title: Second-hand smoke and chronic bronchitis in Taiwanese women: a health-care based study.
abstract: BACKGROUND
  Cigarette smoking cannot fully explain the epidemiologic characteristics of chronic obstructive pulmonary disease (COPD) in women, particularly for those who rarely smoke, but COPD risk is not less than men. The aim of our study is to investigate the relationship between second-hand smoke (SHS) exposure and chronic bronchitis in Taiwanese women.
  
  
  METHODS
  We used Taiwan's National Health Insurance Bureau claims data in 1999, and cross-checked using criteria set by the American Thoracic Society; there were 33 women with chronic bronchitis, 182 with probable chronic bronchitis, and 205 with no chronic bronchitis during our interview time between 2000 and 2005. We measured second-hand smoke (SHS) exposure by self-reported measures (household users and duration of exposure), and validated this by measuring urinary cotinine levels of a subset subjects. Classification of chronic bronchitis was also based on spirometry defined according to the GOLD guidelines to get the severity of COPD.
  
  
  RESULTS
  Women who smoked and women who had been exposed to a lifetime of SHS were 24.81-fold (95% CI: 5.78-106.38) and 3.65-fold (95% CI: 1.19-11.26) more likely to have chronic bronchitis, respectively, than those who had not been exposed to SHS. In addition, there was a significant increasing trend between the severity of COPD and exposure years of SHS (p < 0.01). The population attributable risk percentages of chronic bronchitis for smokers and those exposed to SHS were 23.2 and 47.3% respectively.
  
  
  CONCLUSIONS
  These findings indicate that, besides cigarette smoking, exposure to SHS is a major risk factor for chronic bronchitis in Taiwanese women.
authors.affiliation: Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chia-Fang
authors.initials: CF
authors.lastname: Wu
authors.forename: Nan-Hsiung
authors.initials: NH
authors.lastname: Feng
authors.forename: Inn-Wen
authors.initials: IW
authors.lastname: Chong
authors.forename: Kuen-Yuh
authors.initials: KY
authors.lastname: Wu
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Lee
authors.forename: Jhi-Jhu
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Chia-Tsuan
authors.initials: CT
authors.lastname: Huang
authors.forename: Chung-Ying
authors.initials: CY
authors.lastname: Lee
authors.forename: Shao-Ting
authors.initials: ST
authors.lastname: Chou
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.forename: Ming-Tsang
authors.initials: MT
authors.lastname: Wu
mesh_terms: D000328:Adult; D029481:Bronchitis, Chronic / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007344:Insurance Claim Reporting; D008297:Male; D009313:National Health Programs; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013147:Spirometry; D013624:Taiwan; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000032:analysis*; D016387:Women's Health
chemical_list: D014028:Tobacco Smoke Pollution