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Tobacco
Health Effects of Exposure to
Environmental Tobacco Smoke

TABLE 7.1



EXPOSURE TO SPOUSE'S SMOKING AND RELATIVE RISK (RR)
OF ALL CANCERS IN ADULTS


Cohort Studies # Cases Exposure to RR (95% CI) for
Passive Smoking Spouse's Smoking

Hirayama, 1984 Husband's smoking
All cancers
a 634 Nonsmoking 1.00
1341 Ex-/1-19/day 1.12 (1.03 - 1.21)
b
730 20+/day 1.23 (1.12 - 1.35)

Sandler et al., 1989 Males Household smoking
All cancers
a 84 No 1.0
31 Yes 1.01 (0.66 - 1.53)
Females
211 No 1.00
290 Yes 1.00 (0.82 - 1.21)
All cancers classified as:

Smoking-related cancers Males
24 No 1.0
8 Yes 0.96 (0.43 - 2.62)
Females
27 No 1.0
49 Yes 1.45 (0.88 - 2.40)

Other cancers Males
60 No 1.0
23 Yes 1.03 (0.40 - 2.62)
Females
184 No 1.0
241 Yes 0.93 (0.76 - 1.54)

Reynold et al., 1987 Husband's smoking
All cancers
a 71c No 1.00
Yes 1.68 (1.12 - 1.5)
b
Smoking-related cancers 4
c No 1.00
Yes 7.01 (1.05 - 47.0)

a There were 200 lung cancers in Hirayama (1984); 2 lung cancers in Sandler et al., 1989;
and an unspecified number in Reynold et al., 1987.

b 90% CI confidence intervals.

c The distribution of the 71 cancers by husband's smoking was not presented; the specific
cancer sites were not presented.

TABLE 7.2A

 

HAIR CONCENTRATIONS OF NICOTINE AND COTININE IN
WOMEN AND THEIR NEWBORN INFANTS

Mean (SEM)* Mean (SEM)
Concentration of Concentration of
Nicotine (ng/ml) Cotinine (ng/ml)

Active smoking women (n=36) 19.2 (4.9) 6.3 (4.0)

Newborn of active smoking women 2.4 (0.9) 2.8 (0.8)

 

Passive smoking womena (n=23) 3.2 (0.8) 0.9 (0.3)

Newborn of passive smoking women 0.28 (0.05) 0.6 (0.15)b

 

Nonsmoking women (n=35) 1.2 (0.4) 0.3 (0.06)

Newborn of nonsmoking women 0.4 (0.09) 0.26 (0.04)

Reference: Eliopoulos et al. (1994)

 

a Defined as regular and steady gestational exposure to other person’s cigarette smoke, either at home or in the workplace.

b p< 0.01 when compared to newborns of active smoking women and newborns of nonsmokers.

 

* (SEM) = Standard error of the mean.

 

TABLE 7.2B

4-AMINOBIPHENYL HEMOGLOBIN ADDUCT CONCENTRATIONS IN PREGNANT WOMEN AND FETUSES BY EXPOSURE TO TOBACCO SMOKE

 

Mean Standard

Concentration Deviation

(pg/g of hemoglobin)


Nonsmoking pregnant women
a (n=40) 22 8
Smoking pregnant women (n=15) 183 108

Nonsmoking women by levels of
exposure to passive smoking based
on nicotine concentrations
b,c

g/m3
<0.5 (n = 7) 17.6 2.4
0.5 - 1.9 (n = 20) 20.8 2.0
>2.0 (n = 9) 27.8 1.4

Fetuses of nonsmoking mothers
b (n = 40) 17 13
Fetuses of smoking mothers (n=16) 92 54

a Reference: Coghlin et al. (1991)

b Reference: Hammond et al. (1993)

c This represented weekly average nicotine concentrations measured during the third trimester when each subject wore a lightweight monitor. Nonsmoking women in this study were the same nonsmoking pregnant women reported in Coghlin et al. 1991.

TABLE 7.2C

 

COTININE AND PAH-ALBUMIN LEVELS IN MOTHERS

AND THEIR PRESCHOOL CHILDREN

 

 

Mean (SE)* Mean (SE) PAH-

Cotinine (ng/ml) albumin (fmol/m g)

Level Level

Active smoking women (n=31) 170 (21.2) 0.80 (0.15)

Preschool children of 4.14 (0.54) 0.35 (0.07)

active smoking women

 

Passive smoking womena (n=32) 1.64 (0.97) 0.49 (0.08)

Preschool children of 0.87 (0.20)b 0.18 (0.04)c

passive smoking women

 

Nonsmoking women (n=24) 0.96 (0.79) 0.31 (0.08)

Preschool children of 0.25 (0.12) 0.15 (0.02)

non-smoking women

Reference: Crawford et al. (1994)

 

Abbreviations: PAH = polyaromatic hydrocarbon; SE = standard error

 

a Exposure to ETS at home from other household members and visitors.

b Levels in preschool children in households with ETS exposure were significantly higher
(p <0.01) than those in children in nonsmoking households.

c Levels in preschool children in households with ETS exposure were not significantly higher than those in children in nonsmoking households.

 

* (SE) = Standard error

TABLE 7.3

MATERNAL SMOKING DURING INDEX PREGNANCY AND RISK OF
ALL CHILDHOOD CANCERS COMBINED

 


Cohort Studies # Cases Smoking Odds Ratio (95% CI)

(Age of Subjects) Habits for Maternal Smoking
(cig/day)

Neutel and Buck, 1970 34 No 1.0
(Age <10) 30 Yes 1.3 (0.8 - 2.2)

Pershagen et al., 1992 230 No 1.0
(Age <5) 61 <10 1.04 (0.8 - 1.4)
36 >10 0.92 (0.6 - 1.3)


Case-Control # Cases/ Smoking Odds Ratio (95% CI)

Studies # Controls Habits for Maternal Smoking
(Age of Subjects) (cig/day)


Stjernfeldt et al., 1986 177/220 0 1.0
(Age <16) 30/35 1-9 1.07 (0.6 - 1.8)
73/58 10+ 1.56 (1.1 - 2.3)

McKinney et al., 1986 555/1100
a 0 1.0
(Age <15) 1-10 1.12 (0.9 - 1.5)
11+ 0.84 (0.7 - 1.1)

Buckley et al., 1986 1814/720
a 0 1.0
(Age <15) 1-9 1.31 (0.9 - 1.9)
10+ 0.97 (0.8 - 1.2)

Golding et al., 1990
b 13/61 <5 1.0
(Age <10) 20/38 >5 2.47 (1.2 - 5.1)

John et al., 1991 223/196
a 0 1.0
(Age <14) 1-10 1.4 (0.7 - 2.7)
11+ 1.5 (0.8 - 2.7)

a Numbers represent total cases/controls. Case/control distribution of maternal smoking by case/control status was not presented.

b Case-cohort study.

TABLE 7.4
STUDY CHARACTERISTICS OF THE FOUR U.S. CASE-CONTROL STUDIES
OF LUNG CANCER AND ETS PUBLISHED SINCE 1991

 

  Stockwell et al. (1992) Brownson et al. (1992) Fontham et al.
(1994)
Kabat et al.
(1995)
Area

 

Central Florida Missouri 5 U.S. metropolitan areas 4 U.S. cities
Accrual Period 1987-1991 1986-1991 1985-1991 1983-1990
Sample size1
cases
controls
 

210 (F)
301 (F)

 

432 (F)
1166 (F)

 

653 (F)
1253 (F)

 

69 (F), 41 (M)
187 (F), 117 (M)

 

Ages NA (% by birth year
groupings provided)
30-84 20-79 not specified
Source of cases
Florida Cancer
Registry
Missouri Cancer
Registry
All hospital/registries in specific geographic areas
6 hospitals in the
4 cities
Source of controls
RDD DMV, HCFA RDD, HCFA other hospital
patients
Matching variables of lifetime nonsmoking controls NA age age, area, & ethnicity
age, race, hospital,
date of interview
Percent of self-respondents

cases

controls

 

 

33
100

 

 

34*
100

 

 

63
100

 

 

100
100

Mode of data collection in-person, telephone, mailed questionnaires telephone in-person in-person
% Histologic confirmation

 

100% 76%** 100%** 100%
% adenocarcinoma

 

61% 66% 76% NA
Definition of lifetime nonsmoker smoked for a total of < 6 months or <100 cigarettes in their lifetime not described <100 cigarettes, no use of other tobacco for> 6 mos <365 cigarettes over lifetime
Verification of nonsmoking status multistep- medical record, physician, at initial contact & interview at interview multistep- medical record, physician, at initial contact & interview at interview
Biological markers
none none urinary cotinine none

 

1 Sample size of lifetime nonsmokers in study

* presented for nonsmokers and ex-smokers combined

** confirmed by independent histologic review

Abbreviations: F-females, M-males, NA-not available, RDD-random digit dialing,

DMV-Department of Motor Vehicle, HCFA-Health Care Financing Administration

TABLE 7.5

ASSOCIATION BETWEEN RISK OF LUNG CANCER IN LIFETIME NONSMOKING FEMALES
AND EXPOSURE TO SPOUSAL SMOKING

 

 

 

Study

 

 

Exposure Status

Adjusted
Odds ratio
(95% CI)
for exposed

 

Years exposed /
Amount smoked
by spouse

Odds ratio
(95% CI)
for yrs exp/amt smoked by spouse

 

Stockwell et al. (1992)

 

Spouse smoked a

no

yes

 

 

AOR a

1.0

1.6 (0.8-3.0)

 

Smoke-years in adult

household (spouse and others) a

< 22

23-39

40+

 

AOR a

1.6 (0.8-3.2)

1.4 (0.7-2.9)

2.4 (1.1-5.3)

 

Brownson et al. (1992)

 

Spouse smoked Cases* Controls*

never 213 568

ever 218 598

 

 

 

AOR b

1.0

1.0 (0.8-1.2)

 

Cigarette

pack-years cases controls

0 213 568

0-15 32 128

15-40 54 200

40+ 110 216

 

AOR b

1.0

0.7 (0.5-1.1)

0.7 (0.5-1.0)

1.3 (1.0-1.7)

 

 

Fontham et al. (1994)

Spouse cases exposed/ controls exp

smoked total cases /total controls

any type

tobacco 433/651 766/1253

cigarettes 366/648 691/1253

cigars 85/641 138/1253

pipes 86/640 158/1253

 

 

AOR c

1.29 (1.04-1.60)

1.18 (0.96-1.46)

1.25 (0.92-1.71)

1.19 (0.88-1.60)

By pack-years of exposure

to spouses cases* controls*

0 267 562

< 15.0 146 300

15.1- 39.9 92 190

40.0-79.9 80 126

80.0+ 24 27

 

AOR c

1.00

1.08 (0.86-1.39)

1.04 (0.76-1.42)

1.36 (0.97-1.91)

1.79 (0.99-3.25)

 

Kabat et al. (1995)

Males

Spouse smoked: cases/controls*

no 28 / 79

yes 11 / 19

Females

Spouse smoked: cases/controls*

no 26 / 71

yes 41 / 102

 

AOR d

1.0

1.60 (0.67-3.82)

 

 

1.0

1.08 (0.60-1.94)

Males

Spouse smoked: cases/controls*

1-10 cigs/day 5 / 17

11+ cigs/day 5 / 2

Females

Spouse smoked: cases/controls*

1-10 cigs/day 17 / 50

11+ cigs/day 12 / 28

 

AOR d

0.74 (0.24-2.23)

7.48 (1.35-41.36)

 

 

0.82 (0.42-1.61)

1.06 (0.49-2.30)

 

a Distribution of cases and controls was not presented; ORs adjusted for age, race, and eduction; ORs are from Table 2 of Stockwell et al. (1992).

b Adjusted for age, previous lung disease; ORs are from Table 2 of Brownson et al. (1992).

c Adjusted for age, race, study area, education, fruits & vegetables & supplemental vitamin index, dietary cholesterol, family history of lung cancer,
and employment in high-risk occupations; ORs are from Table 3 of Fontham et al. (1994).

d Adjusted for age, years of education, and type of hospital; ORs are from Table 4 of Kabat et al. (1995).

* The number of cases and controls by intensity of exposure may not add up to the total numbers of subjects due to missing values.

 

 

 

TABLE 7.6
ASSOCIATION BETWEEN RISK OF LUNG CANCER AND
ETS EXPOSURES FROM PARENTS AND OTHER HOUSEHOLD MEMBERS

 



Study/study area



Sex



ETS exposure


Cases/
Controls

Odds Ratio
(95% CI)
for exposed

STUDIES CONDUCTED IN THE U.S.

Janerich et al. (1990)
/New York

 

 

M, F


Smoker-years in childhood/adolescence
0
1-24
25+
 

 

 

37 68

82 94
52 29

 

 

 

1.0

1.09 (0.68-1.73)

2.07 (1.16-3.68)

Stockwell et al. (1992)
/Central Florida
F (Distributions by exposure not presented)
mother
father
siblings

 

During childhood/adolescence
from parents and siblings
(in yrs)
< 18
18-21
22+

210 301

 

 

 

 

 

 

 

1.6 (0.6-4.3)

1.2 (0.6-2.3)

1.7 (0.8-3.9)

 

 

 

 

1.6 (0.7-3.6)

1.1 (0.5-2.6)

2.4 (1.1-5.4)

Brownson et al. (1992)
/Missouri
F During childhood from parents
never
ever

 

During childhood from any household members
never
ever

 

357 877

74 289

 

 

 

323 802

108 364

 

1.0

0.7 (0.5-0.9)

 

 

 

1.0

0.8 (0.6-1.1)

Fontham et al. (1994)
/Five U.S. areas
F During childhood
father
no
yes
mother
no
yes

 

Childhood household exposure
(in yrs.)
0
1-17
18+

 

 

304 699

299 556

 

76 161

548 1079

 

 

 

148 444

95 291

146 485

 

 

 

1.00

0.83 (0.67-1.02)

 

1.00

0.86 (0.62-1.18)

 

 

 

1.00

0.99 (0.73-1.35)

0.89 (0.67-1.16)

 

 

 

TABLE 7.6 (continued)
ASSOCIATION BETWEEN RISK OF LUNG CANCER AND
ETS EXPOSURES FROM PARENTS AND OTHER HOUSEHOLD MEMBERS

 



Study/study area


Sex



ETS exposure


Cases/
Controls

Odds Ratio
(95% CI)
for exposed

Kabat et al. (1995)
/Four U.S. cities

M




F





M




F
Childhood exposure
no
yes
#smokers: 1
#smokers: 2+

no
yes
#smokers: 1
#smokers: 2+

Adulthood household exposure
no
yes
#smokers: 1
#smokers: 2+

no
yes
#smokers: 1
#smokers: 2+

15 41
25 76
18 53
7 22

22 81
47 106
39 82
8 23


28 83
13 34
6 28
7 5

26 68
43 119
34 93
9 25

1.00
0.90 (0.43-1.89)
1.12 (0.46-2.70)
1.13 (0.34-3.75)

1.00
1.55 (0.95-2.79)
1.75 (0.91-3.35)
1.27 (0.43-3.78)


1.00
1.13 (0.53-2.45)
0.64 (0.19-2.13)
4.15 (1.34-12.87)

1.00
0.95 (0.53-1.67)
0.96 (0.50-1.84)
0.94 (0.34-2.63)
Wu et al. (1985)
/Los Angeles
F Parents smoked
no
yes

18 29
11 33

1.0
0.6 (0.2-1.7)
Kabat and Wynder
(1984)
/U.S.A.

M


F
Current ETS exposure at home
no
yes

no
yes

19 20
6 5

37 36
16 17

1.00
1.26 (0.33-4.83)

1.00
0.92 (0.40-2.08)
Kabat et al. (1990) M



F
Family member smoked
no
yes

no
yes

15 36
21 69

17 61
36 77

1.00
0.73 (0.34-1.59)

1.00
1.68 (0.86-3.27)
STUDIES CONDUCTED IN ASIA
Sobue (1990)
/Japan
F During childhood
father
no
yes
mother
no
yes
Other household member
no
yes


35 143
109 588

127 668
17 63

113 587
31 114


1.00
0.79 (0.52-1.21)

1.00
1.33 (0.74-2.37)

1.00
1.18 (0.76-1.84)

 

 

TABLE 7.6 (continued)
ASSOCIATION BETWEEN RISK OF LUNG CANCER AND
ETS EXPOSURES FROM PARENTS AND OTHER HOUSEHOLD MEMBERS

 


Study
/study area



Sex



ETS exposure


Cases/

Controls

Odds Ratio
(95% CI)
for exposed

Shimizu et al. (1988)
/Japan

F

During childhood and/or
adult life (distribution of exposure presented for controls)

father
mother
father-in-law
mother-in-law
brother(s) or sister(s)
son(s) or daughter(s)

 

 

 

 

1.1 a
4.0 (p<0.05)
3.2 (p<0.05)
0.8
0.8
0.8

Gao et al. (1987)
/Shanghai

F

Lived with a smoker during childhood

 

 

 

1.1 (0.7-1.7)
Koo et al. (1987)
/Hong Kong

F

# cohabitants who smoked
(included spouse, parents, in-laws,
children, or other cohabitants)
0
1
2+
 

 

 

27 49
48 68
13 20

 

 

 

 

1.0
1.73 (0.6-6.4)
1.35 (0.6-5.0)

Wu-Williams et al. (1990)
/North China

F

father smoked
no
yes
mother smoked
no
yes
 

335 352
182 250

 

298 410
119 192

 

 

1.0
1.1 (0.8-1.4)

1.0
0.9 (0.6-1.1)

STUDIES CONDUCTED IN EUROPE

 

Pershagen et al. (1986)
/Sweden

F

parents smoked
no
yes

 

9 18

38 76

 

 

1.0
1.0 (0.4-2.3)

 

Svensson et al. (1989)
/Sweden

F

father smoked
no
yes

mother smoked
no
yes

 

19 98
12 71

 

19 98
3 5

 

1.0
0.9 (0.4-2.3)

 

1.0

3.3 (0.5-18.8)

a Shimizu et al. reported p values for findings, but did not report confidence intervals, and confidence intervals could not be calculated from the reported information.

 

TABLE 7.7
STUDIES ON ETS EXPOSURE AT THE WORKPLACE AND LUNG CANCER
AMONG LIFETIME NONSMOKING SUBJECTS

 

Study/
Year of study

 

Questions on
ETS exposure

#unexposed/
#exposed
cases
#unexposed/
#exposed
controls
 

OR (95% CI)
for exposed

STUDIES IN U.S.

 

Kabat & Wynder et al. (1984)
1961-80
current or last job

males

females

 

7/18
27/26

 

14/11
22/31

 

3.3 (1.0-10.4)
0.7 (0.3-1.5)

Garfinkel et al. (1985)
1971-81
#hrs/day exposed to smoke of others at work: past 5 years.
Past 25 years.
 

80/14
42/34

 

262/52
135/118

 

0.88 (0.7-1.2)

0.93 (0.7-1.2)

Wu et al. (1985)
1981-82
# years exposed at each job 13/16 31/31 1.3 (0.5-3.3)
Janerich et al. (1990)
1982-84
# smokers at work (lifetime), amount of time working with smokers NA NA no association
Brownson et al. (1992)
1986-91
current/most recent job, exposed to other’s smoke NA NA no association overall

1.2 (0.9-1.7)a

Stockwell et al. (1992)
1987-91
not described NA NA no association
Fontham et al. (1994)
1985-91
# years exposed at each job (lifetime years of exposure at work)

By years of exposure

0

1-15

16-30

31+

224/385

 

 

cases

224

213

118

54

491/756

 

 

controls

491

450

223

83

1.39 (1.1-1.7)b

 

 

 

1.00 c

1.30 (1.01-1.67)

1.40 (1.04-1.88)

1.86 (1.24-2.78)b

Kabat et al. (1995)
1983-1990
four (4) jobs that lasted
1 year or more

males

females

 

 

18/23
23/35

 

 

52/65
64/85

 

 

1.02 (0.50-2.09)
1.15 (0.62-2.13)

STUDIES IN UK AND GREECE

 

Lee et al. (1986)
1977-82
timing of job not specified, exposure as no, little, a lot

males

females

 

 

3/7
12/3

 

 

40/57
113/47

 

 

1.61 (0.4-6.6)
0.63 (0.2-2.3)

Kalandidi et al. (1990)
1987-89
current/last job
#smokers at work
24/65 40/78 1.39 (0.8-2.5)
STUDIES IN ASIA
Koo et al. (1987)
1981-83
any ETS exposure at work
(all jobs)
NA NA 0.91
Shimizu et al. (1988)
1982-85
most recent/current job, any smokers at work NA NA 1.2
Wu-Williams et al. (1990)
1985-87
exposure at each job 187/230 301/301 1.2 (0.9-1.6)

a For highest quartile of exposure

b p<0.01

c Trend, p = 0.001

TABLE 7.8

ASSOCIATION BETWEEN PASSIVE SMOKE EXPOSURE AND RISK OF NASAL SINUS CANCER IN NONSMOKERS

 



Studies Exposure to Relative Risk (95% CI)

Passive Smoking


Cohort Studies

Hirayama (1984) Spouse's smoking
in cig/day

No (5)
a 1.0


Exsmoker or Smokers
1-14 (9) 1.7 (0.7 - 4.2)
15 - 19 (4) 2.0 (0.6 - 6.3)
20+ (10) 2.6 (1.0 - 6.3)

Case-Control Studies

Fukuda and Shibata (1990) # Smokers in household

0 (11/35)
b 1.0
1 (15/34) 1.4 (0.6 - 3.5)
2+ (9/5) 5.7
c (1.7 - 19.4)
1+ (24/39) 2.0 (0.8 - 4.5)

Zheng et al. (1993) Ever exposedd
No 1.0
Yes 3.0 (1.0 - 8.9)

 


a Number of nasal sinus cancer deaths.

b Number of cases/controls

c p for trend = 0.02.

d Number of cases/controls by exposure category was not presented.

Table 7.9
Relationship Between Active and Passive Smoke Exposure and Risk of Cervical Cancer



# Cases/# Controls Passive Smoking
Study Cervical Cytology Active Smoking (Among Never Smokers)

(among cases)

CA/CO Adj. ORa Hrs/dayb CA/CO Adj. ORa
Slattery 266 cases/408 Never 81/305 1.0 None NA 1.0
et al., 1989 controls (cases: Exsmoker 37/48 1.4 (0.8 - 2.5) 0.1 - 0.9 NA 1.1 (0.5 - 2.9)
78% carcinoma Current smoker 148/55 3.4 (2.1 - 5.6) 1.0 - 2.9 NA 1.6 (0.5 - 4.7)
in-situ, 22% >3.0 NA 3.4 (1.2 - 9.5)
invasive cancer)

At Home
CA/CO Adj. ORc Yrs Exposure CA/CO Adj. ORc
Coker 103 cases/268 Never 37/170 1.0 Not exposed 9/49 1.0
et al., 1992 controls (All Ever smoked 66/96 1.7 (0.9 - 3.3) <17 yrs 18/52 1.5 (0.5 - 4.0)
biopsy-confirmed Current smoker 66/49 3.4 (1.7 - 7.0) >18 yrs 9/69 0.4 (0.1 - 1.3)
cervical
intraepithelial
neoplasia,
class II or III)
At work
Yrs Exposure
Not exposed 28/132 1.0
1-4 yrs 6/21 1.7 (0.5 - 5.1)
>5 yrs 2/16 0.4 (0.1 - 2.5)

 

a Adjusted for age, church attendance, education, and number of sexual partners of the women.

b Number of hours of exposure per day inside and outside of the home; NA = not available

c Adjusted for age, years of education, race, number of pap smears, number of partners, and genital warts.

Table 7.10
nicotine and cotinine measured in the Cervical Mucus of smokers,

passive smokers, and nonsmokers

Levels (ng/ml) of

Nicotine Cotinine

 

Sasson et al., 1985a

Smokers (n = 10) 740 316
Nonsmokers (n = 8) 16 3

 

Hellberg et al., 1988a
Smokers (n = 17) 1056 1061
Nonsmokers with ETS exposure
Yes
b (n = 4) 20 51
No (n = 14) 43 78

Levels of Nicotine (ng/ml)

Mean Median Range

 

Jones et al., 1991c

Smokers (n=31) 34.3 11.8 2.8 - 383.4
Nonsmokers with
ETS exposure
d
at home (n=32) 0.1 0.8 <0.2 - 8.2
outside of home (n = 42) NA
f 0.4 <0.2 - 5.2
none (n = 70) NA 0.2 <0.2 - 3.8

McCann et al., 1992c
Smokers (n=25) 107.2 56 4 - 358
Nonsmokers with
ETS exposure
d
Yes
e (n = 12) 3.6 3.5 <0.2 - 12
No (n = 12) 3.9 3.5
g <0.2 - 14

a Cervical mucus collected using aspiration methods.

b Exposed at home or work, time of passive smoke exposure relative to specimen collection not specified.

c Cervical mucus collected using cervical flush techniques.

d Passive smoke exposure in the last 24 hours.

e Nonsmokers with ETS exposure at home or at work.

f NA = not available.

g Excluded one outlier who was usually exposed to passive smoking several hours/day, but had no exposure within the last 24 hours.

Table 7.11

Passive Smoking and Bladder Cancer Among Nonsmokers

 



Males Females
# Exposed # Exposed
Cases/Controls OR (95% CI) Cases/Controls OR (95% CI)


Kabat et al. (1986)
a
Exposed to passive smoking
At home 6/10 1.5 (0.5, 4.5) 6/13 0.6 (0.5, 1.2)
At work or in transportation 11/25 0.7 (0.2, 1.8) 6/5 2.5 (0.6, 10.1)

Burch et al. (1989)
b
Exposed to passive smoking
At home 37/72 0.9 (0.5 - 2.0) 66/90 0.8 (0.3 - 1.7)
At work 25/45 1.0 (0.5 - 1.9) 26/38 0.9 (0.5 - 1.8)

a Total number of nonsmokers were: males - 23 cases, 44 controls; females - 17 cases, 28 controls.

b Total number of nonsmokers were: males - 61 cases, 112 controls; females - 81 cases, 105 controls.

Table 7.12
Mean Levels of Hemoglobin Adducts of 4- and 3- Aminobiphenyls
in Nonsmokers

 



4-ABP 3-ABP
(pg/g Hb) (pg/g Hb)


Exsmokers (at baseline) 130.4 16.0

Exsmokers (after stopping smoking 33.3 1.7
for two months)

Nonsmokers
ETS exposure (-)
a and 45.9 1.2
Cotinine level (-)

ETS exposure (+)
b and 49.2 1.9
Cotinine level (+)

Reference: MaClure et al. (1989)

 

a Based on 44 subjects - 15 subjects had low levels of self-reported ETS exposure and no detectable cotinine levels; 29 subjects had no reported ETS exposure and no detectable cotinine levels.

b Based on 13 subjects - 7 subjects had low levels of self-reported ETS exposure and detectable cotinine levels, 6 subjects had high levels of self-reported ETS exposure and detectable cotinine levels. The 6 subjects who reported high exposure to ETS showed the highest mean levels of 4-ABP (54 pg/g) and 3-ABP (2.4 pg/g) and median levels of 4-ABP (48 pg/g) and 3-ABP (2.6 pg/g).

 

Table 7.13

Mean Levels of 4-ABP Hemoglobin Adducts (pg/g of Hemoglobin)
Among Smokers and Nonsmokers by Acetylator Phenotype

 

Acetylator Phenotype

Slow Fast


Black-tobacco smokers (n=16) 175.0 117.5
Blond-tobacco smokers (n=31) 111.8 86.4
Nonsmokers (n=50) 31.7 19.4
Exposed to ETS

No (n=35) 30.4 12.3
Yes (n=15) 34.8 33.6

Reference: Bartsch et al. (1990)

 

Table 7.14
Brain TumorS in Children and Exposure to parent's Smoking

Study # Cases/ OR for Smoking Habits of
(Age of Subjects) Controls Mother Father

continued smoking during
pregnancy
a
Gold et al., 1979 84/73 5.0 No data
(Age <20) (population)

84/78

(hospital)
During pregnancy During pregnancy
Preston-Martin 209/209 1.1 1.5
a
et al., 1982

(Age <25)
# cig/day during pregnancy
Stjernfeldt et al., 1986 43/340 0 1-9 10+ cig/day
(Age <16) 1.0 1.0 0.9 No data

# cig/day during pregnancy
0 1-9 10+ cig/day
McKinney and 78/156 1.0 1.1 1.0 No data
Stiller, 1986

(Age <15)
During pregnancy During pregnancy
Howe et al., 1989 74/132 1.4 1.1
(Age <20)
During first trimester 12 months prior to birth
John et al., 1991 48/196 1.0 1.4
(Age <14)
Mother’s smoking alone Father’s smoking alone
* 1.9 (0.9 - 4.2)


at 2-3 mos of pregnancy
0 <10 10+ cig/day
Pershagen et al., 1992 81
b 1.0 0.9 1.1 No data
(Age <5)

a p<0.05

b cohort study

c OR if data obtained from mother

d OR if data obtained from father

e Cases restricted to astrocytoma

* 0 exposed cases, 8 exposed controls

 

 

Table 7.14 (Continued)
Brain TumorS in Children and Exposure to parent's Smoking

Study # Cases/ OR for Smoking Habits of
(Age of Subjects) Controls Mother Father

 

Gold et al., 1993 361/1083 Ever smoked Ever smoked
(Age <18) 0.9 1.1

During yr of birth During yr of birth
0 <1 pack/day pack/day 0 <1 pack/day pack/day
1.0 0.8 1.0 1.0 0.7 1.1

2 yrs before birth 2 yrs before birth
0 <1 pack/day pack/day 0 <1 pack/day pack/day
1.0 0.8 1.0 1.0 0.9 1.2

 

Mother’s smoking alone Father’s smoking alone
1.1 0.9

 

McCredie et al., 1994 82/104 During pregnancy During pregnancy
(Age < 14) 1.3 2.2
a
4.2
c
1.1
d

 

Kuijten et al., 1990 163e/163 During pregnancy During pregnancy
(Age < 14) 1.0 0.8

 

a p<0.05

b cohort study

c OR if data obtained from mother

d OR if data obtained from father

e Cases restricted to astrocytoma

* 0 exposed cases, 8 exposed controls

 

 

 

Table 7.15
Maternal or Parental Smoking During Pregnancy and

Childhood Leukemia


Cohort Studies # Cases Smoking OR (95% CI) for OR (95% CI) for
(Age of Subjects) (Type of Habits (cig/day) Maternal Smoking Paternal Smoking
Leukemia)

Pershagen et al., 1992 All Leukemia 2-3 mos of pregnancy
(Age <5) 72 No 1.0 Not available
18 1-9 0.9 (0.6-1.6)
9 10+ 0.7 (0.4-1.5)

21 (lymphatic) Yes 0.8 (0.5-1.3)
6 (myeloid) Yes 1.6 (0.6-4.8)


Case-Control # Cases/ Smoking OR (95% CI) OR (95% CI)
Studies (Age of Subjects) # Controls Habits (cig/day) Maternal Smoking Paternal Smoking

Van Steensel-Moll 519/507 Yes, yr before
et al.,1985

(Age <15) (ALL)a Pregnancy 1.0 (0.8-1.3) Not available

Yes, during
pregnancy 1.0 (0.7-1.3)

During pregnancy
Stjernfeldt et al., 1986 132/340 1-9 1.3 (0.7-2.6) Not available
(Age <16) (ALL) 10+ 2.1 (1.3-3.3)

During pregnancy
McKinney et al., 1986 171/342 1-10 1.0 (0.6-1.7) No association
(Age <15) (78 ALL, 11+ 0.6 (0.4-1.0)
93 non-ALL)
During pregnancy
Buckley et al., 1986 742/740 1-9 1.0 (0.6-1.5) No association
(Age <15) (ALL) 10+ 0.9 (0.7-1.1)

Magnani et al., 1990 142/307 Smoking up to child's birth
(Not specified) (ALL) Yes 0.7 (0.5-1.1) 0.9 (0.6-1.5)
1-15 cig/day 0.6 (0.4-1.0) 0.9 (0.5-1.6)
16+ cig/day 1.0 (0.4-2.7) 0.9 (0.6-1.5)
22/307
(non-ALL) Yes 2.0 (0.8-4.8) 0.9 (0.3-2.1)


a ALL = Acute lymphocytic leukemias, non-ALL = non acute lymphocytic leukemias.

 

 

 

Table 7.15 (continued)
Maternal or Parental Smoking During Pregnancy and

Childhood Leukemia


Case-Control Studies # Cases/ Smoking OR (95% CI) for OR (95% CI) for
(Age of Subjects) # Controls Habits (cig/day) Maternal Smoking Paternal Smoking
(Type of

Leukemia)

During 3 trimesters During pregnancy
John et al., 1991 73/196 1-10 2.0 (0.7-5.9) 2.6 (0.9-7.9)
(Age <14) (ALL)
a 11-20 2.9 (1.2-6.8) 1.6 (0.7-3.7)
21+ 1.6 (0.7-4.0)

Parent smoking in absence of other parent
2.9 (0.8 - 10.3) 1.7 (0.7 - 3.8)

(non-ALL) During 3 trimesters During pregnancy
Yes 0.6 (0.1-3.0) 0.8 (0.2-2.3)

 

Severson et al., 1993 187/187 During pregnancy

(Age < 18) (acute Yes 1.2 (0.8 - 1.9) No association

myeloid
leukemia)

a ALL = Acute lymphocytic leukemias, non-ALL = non acute lymphocytic leukemias.

Table 7.16
Association Between Exposure to Passive Smoking and Risk of Non-Hodgkins Lymphoma and Lymphoma in Children


Studies Exposure to Passive Smoking Relative Risk 95% CI

Stjernfeldt et al., 1986 Non-Hodgkins Lymphoma (n = 16)
Mother's smoking during pregnancy
0 (cig/day) 1.0
1-9 1.9 (0.3 - 6.7)
10+ 2.1 (0.7 - 6.4)

Hodgkins Lymphoma (n = 15)
0 (cig/day) 1.0
1-9 1.1 (0.2 - 4.9)
10+ 0.3 (0.1 - 2.2)

Buckley et al., 1986 Non-Hodgkins Lymphoma (n = 169)
Mother's smoking during pregnancy
0 (cig/day) 1.0
1-9 0.8 (0.3 - 1.8)
10+ 1.0 (0.7 - 1.4)

Magnani et al., 1990 Non-Hodgkins Lymphoma (n = 19)
Mother's smoking up to child’s birth 1.7 (0.7 - 4.5)
Father's smoking up to child’s birth 6.7 (1.0 - 43.4)

McKinney and Lymphomas (n = 74)
Stiller, 1986 Mother's smoking during pregnancy
0 (cig/day) 1.0
1-10 1.9 (0.9 - 4.0)
11+ 1.0 (0.5 - 2.1)

John et al., 1991 Lymphoma (n = 26)
Mother's smoking
- Three months prior to conception 1.9 (0.7 - 5.2)
- First trimester of pregnancy 2.5 (0.9 - 7.0)
- All three trimesters of pregnancy 2.7 (1.0 - 7.6)
Father's smoking during pregnancy 1.9 (0.7 - 4.8)

Pershagen et al., 1992 Hematopoietic and Lymphatic
excluding leukemia (n = 30)
Mother's smoking at 2-3 months of pregnancy
0 (cig/day) 1.0
1-9 2.4 (1.0 - 5.5)
10+ 1.1 (0.3 - 3.6)

 

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