云南罗平县农村居民烟草暴露及尼古丁依赖调查

目的 了解云南省罗平县农村居民烟草暴露与尼古丁依赖现状。方法 采用按比例概率抽样方法抽取当地12个乡镇≥18岁居民4 611人进行调查。结果 罗平县农村居民吸烟和被动吸烟率分别为40.0%(1 844/4 611)和27.8%(1 281/4 611),其中男性吸烟率为79.2%,女性为1.2%,男性被动吸烟率为8.8%,女性为46.6%,男性吸烟率明显高于女性(P<0.01),而女性被动吸烟率明显高于男性(P<0.01);村民中度及以上尼古丁依赖率为51.1%,家庭种烟者和高收入者(年收入≥15 000元)的吸烟率分别为44.5%和44.1%,明显高于家庭不种烟者和低收入者的37.4%和35.4%,(P<0.01);文化程度初中及以下被动吸烟率为42.9%,高中及以上为24.1%,被动吸烟率随着文化程度的增加而减少(P<0.05);农村居民以吸过滤嘴香烟为主(63.6%),其次为水烟袋(53.4%);初次吸烟年龄主要集中在15~24岁组的青年人群(93.0%),吸烟者中在过去12个月内尝试戒烟1次的比例仅为13.4%,过去7 d内被动吸烟场所在主要集中在家里和公共场所的比例分别为97.0%和88.5%。结论 罗平县村民吸烟和被动吸烟情况较严重,应重点加强家庭种烟者、男性和低文化程度人群的控烟工作。     

Occupational exposure of non-smoking restaurant personnel to environmental tobacco smoke in Finland

BACKGROUND: Environmental tobacco smoke (ETS) exposure levels in different restaurant types in Finland were assessed before the National Tobacco Act restricting smoking in restaurants was activated. METHODS: Exposure to ETS was determined by measuring nicotine in the breathing zone of non-smoking restaurant workers and by quantification of the nicotine metabolites cotinine and 3-hydroxycotinine in the urine of these workers during one whole work week. Altogether 23 workers from 15 restaurants were included in the study. RESULTS: The geometric mean (GM) breathing-zone nicotine level was 3.9 microg/m(3) (3.7 microg/m(3) in pubs, 1.4 microg/m(3) in dining restaurants, and 10.2 microg/m(3) in nightclubs). The GM cotinine and trans-3'-hydroxycotinine level in urine were 3.3 ng/mg((creatinine)) and 15.3 ng/mg((creatinine)), respectively. The exposure to ETS of restaurant workers in dining restaurants was clearly lower than that of workers in pubs and nightclubs as indicated by all ETS-markers used in the present study. During the work week, the cotinine and 3'-hydroxycotinine levels in urine of the study subjects increased. The correlation between breathing zone nicotine and urine cotinine and hydroxycotinine was 0.66 for both compounds. Post-shift cotinine and hydroxycotinine levels were not significantly higher than the pre-shift levels. CONCLUSIONS: If 9 ng cotinine/mg((creatinine)) is considered as the level above which heavy exposure has occurred, then this level was exceeded by 14 (approximately 60%) subjects at least once during the work week. Nicotine metabolite concentrations in the urine increased during the work week in 80% of the subjects, and the increase was especially noticeable for subjects working in both pubs and nightclubs. The study indicates that measures to restrict ETS exposure in restaurants are needed.     

The tobacco industry's worldwide ETS consultants project: European and Asian components

BACKGROUND: The tobacco industry has formed regional environmental tobacco smoke (ETS) consultants programs in order to generate controversy on the issue of secondhand smoke (SHS) in Europe, Asia and Latin America. Only those countries in which the industry foresaw SHS restrictions were included. This paper describes the European and Asian components of the tobacco industry's worldwide ETS consultants program. METHODS: A systematic search was carried out of tobacco industry documents available on the Internet between October 2002 and February 2004. RESULTS: Beginning in 1987, Philip Morris assembled an international ETS consultants program in collaboration with other tobacco companies based on their market shares in different regions of the world. The law firm Covington & Burling contacted and hired consultants with a wide range of expertise, usually affiliated with an academic institution, in order to avoid direct contact with the industry. The objective of the program was to influence policy makers, media and the public by providing, through their consultants, 'accurate' (pro-industry) information concerning smoking regulations in public places and workplaces, indoor air quality and ventilation standards, and scientific claims regarding SHS. Consultants also conducted research related to SHS and organized and attended regional and international symposiums related to SHS without acknowledging industry funding. CONCLUSIONS: Despite evidence that the issue of smoke-free environments was close to emerging within the general public throughout the world in the late 1980s, the tobacco industry used its well-organized network of consultants to avoid SHS regulations in most of the world.     

Developing asthma in childhood from exposure to secondhand tobacco smoke: insights from a meta-regression

OBJECTIVE: Studies have identified associations between household secondhand tobacco smoke (SHS) exposure and induction of childhood asthma. However, the true nature and strength of this association remains confounded in many studies, producing inconsistent evidence. To look for sources of potential bias and try to uncover consistent patterns of relative risk estimates (RRs), we conducted a meta-analysis of studies published between 1970 and 2005. DATA SOURCES: Through an extensive literature search, we identified 38 epidemiologic studies of SHS exposure and the development of childhood asthma (that also controlled for atopy history) from 300 potentially relevant articles. DATA SYNTHESIS: We observed substantial heterogeneity within initial summary RRs of 1.48 [95% confidence interval (CI), 1.32-1.65], 1.25 (1.21-1.30), and 1.21 (1.08-1.36), for ever, current, and incident asthma, respectively. Lack of control for type of atopy history (familial or child) and child's own smoking status within studies and age category altered summary RRs in separate meta-regressions. After adjusting for these confounding characteristics, consistent patterns of association emerged between SHS exposure and childhood asthma induction. Our summary RR of 1.33 (95% CI, 1.14-1.56) from studies of incident asthma among older children (6-18 years of age) is 1.27 times the estimate from studies of younger children and higher than estimates reported in earlier meta-analyses. CONCLUSIONS: This new finding indicates that exposure duration may be a more important factor in the induction of asthma than previously understood, and suggests that SHS could be a more fundamental and widespread cause of childhood asthma than some previous meta-analyses have indicated.     

Exposure to secondhand smoke outside of a bar and a restaurant and tobacco exposure biomarkers in nonsmokers

Background: With an increase in indoor smoking bans, many smokers smoke outside establishments and near their entrances, which has become a public health concern.Objectives: We characterized the exposure of nonsmokers to secondhand smoke (SHS) outside a restaurant and bar in Athens, Georgia, where indoor smoking is banned, using salivary cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL).Methods: In a crossover study, we assigned 28 participants to outdoor patios of a restaurant and a bar and an open-air site with no smokers on three weekend days; participants visited each site once and stayed for 3 hr. We collected saliva and urine samples immediately before and after the visits (postexposure) and on the following morning and analyzed samples for cotinine and total NNAL, respectively. Regression models were fitted and changes in biomarkers were contrasted between locations.Results: Postexposure and preexposure geometric mean salivary cotinine concentrations differed by 0.115 ng/mL [95% confidence interval (CI): 0.105, 0.126)] and by 0.030 ng/mL (95% CI: 0.028, 0.031) for bar and restaurant visits, respectively. There were no significant post- and preexposure differences in cotinine levels after control site visits, and changes after bar and restaurant site visits were significantly different from changes after control site visits (p < 0.001). Results comparing next-day and preexposure salivary cotinine levels were similar. Next-day creatinine-corrected urinary NNAL concentrations also were higher than preexposure levels following bar and restaurant visits [1.858 pg/mg creatinine higher (95% CI: 0.897, 3.758) and 0.615 pg/mg creatinine higher (95% CI: 0.210, 1.761), respectively], and were significantly different from changes after the control visits (p = 0.005).Conclusion: Salivary cotinine and urinary NNAL increased significantly in nonsmokers after outdoor SHS exposure. Our findings indicate that such exposures may increase risks of health effects associated with tobacco carcinogens.     

A study of environmental tobacco smoke in South Australian pubs, clubs and cafes

Exposure to Environmental Tobacco Smoke (ETS) in hotels and clubs is of community concern and may lead to a variety of adverse health outcomes for workers and patrons. This study sought to measure ETS in both smoking and non-smoking areas of hospitality venues in South Australia and to assess the effectiveness of ETS control measures. Seven hotels, clubs and cafes were investigated and the concentrations of airborne nicotine and particulate matter (PM(10)) were measured as markers of ETS exposure during normal to busy periods. Overall average concentrations were higher in smoking areas (nicotine = 15 microg/m(3) and PM(10) = 255microg/m(3)) compared with non-smoking dining areas (nicotine = 7 microg/m(3) and PM(10) = 192 microg/m(3)). The data demonstrate an approximate two-fold reduction of ETS within non-smoking areas and suggest that mechanical ventilation is only partially effective in preventing propagation of ETS throughout premises. Risk models suggest that ETS exposures in non-smoking areas may still represent an appreciable health risk. It is recommended that smoking be totally banned in enclosed publicly accessible areas.     

甘肃省20～80岁汉族男性吸烟和饮酒的交互作用对γ – 谷氨酰转肽酶的影响

  目的  了解浙江省杭州市居民在新版《杭州市公共场所控制吸烟条例》（简称“《条例》”）实施2年后的室内公共场所二手烟暴露情况及其对室内公共场所控烟的满意度,为新版《条例》的推进提供参考。  方法  于2021年1月采用分层随机抽样方法在杭州市下城区、余杭区和桐庐县抽取1320名15～75岁居民进行问卷调查。  结果  杭州市最终纳入分析的1315名居民中目前不吸烟者1101人,不吸烟者中有303人近1周内在公共场所吸入过二手烟,二手烟暴露率为27.52 %;杭州市居民对室内公共场所控烟的总体满意度为67.76 %,其中对控烟宣传的满意度为64.49 %,对控烟监督执法的满意度为59.54 %,对党政机关无烟示范的满意度为65.63 %;在控制了性别、年龄、文化程度、婚姻状况、职业、居住地、是否自报慢性病患病、目前吸烟情况、控烟条例核心知识知晓情况、烟草危害知晓情况和控烟参与意愿等混杂因素后,多因素非条件logistic回归分析结果显示,对控烟宣传满意度（OR = 2.293,95 % CI = 1.507～3.491）、控烟监督执法满意度（OR = 3.960,95 % CI = 2.793～5.615）和党政机关无烟示范满意度（OR = 3.911,95 % CI = 2.534～6.036）越高的杭州市居民,其对室内公共场所控烟的总体满意度越高。  结论  杭州市居民室内公共场所二手烟暴露率较低且对控烟的满意度较高,新版《条例》的实施取得了一定效果,相关部门应重点加强监督执法力度和巩固党政机关的无烟示范作用以提高居民对室内公共场所控烟的总体满意度。     

Assessment of environmental tobacco smoke and respirable suspended particle exposures for nonsmokers in Prague using personal monitoring

Objective: Exposures to respirable suspended particles (RSP) and environmental tobacco smoke (ETS) were assessed in Prague, Czech Republic, to determine the range and degree of personal exposure by means of personal monitoring over a 24-h period. Design: Self-reported nonsmokers were randomly selected from a representative sample of the population of Prague. Housewives were recruited into one group, primarily for assessment exposures in the home, and office workers were recruited into a second group for assessment of the contribution from the workplace. Methods: A total of 238 randomly selected nonsmoking subjects collected air samples near their breathing zone by wearing personal monitors for 24 h. Samples collected were analyzed for RSP, nicotine, 3-ethenylpyridine, and ETS particles (using ultraviolet absorbance, fluorescence, and solanesol measurements). Saliva cotinine analyses were also undertaken to confirm the nonsmoking status of the subjects. Results: The most highly exposed subjects in this study were office workers both living and working with smokers. Median time-weighted average exposure concentrations of 60 μg m⁻³ RSP, 16 μg m⁻³ ETS particles, and 1.6 μg m⁻³ nicotine were determined for these subjects, who also had the highest median saliva cotinine level of 2.4 ng ml⁻¹. Housewives living in nonsmoking households were the least exposed subjects in this study, showing levels of 32 μg m⁻³ RSP, 0.17 μg m⁻³ ETS particles, and 0.15 μg m⁻³ nicotine. As based upon median levels of ETS particles and nicotine, no group would potentially inhale or be exposed to more than 10 cigarette equivalents per year (CE/y) and the least exposed would inhale less than 1 CE/y. The most highly exposed (90th percentile levels) nonsmokers in this study, who both worked and lived with smokers, would potentially inhale up to 29 CE/y. Overall, the workplace was estimated to contribute between 45% and 49% of the annual exposure to nicotine and ETS particles, respectively. On the basis of determined saliva cotinine concentrations, a misclassification rate of between 1.7% and 2.5% was calculated. Conclusions: Highest exposures were apparent for office workers both working and living in smoking environments, and our findings suggest a significant contribution to overall ETS particle and nicotine levels from the workplace where smoking takes place. Overall, the rates at which subjects were determined to have misclassified their smoking status in this study were the lowest observed in any of the European cities investigated to date. Clearly, a more sensitive method of analysis for cotinine in body fluids is needed for more accurate determination of the levels expected for nonsmokers. Received: 19 November 1997 / Accepted: 26 February 1998     

儿童环境烟草烟雾暴露状况及干预措施研究进展

儿童由于其生理特征,暴露于环境烟草烟雾的不良健康影响更大,除了会导致不良的生理作用,如肺功能异常、哮喘、耳部疾病和婴儿猝死综合征等,也会使儿童出现行为、态度及情感方面的障碍。作者主要从环境烟草烟雾对儿童的影响儿童烟草暴露情况及国内外家庭环境中对烟草烟雾的主要干预措施3个方面进行综述。     

浙江省2013年成人吸烟及被动吸烟现状调查

  目的  分析中国城市职业人群吸烟行为及二手烟暴露流行水平。  方法  利用2015年“工作场所健康促进需求评估”专项调查数据,对3 553名职工的吸烟行为和二手烟暴露状况进行分析,指标包括吸烟率、现在吸烟率、现在每日吸烟率、重型吸烟率及二手烟暴露率。  结果  调查对象中,吸烟率为27.4 %,男性吸烟率为48.3 %,女性吸烟率为3.0 %;现在吸烟率为24.2 %,男性为43.0 %,女性为2.4 %;现在每日吸烟率为22.4 %,男性为39.8 %,女性为2.2 %;重型吸烟率为4.1 %,男性为7.5 %,女性为0.1 %。非吸烟者的二手烟暴露率为67.6 %,男性为73.7 %,女性为63.4 %。建筑工地人群现在吸烟率最高（49.6 %）,不同性别、年龄、户籍、文化程度和职业者现在吸烟率差异均有统计学意义（P < 0.05）。人群对吸烟、二手烟暴露引起其他疾病的认知明显不足,对吸烟引起3种疾病的知晓率仅为4.4 %,对二手烟暴露引起3种疾病的知晓率仅为14.9 %。  结论  职业人群吸烟和二手烟暴露情况严重,对烟草知识的认知严重不足。     

Exposure to environmental tobacco smoke: association with personal characteristics and self reported health conditions

STUDY OBJECTIVE: To examine the association between exposure to environmental tobacco smoke (ETS) and demographic, lifestyle, occupational characteristics and self reported health conditions. DESIGN: Cross sectional study, using data from multiphasic health checkups between 1979 and 1985. SETTING: Large health plan in Northern California, USA. PARTICIPANTS: 16 524 men aged 15-89 years and 26 197 women aged 15-105 years who never smoked. RESULTS: Sixty eight per cent of men and 64 per cent of women reported any current ETS exposure (at home, in small spaces other than home or in large indoor areas). The exposure time from all three sources of ETS exposure correlated negatively with age. Men and women reporting high level ETS exposure were more likely to be black and never married or separated/divorced, to have no college or partial college education, to consume three alcoholic drink/day or more and to report exposure to several occupational hazards. Consistent independent relations across sexes were found between any current exposure to ETS and a positive history of hay fever/asthma (odds ratio (OR)=1.22 in men, 1.14 in women), hearing loss (OR=1.30 in men, 1.27 in women), severe headache (OR=1.22 in men, 1.17 in women), and cold/flu symptoms (OR=1.52 in men, 1.57 in women). Any current ETS exposure was also associated with chronic cough (OR=1.22) in men and with heart disease (OR=1.10) in women. Self reported stroke was inversely associated with any current ETS exposure in men (OR=0.27). No associations were noted for cancer or tumour and for migraine. CONCLUSION: ETS exposure correlated with several personal characteristics potentially associated with adverse health outcomes. Although the study design precluded causal inference, ETS exposure was associated with several self reported acute and chronic medical conditions.     

Secondhand Tobacco Smoke Exposure in Open and Semi-Open Settings: A Systematic Review

Background: Some countries have recently extended smoke-free policies to particular outdoor settings; however, there is controversy regarding whether this is scientifically and ethically justifiable.Objectives: The objective of the present study was to review research on secondhand smoke (SHS) exposure in outdoor settings.Data sources: We conducted different searches in PubMed for the period prior to September 2012. We checked the references of the identified papers, and conducted a similar search in Google Scholar.Study selection: Our search terms included combinations of “secondhand smoke,” “environmental tobacco smoke,” “passive smoking” OR “tobacco smoke pollution” AND “outdoors” AND “PM” (particulate matter), “PM_2.5” (PM with diameter ≤ 2.5 µm), “respirable suspended particles,” “particulate matter,” “nicotine,” “CO” (carbon monoxide), “cotinine,” “marker,” “biomarker” OR “airborne marker.” In total, 18 articles and reports met the inclusion criteria.Results: Almost all studies used PM_2.5 concentration as an SHS marker. Mean PM_2.5 concentrations reported for outdoor smoking areas when smokers were present ranged from 8.32 to 124 µg/m³ at hospitality venues, and 4.60 to 17.80 µg/m³ at other locations. Mean PM_2.5 concentrations in smoke-free indoor settings near outdoor smoking areas ranged from 4 to 120.51 µg/m³. SHS levels increased when smokers were present, and outdoor and indoor SHS levels were related. Most studies reported a positive association between SHS measures and smoker density, enclosure of outdoor locations, wind conditions, and proximity to smokers.Conclusions: The available evidence indicates high SHS levels at some outdoor smoking areas and at adjacent smoke-free indoor areas. Further research and standardization of methodology is needed to determine whether smoke-free legislation should be extended to outdoor settings.     

Cooking smoke and tobacco smoke as risk factors for stillbirth

Smoke from biomass combustion produces some of the same pollutants found in tobacco smoke and ambient air, yet only one study to date has linked cooking with biomass fuels to increased risk of stillbirth. The mechanisms by which biomass smoke may cause stillbirth are through exposure to CO and particulates in biomass smoke. Using information on 19,189 ever-married women aged 40-49 included in India's 1998-99 National Family Health Survey, we examined the association between household use of biomass fuels (wood, dung, and crop residues), tobacco smoke (both active and passive), and risk of stillbirth. Data were analyzed using binary and multinomial logistic regression after controlling for several potentially confounding factors. Results indicate that, with other factors controlled, women who cook with biomass fuels are significantly more likely to have experienced a stillbirth than those who cook with cleaner fuels (OR= 1.44; 95% CI: 1.04, 1.97). Women who cook with biofuels are twice as likely to have experienced two or more stillbirths as those who cook with cleaner fuels (RRR= 2.01; 95% CI: 1.11, 3.62). The adjusted effect of active tobacco smoking is also positive (OR = 1.23) but not statistically significant. No effect of passive smoking was found, nor was there evidence of any modifying effects of tobacco smoking.     

Time trends in exposure to environmental tobacco smoke and parental educational level for 6-year-old children in Germany

The aim of the study was to investigate the association between exposure to environmental tobacco smoke of 6-year-old children and parental educational level in Germany under the changing socioeconomic conditions after reunification. Logistic regression was used to examine the relationship between tobacco smoke exposure of children (current environmental tobacco smoke, maternal smoking during pregnancy, environmental tobacco smoke during the first 3 years of the child’s life) and the determinants parental educational level, time and region. In Germany, the risk of environmental tobacco smoke exposure among 6-year-old children was strongly associated with parental educational level (odds ratio: ≥2 ‘low’/‘middle’ versus ‘high’ parental educational level). In West Germany, environmental tobacco smoke exposure generally exhibited a decreasing trend of about 20%. In contrast, in East Germany the environmental tobacco smoke exposure was only decreasing for children of parents with higher education. The gap between low and high parental educational level with respect to current children’s tobacco smoke exposure has increased from 1991 to 2000 in East Germany. A considerable fresh increase of maternal smoking during pregnancy could be observed around 1991 in both parts of Germany. In East Germany, the transition from a socialist economic system to a market economy after reunification might in part explain the increased gap of tobacco smoke exposure between children of parents with lower and higher educational levels.     

Exposure to environmental tobacco smoke in pregnant women: the association between self-report and serum cotinine

The risk of delivering a low-birth-weight infant as the result of exposing a nonsmoking pregnant woman to environmental tobacco smoke (ETS) is not well defined. The method of ascertaining ETS exposure during pregnancy may explain the lack of consistent study findings. In a large sample of pregnant women, we compared distributions between two methods of ETS exposure: self-report and cotinine, a nicotine metabolite, from serum. At livery, subjects were asked about duration and location of exposure to ETS during their second trimester. A single cotinine measurement was assayed from serum collected at 15-19 weeks gestation (limit of detection=0.05 ng/mL). Self-reported (hours per day) ETS exposure was correlated (r=0.38) with cotinine concentration. Regression analysis revealed that while self-reported ETS was significantly associated with (log) cotinine, it did not explain a large amount of total variation. While 72% of subjects reported no exposure to ETS, almost all had measurable levels of cotinine. Studies of pregnant women based upon an hours per day ETS question have likely misclassified a sizable portion of ETS-exposed women as "unexposed." Since there is recent evidence that low levels of ETS exposure result in unfavorable pregnancy outcomes, these studies have underestimated the effect of ETS.     

Passive smoking at work: biochemical and biological measures of exposure to environmental tobacco smoke

Summary Several biochemical and biological measures of tobacco smoke intake were used to evaluate exposure of restaurant personnel to environmental tobacco smoke as compared with active smokers and non-exposed non-smokers. All of the measured parameters — carboxyhaemoglobin (COHb), thiocyanate (SCN) and cotinine in plasma, cotinine and mutagenicity in urine, total white blood cell count (WBC), and sister chromatid exchange (SCE) frequency in cultured lymphocytes — were significantly elevated in the smoker group (n = 22) compared to the non-exposed group (n = 20). Work-related passive exposure (n = 27) was seen most clearly in the cotinine values, both from plasma (mean P-cot in passive smokers 10 ng/ml vs 5.2 ng/ml in non-exposed) and from urine (mean U-cot in passive smokers 56 ng/ml vs 8.3 ng/ml in non-exposed), but significant increases were also seen in the thiocyanate levels (mean P-SNC in passive smokers 58 mol/1 vs 46 mol/1 in non-exposed) and, as a preliminary finding, in total leucocyte count (in passive smokers 8.0 × 10⁹/1 vs 6.8 x 10⁹/1 in non-exposed). The results demonstrate that environmental tobacco smoke may be an occupational health hazard.     

Priority setting for school nutrition research: developing a collaborative research agenda

Priority setting in health research can assist stakeholders to identify research and policies that have the greatest potential for benefits to public health. Priority setting has been utilized by researchers to identify barriers, facilitators, and recommendations for future public health research. This commentary describes how a priority-setting approach was used as part of a workshop activity on the school nutrition environment in Ontario, Canada, to facilitate brainstorming, sorting, and rating of concepts related to the school nutrition environment. This work demonstrates an interesting and concrete case of priority setting, of interest for various planning activities (both programming and research), particularly those around school-based healthy eating programs or a related research agenda.     

Indoor exposure to environmental tobacco smoke and dampness: respiratory symptoms in Sardinian children--DRIAS study

Indoor exposures at home, environmental tobacco smoke (ETS) and mould/dampness adversely affect respiratory health of children. Disturbi Respiratori nell’Infanzia e Ambiente in Sardegna (DRIAS) (Respiratory Symptoms in children and the Environment in Sardegna, Italy) aims at relating the prevalence of respiratory and allergic symptoms to indoor exposures in Sardinian children.DRIAS, a cross-sectional investigation of respiratory symptoms/diseases, used a modified version of ISAAC questionnaire, included 4122 children attending 29 primary schools in the school year 2004-2005.If both parents smoke the prevalence for current wheeze and current asthma is almost doubled in comparison with never smokers, for persistent cough and phlegm a role is suggested when only mother smokes. Among mothers smoking in pregnancy, the prevalence of current wheeze and current asthma is increased. Exposure to ETS and family atopy have a joint effect resulting in an almost tripling of prevalence for current wheeze and more than four times for current asthma. Exposure to “dampness” (mould or dampness) both during the first year of life and currently is associated with increased prevalence of current wheeze, persistent cough or phlegm and current rhino-conjunctivitis; if exposure is only during the first year of life a doubling or more of prevalence is observed for current wheeze, current asthma, and persistent cough or phlegm.DRIAS results add evidence to the causal role of childhood exposure to ETS in the development of respiratory symptoms (cough, phlegm, and wheezing) and asthma. The joint effect of ETS and family atopy is corroborated. The results strengthen the evidence for a causal association between “dampness” and respiratory health, pointing to its possible independent role in causing asthma, a long-lasting exposure entails a doubled prevalence for both asthmatic and bronchitis symptoms.