Pulmonary Function Abnormalities in Never-Smoking Flight Attendants Exposed to Secondhand Tobacco Smoke in the Aircraft Cabin

Arjomandi, Mehrdad; Haight, Thaddeus; Redberg, Rita F.; Gold, Warren M.

doi:10.1097/jom.0b013e3181a7f048

Cited by 30 publications

(62 citation statements)

References 46 publications

(39 reference statements)

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“…Prev. Cessation 2017;3(January):1 http://www.dx.doi.org/10.18332/tpc/67273 contrast to these findings, Arjmandi et al who examined healthy flight attendants found significant decreases in spirometric parameters (mid-and end-expiratory flow), diffusion capacity and lung volumes 6 . Their findings can be attributed to the significantly different environment represented by the flying aircraft cabin, where changes in altitude, pressure fluctuations as well as exposure to ozone, CO2 and various other pollutants (fungi, bacteria, protozoa) exert physical strain on a traveler's body 34 .…”

Section: Discussionmentioning

confidence: 67%

“…A study by Thier de Borba et al measured CR response through sub-maximal exertion incremental testing on a treadmill in the general population separated by smoking status 13 . In 2009, Arjomandi et al studied occupational exposure to SHS in flight cabins among non-smoking flight attendants prior to implementation of commercial smoking bans and examined their flow-volume curves, diffusion capacity and lung volumes 6 . Preventive policies for tobacco control include banning smoking indoors in public places and have been embraced by many countries but leave an estimated 84% of the population unprotected 14 .…”

Section: List Of Abbreviationsmentioning

confidence: 99%

“…In adults, SHS has been associated with cardiovascular diseases (CVD), stroke, lung cancer, chronic obstructive pulmonary disease (COPD), asthma exacerbation and reproductive effects in women such as low birth weight infants 4,5 . Children exposed to SHS are particularly vulnerable, being put at risk for developing rhinitis, eye irritation, middle ear infection, increased respiratory symptoms such as cough, chest discomfort, wheezing, lower respiratory infections and sudden infant death syndrome 6,7 .…”

Section: Introductionmentioning

confidence: 99%

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Cardiorespiratory response to exercise of nonsmokers occupationally exposed to second hand smoke (SHS)

Mantzoros¹,

Teloniatis²,

Lymperi³

et al. 2017

Tob. Prev. Cessation

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INTRODUCTION Occupational exposure to Second Hand Smoke (SHS) continues to be an issue, even in countries with strong tobacco control legislation. The current study assessed the effect of chronic occupational exposure to SHS on cardiorespiratory exercise response among healthy adult non-smokers. METHODS 60 healthy non-smokers; 38 men, 22 women, aged 18-58 years with body mass index (BMI)<30 were separated into exposed to occupational SHS (exposed, n=30) and those non-exposed (controls, n=30) to occupational SHS in the hospitality sector. All individuals underwent baseline spirometry and ergospirometry testing. Non-smoking status was confirmed with exhaled CO, SHS exposure with urine cotinine measurement and indoor environmental pollution with PM2.5 concentration. Statistical differences among groups were determined with an independent t-test and p-value set to <0.05. RESULTS The exposed group had an average range of 6.9% to 14% lower exercise performance against their % predicted compared to controls. Significant mean differences standard deviation found between groups for ergospirometry were: oxygen uptake (VO 2 , mL/minute) 11.8 3.9 (p=0.004) and 11.7 4.8 (p=0.019); carbon dioxide output (VCO 2 ) 14.0 3.7 (p<0.001) and 13.4 5.0 (p=0.009); metabolic equivalents (METS) 11.9 3.9 (p=0.003) and 11.7 4.9 (p=0.018) and for oxygen pulse (VO 2 /HR) 16.6 7.551 (p=0.032) and 11.9 4.554 (p=0.011) at points of maximum oxygen uptake (VO 2 max) and recovery (RC) against % predicted values, respectively. CONCLUSION Chronic occupational SHS exposure among non-smokers deteriorates CR exercise performance. Its impact on chronic disease development should be further explored. These results add to the evidence of the importance of enforcing clean indoor air legislations..Cardiorespiratory response to exercise of nonsmokers occupationally exposed to second hand smoke (SHS)

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Section: Discussionmentioning

confidence: 67%

Section: List Of Abbreviationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cardiorespiratory response to exercise of nonsmokers occupationally exposed to second hand smoke (SHS)

Mantzoros¹,

Teloniatis²,

Lymperi³

et al. 2017

Tob. Prev. Cessation

View full text Add to dashboard Cite

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“…Another study evaluated the impact of heavy workplace passive smoke exposure among 61 never smoking flight attendants who worked in aircraft cabins before the smoking ban on commercial aircraft (range of 3-45 years of preban employment) [16 ]. The flight attendants had normal FEV 1 , FEV 1 /FVC, but they had more subtle evidence of airway obstruction including decreased flow rate at mid-lung and low-lung volumes, curvilinear flowvolume curves, and evidence of air trapping.…”

Section: Introductionmentioning

confidence: 99%

Secondhand smoke at work

Eisner¹

2010

Current Opinion in Allergy &Amp; Clinical Immunology

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“…Investigation of SHSe and health conditions, especially chronic diseases and cancers, among flight attendants is especially important both intrinsically and as the results to inform our understanding of the health effects of SHS. Short-term health effects reported among flight attendants due to occupational SHSe include respiratory irritation, ocular symptoms, decreased tearfilm stability, and alterations in nasal patency (5,6) ; and chronic effects include pulmonary function abnormalities, (7,8) respiratory diseases, (9,10) increased rates of hypertension, (11) breast cancer, and malignant melanoma. (12) Interestingly, increased lung cancer incidence or mortality has not been observed among flight attendants comparing to the general population.…”

Section: Introductionmentioning

confidence: 99%

Modeling Flight Attendants’ Exposure to Secondhand Smoke in Commercial Aircraft: Historical Trends from 1955 to 1989

Liu

Dix-Cooper

Hammond

2015

Journal of Occupational and Environmental Hygiene

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Flight attendants were exposed to elevated levels of secondhand smoke (SHS) in commercial aircraft when smoking was allowed on planes. During flight attendants' working years, their occupational SHS exposure was influenced by various factors, including the prevalence of active smokers on planes, fliers' smoking behaviors, airplane flight load factors, and ventilation systems. These factors have likely changed over the past six decades and would affect SHS concentrations in commercial aircraft. However, changes in flight attendants' exposure to SHS have not been examined in the literature. This study estimates the magnitude of the changes and the historic trends of flight attendants' SHS exposure in U.S. domestic commercial aircraft by integrating historical changes of contributing factors. Mass balance models were developed and evaluated to estimate flight attendants' exposure to SHS in passenger cabins, as indicated by two commonly used tracers (airborne nicotine and particulate matter (PM)). Monte Carlo simulations integrating historical trends and distributions of influence factors were used to simulate 10,000 flight attendants' exposure to SHS on commercial flights from 1955 to 1989. These models indicate that annual mean SHS PM concentrations to which flight attendants were exposed in passenger cabins steadily decreased from approximately 265 μg/m(3) in 1955 and 1960 to 93 μg/m(3) by 1989, and airborne nicotine exposure among flight attendants also decreased from 11.1 μg/m(3) in 1955 to 6.5 μg/m(3) in 1989. Using duration of employment as an indicator of flight attendants' cumulative occupational exposure to SHS in epidemiological studies would inaccurately assess their lifetime exposures and thus bias the relationship between the exposure and health effects. This historical trend should be considered in future epidemiological studies.

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Pulmonary Function Abnormalities in Never-Smoking Flight Attendants Exposed to Secondhand Tobacco Smoke in the Aircraft Cabin

Cited by 30 publications

References 46 publications

Cardiorespiratory response to exercise of nonsmokers occupationally exposed to second hand smoke (SHS)

Cardiorespiratory response to exercise of nonsmokers occupationally exposed to second hand smoke (SHS)

Secondhand smoke at work

Modeling Flight Attendants’ Exposure to Secondhand Smoke in Commercial Aircraft: Historical Trends from 1955 to 1989

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