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  1. Ramesh KN, Vidyadaran MK, Goh YM, Nasaruddin AA, Jammal ABE, Zainab S
    Med J Malaysia, 2005 Aug;60(3):305-10.
    PMID: 16379184
    A study was undertaken to 1) determine the effects of tobacco smoke exposure on maternal and neonatal weight and body mass index (BMI) and placental weight, volume and surface area and 2) establish any correlations between the placental surface area, volume and weight with maternal and neonatal body weight and BMI in mothers exposed to cigarette smoke. A total of 154 full-term placentae, 65 from mothers exposed to tobacco smoke and 89 from non-exposed mothers were collected from Kuala Lumpur Maternity Hospital. The placental surface area was determined using a stereological grid, the volume by Scherle's method and the weight by using an electronic weighing machine. In general there were no differences in maternal, placental and neonatal parameters between the exposed and non-exposed groups. However, there were significant correlations between placental weight with maternal weight and maternal BMI in both exposed (r = 0.315; p = 0.013) and (r = 0.265; p = 0.038), and non-exposed (r = 0.224; p = 0.035) and (r = 0.241; p = 0.023) mothers. It was also found that the maternal weight on admission correlated significantly with placental weight in both Malay (r = 0.405; p = 0.020) and Indian (r = 0.553; p = 0.050) passive smokers. Correcting the placental parameters for the maternal weight had no effect on the results.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  2. Nur Husna SM, Siti Sarah CO, Tan HT, Md Shukri N, Mohd Ashari NS, Wong KK
    Sci Rep, 2021 01 13;11(1):1245.
    PMID: 33441633 DOI: 10.1038/s41598-020-79208-y
    The breakdown of nasal epithelial barrier occurs in allergic rhinitis (AR) patients. Impairment of cell junction molecules including tight junctions (TJs) and desmosomes plays causative roles in the pathogenesis of AR. In this study, we investigated the transcript expression levels of TJs including occludin (OCLN), claudin-3 and -7 (CLDN3 and CLDN7), desmoglein 3 (DSG3) and thymic stromal lymphopoietin (TSLP) in AR patients (n = 30) and non-allergic controls (n = 30). Nasal epithelial cells of non-allergic controls and AR patients were collected to examine their mRNA expression levels, and to correlate with clinico-demographical and environmental parameters. We demonstrated that the expression of OCLN (p = 0.009), CLDN3 (p = 0.032) or CLDN7 (p = 0.004) transcript was significantly lower in AR patients compared with non-allergic controls. No significant difference was observed in the expression of DSG3 (p = 0.750) or TSLP (p = 0.991) transcript in AR patients compared with non-allergic controls. A significant association between urban locations and lower OCLN expression (p = 0.010), or exposure to second-hand smoke with lower CLDN7 expression (p = 0.042) was found in AR patients. Interestingly, none of the TJs expression was significantly associated with having pets, frequency of changing bedsheet and housekeeping. These results suggest that defective nasal epithelial barrier in AR patients is attributable to reduced expression of OCLN and CLDN7 associated with urban locations and exposure to second-hand smoke, supporting recent findings that air pollution represents one of the causes of AR.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  3. Hasniah AL, Tan YP, Nur Buhairah MA, Chan TW, Muhammad Nabil TI, Syed Zulkifli SZ
    Public Health, 2016 08;137:182-4.
    PMID: 26976490 DOI: 10.1016/j.puhe.2015.10.028
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  4. Mohamed M, Sulaiman SA, Sirajudeen KN
    Toxicol Ind Health, 2013 Apr;29(3):264-71.
    PMID: 22275383 DOI: 10.1177/0748233711432568
    Cigarette smoking is associated with sexual dysfunction and impaired fertility in males. The aim of this study was to determine the potential protective effect of honey against the toxic effect of cigarette smoke (CS) on sexual behavior and fertility of male rats. Thirty-two adult Sprague-Dawley rats were randomly divided into four groups (8 rats/group) as control, honey (H), CS and H plus CS (H + CS) groups. Rats in control and CS groups received oral administration of distilled water daily while rats in H and H + CS groups received honey (1.2 g/kg body weight/day) by oral gavage. Rats in CS and H + CS groups were also exposed to CS for 8 min 3 times/day. From 10 to 13 weeks of treatment, each male rat was cohabited with 3 untreated female rats for sexual behavioral and reproductive performance studies. Honey significantly increased the percentages of rats achieving intromission and ejaculation as well as increased mating and fertility indexes of male rats exposed to CS. Thus, honey has a protective effect against CS-induced impaired sexual behavior and fertility in male rats.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  5. Zulkifli A, Abidin NZ, Abidin EZ, Hashim Z, Rahman AA, Rasdi I, et al.
    Asian Pac J Cancer Prev, 2014;15(12):4815-21.
    PMID: 24998546
    BACKGROUND: This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation.

    MATERIALS AND METHODS: A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire.

    RESULTS: The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8).

    CONCLUSIONS: Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  6. Abidin NZ, Zulkifli A, Abidin EZ, Rasdi I, Ismail SN, Rahman AA, et al.
    Int J Tuberc Lung Dis, 2014 Jul;18(7):856-61.
    PMID: 24902566 DOI: 10.5588/ijtld.13.0906
    OBJECTIVE: To identify the relationship between knowledge, attitude and perception regarding environmental tobacco smoke (ETS) and smoking among Malaysian adolescents living in states with complete or partial smoke-free legislation (SFL).
    METHODS: A total of 898 respondents aged 13-14 years were randomly selected from 21 secondary schools. The Malay version of the modified Global Youth Tobacco Survey questionnaire was used. Hierarchical logistic regression was performed in examining predictors of smoking attempt among adolescents.
    RESULTS: Participants exposed to ETS >5 h/day were more likely to have smoked compared to those exposed to ETS <1 h/day (OR 4.1, 95%CI 1.03-16.0). Living in a state with partial SFL was associated with a two-fold increase in self-reported smoking attempts (OR 1.95, 95%CI 1.10-3.43) compared to living in a state with complete SFL. Negative attitudes and perceptions towards smoking and ETS exposure were linked to lower smoking attempts in states with complete SFL.
    CONCLUSIONS: Adolescents with limited ETS exposure who lived in a state with complete SFL were less likely to attempt smoking compared to those exposed more regularly to ETS and living in a state with partial SFL. Preventing adolescents from becoming smokers is the key to reducing national prevalence rates in smoking. There is a need to implement comprehensive smoke-free legislation nationally across Malaysia.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  7. Norbanee TH, Norhayati MN, Norsa'adah B, Naing NN
    PMID: 16771239
    The aims of this study were to determine the prevalence, knowledge and factors that influence smoking in Malay primary school children in Tumpat, Kelantan. A cross-sectional study was conducted in February 2004 among primary school children in Tumpat District. Two hundred-twelve children in standard one to six were randomly selected from three rural schools. An interview that included information on history of ever smoking, knowledge related to smoking and health, and potential factors that could influence smoking was done. Twenty-five children had previously smoked, with a prevalence of 11.8% (95%CI=8.0, 17.0) and 8 were current smokers (3.8%, 95%CI=1.2, 6.4). More than half (64.6%) of the children had a good knowledge of smoking. However, only 105 (49.5%) of them knew that passive smokers have a higher risk of developing diseases. Of those who had ever smoked, 12 (36.6%) were influenced by peers and 17 (51.5%) had a self-desire to smoke. The earliest age to start smoking was at 6 years. Factors found to be significantly associated with smoking on multivariate analysis were increasing age (OR=2.8, 95%CI=1.6, 5.1), being boys (OR=5.8, 95%CI=2.0, 16.8), being at second school level (standard 4, 5, 6)(OR=7.8, 95%CI=1.3, 45.3) and having other family members (excluding father) who smoked (OR=2.8, 95%CI=1.2, 6.5). However, having a father who smoked and a good knowledge were not reported as influencing factors.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  8. Nazar GP, Lee JT, Arora M, Millett C
    Nicotine Tob Res, 2016 May;18(5):1230-9.
    PMID: 26610936 DOI: 10.1093/ntr/ntv261
    INTRODUCTION: In high-income countries, secondhand smoke (SHS) exposure is higher among disadvantaged groups. We examine socioeconomic inequalities in SHS exposure at home and at workplace in 15 low- and middle-income countries (LMICs).
    METHODS: Secondary analyses of cross-sectional data from 15 LMICs participating in Global Adult Tobacco Survey (participants ≥ 15 years; 2008-2011) were used. Country-specific analyses using regression-based methods were used to estimate the magnitude of socioeconomic inequalities in SHS exposure: (1) Relative Index of Inequality and (2) Slope Index of Inequality.
    RESULTS: SHS exposure at home ranged from 17.4% in Mexico to 73.1% in Vietnam; exposure at workplace ranged from 16.9% in Uruguay to 65.8% in Bangladesh. In India, Bangladesh, Thailand, Malaysia, Philippines, Vietnam, Uruguay, Poland, Turkey, Ukraine, and Egypt, SHS exposure at home reduced with increasing wealth (Relative Index of Inequality range: 1.13 [95% confidence interval [CI] 1.04-1.22] in Turkey to 3.31 [95% CI 2.91-3.77] in Thailand; Slope Index of Inequality range: 0.06 [95% CI 0.02-0.11] in Turkey to 0.43 [95% CI 0.38-0.48] in Philippines). In these 11 countries, and in China, SHS exposure at home reduced with increasing education. In India, Bangladesh, Thailand, and Philippines, SHS exposure at workplace reduced with increasing wealth. In India, Bangladesh, Thailand, Philippines, Vietnam, Poland, Russian Federation, Turkey, Ukraine, and Egypt, SHS exposure at workplace reduced with increasing education.
    CONCLUSION: SHS exposure at homes is higher among the socioeconomically disadvantaged in the majority of LMICs studied; at workplaces, exposure is higher among the less educated. Pro-equity tobacco control interventions alongside targeted efforts in these groups are recommended to reduce inequalities in SHS exposure.
    IMPLICATIONS: SHS exposure is higher among the socioeconomically disadvantaged groups in high-income countries. Comprehensive smoke-free policies are pro-equity for certain health outcomes that are strongly influenced by SHS exposure. Using nationally representative Global Adult Tobacco Survey (2008-2011) data from 15 LMICs, we studied socioeconomic inequalities in SHS exposure at homes and at workplaces. The study showed that in most LMICs, SHS exposure at homes is higher among the poor and the less educated. At workplaces, SHS exposure is higher among the less educated groups. Accelerating implementation of pro-equity tobacco control interventions and strengthening of efforts targeted at the socioeconomically disadvantaged groups are needed to reduce inequalities in SHS exposure in LMICs.
    Study name: Global Adults Tobacco Survey (GATS-2011)
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  9. Lee ZL, Gan WY, Lim PY, Hasan R, Lim SY
    BMC Oral Health, 2020 06 03;20(1):164.
    PMID: 32493338 DOI: 10.1186/s12903-020-01152-0
    BACKGROUND: Dental caries in primary teeth is a serious oral health concern among children. It can lead to detrimental impacts on a child's growth, development, and quality of life. Therefore, this cross-sectional study aimed to examine the prevalence of dental caries and its associations with nutritional status, sugar and second-hand smoke exposure among pre-schoolers.

    METHODS: A total of 26 pre-schools in Seremban, Malaysia were randomly selected using the probability proportional to size sampling. Dental examination was performed by a dentist to record the number of decayed teeth (dt). Weight and height of the pre-schoolers were measured. The mother-administered questionnaire was used to gather information pertaining to the sociodemographic characteristics and second-hand smoke exposure. Total sugar exposure was calculated from a 3-day food record.

    RESULTS: Among the 396 participating pre-schoolers, 63.4% of them had at least one untreated caries, with a mean ± SD dt score of 3.56 ± 4.57. Negative binomial regression analysis revealed that being a boy (adjusted mean ratio = 1.42, 95% CI = 0.005-0.698, p = 0.047), exposed to second-hand smoke (adjusted mean ratio = 1.67, 95% CI = 0.168-0.857, p = 0.004) and those who had more than 6 times of daily total sugar exposure (adjusted mean ratio = 1.93, 95% CI = 0.138-0.857, p = 0.013) were significantly associated with dental caries among pre-schoolers.

    CONCLUSION: A high prevalence of dental caries was reported in this study. This study highlights the need to reduce exposure to second-hand smoke and practice healthy eating behaviours in reducing the risk of dental caries among pre-schoolers.

    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  10. Abdullah B, Muadz B, Norizal MN, Ismail N, Kornain NK, Kutty M
    PMID: 28494268 DOI: 10.1016/j.ejogrb.2017.05.002
    OBJECTIVE: To compare the pregnancy outcome and cord blood cotinine levels between secondhand smokers and non-secondhand smokers.

    STUDY DESIGN: This was a cross-sectional comparative study in a Malaysian tertiary obstetric hospital involving 200 non-smoking pregnant women at term, of whom 100 were secondhand smokers and 100 were non-secondhand smokers. Those with multiple pregnancies, with a body mass index (BMI) of more than 30kg/m2or who delivered by Caesarean section were excluded. The participants' basic demographic details, delivery details, neonatal outcome and placental weight were recorded. Umbilical cord blood samples were obtained, and cord blood cotinine levels were measured with a Cotinine ELISA kit. The primary outcomes were baby's birth weight, length, and head circumference, Apgar score at 5min and placental weight. The secondary outcome was difference in cord blood cotinine levels between the two groups and the correlation of these differences with the neonatal outcome.

    RESULTS: The secondhand smoker group had significantly lower baby weight (2.94±0.31kg vs 3.05±0.40kg), head circumference (30.87±2.35cm vs 37.13±2.36cm), length (46.58±1.95cm vs 51.53±2.05cm) and placental weight (520±73.5g vs 596±61.3g) and significantly higher cord blood cotinine levels (16.35±12.84ng/mL vs 0.56±0.22ng/mL). Cord blood cotinine levels had significant negative correlations with placental weight (r=-0.461), baby's weight (r=-0.297), baby's head circumference (r=-0.501) and baby's length (r=-0.374).

    CONCLUSION: Secondhand smoke increases the incidence of adverse pregnancy outcomes (newborns'anthropometric measurements and placental weight) and causes higher cord blood cotinine levels.

    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  11. Azizi BHO, Zulkifli HI, Kasim S
    J Asthma, 1995;32(6):413-8.
    PMID: 7592244 DOI: 10.3109/02770909409077752
    We performed a hospital-based study to examine a hypothesis that indoor air pollution was associated with acute asthma in young children living in Kuala Lumpur City. A total of 158 children aged 1 month to 5 years hospitalized for the first time for asthma were recruited as cases. Controls were 201 children of the same age group who were hospitalized for causes other than a respiratory illness. Information was obtained from mothers using a standardized questionnaire. Univariate analysis identified two indoor pollution variables as significant factors. Sharing a bedroom with an adult smoker and exposure to mosquito coil smoke at least three nights in a week were both associated with increased risk for asthma. Logistic regression analysis confirmed that sharing a bedroom with an adult smoker (OR = 1.91, 95% CI 1.13, 3.21) and exposure to mosquito coil smoke (OR = 1.73, 95% CI 1.02, 2.93) were independent risk factors. Other factors independently associated with acute asthma were previous history of allergy, history of asthma in first-degree relatives, low birth weight, and the presence of a coughing sibling. There was no association between asthma and exposure to kerosene stove, wood stove, aerosol mosquito repellent, type of housing, or crowding. We conclude that indoor air pollution is an avoidable factor in the increasing morbidity due to asthma in children in a tropical environment.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  12. Al-Naggar RA, Kadir SY
    Asian Pac J Cancer Prev, 2013;14(1):103-9.
    PMID: 23534705
    BACKGROUND: The objective of this study is to determine knowledge about lung cancer among secondary school male teachers in Kudat, Sabah, Malaysia.

    MATERIALS AND METHODS: A cross-sectional study was conducted among three secondary schools located in Kudat district, Sabah, Malaysia during the period from June until September 2012. The protocol of this study was approved by ethics committee of Management and Science University, Malaysia. The aims were explained and a consent form was signed by each participant. Respondents were chosen randomly from each school with the help of the headmasters. Self-administrated questionnaires, covering socio-demographic characteristics and general knowledge of lung cancer, were distributed. Once all 150 respondents completed the questionnaire, they passed it to their head master for collecting and recording. All the data were analyzed using Statistical Package for the Social Sciences (SPSS) version 13. ANOVA and t-test were applied for univariate analysis; and multiple linear regression for multivariate analysis.

    RESULTS: A total of 150 male secondary school teachers participated in this study. Their mean age was 35.6 ∓ 6.5 (SD); maximum 50 and minimum 23 years old. More than half of the participants were Malay and married (52%, 79%; respectively). Regarding the knowledge about lung cancer, 57.3% of the participants mentioned that only males are affected by lung cancer. Some 70.7% mentioned that lung cancer can be transmitted from one person to another. More than half (56.7%) reported that lung cancer is not the leading cause of death in Malaysian males. As for risk factors, the majority reported that family history of lung cancer is not involved. However, 91.3% were aware that cigarettes are the main risk factor of lung cancer and more than half (52%) believed that second-hand smoking is one of the risk factor of lung cancer. More than half (51.3%) were not aware that asbestos, ionizing radiation and other cancer causing substances are risk factors for lung cancer. Quitting smoking, avoiding second-hand smoking and avoiding unnecessary x-ray image of the chest (53.3%, 96.0%, 87.3%; respectively) are the main preventive measures mentioned by the participants. For the factors that influence the participants knowledge, univariate and multivariate analysis showed that only race was significant.

    CONCLUSIONS: Overall, the knowledge of school male teachers about lung cancer was low. However, few items were scored high: cigarettes are the main risk factor; avoiding second-hand smoking; and avoiding x-rays. Interventions to increase lung cancer awareness are needed to improve early detection behavior. Increase the price of pack of cigarettes to RM 20 and banning smoking in public places such as restaurants are highly recommended as primary preventive measures.

    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  13. Loy SL, Jan Mohamed HJ
    Women Health, 2014;54(2):145-60.
    PMID: 24329183 DOI: 10.1080/03630242.2013.870632
    This study aimed to examine the associations among prenatal nicotine exposure, oxidative stress, and postpartum visceral fat among women exposed to secondhand smoke (SHS). The study was conducted in Kelantan, Malaysia, from April 2010 to December 2012. Blood samples were collected in the second and third trimesters from 135 healthy pregnant women who were followed-up at delivery, 2 months, 6 months and 12 months postpartum. Maternal hair nicotine and oxidative stress markers during pregnancy were measured. Visceral fat was assessed by bioelectrical impedance. Multiple linear regression analysis revealed that maternal hair nicotine concentration was associated with increased DNA damage (tail moment: β=0.580, p=0.001) and decreased glutathione peroxidase (β=-12.100; p=0.009) in the second trimester of pregnancy. Increased DNA damage, protein oxidation and total antioxidant capacity in the second trimester were associated with 2, 6, and 12 months postpartum visceral fat. No direct association was found between prenatal hair nicotine level and postpartum visceral fat; however, these results suggest that any relation of SHS to visceral adiposity may be indirect, mediated via enhanced oxidative stress.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  14. Mohamed NN, Loy SL, Lim PY, Al Mamun A, Jan Mohamed HJ
    Sci Total Environ, 2018 Jan 01;610-611:147-153.
    PMID: 28803192 DOI: 10.1016/j.scitotenv.2017.08.030
    Exposure to secondhand smoke (SHS) can affect fetal brain development as well as subsequent neurodevelopment. This study aimed to determine the association between prenatal and postnatal SHS exposure with children's neurodevelopment at 2years of age. Among 107 mother-child pairs from a Malaysia prospective cohort, prenatal and postnatal SHS exposure was determined based on maternal and child hair nicotine concentrations. Multiple linear regressions were used to determine the association between prenatal and postnatal levels of nicotine in maternal and children's' hair with children's neurodevelopment. After adjustment for confounders, prenatal nicotine concentration levels were negatively associated with communication (β=-2.059; p=0.015) and fine motor skills (β=-2.120; p=0.002) while postnatal nicotine concentration levels were inversely associated with fine motors (β=-0.124; p=0.004) and problem solving skills (β=-0.117; p=0.013). In conclusion, this study suggests that early life exposure to SHS may affect children's neurodevelopment.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  15. Mohamed M, Sulaiman SA, Jaafar H
    PMID: 23983363
    The effect of cigarette smoke (CS) on histology of male accessory reproductive organs and the possible protective effect of honey supplementation in rats were investigated in this study. Rats received distilled water, honey, CS exposure or honey plus CS exposure. Honey (1.2 g/kg body weight/day) was administered by gavage and CS exposure (3 times per day) was done in a chamber for 13 weeks. CS exposure significantly increased relative weight of epididymis and ventral prostate. There were also significantly increased number of clear cells and epithelial height of cauda epididymis as well as severe interstitial oedema and decreased epithelial height of prostate gland. However, with the supplementation of honey, these histological changes were significantly reversed suggesting the protective effect of honey against the toxic effect of CS on male accessory reproductive organs in rats.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  16. Jie Y, Isa ZM, Jie X, Ju ZL, Ismail NH
    PMID: 23625129 DOI: 10.1007/978-1-4614-6898-1_2
    In this review, our aim was to examine the influence of geographic variations on asthma prevalence and morbidity among adults, which is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity. Asthma is a complex inflammatory disease of multifactorial origin, and is influenced by both environmental and genetic factors. The disparities in asthma prevalence and morbidity among the world's geographic locations are more likely to be associated with environmental exposures than genetic differences. In writing this article, we found that the indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke in both urban and rural areas. Asthma and asthma-related symptoms occurred more frequently in urban than in rural areas, and that difference correlated with environmental risk exposures, SES, and healthcare access. Environmental risk factors to which urban adults were more frequently exposed than rural adults were dust mites,high levels of vehicle emissions, and a westernized lifestyle.Exposure to indoor biological contaminants in the urban environment is common.The main risk factors for developing asthma in urban areas are atopy and allergy to house dust mites, followed by allergens from animal dander. House dust mite exposure may potentially explain differences in diagnosis of asthma prevalence and morbidity among adults in urban vs. rural areas. In addition, the prevalence of asthma morbidity increases with urbanization. High levels of vehicle emissions,Western lifestyles and degree of urbanization itself, may affect outdoor and thereby indoor air quality. In urban areas, biomass fuels have been widely replaced by cleaner energy sources at home, such as gas and electricity, but in most developing countries, coal is still a major source of fuel for cooking and heating, particularly in winter. Moreover, exposure to ETS is common at home or at work in urban areas.There is evidence that asthma prevalence and morbidity is less common in rural than in urban areas. The possible reasons are that rural residents are exposed early in life to stables and to farm milk production, and such exposures are protective against developing asthma morbidity. Even so, asthma morbidity is disproportionately high among poor inner-city residents and in rural populations. A higher proportion of adult residents of nonmetropolitan areas were characterized as follows:aged 55 years or older, no previous college admission, low household income, no health insurance coverage, and could not see a doctor due to healthcare service availability, etc. In rural areas, biomass fuels meet more than 70% of the rural energy needs. Progress in adopting modern energy sources in rural areas has been slow. The most direct health impact comes from household energy use among the poor, who depend almost entirely on burning biomass fuels in simple cooking devices that are placed in inadequately ventilated spaces. Prospective studies are needed to assess the long-term effects of biomass smoke on lung health among adults in rural areas.Geographic differences in asthma susceptibility exist around the world. The reason for the differences in asthma prevalence in rural and urban areas may be due to the fact that populations have different lifestyles and cultures, as well as different environmental exposures and different genetic backgrounds. Identifying geographic disparities in asthma hospitalizations is critical to implementing prevention strategies,reducing morbidity, and improving healthcare financing for clinical asthma treatment. Although evidence shows that differences in the prevalence of asthma do exist between urban and rural dwellers in many parts of the world, including in developed countries, data are inadequate to evaluate the extent to which different pollutant exposures contribute to asthma morbidity and severity of asthma between urban and rural areas.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  17. Jie Y, Ismail NH, Jie X, Isa ZM
    J Formos Med Assoc, 2011 Sep;110(9):555-63.
    PMID: 21930065 DOI: 10.1016/j.jfma.2011.07.003
    This review summarizes the results of epidemiological studies focusing on the detrimental effects of home environmental factors on asthma morbidity in adults. We reviewed the literature on indoor air quality (IAQ), physical and sociodemographic factors, and asthma morbidity in homes, and identified commonly reported asthma, allergic, and respiratory symptoms involving the home environment. Reported IAQ and asthma morbidity data strongly indicated positive associations between indoor air pollution and adverse health effects in most studies. Indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke. Environmental exposure may increase an adult's risk of developing asthma and also may increase the risk of asthma exacerbations. Evaluation of present IAQ levels, exposure characteristics, and the role of exposure to these factors in relation to asthma morbidity is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  18. Azizi BH, Henry RL
    Pediatr Pulmonol, 1990;9(1):24-9.
    PMID: 2388776
    In a cross-sectional study of 7-12 year-old primary school children in Kuala Lumpur city, lung function was assessed by spirometric and peak expiratory flow measurements. Spirometric and peak expiratory flow measurements were successfully performed in 1,214 and 1,414 children, respectively. As expected, the main predictors of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and peak expiratory flow rate (PEFR) were standing height, weight, age, and sex. In addition, lung function values of Chinese and Malays were generally higher than those of Indians. In multiple regression models which included host and environmental factors, asthma was associated with significant decreases in FEV1, FEF25-75, and PEFR. However, family history of chest illness, history of allergies, low paternal education, and hospitalization during the neonatal period were not independent predictors of lung function. Children sharing rooms with adult smokers had significantly lower levels of FEF25-75. Exposures to wood or kerosene stoves were, but to mosquito repellents were not, associated with decreased lung function.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
  19. Azizi BH, Henry RL
    Int J Epidemiol, 1991 Mar;20(1):144-50.
    PMID: 2066213 DOI: 10.1093/ije/20.1.144
    The effects of indoor environmental factors on respiratory illness were studied in 15017-12 year old school children in Kuala Lumpur. Exposure to mosquito coil smoke for at least three nights a week was independently associated with asthma and persistent wheeze. Passive smoking, defined as sharing a bedroom with an adult smoker, was independently associated with a chest illness in the past year. No relationships were found between exposure to kerosene stoves, wood stoves, fumigation mat mosquito repellents or aerosol insecticides and respiratory illness. Host factors predictive of at least one respiratory outcome included family history of chest illness, history of allergy, male sex, hospitalization in the neonatal period and low paternal education. With 95% confidence, avoidance of regular exposure to mosquito coil smoke and passive smoking could reduce the prevalences of persistent wheeze, asthma and chest illness by up to 29%. Measurements of lung function confirmed the validity of questions pertaining to wheezing and asthma in the study questionnaire.
    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects
  20. Arffin F, Al-Bayaty FH, Hassan J
    Arch Gynecol Obstet, 2012 Nov;286(5):1187-91.
    PMID: 22718098 DOI: 10.1007/s00404-012-2417-0
    BACKGROUND: Exposure of pregnant women to environmental tobacco smoke has been shown to be associated with low birth weight. Many studies have suggested that stress have a role in the etiology of preterm birth.

    AIMS: This study carried out from June 2008 to March 2009 to find the relation between environmental tobacco smoke, stress and miscarriage and preterm births.

    METHODS: A total of 33 subjects consisted of multiparous pregnant women that were in their early third trimester were chosen for this investigation. Subjects were divided into test group women with adverse pregnancy outcome, control group women with successful pregnancy. Four ml of unstimulated whole saliva were collected. The concentrations of cotinine and cortisol were evaluated using commercially available ELISA kit.

    RESULTS: Pregnancies in which the average standardized cortisol during history of previous miscarriage(s) which occurred within 6th-27th week or/and history of preterm labor which occurred within 28th-36th weeks of gestation, demonstrated higher cortisol level (1.0201 ± 0.1855 ng/ml) compared to control group 0.9757 ± 0.2860 ng/ml (P = 0.323); statistical analysis showed no significant differences. Women of control group were more likely to be environmental tobacco smoke exposed (1.2714 ± 1.7639 ng/ml) than women with miscarriage and preterm births (0.9889 ± 0.5498 ng/ml).

    CONCLUSION: The results from this primarily study demonstrated no association between cotinine, cortisol, miscarriage and preterm births.

    Matched MeSH terms: Tobacco Smoke Pollution/adverse effects*
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