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Effect of Smoking on Tear Stability and Corneal Surface

Mohidin N, Jaafar AB

J Curr Ophthalmol, 2020 07 04;32(3):232-237.
PMID: 32775796 DOI: 10.4103/JOCO.JOCO_70_20

Purpose: To determine the effect of smoking on tear stability and ocular surface of the cornea among students aged between 19 and 25 years. This study also aimed to find a correlation between tear film stability with a score of McMonnies Dry Eye Questionnaire (MDEQ) and Ocular Surface Disease Index Questionnaire (OSDI).
Methods: This is a prospective, non-interventional, comparative study of 59 male (27 smokers and 32 non-smokers) undergraduates of a public university. Tear film stability was evaluated using non-invasive tear break-up time and fluorescein tear break-up time. Corneal staining was determined using Efron grading scale. MDEQ and OSDI Questionnaires were used to assess dry eye symptoms. Data were obtained from the right eye only and analyzed using descriptive and correlation analysis.
Results: The age range of the participants was between 19 and 25 years. The mean age for smokers and non-smokers was 22.19 ± 2.20 and 21.22 ± 1.83 years, respectively (P = 0.07). The smoker group had statistically significant lower tear film stability than the non-smoker group (P < 0.0001). Corneal staining was statistically significant higher at the nasal and temporal parts of the cornea in smokers (P < 0.05). There was a moderate correlation between tear film stability and scores of MDEQ and OSDI.
Conclusions: Tobacco smoke has a significant effect on the tear film stability, seen in reduced tear stability values among smokers. Corneal staining was found to be more extensive in the smokers. These findings would be useful to eye-care providers in the management of their dry eye patients related to smoking.

Matched MeSH terms: Tobacco Smoke Pollution
Fulltext Lung function and cognitive performance of primary school children exposed to secondhand smoke at home in Kota Bharu, Kelantan

Sharina D, Zulkifli A, Naing NN

Malaysian Journal of Public Health Medicine, 2004;4(2):19-23.
MyJurnal

Exposure to secondhand smoke has consistently been linked to adverse health effects in children, including reduced lung function and various respiratory diseases. There is also increasing evidence that secondhand smoke exposure is associated with cognitive impairment and behavioral problems in children, This cross sectional study was done on 795 chiildren to determine the association between secondhand smoke exposure and peak expiratory flow rate (PEFR) and cognitive performance among the primary school children in Kota Bharu Kelantan. A questionnaire was used to obtain information on socio-demography and smoking status of the household. The PEER was measured using a child Mini Wright peak expiratory flow meter while cognitive performance was assessed by four subtests of Weschler Intelligence Scale For Children (WISC III). Data analysis was done using SPSS version 11. Children were classified as exposed to secondhand smoke when at least one househoH member smoked. There were 442 (55 .6%) children exposed to secondhand smoke at home. The mean (SD) PEFR for unexposed and exposed children were 266.18 (60.80) l/min and 266 .06 (57. 70) l/min respectively, The mean (SD) scores for Digit Span Forward, Digit Span Backward Coding and Arithmetic in unexposed chiMren were 6.84 (1.80), 4.Z7(1.68), 45.25 (9,99) and 8.04 (1.04) respectively. The mean (SD) scores for exposed children were 6.73 (1 .77). 4.07 (l .65), 45.1 I (1 I ,03) and 8.13 (1 .00) respectively. Multivariate analysis of variance showed no signincant dijference in the PEFR (p=O.816) and the cognitive scores between exposed and unexposed primary school children in Kota Bharu, Kelantan

Matched MeSH terms: Tobacco Smoke Pollution
Fulltext Passive Smoking Mothers And Fetal Outcomes: An Experience In Maternity Hospital Kuala Lumpur 2004

Hejar, A.R, Noraihan, M. N., Liyana Mastura, M.J., Nurzoara Aisha Noorazyze, R.A.N.

International Medical Journal Malaysia, 2006;5(1):1-8.
MyJurnal

Passive smoking among pregnant mothers has been associated with numerous maternal and fetal effects. The aim of this study was to determine the effects of passive smoking on the fetal outcome among women who delivered at the Maternity Hospital Kuala Lumpur. This cross sectional study was carried out at the Maternity Hospital Kuala Lumpur in July 2004. Universal sampling of the women who delivered at the hospital was used and data was collected by interview using pre-tested questionnaire and patients’ medical records. Analysis was done by SPSS version 11.5. More than 75% were Malays, between 21 to 35 years, married, received secondary education, housewives and family income between RM 1000 – RM 1999. Seventy-seven per cent of the women were exposed to environmental tobacco smoke and majority were exposed at home and for less than 1 hour a week. There were significant relationships between duration of exposure with exposure at workplace, exposure at home and exposure in the car. Most of the babies delivered were males, term, normal weight and normal. Health education of the adverse effects of smoking to the pregnant women, spouses and family members need to be intensified by the hospital and the Ministry of Health.

Matched MeSH terms: Tobacco Smoke Pollution
Fulltext Secondhand smoke exposure at home and respiratory symptoms among primary school children in Kota Bharu, Kelantan

Sharina, D., Zulkifli, A., Nyi, N.N.

Malaysian Journal of Public Health Medicine, 2007;7(2):59-63.
MyJurnal

In recent years, there has been concern that non-smokers may also be at risk from secondhand smoke exposure, especially children. This study was done to determine the prevalence of secondhand smoke exposure at home and the association between secondhand smoke exposure and respiratory symptoms among primary schoolchildren in Kota Bharu, Kelantan. This was a comparative cross-sectional study involving children, aged 10·12 years. A structured questionnaire was used to obtain the information on sociodemographic, respiratory symptoms and smokers in the house. A random sample of 10 from 95 primary schools in Kota Bharu was included. Six classes were randomly selected from each school, two classes each from each school year of primary 4·6. A total of 795 children completed the questionnaire during September 2003 till March 2004. 386 of children (48.6%) were boys and 409 children (51.4%) were girls. Most of the children were Malay (99.9%). A total of 442 (55.6%) children lived with at least 1 smoker in the house mainly from the smoking fathers. Significantly increased odds ratios due to secondhand smoke exposure were observed for most of the respiratory symptoms. The odds ratios (95% confidence interval) were 1.67 (1.18, 2.39) for cough in the morning, 1.59 (1.10, 2.30) for cough at night, 1.76 (1.16, 2.65) for cough most days for the previous 3 months, 1.57 (1.14, 2.17) for phlegm in the morning, 1.49 (1.08, Z.07) for phlegm during daytime or at night, 1.38 (1.03, 1.86) for nose problems in the morning, 1.40 (1.03, 1.90) for nose problems at night and 1.78 (1.14, 2.78) for throat problems at night, 1.55 (1.06, 2.26) for ever wheeze or diagnosed asthma by doctor, 1.57 (1.05, 2.36) for throat problems in the morning and 1.81 (1.15, 2.85) for throat problems during daytime. The odds ratios increased with increasing number of smokers at home for cough in the morning, cough most days for the previous 3 months, phlegm in the morning, ever wheeze or diagnosed asthma by doctor, throat problems in the morning, throat problems during daytime and throat problems at night. In view of the significant health risks posed to children by secondhand smoke, public health policies are needed to protect this vulnerable population. The aim of such policies Ls to ensure the right of every child to grow up in an environment free of tobacco smoke.

Matched MeSH terms: Tobacco Smoke Pollution
Fulltext Prevalence and risk factors associated with otitis media with effusion in children visiting tertiary care centre in Malaysia

Tikaram A, Chew YK, Zulkiflee AB, Chong AW, Prepageran N

International Medical Journal Malaysia, 2012;11(1):37-40.
MyJurnal

Introduction: The aim of this study is to determine the prevalence of otitis media with effusion (OME) in Malaysian children between three months to twelve years of age and to identify the risk factors associated with it.
Materials and methods: This is a cross-sectional study consists of 153 children selected by stratified random sampling method. Parents of these children were interviewed with a structured questionnaire. Clinical examination, including otoscopic examination and tympanometry was performed for each child.
Results: The prevalence of OME was 18.3%. There was no statistical significant relationship between OME and gender, race, household size, attendance to daycare center, breast feeding, and exposure to passive smoking, allergy, and asthma.
Conclusion: The prevalence of OME is 18.3% in Malaysian children between three months to twelve years of age. Frequency of AOM is a statistically significant factor to the development of OME later in life. The different risk factors associated with OME are still controversial.

Matched MeSH terms: Tobacco Smoke Pollution
Fulltext Exposure to second-hand smoke and the risk of non-syndromic oral cleft among Malay children in Kelantan

Ayu, A., Samsudin, A.R., Ismail, N.M., Isa, M.N.

Malaysian Journal of Public Health Medicine, 2003;3(2):41-47.
MyJurnal

The prevalence of cleft lip and palate in human is 1 in 500 live births worldwide. Non·syndromic clefts are a complex trait with both genetic and environmental etiology. The aim ofthe study was to assess the association between maternal exposure to second-hand smoke during pregnancy and ruk of having cleft child. Unmatched case-control study was carried out among Malays in Kelantan.
1 Case and control subjects were denned as mothers of cleft children and mothers of normal children respectively. The cleft children were recruited from the Combined Cleft Clinic at Kota Bharu Dental Clinic. Normal chiMren were selected at Orthodontic Clinic, Kota Bharu. A total of 184 cases and controb with age range from 17 to 50 years were interviewed using the standard craniofacial
registration form. Multiple Logistic Regression modeling was used to estimate adjusted odds ratio of factors associated with non-syndromic oral cleft. Signijicant factors include history of miscarriage (OR: 3.40; 95% C1:1.05, 11 .08) p=0.042; duration of exposure to second-hand smoke for 15-30 minutes (OR: 2.41; 95% C1:1.42, 4.09) p 30 minutes (OR: 5.16; 95% C1:Z.87, 9.28) p

Matched MeSH terms: Tobacco Smoke Pollution
Fulltext Metabolic, inflammatory, and oxidative stress markers in women exposed to secondhand smoke

Siti Hajar MH, Zulkefli S, Juwita S, Norhayati MN, Siti Suhaila MY, Rasool AHG, et al.

PeerJ, 2018;6:e5758.
PMID: 30356972 DOI: 10.7717/peerj.5758

Background: Secondhand smoke (SHS) exposure has adverse effects on the cardiovascular system. This study aimed to determine the effects of SHS on the cardiovascular disease biomarkers, namely the metabolic, inflammatory, and oxidative stress markers in healthy adult women.
Methods: This comparative cross-sectional study was conducted among healthy women. The cases included those women exposed to SHS, and the controls included those women not exposed to SHS. SHS exposure was defined as being exposed to SHS for at least 15 min for 2 days per week. Venous blood was taken to measure the metabolic markers (high molecular weight adiponectin, insulin level, insulin resistance, and nonesterified fatty acids), oxidative stress markers (oxidized low density lipoprotein cholesterol and 8-isoprostane), and inflammatory markers (high-sensitivity C-reactive protein and interleukin-6). A hair nicotine analysis was also performed. An analysis of covariance and a simple linear regression analysis were conducted.
Results: There were 101 women in the SHS exposure group and 91 women in the non-SHS exposure group. The mean (with standard deviation) of the hair nicotine levels was significantly higher in the SHS exposure group when compared to the non-SHS exposure group [0.22 (0.62) vs. 0.04 (0.11) ng/mg; P = 0.009]. No significant differences were observed in the high molecular weight adiponectin, insulin and insulin resistance, nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, interleukin-6, and high-sensitivity C-reactive protein between the two groups. The serum high molecular weight adiponectin was negatively associated with the insulin level and insulin resistance in the women exposed to SHS. However, no significant relationships were seen between the high molecular weight adiponectin and nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, high-sensitivity C-reactive protein in the SHS group.
Discussion: There were no significant differences in the metabolic, oxidative stress, and inflammatory markers between the SHS exposure and non-SHS exposure healthy women. A low serum level of high molecular weight adiponectin was associated with an increased insulin level and resistance in the women exposed to SHS.

Matched MeSH terms: Tobacco Smoke Pollution
Determination of hair nicotine by gas chromatography-mass spectrometry

Man CN, Ismail S, Harn GL, Lajis R, Awang R

J Chromatogr B Analyt Technol Biomed Life Sci, 2009 Jan 15;877(3):339-42.
PMID: 19109080 DOI: 10.1016/j.jchromb.2008.12.014

Hair nicotine is a known biomarker for monitoring long-term environmental tobacco smoke (ETS) exposure and smoking status. In general, hair nicotine assay involves alkaline digestion, extraction and instrumental analysis. The gas chromatography-mass spectrometry (GC-MS) assay currently developed has shown to be of high throughput with average approximately 100 hair samples being extracted and analyzed per day. This was achieved through simplified extraction procedure and shortened GC analysis time. The extraction was improved by using small volume (0.4 mL) of organic solvent that does not require further evaporation and salting steps prior to GC-MS analysis. Furthermore, the amount of hair utilized in the extraction was very little (5 mg) while the sensitivity and selectivity of the assay is equal, if not better than other established methods. The linearity of the assay (r(2)>0.995), limit of quantitation (0.04 ng/mg hair), within- and between-assays accuracies and precisions (<11.4%) and mean recovery (92.6%) were within the acceptable range.

Matched MeSH terms: Tobacco Smoke Pollution