Indoor Smoking Research Articles

Association of early menopause with indoor air pollution: A multilevel modelling analysis of the nationally representative cross-sectional study in India

ABSTRACT Background: Early onset of menopause poses a risk for various health issues in women. This study aimed to primarily examine the link between early menopause and indoor air pollution (IAP) and demonstrate this association within the Indian population, considering their place of residence. Methods: This longitudinal study included 24,862 eligible participants out of 73,000 surveyed. Logistic regression analyses, both crude and adjusted odds ratios (aOR), were used to examine the association between early menopause and various sociodemographic factors, IAP, and place of residence (rural/urban). Results: The study identified a significant correlation between early menopause and body mass index (BMI), educational status, marital status, occupation, physical activity, self-rated health, and smoking status. Women using unclean fuels did not show increased odds of early menopause (aOR: 1.00, 95% confidence interval [CI]: 0.93-1.08). Poor ventilation was linked to a slightly higher incidence (28.1% vs. 26.9%, aOR: 1.07, 95% CI: 0.99-1.15). Exposure to pollution-generating sources was significantly associated with early menopause (28.8%, aOR: 1.10, 95% CI: 1.02-1.18), especially in urban areas (aOR: 1.17, 95% CI: 1.01-1.36) but not rural (aOR: 1.08, 95% CI: 0.99-1.17). Indoor smoking was linked to higher odds (aOR: 1.09, 95% CI: 1.02-1.17), particularly in rural areas (aOR: 1.09, 95% CI: 1.01-1.18). Overall, IAP was significantly associated with early menopause (aOR: 1.07, 95% CI: 1.01-1.15). Conclusion: The findings reveal that IAP, from sources such as smoke and pollutants, significantly increases the risk of early menopause among Indian women. Urban women are more affected by pollution, whereas indoor smoking impacts both urban and rural women. Enhancing indoor air quality could reduce early menopause and improve women’s health in India.

Anthracosis, epidemiology, gene and cancer: An updated mini-review.

It is believed that anthracosis is one of the most important occupational diseases, mainly seen in the residents of industrial areas and coal mine workers. This bronchial disease is more common in Asia's rural areas, particularly in the Middle East. In this study, we examined the epidemiology and genetic factors affecting this disease and its relationship with different types of cancer. In this review article, we searched four databases (Pubmed, the Cochrane Database of Systematic Reviews, Embase and Scopus) up to June 3, 2022, for published articles on anthracosis, epidemiology, gene, and cancer. Non-published studies, studies not published in indexed journals or without peer review, and studies not available in English were all excluded. The relationship between this disease and tobacco, smoking, air pollution, mycobacterium tuberculosis, gender, and indoor smoke was researched, and its prevalence was cited. Mutations in tumour suppressor genes such as P16 and P53 and expression levels of P16, CDH1, LUNX and RASSF1A genes were researched. Finally, this article discussed the relationship between anthracosis and cancers. According to the studied literature, antracotic people are more susceptible to pulmonary adenocarcinoma, hepatic nodules, renal cell carcinoma, and esophageal cancer.

METTL16 controls airway inflammations in smoking-induced COPD via regulating glutamine metabolism.

The persistent airway inflammation is the main characteristic of chronic obstructive pulmonary disease (COPD), typically caused by an indoor environment pollution cigarette smoke (CS). METTL16 is an m6A methyltransferase that has been proven to be closely associated with the occurrence of various diseases. However, its exact role in smoking-induced COPD remains to be investigated. In this study, we found that the level of METTL16 was aberrantly decreased in lung tissues of COPD smokers. Similarly, murine model induced by CS and lung epithelial cell model induced by cigarette smoke extract (CSE) also confirmed this discovery. Moreover, in the Mettl16-deficient (Mettl16+/-) mice challenged with CS, airway inflammation was aggravated. To identify the potential target genes and regulatory pathways through METTL16, methylated RNA immunoprecipitation sequencing (meRIP-seq), RNA sequencing (RNA-seq) and metabolomic profiling were used. Knockdown of METTL16 significantly reduced the stability of glutamic-oxaloacetic transaminase 2 (GOT2) and downregulated its expression through m6A modification, while reprogramed glutamine metabolism in lung epithelial cells. Significant reduction in inflammation levels was observed in the 3-month COPD murine model fed a glutamine-supplemented diet. Mechanistically, METTL16 could regulate lung epithelial mitochondrial function by participating in the reprogramming of glutamine metabolism. Our study characterized the role of the METTL16/GOT2/glutamine axis in the occurrence and development of COPD, and emphasized the potential value of METTL16 and glutamine in the therapy of chronic airway inflammation in smoking-induced COPD.

A Study on Adolescent Smoking Prevention and Cessation Policies: Based on the Propensity Score Matching-Difference-in-Differences Method.

Introduction: Adolescent smoking can lead to various health problems including atherosclerosis and cardiovascular disease, making it more difficult to quit smoking during adulthood. This study aims to evaluate the effect of the ordinance by assessing adolescents' smoking cessation behaviors and environmental conditions, according to the "Ordinance for the Prevention of Child and Adolescent Smoking and Support for Smoking Cessation", which was enacted in 2019 in Gwangju City, South Korea, for the first time in the country. Methods: The data for the analysis were obtained from the 2018 and 2021 Korea Youth Risk Behavior Survey. Propensity score matching (PSM) ensured homogeneity between ordinance-adopted and non-adopted areas, followed by a difference-in-differences (DID) analysis to assess changes in adolescent smoking behavior, secondhand smoke exposure, and related advertisements. Results: The difference-in-differences analysis of the homogeneous treatment and control groups in 2018 and 2021 showed statistically significant reductions in the variables "experience of secondhand smoke indoors at school" in the secondhand smoke category, and "exposure to smoking advertisements in convenience stores" in the smoking advertising category. However, there were no statistically significant changes in the other eight variables, such as smoking behavior and smoking cessation advertising. Conclusions: The results of this study suggest that the ordinance enacted in Gwangju Metropolitan City in 2019 created a positive environment for smoking prevention in convenience stores and schools for adolescents. Furthermore, if the ordinance is supplemented with the management of smoking behaviors and smoking cessation advertisements, it is expected to achieve the main purpose of the policy, which is to protect adolescents from smoking.

Effect of ventilation ducts on smoke spread between two adjacent cabins arranged along a corridor: An experimental and numerical investigation

When a fire occurs onboard a ship, ventilation ducts may become hidden pathways for smoke to spread, and this issue has long attracted attention in the industry. In this paper, an experimental and numerical investigation on the smoke movement and indoor temperature characteristics were carried out. The results show that under the effect of thermal buoyancy, ducts with the openings located on the ceiling can easily become pathways for smoke to spread across the cabins. Compared with the scenario where the ducts are removed, the smoke jets from the ducts make the smoke movement in the adjacent cabin more complicated, and the maximum temperature in the cabin is also significantly increased. Moreover, it is found that the mass flow rate (MFR) of the gas in the duct is mainly determined by the pressure difference Δp between the two ends of the duct, and the MFR increases linearly with the increase of Aflow(2Δp)1/2, but its maximum value is limited by the cross-sectional area of the duct. The research results will help to better understand the cross-compartment smoke spread under the effect of ventilation ducts and serve as a reference for the quantitative evaluation of the smoke flow in ducts.

The Relationship Between Intrinsic, Extrinsic Factors, and Socio Economic Status With the Level of Pneumonia Among Toddlers at Paal V Health Center, Jambi City

ABSTRACT Pneumonia is the most significant trigger of infections leading to death in children globally. Every year, an estimated 921,000 children under the age of 5 die due to pneumonia. This study aims to determine the relationship between intrinsic, extrinsic, and socioeconomic factors with the level of pneumonia in toddlers at the Paal V Community Health Center in Jambi City. This study uses an analytical quantitative research method, with a cross-sectional study design. The respondents in this study were 87 toddlers (aged 0-59 months). Data analysis was conducted using chi-square statistical analysis. The research results show the p-value of intrinsic factors, namely age PR 0.447 (p=0.339), gender PR 0.747 (p=0.668), Exclusive Breastfeeding PR 4.474 (p=0.000), low birth weight PR 2.364 (p=0.064), nutritional status PR 5.250 (p=0.000), history of Vitamin A supplementation PR = 3.897 (p=0.002), history of ARI PR 3.687 (p=0.003), history of asthma PR 5.647 (p=0.008), history of tuberculosis TB 2.514 (p=0.033). Extrinsic factors such as household crowding density PR 5.778 (p=0.000), smoking behavior indoors PR 0.763 (p=0.11). Socioeconomic factors such as mother's education PR 3.055 (p=0.025), mother's occupation PR 0.753 (p=0.036), and household income PR 2.703 (p=0.04). There is a relationship between Exclusive Breastfeeding, nutritional status, history of Vitamin A supplementation, history of ARI, history of asthma, history of Tuberculosis, household crowding density, mother's education, mother's occupation, and household income with the level of pneumonia in toddlers in Jambi City in 2023. Meanwhile, there is no relationship between age, gender, history of low birth weight, and indoor smoking behavior with the level of pneumonia in toddlers in Jambi City in 2023. Keywords: Pneumonia, Toddlers, Intrinsic, Extrinsic, Socioeconomic

Lady health workers smoking cessation initiative in rural Pakistan

BackgroundIn Pakistan, tobacco smoking and indoor smoke from cooking fires pose significant health risks. Lady Health Workers (LHWs) play a crucial role in improving healthcare access, particularly in rural areas. This study aimed to explore the practicality of training LHWs to deliver health education aimed at reducing household exposure to tobacco smoke and indoor biomass smoke, while also documenting baseline exposure levels and assessing the immediate impact on household awareness and intentions to reduce exposure.The ProgramOver 170 LHWs were trained and equipped with health education resources to raise awareness about the risks of tobacco and biomass smoke exposure. The training was designed to be integrated into their routine duties.ResultsOver 24 weeks, the program was delivered to 25,760 households in Gujranwala district. Approximately half of these households had at least one person who smoked, with 90% smoking indoors. Many (85%) households used indoor cooking fires. Only 24% of household head-women were aware of the health risks associated with indoor smoke exposure. Awareness of less harmful alternatives to smoking was low. Most households had someone who wanted to stop smoking and 51 women and 146 men agreed to try a tobacco harm reduction (THR) product. Primary health units’ staff appreciated the project, especially the training provided. They believed the program could be sustainable, and LHWs expressed interest in continuing it.ConclusionThe study demonstrated the practicality of training LHWs to deliver health education on reducing tobacco and biomass smoke exposure in rural settings. The program effectively raised awareness and showed potential for sustainable integration into existing healthcare structures, highlighting the value of community-centric approaches in low-resource settings.

Prevalence and predictors of indoor secondhand tobacco smoke exposure among Senegalese household population

ABSTRACT Indoor secondhand tobacco smoke (SHS) exposure imposes substantial health risks among all household members, including children. Earlier studies reported high tobacco use in West African country Senegal. Despite the high health risks, no recent study has presented the situation of indoor SHS exposure in Senegal. Using cross-sectional design, we assessed the prevalence and predictors of indoor SHS exposure in Senegal. We used recent demographic and health survey (DHS) 2023 data of 75,080 household members of all ages. Analyzing these data, the prevalence of indoor SHS was assessed, and binomial logistic regression was used to identify predictors of indoor SHS exposure. The prevalence of indoor SHS exposure in Senegal was 24% (95% CI 23.5–24.2). Females, compared to males, were less likely to get indoor SHS exposure (aOR 0.9; 95% CI 0.8–0.9). Compared to the urban population, rural residents were less likely to get indoor SHS exposure (aOR 0.8; 95% CI 0.7–0.8). Individuals lived in households where members experienced shock events (aOR 1.2; 95% CI 1.1–1.2) and had members with psychological issues (aOR 1.5; 95% CI 1.4–1.6) were more susceptible to indoor SHS exposure. We conclude that indoor SHS exposure is high, particularly among Senegalese males, urban residents, and the poorest wealth quintiles. Additionally, susceptibility to indoor SHS increases with the presence of stressors like past adverse shock events and mental health issues. Both of these stressors encourage indoor smoking and intensify the risk of indoor SHS exposure among all household members. Community-based interventions providing behavior change communication on quitting tobacco and preventing indoor smoking are recommended.

Energy retrofits: Factors affecting a just transition to better indoor air quality

In comparison with other European countries, Ireland has a disproportionately high number of poorly performing energy-inefficient buildings. Consequently, Ireland has one of the most ambitious energy retrofit programmes in Europe. The aim of this study was to evaluate the impact of deep energy renovation measures i.e. (replacement of heating system and upgrade to building envelope) on indoor air quality, thermal comfort and ventilation in a sample of primarily social housing in Ireland. A mixed methods approach including measurement of indoor air quality and a thermal comfort questionnaire survey was employed. Indoor concentration measurements of PM2.5, carbon dioxide, formaldehyde, and radon along with measurements of air temperature and relative humidity were made (N=14). Occupants (n=56) completed a thermal comfort questionnaire survey pre- and post-retrofit. Data collection ran from autumn 2020 until autumn 2023.Thermal comfort improved post-retrofit along with occupant satisfaction with the indoor thermal environment and heating-systems. Post-retrofit, higher bedroom CO2, and higher PM2.5 concentrations were recorded in both living areas and bedrooms. Occupant behaviours e.g. blocking wall vents were significant predictors of poorer ventilation while smoking indoors was related to higher concentrations of PM2.5. In general, homes that had mechanical ventilation systems installed were better ventilated. Underventilation, as indicated by visible condensation or mould was observed in half of the social homes surveyed and reported by questionnaire respondents (26 %). Tailored communications to occupants regarding the important role of ventilation and indoor air quality is required as part of retrofit to optimise impacts on IEQ.

Impacts of revised smoke-free regulations under the 2020 Japan Health Promotion Act on cigarette smoking and heated tobacco product use in indoor public places and homes: findings from 2018 to 2021 International Tobacco Control (ITC) Japan Surveys

BackgroundIn April 2020, Japan’s revised Health Promotion Act (HPA) banned cigarette smoking and heated tobacco products (HTP) use in indoor public places but exempted small establishments and permitted smoking-designated/HTP-designated rooms....

Ambient smoke exposure and indoor air quality in eastern Massachusetts during the 2023 wildfire season

ABSTRACT Widespread North American wildfires in 2023 led to exposure to ambient wildfire smoke outside of traditionally wildfire-prone regions. The objective was to evaluate levels of indoor air pollutants in relation to ambient wildfire smoke exposure in eastern Massachusetts. Using a real-time multipollutant sensor system in five Boston area households, this study assessed indoor fine particulate matter (PM2.5), nitrogen dioxide (NO2), and total volatile organic compound concentrations (TVOC) two days before and during days of hazardous wildfire smoke exposure (smoke days). The relationship between ambient PM2.5 from regulatory monitors and indoor PM2.5 before and during smoke days was investigated by mixed effects linear regression. During smoke days and the preceding non-smoke days, median indoor PM2.5 was 9.9 µg/m3 and 3.5 µg/m3 (p < 0.001), respectively; median NO2 was 20.5 ppb and 18.4 ppb (p = 0.11); median TVOC was 6,715 µg/m3 and 5,361 µg/m3 (p = 0.35). A 1% increase in ambient PM2.5 was associated with a 0.93% increase in indoor PM2.5 on smoke days (95% CI, 0.54%–1.32%) and a 0.34% increase on non-smoke days (95% CI, 0.17%–0.66%), though interaction testing of smoke day status was not statistically significant (p = 0.14). In Northeastern US homes, indoor PM2.5 increased significantly during ambient wildfire smoke exposure, which may reflect increased infiltration and increased indoor particle-generating activities during smoke days. Implications: This study reports on household exposure to wildfire smoke in eastern Massachusetts, finding that indoor PM2.5 more than doubled compared to preceding non-smoke days, while indoor NO2 and TVOC did not significantly rise. Though the generalizability of this study is limited by the small number of homes studied, the findings suggest that more investigation is needed to understand indoor air pollution during future wildfire smoke exposure in regions not traditionally wildfire-prone and to inform mitigation efforts.

The Association Between The Physical Condition of the House and the Smoking Habits of Residents with the Incidence of Pneumonia In Children Under Five Years

Pneumonia is leading cause of death worldwide, with a prevalence of 44%, and is second leading cause of death among under-fives in Indonesia, at 15.5%. Pneumonia is caused by viruses and bacteria that are associated with physical conditions, air quality, and smoking habits in house. This study aimed to determine association between physical house conditions and smoking habits with incidence of pneumonia in children under five years in Cengkareng Health Center working area. This study was a case-control design analytic observational study. Population involved chindren under five aged 12-59 months with a sample of 43 cases and 43 controls calculated using Lemeshow’s formula, taken using purposive sampling technique. Independent variables included floor and wall types, ventilation, occupancy density, temperature, humidity, light intensity, PM10 and PM2.5 levels, and smoking habits. Dependent varariable are incident of pneumonia. Data were collected through observation, sanitarian kits, and questionnaires. Data were analyzed using chi-square and logistic regression with 95% CI and alpha 0.05. The results showed that PM2.5 levels (p=0.010, OR=3.290, 95% CI=1.323-8.181) and indoor smoking (p=0.044, OR=2.758, 95% CI=1.027-7.410) were most significant factors associated with pneumonia. This study recommends optimizing educational programs regarding PM2.5 exposure and smoking habits to improve healthy living practices and reduce risk of pneumonia

Support for regulating smoking in private and public places by adults who currently smoke and recently quit smoking in Spain.

While indoor smoking restrictions are common, outdoor restrictions are still rare. We explored opinions and support for regulating smoking in different indoor and outdoor environments among adults who smoke and those who recently quit smoking, in Spain. The 2021 ITC EUREST-PLUS Spain Survey is a cross-sectional study conducted among a nationally representative sample of 1006 adults aged ≥18 years who smoked cigarettes (n=867) or had recently quit smoking (n=139). Using Poisson regression with robust variance, we estimated adjusted prevalence and prevalence ratios of favorable opinions on regulating smoking in different indoor and outdoor environments and support for regulation in unregulated outdoor environments, by sociodemographic and smoking-related characteristics. There were highly favorable opinions for regulating smoking in places with minors (>95% in primary and secondary playgrounds, and cars with pre-school children and minors) and outdoor transportation (60-80%). There were less favorable opinions for regulating smoking in outdoor terraces of bars/pubs and restaurants (15-20%). Support for further total outdoor regulations on smoking was moderate for markets/shopping centers, public building entrances and swimming pools (40-60%), and low for restaurants/bars/pubs (29.2%). Having quit smoking, having no significant others who smoke and/or believing that cigarette smoke is harmful to others, were factors positively associated with favorable opinions and support for regulating smoking. The settings in Spain with the most favorable opinions for regulation among adults who smoke and have recently quit smoking are places with minors, private cars with others and outdoor areas of public transportation, while the settings with the least favorable opinions were outdoor terraces of bars, pubs, and restaurants. Support for further total outdoor smoking bans is generally moderate, but low for restaurants, bars, and pubs. Overall, these findings suggest the feasibility of extending smoke-free policies to other public and private settings to protect others from tobacco smoke exposure.

An Image Restoration Method for Improving Matching Robustness of Indoor Smoke Scene

An Image Restoration Method for Improving Matching Robustness of Indoor Smoke Scene

Phase distribution and probabilistic risk assessment of polycyclic aromatic hydrocarbons in indoor air of coffee shops at Zahedan, Iran

Polycyclic aromatic hydrocarbons (PAHs) are a class of hydrocarbons, some of which are established human carcinogens. Human exposure to these chemicals is complex and originates from both indoor and outdoor sources. This study measured the concentration of PAHs in the gaseous and particulate phases during the cold months of 2022 using XAD-2 sorbent tubes and Polytetrafluoroethylene (PTFE) filters in the indoor air of coffee shops in Zahedan, Iran (n = 23). The average concentrations of particulate-bound PAHs and gaseous PAHs were 13,411.86 ± 6517.24 ng/m³ and 6432.76 ± 4311.72 ng/m³, respectively. Source apportionment analyses indicated that the primary sources of PAHs in coffee shops were fossil fuel combustion and environmental tobacco smoke (ETS), commonly referred to as second and third-hand smoke. The lifetime cancer risk (LTCR) of inhaled PAHs was calculated using the Monte Carlo simulation method. The mean LTCR for adults and children from inhaling these substances were 9.43 × 10-6 ± 5.06 × 10-6 and 5.34 × 10-6 ± 2.87 × 10-6, respectively. The hazard quotient (HQ) of PAHs exceeded 1. These findings highlight the need to reduce PAHs exposure in public spaces through proper health warning labels and regulated indoor smoking policies.

Quantitative evaluation of nicotine and particulate matter exposure for passive- and non-smokers via a nicotine passive sampler and a particulate matter sensor

AbstractPassive smoking poses a major hazard to the health of non-smokers. Cigarette combustion emits environmental tobacco smoke (ETS) that contains various pollutants, including volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons, and particulate matter with particles &lt; 2.5 μm in aerodynamic diameter (PM2.5). Therefore, to assess the risk of passive smoking, it is necessary to determine the exposure levels to ETS compounds caused by passive smoking. However, it is difficult to assess exposure to ETS compounds by excluding the effects of other sources of pollution. In this study, we assessed the individual exposure levels to ETS compounds using a nicotine passive sampler and PM2.5 sensor in 258 non-smokers. Median nicotine and PM2.5 concentrations were 0.065 and 7.5 µg m− 3, respectively. The median nicotine concentration was nearly identical to that found in non-smoking areas (0.05 µg m− 3). The median PM2.5 concentrations were below the standard value for indoor PM2.5 concentrations (12 µg m− 3). These results indicated that the effect of passive smoking was rather modest. Nicotine concentrations in individuals exposed to passive smoking indoors were significantly higher than in those not exposed to passive smoking. Nicotine exposure from domestic passive smoking was twice that from non-domestic passive smoking. There was no significant difference in PM2.5 exposure between passive smoking in domestic and non-domestic settings. Moreover, it was suggested that passive smoking was equivalent to the act of smoking 2.4 × 10− 3 cigarettes per day.

Promising microRNAs in pre-diagnostic serum associated with lung cancer up to eight years before diagnosis: a HUNT study

IntroductionBlood biomarkers for early detection of lung cancer (LC) are in demand. There are few studies of the full microRNome in serum of asymptomatic subjects that later develop LC. Here we searched for novel microRNA biomarkers in blood from non-cancer, ever-smokers populations up to eight years before diagnosis.MethodsSerum samples from 98,737 subjects from two prospective population studies, HUNT2 and HUNT3, were considered initially. Inclusion criteria for cases were: ever-smokers; no known cancer at study entrance; 0–8 years from blood sampling to LC diagnosis. Each future LC case had one control matched to sex, age at study entrance, pack-years, smoking cessation time, and similar HUNT Lung Cancer Model risk score. A total of 240 and 72 serum samples were included in the discovery (HUNT2) and validation (HUNT3) datasets, respectively, and analysed by next-generation sequencing. The validated serum microRNAs were also tested in two pre-diagnostic plasma datasets from the prospective population studies NOWAC (n = 266) and NSHDS (n = 258). A new model adding clinical variables was also developed and validated.ResultsFifteen unique microRNAs were discovered and validated in the pre-diagnostic serum datasets when all cases were contrasted against all controls, all with AUC > 0.60. In combination as a 15-microRNAs signature, the AUC reached 0.708 (discovery) and 0.703 (validation). A non-small cell lung cancer signature of six microRNAs showed AUC 0.777 (discovery) and 0.806 (validation). Combined with clinical variables of the HUNT Lung Cancer Model (age, gender, pack-years, daily cough parts of the year, hours of indoor smoke exposure, quit time in years, number of cigarettes daily, body mass index (BMI)) the AUC reached 0.790 (discovery) and 0.833 (validation). These results could not be validated in the plasma samples.ConclusionThere were a few significantly differential expressed microRNAs in serum up to eight years before diagnosis. These promising microRNAs alone, in concert, or combined with clinical variables have the potential to serve as early diagnostic LC biomarkers. Plasma is not suitable for this analysis. Further validation in larger prospective serum datasets is needed.

Exposure to toxic chemical elements among people living with HIV/AIDS in Northern Tanzania

Environmental exposure to toxic chemicals including cadmium (Cd), lead (Pb), and mercury (Hg), are known risk factors for cardiovascular (CVD) and kidney disease. In people living with HIV (PLWH), CVD and kidney disease are the leading cause of death. Neither traditional risk factors nor markers of HIV infection fully explain such an increased risk. It is of paramount importance to establish the epidemiology of toxic chemicals exposure in PLWH, to inform screening and prevention interventions in this vulnerable population. This cross-sectional study compares toxic chemical levels (T-Cd, T-Pb, and T-Hg) among PLWH and HIV-uninfected adults in Northwestern Tanzania. A total of 495 PLWH and 505 HIV-uninfected subjects were analyzed. Spearman's rank correlations were used to examine the relationship between toxic chemical elements by HIV status. Linear regression models were used to determine the association between exposures and outcomes of interest among study participants. In both PLWH and HIV-uninfected adults, blood T-Cd, T-Pb, and T-Hg levels were frequently found at levels above the reference value of 5, 50, and 20 μg/L, respectively. Overall, factors associated with blood toxic chemical levels included vegetable servings per week, obesity, untreated water sources, use of alcohol, and HIV. Among PLWH, weekly vegetable intake provided a protective effect against T-Cd (Coeff = −0.03, 95%CI = −0.06, −0.01) and T-Pb (Coeff = −0.05, 95%CI = −0.09, −0.01) exposure among PLWH. Alcohol intake (Coeff = 0.10, 95%CI = 0.06, 0.13), obesity (Coeff = 0.08, 95%CI = 0.02, 0.13), longer duration to indoor smoke exposure (Coeff = 0.003, 95%CI = 0.001, 0.004), and HIV infection (Coeff = 0.11, 95%CI = 0.07, 0.15) were associated with increased individuals blood T-Hg levels. Individuals in northwestern Tanzania, including PLWH, have high blood levels for T-Cd, T-Pb, and T-Hg. Factors associated with higher blood levels include water sources, obesity, use of alcohol, exposure to indoor smoke, and HIV infection.

Secondhand Nicotine Absorption From E-Cigarette Vapor vs Tobacco Smoke in Children

ImportanceWith the prevalence of e-cigarette use (vaping) increasing worldwide, there are concerns about children’s exposure to secondhand vapor.ObjectiveTo compare nicotine absorption among children who are (1) exposed to secondhand tobacco smoke only or (2) exposed to secondhand vapor only with (3) those exposed to neither.Design, Setting, and ParticipantsThe US Continuous National Health and Nutrition Examination Survey (NHANES) is a repeat cross-sectional survey. Participants are interviewed in their homes and, several days after, visit a mobile examination center to provide biological specimens. This study uses data from a nationally representative sample of US households from 2017 to 2020. Participants were children aged 3 to 11 years with serum cotinine levels incompatible with current firsthand nicotine use (ie, <15 μg/L). The final analysis was conducted on January 9, 2024.ExposuresReported exposure to secondhand smoke or vapor indoors in the past 7 days (only secondhand smoke, only secondhand vapor, or neither). Covariates included age, sex, ethnicity, family income, body weight, and height.Main Outcomes and MeasuresThe primary outcome was serum cotinine concentration, an objective biomarker of nicotine absorption. Geometric mean cotinine levels and 95% CIs were calculated using log-normal tobit regression, accounting for the complex survey design and weights.ResultsThe mean (SD) age of the 1777 children surveyed was 7.4 (2.6) years, 882 (49.6%) were female, and 531 (29.9%) had family incomes below the poverty level. Nicotine absorption, as indexed by serum cotinine level, was highest among children only exposed to secondhand smoke (0.494 μg/L μg/L; 95% CI, 0.386-0.633 μg/L), followed by those exposed only to secondhand vapor (0.081 μg/L; 95% CI, 0.048-0.137 μg/L), equating to 83.6% (95% CI, 71.5%-90.5%; P < .001) lower nicotine absorption. Among children with no reported secondhand exposure, the geometric mean cotinine level was 0.016 μg/L (95% CI, 0.013-0.021 μg/L), or 96.7% (95% CI, 95.6%-97.6%; P < .001) lower than for those with exposure to secondhand smoke. Results were similar after covariate adjustment.Conclusions and RelevanceIn this cross-sectional study of US children, nicotine absorption was much lower in children who were exposed to secondhand vapor vs secondhand smoke, but higher than in those exposed to neither. These findings suggest that switching from smoking to vaping indoors may substantially reduce, but not eliminate, children’s secondhand exposure to nicotine and other noxious substances.

Association of anaemia with indoor air pollution among older Indian adult population: multilevel modelling analysis of nationally representative cross-sectional study

IntroductionAnaemia is a disease of public health importance with multi-causal pathways. Previous literature suggests the role of indoor air pollution (IAP) on haemoglobin levels, but this has been studied less due to logistic constraints. A high proportion of the population in developing countries, including India, still depends on unclean fuel, which exacerbates IAP. The objective was to study the association between anaemia and IAP among the older Indian adult population (≥ 45 years) as per gender.MethodsOur study analysed the nationally representative dataset of the Longitudinal Ageing Study in India (LASI 2017–18, Wave-1). We have documented the association of anaemia (outcome variable) with IAP (explanatory variable). To reduce the confounding effects of demographic and socioeconomic; health related and behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was conducted. States and union territories were categorised cross tabulated as low, middle and high as per anaemia and IAP exposure. P value < 0.05 was considered statistically significant. SATA version 17 was used for analysis.ResultsMore than half (52.52%) of the participants were exposed to IAP (male (53.55%) > female (51.63%)). The odds of having anaemia was significantly 1.19 times higher (AOR 1.19 (1.09–1.31)) among participants using unclean/ solid fuel. The adjusted odds were significantly higher among participants exposed to pollution-generating sources (AOR 1.30; 1.18–1.43), and household indoor smoking (AOR 1.17 (1.07–1.29). The odds of having anaemia were significantly higher (AOR 1.26; 1.15–1.38) among participants exposed to IAP, which was higher in males (AOR 1.36; 1.15–1.61) than females (AOR 1.21; 1.08–1.35). Empowered Action Group (EAG) states like Uttar Pradesh, Chhattisgarh, Madhya Pradesh, Bihar had both high anaemia and IAP exposure.ConclusionThis study established the positive association of anaemia with indoor air pollution among older Indian adults through a nationally representative large dataset. The association was higher among men. Further research is recommended to understand detailed causation and to establish temporality. It is a high time to implement positive intervention nationally to decrease solid/ unclean fuel usage, vulnerable ventilation, indoor smoking, IAP and health hazards associated with these with more focused actions towards EAG states.