Heated tobacco products (HTPs) are a form of nicotine delivery intended to provide an alternative to traditional cigarettes. The aim of this systematic review was to present the current state of knowledge on HTPs with an emphasis on the potential impact of HTP use on human health. During the preparation of this systematic review, the literature on HTPs available within Medline/PubMed, EMBASE, CINAHL, ScienceDirect, and Google Scholar was retrieved and examined. In the final review, 97 research papers were included. The authors specifically assessed the construction and operation of HTPs, as well as the chemical composition of HTP tobacco sticks and the generated aerosol, based on evidence from experimental animal and cellular studies, and human-based studies. Heated tobacco products were found to generate lower concentrations of chemical compounds compared to traditional cigarettes, except for water, propylene glycol, glycerol, and acetol. The nicotine levels delivered to the aerosol by HTPs were 70-80% as those of conventional combustion. The results of in vitro and in vivo assessments of HTP aerosols revealed reduced toxicity, but these were mainly based on studies sponsored by the tobacco industry. Independent human-based studies indicated that there was a potentially harmful impact of the active and passive HTP smoking on human health. Currently, a large body of knowledge on HTP exposures and health effects is provided by the tobacco industry (52% of identified studies). Based on the available evidence, HTPs produce lower levels of toxic chemicals, compared to conventional cigarettes, but they are still not risk-free. Int J Occup Med Environ Health. 2019;32(5):595 -634
Our findings are in line with the concept of a real increase in the occurrence of asthma and allergic disease in children. The pattern involves not only physician-diagnosed allergic diseases but also occurrence of symptoms related to respiratory disorders. Diagnosed asthma is better treated and better controlled.
The aim of this paper was to find out whether fetal exposure to environmental tobacco smoke (ETS), as compared to postnatal ETS exposure, is an independent risk factor for respiratory symptoms and diseases in younger schoolchildren. The cross-sectional epidemiological study comprised population of 1,561 Polish schoolchildren, aged 9-11 years. Information on the exposure to tobacco smoke and other sources of indoor air pollution at home, respiratory and allergic health status, and socio-economic status of the family was obtained by questionnaire survey. The respiratory health status was described by presence of wheezing, attacks of dyspnoea (noted during the last year or ever), bronchitis, wheezy bronchitis and asthma, ever diagnosed by a physician. Multivariate logistic regression analysis with adjustment for age, sex, area of residence, household density, damp and mould stains found at home, use of coal-fired stove, co-habitant pets, mother's education and paternal current and past smoking habit was used to assess the effect of fetal and postnatal exposures on respiratory health outcomes. The results of the multivariate analyses revealed statistically significant associations between fetal exposure to ETS and wheezing ever: log OR = 1.4 (95% CI: 1.0-2.0), attacks of dyspnoea ever: log OR = 1.8 (95% CI: 1.1-2.9), bronchitis: log OR = 2.1 (95% CI: 1.5-2.9), and wheezy bronchitis: log OR = 1.8 (95% CI: 1.1-2.9). The effect of postnatal ETS was statistically significant only for bronchitis: log OR = 1.4 (95% CI: 1.1-1.9). The results of our study showed that fetal exposure to tobacco smoke is an independent risk factor for symptoms of wheeze and wheezy bronchitis in schoolchildren when compared to postnatal ETS exposure.
The hypothesis that exercise limitation of respiratory origin can be predicted accurately from the lung function impairment has been tested using maximal oxygen uptake (VO2max) as the dependent variable in a multiple regression analysis. The subjects were 157 men who met objective criteria for exercise being limited by respiratory impairment. VO2max (mean value, 1.38 L min-1) was described by FEV1 and single-breath lung transfer factor (diffusing capacity) for carbon monoxide (TL') singly or in combination, but the accuracy was poor (at best, standard error of the estimate, 0.36 L min-1; r2, 29.1%). FEV1 could be replaced by FVC and FEV1/FVC. Description of VO2max was improved by also including in the equation the variables age, fat-free mass, and submaximal exercise ventilation (VE). Transfer factor did not then contribute significantly. VO2max as percent of predicted (mean value of 60%) was described by %FVC or %FEV1, but the accuracy was poor (SEE, 16.0%; r2, 14%). Prediction was improved somewhat by the alternative use of inspiratory vital capacity and FEV1/FVC. Transfer factor did not contribute additional information; however, inclusion of VE materially improved the accuracy (SEE, 12.9%; r2, 44%). Among a subgroup of 35 men whose lung disease was due to asbestos, %TL' or transfer factor measured using a multibreath estimate of residual volume (%TLCO) made a small contribution to the explained variance, e.g.: %VO2max = 0.44% FEV1 -0.78 VE + 0.16% TLCO + 52.3 SEE 7.27%. This equation also described the %VO2max of all subjects (SEE, 13%).(ABSTRACT TRUNCATED AT 250 WORDS)
(i) CKD affects almost one-third of the elderly Polish population. (ii) In Poland elderly subjects with CKD are usually unaware of their kidney disease. (iii) In Polish elderly population, CKD is more frequently present among urban residents, non-smokers, abstainers and less physically active people. (iv) Only in women is higher educational status related to the lower risk of CKD.
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