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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Meta-analysis of the association between second-hand smoke exposure and ischaemic heart diseases, COPD and stroke

Authors: Florian Fischer, Alexander Kraemer

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Second-hand smoke (SHS) is the most important contaminant of indoor air in first world countries. The risks associated with SHS exposure are highly relevant, because many people are regularly, and usually involuntarily, exposed to SHS. This study aims to quantify the effects of SHS exposure. Therefore, its impact on ischaemic heart diseases (IHD), chronic obstructive pulmonary diseases (COPD) and stroke will be considered.

Methods

A systematic literature review was conducted to identify articles dealing with the association between SHS and the three outcomes IHD, COPD and stroke. Overall, 24 articles were included in a meta-analysis using a random effects model. Effect sizes stratified for sex and for both sexes combined were calculated.

Results

The synthesis of primary studies revealed significant effect sizes for the association between SHS exposure and all three outcomes. The highest RR for both sexes combined was found for COPD (RR = 1.66, 95 % CI: 1.38–2.00). The RR for both sexes combined was 1.35 (95 % CI: 1.22–1.50) for stroke and 1.27 (95 % CI: 1.10–1.48) for IHD. The risks were higher in women than in men for all three outcomes.

Conclusions

This is the first study to calculate effect sizes for the association between SHS exposure and the disease outcomes IHD, COPD, and stroke at once. Overall, the effect sizes are comparable with previous findings in meta-analyses and therefore assumed to be reliable. The results indicate the high relevance of public health campaigns and legislation to protect non-smokers from the adverse health effects attributable to SHS exposure.
Appendix
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Footnotes
1
Because some articles dealt with multiple outcomes, the sum of all articles did not add up to 403.
 
2
The number of articles excluded for each criterion is mentioned in brackets. The sum did not add up to 71, because some articles were excluded for multiple reasons.
 
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Metadata
Title
Meta-analysis of the association between second-hand smoke exposure and ischaemic heart diseases, COPD and stroke
Authors
Florian Fischer
Alexander Kraemer
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2489-4

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