Dataset Information

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis.

ABSTRACT:

Context

In 2006, we reviewed the evidence on environmental tobacco smoke (ETS) and breast cancer in nonsmoking women. Since then various studies and reviews have been published but opinion remains divided.

Objective

To provide an updated review.

Methods

We extracted study details, derived relative risk (RR) estimates with confidence intervals (CIs) for various ETS exposure indices, and conducted meta-analyses.

Results

The update increased the number of studies from 22 to 47. Using an index for each study most closely equivalent to "spouse ever smoked", a weak but significant association was seen (random-effects RR?=?1.15, 95% CI?=?1.07-1.23). However, the estimates were heterogeneous: higher for Asian studies than for North American or European studies, higher for studies adjusting for fewer potential confounding variables, and close to 1.0 for prospective studies, regardless of whether or not they asked detailed questions on ETS exposure. The RR for eight prospective studies asking detailed questions was 1.003, 95% CI?=?0.96-1.05. Risk was increased in premenopausal women (RR?=?1.36, 95% CI?=?1.15-1.60), but not postmenopausal women. Dose-response findings were similarly heterogeneous. No significant increase was seen for childhood or workplace exposure, but an increase was seen for total exposure (RR?=?1.22, 95% CI?=?1.09-1.37).

Conclusions

Increases mainly derived from case-control studies are prone to recall bias. Study weaknesses and possible publication bias limit interpretation. Considering also the weak association of smoking with breast cancer, and the much lower exposures from ETS than from smoking, our analyses do not clearly demonstrate that ETS exposure increases risk of breast cancer in nonsmokers. More research is needed.

SUBMITTER: Lee PN

PROVIDER: S-EPMC5020324 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis.

Lee Peter N PN Hamling Jan S JS

Inhalation toxicology 20160801 10

<h4>Context</h4>In 2006, we reviewed the evidence on environmental tobacco smoke (ETS) and breast cancer in nonsmoking women. Since then various studies and reviews have been published but opinion remains divided.<h4>Objective</h4>To provide an updated review.<h4>Methods</h4>We extracted study details, derived relative risk (RR) estimates with confidence intervals (CIs) for various ETS exposure indices, and conducted meta-analyses.<h4>Results</h4>The update increased the number of studies from 2 ...[more]

PMID: 27541291

Similar Datasets

Project description:ObjectiveA systematic review was conducted to summarize the epidemiological evidence on environmental tobacco smoke (ETS) exposure and prevalent periodontitis endpoints among nonsmokers.MethodsWe searched PubMed, EMBASE, Web of Science, Pro-Quest dissertations, and conference proceedings of a dental research association. We included studies from which prevalence odds ratios (POR) could be extracted for periodontitis determined by examiner measurements of clinical attachment level (CAL) and/or probing pocket depth (PD) or self-report of missing teeth. Studies determined ETS exposure by self-report or biomarker (cotinine) levels.ResultsFor studies reporting CAL and/or PD (n = 6), associations were stronger with cotinine-measured exposure (n = 3; random effects POR [95% prediction interval] = 1.63 (0.90, 2.96)) than self-reported exposure (n = 3; random effects POR = 1.15 (0.68, 1.96)). There was no meaningful difference in summary estimate for studies reporting CAL and/or PD endpoint (n = 6; random effects POR = 1.34 (0.93, 1.94)) as opposed to tooth loss (n = 2; random effects POR = 1.33 (0.52, 3.40)).ConclusionsThere appears to be a positive association between exposure to ETS and prevalent periodontitis endpoints among nonsmokers, the magnitude of which depended mostly on the method of ETS assessment.ImplicationsThe notoriety of ETS is often discussed in terms of its associations with cancer, chronic conditions like cardiovascular diseases, and respiratory illnesses in children. However, very little attention is paid to its association with oral diseases, especially periodontitis. Periodontitis affects a large proportion of the population and is a major cause of tooth loss. This study summarized the epidemiologic association between exposure to ETS and periodontitis among nonsmokers. Although the findings are consistent with a positive association, methodological weaknesses relating to study design, assessment of ETS, periodontitis, and adjustment covariates were highlighted and recommendations for improvement in future studies provided.

Project description:The developing fetus is especially vulnerable to environmental toxicants, including tobacco constituents. The aim of this study was to assess the impact of environmental tobacco smoke (ETS) exposure during pregnancy on child neurodevelopment within the first two years of life. The study population consisted of 461 non-smoking pregnant women (saliva cotinine level <10 ng/mL). Maternal passive smoking was assessed based on the cotinine level in saliva analyzed by the use of high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS) and by questionnaire data. The cotinine cut-off value for passive smoking was established at 1.5 ng/mL (sensitivity 63%, specificity 71%). Psychomotor development was assessed in children at the age of one- and two-years using the Bayley Scales of Infant and Toddler Development. Approximately 30% of the women were exposed to ETS during pregnancy. The multivariate linear regression model indicated that ETS exposure in the 1st and the 2nd trimesters of pregnancy were associated with decreasing child language functions at the age of one (? = -3.0, p = 0.03, and ? = -4.1, p = 0.008, respectively), and two years (? = -3.8, p = 0.05, and ? = -6.3, p = 0.005, respectively). A negative association was found for cotinine level ?1.5 ng/mL in the 2nd trimester of pregnancy and child cognition at the age of 2 (? = -4.6, p = 0.05), as well as cotinine levels ?1.5 ng/mL in all trimesters of pregnancy and child motor abilities at two years of age (? = -3.9, p = 0.06, ? = -5.3, p = 0.02, and ? = -4.2, p = 0.05, for the 1st, the 2nd, and the 3rd trimester of pregnancy, respectively; for the 1st trimester the effect was of borderline statistical significance). This study confirmed that ETS exposure during pregnancy can have a negative impact on child psychomotor development within the first two years of life and underscore the importance of public health interventions aiming at reducing this exposure.

Dataset Information

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis.

Context

Objective

Methods

Results

Conclusions

Publications

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women. An updated review and meta-analysis.

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