title: Secondhand smoke exposure and osteoporosis in never-smoking postmenopausal women: the Fourth Korea National Health and Nutrition Examination Survey.
abstract: CONCLUSIONS
  The association between secondhand smoke (SHS) exposure and lumbar and femoral neck osteoporosis was assessed in postmenopausal never-smoking Korean women. The presence of family members who actively smoked was associated with femoral neck osteoporosis. The number of cigarettes consumed by cohabitant smokers was positively associated with lumbar and femoral neck osteoporosis.
  
  
  BACKGROUND
  This study aimed to assess the association between SHS and postmenopausal osteoporosis.
  
  
  METHODS
  Of 2,067 postmenopausal women (age, ≥55 years) participating in the Fourth Korea National Health and Nutrition Examination Survey, 925 never-smokers identified through interviews and urinary cotinine level verification were enrolled. Cross-sectional relationships between self-reported SHS exposure and osteoporosis of the lumbar vertebrae and femoral neck (defined using the World Health Organization T-score criteria) were investigated by bone densitometry.
  
  
  RESULTS
  Participants having actively smoking family members showed increased adjusted odds ratio (aOR) for femoral neck osteoporosis compared with participants not exposed to SHS (aOR, 3.68; 95 % confidence interval [CI], 1.23-10.92). Participants whose cohabitant smokers consumed any number of cigarettes per day showed increased occurrences for lumbar and femoral neck osteoporosis compared with the nonexposed group. Participants whose cohabitant smokers consumed ≥20 cigarettes/day showed increased aORs for lumbar (aOR, 5.40; 95 % CI, 1.04-28.04) and femoral neck (aOR, 4.35; 95 % CI, 1.07-17.68) osteoporosis compared with participants not exposed to SHS.
  
  
  CONCLUSIONS
  In postmenopausal never-smoking Korean women, exposure to SHS was positively associated with osteoporosis. This finding further emphasizes a need to identify vulnerable groups exposed to SHS to increase bone health.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.forename: C M
authors.initials: CM
authors.lastname: Lee
authors.forename: S M
authors.initials: SM
authors.lastname: Park
authors.forename: B
authors.initials: B
authors.lastname: Cho
authors.forename: Y
authors.initials: Y
authors.lastname: Chang
authors.forename: S G
authors.initials: SG
authors.lastname: Park
authors.forename: K
authors.initials: K
authors.lastname: Lee
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000652:urine; D015519:Bone Density / Q000502:physiology; D003367:Cotinine / Q000652:urine; D005192:Family Health / Q000706:statistics & numerical data; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006306:Health Surveys; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data
chemical_list: D015415:Biomarkers; D014028:Tobacco Smoke Pollution; D003367:Cotinine