitherto under-appreciated among Asians.
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Hutchens L, Senserrick TM, Jamieson PE, Romer D, Winston FK. Teen driver crash risk and associations with smoking and drowsy driving. ACCIDENT; ANALYSIS AND PREVENTION 2008; 40:869-876. [PMID: 18460353 DOI: 10.1016/j.aap.2007.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Revised: 08/08/2007] [Accepted: 10/03/2007] [Indexed: 05/26/2023]
Abstract
Motor vehicle crashes are the leading cause of death for young people in the United States. The goal of this study was to identify risk factor profiles of teen and young adult drivers involved in crashes. General demographic and behavioral as well as driving-related factors were considered. Analysis of a nationally representative telephone survey of U.S. young drivers ages 14 to 22 (N=900) conducted in 2005 was restricted to 506 licensed drivers (learners excluded). Statistically significant univariate associations between factors of interest and the primary outcome, crash involvement (ever) as a driver, were identified and included within a multivariate logistic regression model, controlling for potential demographic confounders. Aside from length of licensure, only driving alone while drowsy and being a current smoker were associated with having been in a crash. Gaining a better understanding of these behaviors could enhance the development of more customized interventions for new drivers.
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Affiliation(s)
- Lauren Hutchens
- Center for Injury Research and Prevention (formerly TraumaLink), The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
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Janse Van Rensburg K, Taylor AH. The effects of acute exercise on cognitive functioning and cigarette cravings during temporary abstinence from smoking. Hum Psychopharmacol 2008; 23:193-9. [PMID: 18219623 DOI: 10.1002/hup.925] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Abstinence from smoking is associated with increased cravings, risk of accidents and self-reported poor concentration. A single exercise session can reduce cravings and self-reported poor concentration and can enhance cognitive performance among non-smokers. OBJECTIVE To assess whether acute exercise impacts on the cognitive performance and cravings of abstaining smokers. METHODS In a counterbalanced cross-over design, participants (n = 23) did a 15 min passive or exercise condition, following cigarette abstinence. Cognitive functioning was measured by a computerised version of the Stroop colour-word interference task. Cravings were measured using the 10-item, 2-factor QSU-Brief and a single item for 'desire to smoke'. Measures were recorded at baseline, immediately post, 5, 10 and 15-min post treatment. RESULTS A 2-way ANOVA showed no significant condition x time interaction for cognitive functioning. Significant interaction effects were found for desire to smoke, QSU Factor 1 (desire-behave) and 2 (desire-affect). Exercise reduced cravings for up to 15 min post treatment. DISCUSSION Findings support previous research that acute exercise reduces cravings to smoke. Future research should determine if exercise can enhance other objective aspects of cognitive performance, and repeat the present study with a more homogeneous sample, in terms of Stroop performance. CONCLUSION This is the first study to show that exercise can reduce both factors of the QSU-Brief, but effects on cognitive functioning were not observed.
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Respiratory Effects of Secondhand Smoke Exposure Among Young Adults Residing in a “Clean” Indoor Air State. J Community Health 2008; 33:117-25. [DOI: 10.1007/s10900-007-9076-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ryb GE, Dischinger P, Kufera J, Soderstrom C. Smoking is a marker of risky behaviors independent of substance abuse in injured drivers. TRAFFIC INJURY PREVENTION 2007; 8:248-52. [PMID: 17710714 DOI: 10.1080/15389580701272353] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Smoking has been linked to disease and injury. The purpose of this study is to investigate the smoking habits of motor vehicular driver trauma center patients and their association with previous injury history and risky behaviors. METHODS The studied population included 323 motor vehicular driver injury patients (123 smokers and 200 non-smokers) interviewed as part of a larger study of psychoactive substance use disorders at an adult Level I trauma center. Patients with head injuries, hospital stays of less than two days, and diminished cognition were excluded. Interviews included demographics (age, gender, race, marital status), socioeconomic status (SES; income, education, employment), risky behaviors (seatbelt non-use, drinking and driving, riding with drunk driver, binge drinking), and trauma history information (vehicular, assault, and other injuries). Substance abuse (alcohol and drug dependence) was evaluated in depth using DSM III-R criteria. Smokers and non-smokers were compared in relation to control and dependent variables using student's t test and chi-square (alpha = 0.05). Outcome variables included previous trauma history and risky behaviors. Multiple logistic regression models using step-down selection methods (alpha = 0.05) were constructed with risky behaviors and trauma history as dependent variables including demographics, SES and substance as independent variables. RESULTS Smokers represented 38 percent of the 323 patients studied. Smokers (n = 123) were younger (34 vs. 43 years), more likely to be male (72 percent vs. 50 percent), not married (72 percent vs. 56 percent), and had higher rates of alcohol (29 percent vs. 9 percent) and drug dependence (14 percent vs. 3 percent) than non-smokers (n = 200). Educational achievement (20 percent vs. 15 percent less than high school) and income level (24 percent vs. 23 percent with less than $15,000 of yearly income) were not different between smokers and non-smokers. Smokers were more likely than non-smokers to have a history of prior vehicular trauma (48 percent vs. 26 percent), assault (25 percent vs. 9 percent), or other injury (50 percent vs 37 percent). The following injury-prone behaviors were also more common among the smokers than non-smokers: seatbelt non-use (49 percent vs. 29 percent), drinking and driving (38 percent vs. 15 percent), riding with drunk driver (38 percent vs. 13 percent), and binge drinking (68 percent vs. 26 percent). In multiple logistic regression models adjusting for demographics, SES, and substance abuse, smoking revealed significantly higher odds ratios (OR) for the following dependent variables: seatbelt non-use (OR = 2.9), riding with drunk driver (OR = 2.2), binge drinking (OR = 2.4), previous vehicular (OR = 2.0), and assault injuries (OR = 2.5). Smoking did not reach significance for drinking and driving and other (non-vehicular and non-assault) injury. CONCLUSION Smoking is independently associated with risky behaviors and repeated history of vehicular or assault injury within the vehicular trauma population.
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Affiliation(s)
- Gabriel E Ryb
- The Charles Mc C Mathias, Jr National Study Center for Trauma and EMS, University of Maryland, Baltimore, MD, USA.
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Nakata A, Ikeda T, Takahashi M, Haratani T, Hojou M, Fujioka Y, Araki S. Non-fatal occupational injury among active and passive smokers in small- and medium-scale manufacturing enterprises in Japan. Soc Sci Med 2006; 63:2452-63. [PMID: 16867309 DOI: 10.1016/j.socscimed.2006.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2005] [Indexed: 11/18/2022]
Abstract
Active smoking is a risk factor for occupational injury, whereas its association with passive smoking is unknown. To evaluate the contribution of active and passive smoking to non-fatal occupational injury in manufacturing sectors, 2302 randomly selected workers aged 16-83 years working in 244 small- and medium-scale enterprises in Yashio city, Japan, were surveyed by means of a self-administered questionnaire. Smoking history, exposure to passive smoking, and occupational injury were evaluated by self-report. Exposure levels to passive smoking were assessed separately at work and at home as never, occasional, or regular exposure. Overall, 61.4% of men and 22.3% of women were current smokers. Among never smokers, 62.2% of men and 68.6% of women reported exposure to passive smoking either at work or home. Prevalence of occupational injuries was 36.2% for never, 43.3% for former, and 41.2% for current smokers among men and 19.7% for never, 22.2% for former, and 25.2% for current smokers among women. Among never smoking men, odds ratios (ORs) of occupational injury were 2.11 when regularly exposed to passive smoking at work or at home (p=0.025), 2.27 at work (p=0.015), and 3.08 at home (p=0.106), in comparison to never smoking men who were never exposed to passive smoking either at work or at home (referent group). These associations were attenuated to be non-significant, after controlling for potential confounders. Never smoking men with occasional exposure to passive smoking were not significant ORs (1.11-1.19). In contrast, current and former smoking men had significant increases in adjusted ORs (1.57-2.00). In women exposed to smoking there was a non-significant increase in occupational injury. The present study indicates an expected increase in the risk of, occupational injury for current and former smoking men and suggests that exposure to passive smoking is a possible risk factor for never smoking men.
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Affiliation(s)
- Akinori Nakata
- National Institute of Occupational Safety and Health, Japan.
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Martin J, George R, Andrews K, Barr P, Bicknell D, Insull E, Knox C, Liu J, Naqshband M, Romeril K, Wong D, Thomson G, Wilson N. Observed smoking in cars: a method and differences by socioeconomic area. Tob Control 2006; 15:409-11. [PMID: 16998177 PMCID: PMC2563644 DOI: 10.1136/tc.2006.015974] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To establish a reproducible method to estimate he point prevalence of smoking and second-hand smoke (SHS) exposure in cars, and to compare this prevalence between two areas of contrasting socioeconomic status. METHOD A method involving two teams of observers was developed and evaluated. It involved observing 16,055 cars in Wellington, New Zealand. Two of the observation sites represented a high and a low area of deprivation (based on a neighbourhood deprivation index) and three were in the central city. RESULTS A 4.1% point prevalence of smoking in cars was observed (95% confidence interval (CI) 3.8% to 4.4%). There was a higher prevalence of smoking in cars in the high deprivation area relative to the other sites, and particularly compared to the low deprivation area (rate ratio relative to the latter 3.2, 95% CI 2.6 to 4.0). Of cars with smoking, 23.7% had other occupants being exposed to SHS. Cars with smoking and other occupants were significantly more likely to have a window open (especially if the smoker was not the driver). The observation method developed was practical, and inter-observer agreement was high (kappa value for the "smoking seen in car" category 0.95). CONCLUSIONS Observational studies can be an effective way of investigating smoking in cars. The data from this survey suggest that smoking in cars occurs at a higher rate in relatively deprived populations and hence may contribute to health inequalities. Fortunately, there are a number of policy options for reducing SHS exposure in cars including mass media campaigns and laws for smoke-free cars.
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Affiliation(s)
- Josh Martin
- Department of Public Health, Wellington School of Medicine & Health Sciences, Otago University, Wellington South, New Zealand
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Jalleh G, Donovan RJ, Stewart S, Sullivan D. Is there public support for banning smoking in motor vehicles? Tob Control 2006; 15:71. [PMID: 16436414 PMCID: PMC2563616 DOI: 10.1136/tc.2005.014308] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wen CP, Tsai SP, Chen CJ, Cheng TY, Tsai MC, Levy DT. Smoking attributable mortality for Taiwan and its projection to 2020 under different smoking scenarios. Tob Control 2005; 14 Suppl 1:i76-80. [PMID: 15923454 PMCID: PMC1766186 DOI: 10.1136/tc.2004.007955] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To estimate smoking attributable mortality (SAM) in Taiwan for the years 2001 through 2020 under scenarios of reductions in smoking rates by 0%, 2%, 4%, and 10% per year. METHOD The smoking attributable fraction (SAF) was used to calculate SAM from the risk experience in following up a large cohort (86 580 people) in Taiwan. Smoking rates were based on the 2001 National Health Interview Survey and other national surveys. An average 10 year lag was assumed between smoking rates and subsequent mortality. RESULTS In 2001, 18 803 deaths, or 1 out of 4 deaths (27%), in middle aged men (35-69 years old) were attributable to smoking. SAM has been increasing and will continue to increase if smoking rates remain constant or even if reduced annually by 2%. SAM would begin to decrease only if rates were to be reduced by at least 4% a year. CONCLUSIONS The projected SAM in this study illustrates the seriousness of smoking caused mortality. Current efforts in tobacco control would lead to a progressive increase in SAM, unless efforts were doubled and smoking rates reduced by more than 4% a year. The urgency in requiring stronger tobacco control programmes to attenuate the staggering death tolls is compelling.
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Affiliation(s)
- C P Wen
- Division of Health Policy Research, National Health Research Institutes, Taipei, Taiwan.
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