Secondhand Tobacco Smoke Exposure Research Articles

Estimated Worldwide Mortality Attributed to Secondhand Tobacco Smoke Exposure, 1990-2016

The World Health Organization estimates that the 1 billion individuals who smoke worldwide contribute to the 880 000 secondhand smoke (SHS)-related deaths among individuals who do not smoke each year. A better understanding of the scale of harm of SHS to those who do not smoke could increase awareness of the consequences of smoking and help to design measures to protect individuals who do not smoke, especially children. To calculate the number of individuals who smoke associated with the death of 1 individual who died of SHS exposure both on a global scale and in various World Bank regions. In this cross-sectional epidemiologic assessment, data from Our World in Data were used to tabulate the number of individuals who smoke in each country and number of premature deaths related to SHS in that country from 1990 to 2016. The mean number of cigarettes consumed in all countries was also included in analyses. Data were collected for the following World Bank regions: North America, Latin America and the Caribbean, Europe and Central Asia, the Middle East and North Africa, sub-Saharan Africa, South Asia, and East Asia and the Pacific from 1990 and 2016. Statistical analysis was conducted in July 2019. Secondhand smoke. The pack-year index, calculated as the number of pack-years associated with the death of 1 individual who does not smoke but was exposed to SHS, and the SHS index, calculated as the number of individuals who smoked for 24 years (ie, the mean duration of smoking) associated with the death of 1 individual who does not smoke. Globally, the SHS index changed favorably, from 31.3 (95% CI, 30.6-32.0) individuals who smoked associated with the death of 1 individual who did not smoke in 1990 to 52.3 (95% CI, 51.2-53.5) individuals who smoked in 2016. There was a wide regional variation in the 2016 secondhand smoke index, from 42.6 (95% CI, 41.6-43.5) individuals who smoked in the Middle East and North Africa to 85.7 (95% CI, 83.8-87.7) individuals who smoked in North America. Worldwide, the pack-year index also changed favorably from 751.9 (95% CI, 736.3-770.7) pack-years associated with 1 death in 1990 to 1255.9 (95% CI, 1227.2-1284.4) pack-years in 2016. In this study, the substantial disparity among regions in both the SHS index and pack-year index reflected large differences in the scale of the harm of SHS on those who do not smoke. This information may help local policy makers implement measures to better protect those who do not smoke and increase public engagement. Although the number of pack-years and the number of individuals who smoke associated with the death of 1 individual who did not smoke favorably changed over the study period, as of 2016, 52.3 individuals who smoked were associated with the death of 1 individual who did not smoke.

Secondhand smoke exposure and higher blood pressure in children and adolescents participating in NHANES

We assessed the relationship between acute and intermittent secondhand tobacco smoke (SHS) exposure with child and adolescent blood pressure (BP). We analyzed cross-sectional data from 3579 children and adolescents aged 8–17 years participating in the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2012, with SHS exposure assessed via serum cotinine (a biomarker for acute exposures) and urine NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, a biomarker for intermittent exposures). BP percentiles and z-scores were calculated according to the 2017 guidelines established by the American Academy of Pediatrics. We used weighted linear regression accounting for the complex sampling weights from NHANES and adjusting for socio-demographic and clinical characteristics. Overall, 56% of the children were non-Hispanic white with a mean age of 12.6 years. There was approximately equal representation of boys and girls. Approximately 15.9% of participants lived in homes where smoking was present. In adjusted models, an interquartile range (IQR) increase in urinary NNAL was associated with 0.099 (95% CI: 0.033, 0.16) higher diastolic blood pressure (DBP) z-score, and with a 0.094 (95% CI: 0.011, 0.18) higher systolic blood pressure (SBP) z-score. The odds of being in the hypertensive range was 1.966 (95% CI: 1.31, 2.951) times greater among children with high NNAL exposures compared to those with undetectable NNAL. For serum cotinine, an IQR increase was associated with 0.097 (95% CI: 0.020, 0.17) higher DBP z-scores, but was not significantly associated with SBP z-scores. The associations of cotinine and NNAL with BP also differed by sex. Our findings provide the first characterization of the relationship between a major tobacco-specific metabolite, NNAL, and BP z-scores in a nationally representative population of US children.

The Association Between Secondhand Smoke Exposure and Survival for Patients With Heart Failure

The effect of secondhand tobacco smoke (SHS) exposure on patients with heart failure (HF) is uncertain. We investigated the association of mortality with SHS exposure for patients with HF. Nonsmokers with clinical HF were enrolled from 2003 to 2008 in a single-center longitudinal cohort study. The effect of SHS exposure determined by high-sensitivity urinary cotinine on mortality was estimated by multivariable proportional hazards modeling. Mortality was assessed after median 4.3 years. Of 202 patients, enrollment urinary cotinine levels were below the limit of detection for 106 (52%) considered unexposed to SHS. The median detectable cotinine was 0.47 ng/mL (interquartile range: [0.28, 1.28]). Participants were 41% female, 65 ± 17 years old, and 57% white race. Elevated cotinine was associated with increased mortality after multivariate adjustment: hazard ratio (HR) per 1 ng/mL increase in urinary cotinine: 1.15, 95% confidence interval (CI): 1.08-1.23, P < .001. Higher age (HR per 5-year increase: 1.32, 95% CI: 1.22-1.43, P < .001), male sex (HR vs female: 1.52, 95% CI: 1.02-2.28, P = .040), and New York Heart Association class (HR for class III vs I: 2.91, 95% CI: 1.71-4.99, P < .001) were also associated with mortality. SHS exposure is associated with a dose-dependent increase in mortality for patients with HF.

An impact of the governmental tobacco control policy on chronic bronchitis incidence in the Russian Federation

Chronic bronchitis (CB) is one of the most common respiratory diseases. An important risk factor of CB is tobacco smoking which is highly prevalent in the Russian Federation (RF). In 2013, a Federal Law about health protection against second-hand tobacco smoke exposure and consequences of tobacco consumption came into the legal force in the RF. This law resulted in a significant reduction in the prevalence of active and passive tobacco smoking. The aim of the present research was to analyze an impact of the governmental tobacco control policy on CB incidence in the RF. Methods : The incidence of CB was analyzed using the official statistics for the period of 2009 – 2017 and was defined as number of newly diagnosed CB patients per 100,000. To evaluate an impact of the Federal Law on CB incidence, primary morbidities were compared between the years 2009 – 2013 (before adoption of the Law) and 2014 – 2017 (after adoption of the Law). Results . Before the year 2013, the CB incidence had tended to a substantial increase followed by its reduction after the year 2014. A relative reduction in the CB incidence in 2014 – 2017 was ≥ 36%. Conclusions : The current analysis demonstrated a steady downward trend in CB incidence in RF after the adoption of the Federal Law on tobacco control policy in 2013. This is probably related to decreasing prevalence of active smoking and to second-hand smoking reduction as well. Therefore, the comprehensive governmental tobacco control strategy positively inf luenced on the health status of Russian population.

Sources and Biomarkers of Secondhand Tobacco Smoke Exposure in Urban Adolescents.

In an urban adolescent population, we evaluated sources of exposure to secondhand smoke exposure (SHS), examined differences in exposure by race/ethnicity, age and sex, and determined the relationship between exposure source(s) and the biomarkers cotinine and NNAL. Participants were recruited from a public hospital-based outpatient clinic in San Francisco, CA, USA. Of a sample of N=298 adolescents screened, 235 were biologically confirmed to be exposed to tobacco smoke. Of those, N=16 were active smokers and N=219 were exposed to SHS; 91 (39%) were heavily SHS exposed (median cotinine=0.76 ng/mL) and 128 (54%) had light SHS exposure (median cotinine=0.11 ng/mL). Within those SHS exposed, the most common source of exposure was in a public area. No significant racial/ethnic differences were found, although African American adolescents were more likely to live in a home that allowed smoking. Older adolescents were more likely to be exposed across several difference sources, and females more likely to be exposed in a car and in public areas. Past 7-day exposure in the home, in a car, and current blunt use were significantly related to biomarkers of exposure. Urban adolescents are exposed to SHS across a variety of sources. Although exposure in a public area is most common, exposure in the home and in cars significantly influences tobacco biomarker levels. Interventions to reduce exposure would have the greatest impact in this population if they focused on reducing exposure in the home and in cars. History of blunt use is a strong determinant of tobacco exposure.

Exposure to secondhand tobacco smoke is associated with reduced muscle strength in US adults

Secondhand tobacco smoke (SHS) exposure is a well-established risk factor for several diseases in adults. Despite the evidence that active tobacco smoke is harmful for the muscles, the association between SHS and muscle strength is still uncertain.We analyzed data from 5390 nonsmoking U.S. adults aged >30 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Exposure to SHS was assessed with serum cotinine concentrations. Grip strength was measured using a Takei digital handgrip dynamometer, and combined grip strength was calculated as the sum of the largest reading from each hand. Median (interquartile range) serum cotinine and grip strength were 0.015 ng/mL (IQR 0.011-0.36) and 65.5 kg (IQR 53.4-86.4), respectively. After adjusting for sociodemographic, anthropometric, health-related behavioral, and clinical risk factors, the highest (0.047-9.9 ng/mL) vs lowest (≤0.011 ng/mL) quartile of serum cotinine was associated with a reduction in combined grip strength of 1.41 kg (95%CI: -2.58, -0.24), p-trend=0.02. These results were consistent across socio-demographic and clinical subgroups. In the US nonsmoking adult population, even low levels of exposure to passive smoking were associated with decreased grip strength. Despite great achievements in tobacco control, extending public health interventions to reduce SHS exposure is still needed.

Timing of secondhand smoke, pet, dampness or mould exposure and lung function in adolescence

BackgroundThe relevance of timing of exposure in the associations of secondhand tobacco smoke (SHS), pets, and dampness or mould exposure with lung function is unclear. We investigated the relevance of...

Secondhand smoke exposure and blood pressure in children and adolescents participating in the United States National Health and Nutrition Examination Survey, 2007-2012

TPS 771: Diet and lifestyle, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background/Aim: To assess the relationship between acute and intermittent secondhand tobacco smoke (SHS) exposure with child and adolescent blood pressure (BP). Methods: We analyzed data from 3579 children and adolescents participating in the United States National Health and Nutrition Examination Survey (NHANES) between 2007 and 2012, with SHS exposure assessed via serum cotinine (biomarker for acute exposures) and urine NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, biomarker for intermittent exposures). BP measures were calculated as percentiles (adjusted for age, sex, height) according to the 2017 guidelines established by the American Academy of Pediatrics. We used weighted linear regression accounting for the complex sampling weights from NHANES and adjusting for socio-demographic and clinical characteristics. Results: Overall, participants were predominantly non-Hispanic white with a mean age of 12.6 years. There was approximately equal representation of boys and girls. Approximately 15.9% of participants lived in homes where smoking is present. In adjusted models, an interquartile range (IQR) increase in urinary NNAL was associated with a 2.93 (95% CI: 1.00-4.87) point increase in diastolic blood pressure (DBP) percentiles, and with a 2.76 (95% CI: 0.29-5.22) point increase in systolic blood pressure (SBP) percentiles. The association of NNAL and BP differed by sex. Among boys, an IQR increase in NNAL was associated with a 4.77 (95% CI: 2.50-7.06) point increase in DBP percentiles, but was not associated with SBP percentiles. Meanwhile, among girls, an IQR increase in NNAL was not associated with DBP percentiles, but was associated with a 4.30 (95% CI: 0.56-8.03) point increase in SBP percentiles. An IQR increase in serum cotinine was associated with a 2.73 (95% CI: 0.42-5.05) point increase in DBP percentiles, but was not associated with SBP percentiles. Conclusions: Our findings provide strong evidence for the relationship between acute and intermittent SHS and increased BP percentiles among children and adolescents in the United States.

Air Pollution in a Nationally Representative Sample: Findings from the National Adult Tobacco Survey of Lao PDR

In Southeast Asia, household air pollution (HAP) from solid fuel use is the leading cause of disability-adjusted life years (DALYs), a risk which is compounded by exposure to other sources of indoor and outdoor air pollution including secondhand tobacco smoke (SHS). The purpose of this study was to measure the individual and combined prevalence of exposure to household and community sources of air pollution in a national sample of adults in Lao PDR. We analyzed data from the 2012 National Adult Tobacco Survey (NATSL) of Lao PDR—a multi-stage stratified cluster sample of 9706 subjects from 2822 households located in all 17 provinces. Our findings indicate a high prevalence of exposure to household air pollution from cooking fires (78%) and SHS exposure in the home (74.5%). More than a third (32.8%) reported exposure to both inside the home. Exposure to outdoor sources of smoke from cooking, trash, and crop fires was substantial (30.1% to 56.0%). The aggregation of exposures from multiple sources of household air pollution raises the need for initiatives that establish programmatic linkages in the health, environmental, and agricultural sectors to provide a comprehensive strategy to reduce risk factors for respiratory disease in Lao PDR and the region.

Secondhand tobacco smoke exposure of infants at home: A population based cross-sectional study

IntroductionSecondhand smoke exposure is one of the important public health problems especially infants and children. The aim of this study was to assess prevalence and social predictors of secondhand smoke exposure of newborns and infants in household. MethodsA cross sectional study conducted with a sample of 763 infants from 1 June to 31 August 2012 in Burdur. A questionnaire developed by was used for this study. It includes questions about socio- and bio-demographic features of participants and smoking related data by self reports of participants. Second hand smoke exposure of infants was considered as smoking someone at least one day per a week in the house. ResultsSecondhand smoke exposure prevalence of infants was 64% in Burdur. It was found that five factors including mothers' education level, family type, mothers' smoking status, infants' age and fathers' smoking status were related with infants’ second hand smoke exposure. ConclusionThe rate of secondhand smoke exposure of infants at home is very high. The most important factor affecting second hand smoke exposure was parents'; especially fathers’ smoking status. Therefore parents should be encouraged to quit smoking.

Asking the Right Questions About Secondhand Smoke.

Despite knowledge about major health effects of secondhand tobacco smoke (SHS) exposure, systematic incorporation of SHS screening and counseling in clinical settings has not occurred. A three-round modified Delphi Panel of tobacco control experts was convened to build consensus on the screening questions that should be asked and identify opportunities and barriers to SHS exposure screening and counseling. The panel considered four questions: (1) what questions should be asked about SHS exposure; (2) what are the top priorities to advance the goal of ensuring that these questions are asked; (3) what are the barriers to achieving these goals; and (4) how might these barriers be overcome. Each panel member submitted answers to the questions. Responses were summarized and successive rounds were reviewed by panel members for consolidation and prioritization. Panelists agreed that both adults and children should be screened during clinical encounters by asking if they are exposed or have ever been exposed to smoke from any tobacco products in their usual environment. The panel found that consistent clinician training, quality measurement or other accountability, and policy and electronic health records interventions were needed to successfully implement consistent screening. The panel successfully generated screening questions and identified priorities to improve SHS exposure screening. Policy interventions and stakeholder engagement are needed to overcome barriers to implementing effective SHS screening. In a modified Delphi panel, tobacco control and clinical prevention experts agreed that all adults and children should be screened during clinical encounters by asking if they are exposed or have ever been exposed to smoke from tobacco products. Consistent training, accountability, and policy and electronic health records interventions are needed to implement consistent screening. Increasing SHS screening will have a significant impact on public health and costs.

SHS exposure among high school students in Taiwan

ABSTRACTObjective: This study evaluated the frequency and risk factors of secondhand tobacco smoke (SHS) among high school students in Taiwan.Methods: Data from the General Tobacco Hazard Proficiency Test were investigated for 4,671 students during 2017. The SHS exposure was divided into four groups with the intensity of exposure. The chi-square test and ordinal logistic regression were used for inferential statistical analysis.Results: 9.9% of students are exposed to SHS every day; the highest exposure rate was found in people living in urban areas (≥100,000 people per kilometer), male and family members smoking or with betel chewing habits. Boys were less likely exposed to SHS than female students (aOR 0.769, 95% CI 0.682 to 0.868). The areas with less than 49,999 people per kilometer have the lowest SHS exposure rate (aOR 0.713, 95% CI 0.533 to 0.954), and students with smoking or betel chewing family members proved a higher SHS exposure rate (aOR 5.332, 95% CI 4.641 to 6.126 and aOR 1.422, 95% CI 1.232 to 1.642, respectively).Conclusions: These findings not only highlight the risk factors of SHS exposure in high school students, but also show a direction for developing effective intervention programs for the prevention of SHS exposure.

Workplace Secondhand Tobacco Smoke Exposure Among U.S. Nonsmoking Workers, 2015.

Secondhand tobacco smoke (SHS) exposure contributes to ill health and disease, including heart disease, lung cancer, and stroke (1). Although cigarette smoking has declined among U.S. workers, workplace exposure to SHS remains high, particularly among workers in certain industries, such as construction (2,3). Implementation of smoke-free laws has proven to be beneficial in reducing SHS exposure in general (1). CDC analyzed data from the 2015 National Health Interview Survey (NHIS) Occupational Health Supplement to assess the prevalence of self-reported workplace SHS exposure among nonsmoking workers by smoke-free policy status in the workers' states of residence and in detailed industry categories and subcategories. In 2015, 19.9% of nonsmoking workers reported any exposure to SHS at work during the 12 months preceding the interview, and 10.1% reported frequent exposure (twice a week or more). Nonsmoking workers who resided in states with comprehensive smoke-free laws in all three categories of venues (private worksites, bars, and restaurants) were least likely to report frequent exposure to workplace SHS. Nonsmoking workers employed in the commercial and industrial machinery and equipment repair and maintenance industry reported the highest prevalences of any workplace SHS exposure (65.1%), whereas the construction industry had the highest reported number of exposed workers (2.9 million); these industry categories/subcategories include outdoor workplaces and other settings that are unlikely to be protected by smoke-free laws. Identifying specific at-risk workplaces and implementing targeted intervention strategies could help reduce SHS exposure at work and protect workers' health.

Second-hand tobacco smoke exposure and passive exposure to electronic cigarette aerosol in 12 European countries: the TackSHS Project survey

Second-hand tobacco smoke exposure and passive exposure to electronic cigarette aerosol in 12 European countries: the TackSHS Project survey

A clean fuel cookstove is associated with improved lung function: Effect modification by age and secondhand tobacco smoke exposure

Household air pollution (HAP) secondary to the burning of solid fuels is a major risk factor for the development of COPD. Our study seeks to examine the impact of a clean cookstove, liquid petroleum gas (LPG), on respiratory outcomes. Women (n = 200) from neighboring Indian communities, one cooking with LPG and one with biomass, were enrolled. Spirometry was performed. Relationships between primary cooking fuel and spirometry measures, as raw values, Global Lung Initiative (GLI) percent predicted (pp), and GLI z-scores, were examined using linear regression. Effect modification by age was explored. Women were young (average age 33.3 years), with low education (median 5.0 years), and the majority had multiple sources of air pollution exposures. Overall, the lung function in both groups was poor [FEV1 z-score median −2.05, IQR (−2.64, −1.41). Biomass was associated with lower FEV1/FVC (raw values −7.0, p = 0.04; GLI pp −7.62, p = 0.05, and z-score −0.86, p = 0.05) and FEF25–75 (GLI pp −25.78, p = 0.05, z-score −1.24, p = 0.05), after adjusting for confounders. Increasing impairment in lung function with age was found among biomass users (p-interaction = 0.01). In conclusion, use of a clean fuel cookstove may improve lung function. These findings have broad implications for research and public policy.

Association of secondhand tobacco smoke exposure during childhood on adult cardiovascular disease risk among never-smokers

PurposeAdult secondhand tobacco smoke (SHS) exposure is related to stroke and coronary heart disease (CHD) risk, but long-term effects are less clear. We evaluated whether childhood SHS exposure affects subsequent stroke or CHD risk among adult black and white never-smokers followed for stroke and CHD. MethodsIn this prospective cohort study, inverse probability weights were calculated to correct for bias due to attrition and survey nonresponse. Cox proportional hazards models were used to assess hazard ratios and 95% confidence intervals for stroke or CHD, separately, by number of childhood household smokers. ResultsOf 13,142 eligible participants, 6136 had childhood SHS exposure assessed. Baseline mean (SD) age was 63.5 (9.0), 65% were female, 30% black, 46% reported 0 childhood household smokers, 36% reported 1, and 18% reported 2+. In 60,649 person-years, 174 strokes were observed (2.9% of participants), and in 45,195 person-years, 114 CHD events were observed (2.1% of participants). The weighted and adjusted hazard ratios (95% confidence intervals) of stroke for 2+ versus 0 childhood household smokers was 1.66 (1.29–2.13) and was 1.15 (0.82–1.59) for CHD. ConclusionsWe observed a significant association between childhood SHS exposure and stroke, but not CHD, after age 45 years and adjusting for missing information.

The effect of maternal tobacco smoking and second-hand tobacco smoke exposure on human milk oxidant-antioxidant status

BackgroundMany women who smoke tobacco continue to do so during lactation, and many non-smoking women are exposed to second-hand tobacco smoke (SHS) during the period that she wishes to breastfeed. There are reports documenting the adverse effects of maternal smoking during lactation on their infant's health; however, the pathophysiological mechanisms underlying these effects are incompletely understood. ObjectivesOur study purpose was to examine the influence of tobacco smoke on biochemical markers reflecting the intensity of oxidative stress using concentration of total protein (TP), trolox equivalent antioxidant capacity (TEAC), S-nitrosothiols (RSNO), nitric oxide (NO), thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), glutathione S-transferase (GST), glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT) in the plasma, colostrum, and mature milk of women who smoke, those only exposed to SHS, and non-smokers. MethodsQuestionnaire data on the tobacco smoking status were verified based on the determination of cotinine by high performance liquid chromatography with diode array detector (HPLC-DAD). Relevant markers of oxidative stress and biochemical parameters were determined using spectrophotometric methods. ResultsWe found that tobacco smoking during lactation increases oxidative stress in the mother's plasma, colostrum, and mature milk, and lesser so in those exposed to SHS. Tobacco smoke significantly increase TBARS and decrease TEAC in colostrum and mature milk. In response to ROS generated by tobacco smoke increase the activity of antioxidant enzymes (SOD, GST, GPx and CAT), p < 0.05. DiscussionSuch exposure to tobacco smoke influences the antioxidant barrier of human colostrum and mature milk that can adversely affect their infant's health. Greater public health awareness of the adverse effects of tobacco smoking during lactation on breast milk quality and its protective effects is urgently needed.

Home Health and Community Care Workers' Occupational Exposure to Secondhand Smoke: A Rapid Literature Review.

IntroductionAlthough many workers are protected from exposure to secondhand tobacco smoke (SHS), home health and community care workers enter domestic settings where SHS is commonly present. Little is known about the extent of SHS exposure among this occupational group.MethodsA rapid review to examine the literature on home health and community care workers’ exposure to SHS at work and identify research gaps. Systematic searches combining terms for SHS exposure (eg, “tobacco smoke pollution”) with terms for home health and care workers, patients and settings (eg, “home health nursing”) were run in CINAHL and Medline (with no date or language limitations). Web site and backward-forward citation searches identified further papers for narrative review.ResultsTwenty relevant publications covering seventeen studies considered home health or community care workers’ exposure to SHS either solely or as part of an assessment of other workplace hazards. Eight studies provided data on either the proportion of home care workers exposed to SHS or the frequency of exposure to SHS. No studies provided quantification of SHS concentrations experienced by this group of workers.ConclusionsExposure to SHS is likely to be common for workers who enter private homes to provide care. There is a need for research to understand the number of workers exposed to SHS, and the frequency, duration, and intensity of the exposure. Guidance should be developed to balance the rights and responsibilities of those requiring care alongside the need to prevent the harmful effects of SHS to workers providing care in domestic settings.ImplicationsVery little is known about home health and community care workers’ exposure to SHS. There is a need for research to quantify how many workers are exposed, how often and for how long exposure occurs, and the concentrations of SHS experienced. In many countries, home health care workers may be one of the largest working groups that experience exposure to SHS as part of their employment. The public health community needs to engage in a debate about how home health care workers can be best protected from SHS.

Longitudinal Residential Exposures and Lung Function Until Age 16

Background: Exposure to secondhand tobacco smoke (SHS), pets, and dampness and molds have been linked to reduced lung function. Distinct ranges of ages have been studied, but evidence for associations between longitudinal cumulative patterns of exposure and lung function is scarce. We investigated associations of longitudinal exposure to SHS, pets, and dampness and molds from birth/early life until age 14 with lung function growth between ages 12 and 16.Methods: We used data from the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) cohort (N&amp;#61;1461). Data on residential SHS, pets, dampness and molds exposures, as well as health and lifestyle were obtained by questionnaires during follow up. Lung function (forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC)) was measured during medical examinations at ages 12 and 16. Time-varying residential exposures from birth/early life into adolescence were characterized into longitudinal patterns using Latent Class Growth Analysis (LCGA). We analyzed the associations of patterns of residential exposures with FEV1 and FVC using linear mixed effects models.Results: SHS exposure patterns were associated with reduced FEV1 growth e.g. -32.6 ml/year (95% confidence interval (CI): -43.4 to -21.7) and reduced FVC growth -20.7 ml/year (-32.9 to -8.4 ) for almost always exposure pattern vs. very low SHS exposure pattern. Pet exposure patterns were associated with increased FEV1 growth e.g. 11.1 ml/year (3.4 to 18.8) for high early life exposure vs. very low pet exposure pattern. Early life exposure to dampness and molds was associated with reduced FEV1 growth (-18.8 ml/year (-27.9 to -9.6 )) and FVC growth (-15.8 ml/year (-26.0 to -5.7 )) as compared to very low dampness and mold exposure pattern.Conclusion: Longitudinal residential exposures to SHS, pets and dampness and molds were associated with lung function growth from 12 to 16 years.

Childhood Secondhand Tobacco Smoke Exposure and Ovarian Reserve Among Females Seeking Fertility Care, and Interaction with N- Acetyltransferase 2(NAT2) Genotype

This article describes subtype diversity among diagnosed HIV-1 infections in the United States during 2008–2016 by demographic or risk group and over time.HIV-1 polymerase sequences reported to the National HIV Surveillance System for persons in 17 U.S. states with HIV infection diagnosed during 2008–2016 were subtyped using COMET, an automated subtyping tool, and National HIV Surveillance System demographic data were analyzed.Subtype B was identified in 93.6% of 121,793 reported sequences. The most common non-B subtypes and circulating recombinant forms (CRFs) were C, CRF02_AG, A, CRF01_AE, and G. Elevated percentages of non-B subtypes or CRFs were found in persons who were female, aged less than 13 years at diagnosis, Asian, or had transmission attributable to heterosexual contact (females only) or perinatal exposure. Foreign-born persons had a higher percentage of non-B subtypes. The prevalence of non-B subtypes and CRFs increased from 5.0% in 2008 to 8.5% in 2016; among specific subtypes and CRFs, subtype G and CRF01_AE increased.Subtype B remains the predominant strain in the United States. Non-B subtypes and CRFs were not widespread, but diversity and numbers increased from 2008 through 2016, which could have consequences for clinical management, diagnostic testing, and vaccine development.