title: Changes in environmental tobacco smoke exposure: the Beaver Dam experience.
abstract: OBJECTIVE
  Environmental tobacco smoke (ETS) exposure has been associated with adverse health outcomes. Our goal was to determine if ETS exposure changed between 1998-2000 and 2003-2005 among participants in the population-based Epidemiology of Hearing Loss Study.
  
  
  METHODS
  ETS exposure was ascertained using a cotinine-validated questionnaire at the 5-year (1998-2000) and 10-year follow-up examinations (2003-2005). Non-smoking participants with data from both visits were included (n=1898; ages 53-96 years at 5-yr follow-up). McNemar's test was used to test differences in ETS exposure overall and in 3 settings: home, work, and social settings. Generalized estimating equations (GEE) were used for multivariate logistic regression models of exposure.
  
  
  RESULTS
  The proportion of nonsmokers with no or little ETS exposure increased from 80% to 88% (P< 0.0001). The percent living in a home with no indoor smokers increased from 94% to 97% (P<0.0001). The percent reporting no exposure at work increased from 91% to 95% (P<0.0001). The percent reporting the lowest frequency of social exposure increased from 65% to 77% (P<0.0001). In the GEE model, age was inversely associated with overall ETS exposure (Odds Ratio [OR] per 5 yr= 0.87, 95% CI= 0.81, 0.94), as was education (OR for college vs < high school=0.25, 95% CI=0.16, 0.37), female gender (ORI= 0.41, 95% CI= 0.33, 0.51), and later examination period (OR =0.62, 95% CI= 0.53, 0.73); current employment was positively associated with exposure (OR=1.44, 95% CI=1.14, 1.83).
  
  
  CONCLUSIONS
  Between the late 1990s and the mid-2000s, ETS exposure in older adults decreased. Decreasing exposures suggest there may be future declines in ETS-related adverse health outcomes.
authors.affiliation: University of Wisconsin, School of Medicine and Public Health, Department of Population Health Sciences, Madison, WI 53726-2397, USA. mwichmann@wisc.edu
authors.forename: Margarete A
authors.initials: MA
authors.lastname: Wichmann
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Cruickshanks
authors.forename: David M
authors.initials: DM
authors.lastname: Nondahl
authors.forename: Richard
authors.initials: R
authors.lastname: Chappell
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Mary E
authors.initials: ME
authors.lastname: Fischer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D014028:Tobacco Smoke Pollution