https://works.bepress.com/david_mannino/26/download/

COPD in never smokers: results from the population-based burden of obstructive lung disease study.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)61378-6.pdf

Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study

An imbalance in reducing and oxidizing (redox) systems favoring a more oxidative environment is present in asthma and linked to the pathophysiology of the defining symptoms and signs including airflow limitation, hyper-reactivity, and airway remodeling. High levels of hydrogen peroxide, nitric oxide (•NO), and 15-F2t-isoprostane in exhaled breath, and excessive oxidative protein products in lung epithelial lining fluid, peripheral blood, and urine provide abundant evidence for pathologic oxidizing processes in asthma. Parallel studies document loss of reducing potential by nonenzymatic and enzymatic antioxidants. The essential first line antioxidant enzymes superoxide dismutases (SOD) and catalase are reduced in asthma as compared to healthy individuals, with lowest levels in those patients with the most severe asthma. Loss of SOD and catalase activity is related to oxidative modifications of the enzymes, while other antioxidant gene polymorphisms are linked to susceptibility to develop asthma. M...

Redox control of asthma: molecular mechanisms and therapeutic opportunities.

Original Research C is an important and increasing cause of morbidity and mortality worldwide. COPD is projected to rank third among all causes of death by 2020, 1 yet its impact is underestimated by health and government offi cials. The term “COPD” has little public recognition, and a clear connection has not been made to most of its diverse risk factors. Although cigarette smoke is widely acknowledged as the single most important risk factor for COPD, it is now recognized that never smokers may account for between one-fourth and one-third of all COPD cases. 2-5 A recent review of existing data supports the notion that the burden of nonsmoking COPD is much higher than supposed in both developing and developed countries. 6

Results From the Population-Based Burden of Obstructive Lung Disease Study

https://www.amjmed.com/article/S0002-9343(05)00505-X/pdf

Airway obstruction in never smokers: Results from the Third National Health and Nutrition Examination Survey

The aim of the present study was to examine the relationship between reported environmental tobacco smoke (ETS) exposure and respiratory symptoms.

In 1996, a postal questionnaire was randomly distributed in three areas of Estonia to a population-based sample, of which 4,995 females and 1,822 males had never smoked. The main outcome measures were current respiratory symptoms and the amount of reported ETS exposure outside the home.

ETS exposure at home was more common in females (31% versus 19%), while exposure outside of the home was more common in males (53% versus 7%). Females reported more symptoms from tobacco smoke than males (37.7% versus 21.6%). If ETS exposure outside of the home exceeded 5 h daily, the risk for wheeze (odds ratio (OR) 2.67, 95% confidence interval (CI) 1.98–3.61) and physician-diagnosed asthma (OR 1.79, 1.02–3.16) were increased. ETS exposure outside of the home was shown to be strongly related to almost all respiratory symptoms in a dose/response manner. ETS exposure at home did not show significantly elevated ORs for any respiratory symptoms.

This study shows that females seem to be more troubled by environmental smoke exposure than males and provides further evidence of the serious health hazards associated with environmental smoke exposure. Indeed, the findings of this study support a ban on smoking in the workplace and public areas.

This study was supported by grants from the Estonian Science Foundation, The National Health Institute, The Heart and Lung Foundation, and The Research Committee of Orebro County Council, Sweden.

https://erj.ersjournals.com/content/erj/21/4/672.full.pdf

Passive smoking and respiratory symptoms in the FinEsS Study

Passive smoking and respiratory symptoms in Estonia (The FinEsS Studies)

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Passive smoking and respiratory symptoms in the FinEsS Study

Passive smoking and respiratory symptoms in Estonia (The FinEsS Studies)