title: Influence of air pollution on exhaled carbon monoxide levels in smokers and non-smokers. A prospective cross-sectional study.
abstract: BACKGROUND
  The poor air quality and cigarette smoking are the most important reasons for increased carbon monoxide (CO) level in exhaled air. However, the influence of high air pollution concentration in big cities on the exhaled CO level has not been well studied yet.
  
  
  OBJECTIVE
  To evaluate the impact of smoking habit and air pollution in the place of living on the level of CO in exhaled air.
  
  
  METHODS
  Citizens from two large cities and one small town in Poland were asked to complete a survey disclosing their place of residence, education level, work status and smoking habits. Subsequently, the CO level in their exhaled air was measured. Air quality data, obtained from the Regional Inspectorates of Environmental Protection, revealed the differences in atmospheric CO concentration between locations.
  
  
  RESULTS
  1226 subjects were divided into 4 groups based on their declared smoking status and place of living. The average CO level in exhaled air was significantly higher in smokers than in non-smokers (p<0.0001) as well as in non-smokers from big cities than non-smokers from small ones (p<0.0001). Created model showed that non-smokers from big cities have odds ratio of 125.3 for exceeding CO cutoff level of 4ppm compared to non-smokers from small towns.
  
  
  CONCLUSIONS
  The average CO level in exhaled air is significantly higher in smokers than non-smokers. Among non-smokers, the average exhaled CO level is significantly higher in big city than small town citizens. These results suggest that permanent exposure to an increased concentration of air pollution and cigarette smoking affect the level of exhaled CO.
authors.affiliation: Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland.
authors.forename: Mikołaj
authors.initials: M
authors.lastname: Maga
authors.affiliation: Medical University of Warsaw, 2a Trojdena Street, Warsaw, Poland.
authors.forename: Maciej K
authors.initials: MK
authors.lastname: Janik
authors.affiliation: Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland. Electronic address: agnieszka.wachsmann@gmail.com.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wachsmann
authors.affiliation: Medical University of Warsaw, 2a Trojdena Street, Warsaw, Poland.
authors.forename: Olga
authors.initials: O
authors.lastname: Chrząstek-Janik
authors.affiliation: Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Koziej
authors.affiliation: Medical University of Warsaw, 2a Trojdena Street, Warsaw, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Bajkowski
authors.affiliation: Angiology Department, Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Maga
authors.affiliation: Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Tyrak
authors.affiliation: Immunology and Allergology Department, Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Wójcik
authors.affiliation: Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Gregorczyk-Maga
authors.affiliation: Angiology Department, Jagiellonian University Medical College, 8 Skawinska Street, Krakow, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Niżankowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis*; D003430:Cross-Sectional Studies; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D011446:Prospective Studies; D012424:Rural Population; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000032:analysis*; D014505:Urban Population; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D014028:Tobacco Smoke Pollution; D002248:Carbon Monoxide
keywords: Air pollution; Air quality; Exhaled carbon monoxide; Health risk assessment; Smoking cigarettes