• Clinical and Experimental Pediatrics
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• 제53권2호
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• pp.121-128
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• 2010

In recent years, environmental tobacco smoke (ETS) has become an important worldwide public health issue. Children are particularly vulnerable to ETS because they are still developing. ETS exposure causes a wide range of adverse health effects on childhood asthma. There is convincing evidence that ETS exposure is causally associated with an increased prevalence of asthma, increased severity of asthma and worsening asthma control in children who already have the disease, even though a causal relationship with asthma onset is not yet established for asthma incidence. Mechanisms underlying these adverse effects of ETS are not clearly elucidated but e studies on this issue suggest that genetic susceptibility, impaired lung function, and augmented airway inflammation and remodeling may be involved. Children with asthma are just as likely to be exposed to ETS as children in general and there is no risk-free level of exposure. Therefore, providing a smoke-free environment may be of particular importance to the asthmatic children exposed to ETS who have adverse asthma outcomes, as well as to children with genetic susceptibility who are at increased risk of developing asthma upon exposure to ETS in early childhood.

• 동의생리병리학회지
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• 제26권1호
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• pp.40-46
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• 2012

Cigarette smoking is known to be associated with various chronic pulmonary and cardiovascular diseases ranging from inflammation to cancer. Not only first-hand smoke but also second-hand smoke is suggested to be a factor of health risk. This study was to investigate whether Platycodi Radix extract administration would alter oxidative stress in lung leading to protection of cigarette smoke-induced lung damage. Sprague-Dawley rats were randomly divided into 3 groups; Intact, Smoke+PR and Smoke+Vehicle. In Smoke+PR and Smoke+Vehicle group, the exposure to cigarette smoke was performed for 15 min/day for 4 weeks in ventilated smoking chamber. The Platycodi Radix extract and saline were orally administrated to Smoke+PR and Smoke+Vehicle group each. The rats of Intact group were just kept in ventilated chamber without cigarette smoke. After the experiment for 4 weeks, the lung tissues were collected for histological observation and immunohistochemistry. In Results, airspace enlargement and goblet cell hyperplasia were observed after 4 weeks' exposure to cigarette smoke. Whereas, the oral administration of Platycodi Radix extract for 4 weeks reduced airspace enlargement and goblet cell hyperplasia. Moreover, the alterations of BAX/Bcl-2 proteins in lung tissues were observed. These results suggest that Platycodi Radix extract ameliorates lung damage in cigarette smoke-exposed rats and has protective effects on second-hand smoke injury.

• 한국연초학회지
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• 제31권1호
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• pp.58-67
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• 2009

Biomarkers could be critical and useful tools for assessing the biological effects of smoking and detecting differences between potentially reduced exposure product (PREP) and conventional cigarettes. Smoking-related biomarkers can be classified into three categories as biomarkers of exposure, biomarkers of effects, and biomarkers of potential harm. When compared with the biomarkers of effects or harm, the biomarkers of exposure for chemical constituents of cigarette smoke are well established and characterized. In addition, they could offer the important information in understanding how cigarette smoke interacts with biological molecules and causes the disease to human. Therefore, we provide an overview of 6 biomarkers of exposure (Nicotine and nicotine metabolites, Carboxyhaemoglobin, NNAL (4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanol) and NNAL - glucuronide, 3-Hydroxypropyl-mercapturic acid, and Monohydroxy-butenyl-mercapturic acids, and Urine mutagenicity) which were validated through extensive research and clinical experience. These reliable biomarkers could help identify the efficacy of PREP by predicting early toxicological effects and lead to improve it.

• Tuberculosis and Respiratory Diseases
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• 제73권4호
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• pp.210-218
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• 2012

Background: The level of urine cotinine is an indicator of tobacco smoke exposure. The purpose of this study is to investigate urine cotinine for the purpose of assessing the smoking status of Korean smokers and non-smokers exposed to tobacco smoke. Methods: The subjects were identified from the 2007-2009 and the 2010 data sets of the Korea National Health and Nutrition Examination Survey (KNHANES). They were assigned as non-smokers, current smokers and ex-smokers. Non-smokers were also divided into three subset groups according to the duration of smoke exposure. Each group was stratified by gender prior to analysis. Results: The median value of urine cotinine in the male current smokers was 1,221.93 ng/mL which was the highest among all groups. The difference between levels of urine cotinine for male and the female groups was statistically significant (p<0.01). In the female group, passive smoke exposure groups reported higher urine cotinine levels than non-exposure groups (p=0.01). The cutoff point for the discrimination of current smokers from non-smokers was 95.6 ng/mL in males and 96.8 ng/mL in females. The sensitivity and specificity were 95.2% and 97.1%, respectively, in males, 96.1% and 96.5% in females. However, the determination of urine cotinine level was not useful in distinguishing between passive smoke exposure groups and non-exposure groups. Conclusion: Urine cotinine concentration is a useful biomarker for discriminating non-smokers from current smokers. However, careful interpretation is necessary for assessing passive smoke exposure by urine cotinine concentration.

• 보건행정학회지
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• 제30권4호
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• pp.505-512
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• 2020

Background: In monitoring exposure to environmental smoke (ETS), biomarkers can overcome the subjectivity and inaccuracy of self-reporting measurements, and have the advantage of reflecting ETS exposure in all places. This study aims to evaluate the effectiveness of ETS exposure measurement using biomarkers such as urine cotinine. Methods: This study used the Korea National Health and Nutrition Survey data from 2009 to 2018. A total of 28,574 non-smokers with urine cotinine data were selected for the study. The cotinine concentration and ETS exposure rate using urine cotinine was estimated and then compared with the self-reporting measurements. The degree of agreement among measurements of ETS exposure was confirmed. Results: As a result of measuring ETS exposure with urine cotinine, 23,594 (83.8%) out of 28,574 subjects were classified as to exposure groups. This estimate differs significantly from measurements made by self-reporting. In addition, the average concentration of cotinine in non-smokers has decreased to a 10th level over the past 10 years. Based on the biomarker, the sensitivity of the self-reporting was 8.5%-29.0%, the specificity was 16.4%-19.5%, and the kappa value was 2.0%-5.8%. Conclusion: The findings of our study show that self-reporting measurement does not well reflect the extent to which non-smoker's exposure to smoking materials. Whereas cotinine concentration has decreased significantly over the past 10 years, the ETS exposure rate has not reduced. It strongly suggests the need for intervention in the group of non-smokers exposed to low concentrations of smoke. Therefore, an assessment using biomarkers such as cotinine-based measurement should be made in the Health Plan 2030.

• 한국환경보건학회지
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• 제44권1호
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• pp.90-97
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• 2018

Objectives: Thirdhand smoke (THS) refers to residual tobacco smoke pollutants that remain after cigarette smoking. The purpose of this study was to determine predictors of the belief among adults in Korea that THS is harmful to children. Methods: A population-based sample of 3,000 adults (${\geq}19$ years) among a web-based panel in Korea was obtained in November 2016. The respondents filled out questionnaires, including THS beliefs, smoking status, presence of voluntary smoke-free rules at home, and support for the implementation of smoke-free regulations at home. THS beliefs were assessed with a statement that staying in a room today where people smoked yesterday can harm the health of children. Results: Overall, 92.2 % of adults believed that THS exposure could harm the health of children. Respondents who were nonsmokers, believed that SHS exposure were associated with pneumonia of children, lived in home with complete smoke-free rule at home, and supported the implementation of smoke-free regulation at home were more likely to believe that THS could harm for health of children. Conclusions: The majority of Korean adults believed that THS exposure could harm the health of children. Predictors identified in the study can be useful to address the risk of THS beliefs and promote implementation of tobacco control policies.

• 한국환경보건학회지
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• 제28권2호
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• pp.173-182
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• 2002

Exposure to environmental tobacco smoke(ETS) increases the risk of lung cancer and other diverse health effect for nonsmokers. Health risk assessment of nonsmokers related to ETS exposure requires large and exact data of ETS exposure to nonsmokers. This study presented the data of ETS exposure to workers at three category of restaurants(Korean restaurant, coffee shop, wine shop) in Seoul. Markers of ETS exposure measured in this study were area and personal NO$_2$, area and urine nicotine, area respiratory suspended particulate(RSP) and urine cotinine. The mean concentration of RSP and nicotine of all restaurant indoor samples was 177.8$\mu\textrm{g}$/㎥(range:75.3~317.0$\mu\textrm{g}$/㎥) and 7.8$\mu\textrm{g}$/㎥(range:0~57.3$\mu\textrm{g}$/㎥). The mean concentration of urine cotinine measured for the biomarker of ETS exposure was 77.3ng/mL(range:17.3~174.6ng/mL). In all measurements, the concentration of ETS markers at the wine shop was higher than those at other restaurants. The correlation coefficient among the ETS markers measured in the study was significant between area RSP and nicotine concentration and between area NO$_2$and nicotine concentration.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4815-4821
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• 2014

Background: This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. Materials and Methods: A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. Results: The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). Conclusions: Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1235-1242
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• 2016

Background: A school-based smoke free home (SFH) program is useful in empowering the mother and child to reduce secondhand smoke exposure but the effects of pretesting on knowledge and attitude has been largely ignored. We aimed to test whether such a program can be effective in Southern Thailand with an additional assessment of the net effect of the pretest. Materials and Methods: A Solomon four-group design was used. Twelve rural primary schools were assigned to one of the four conditions (each with 3 schools): intervention with and without a pretest, control with and without the same pretest. The intervention was performed in the classroom and home over a period of 1 month. Outcomes were assessed at baseline and 3 months after the intervention on whether the home was smoke free and related knowledge and attitude. Results: The intervention could lead to a smoke-free home without statistical significance. Attitude, knowledge and self-confidence on creating a smoke-free home, and self-confidence in avoidance of secondhand smoke exposure and persuading smokers to not smoke in their home were significantly improved. No pretest effect was observed. Conclusions: Gain in attitude, knowledge and self-confidence among family members from the brief school-based education should be enhanced by other measures.

• Journal of Korean Biological Nursing Science
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• 제18권1호
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• pp.27-35
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• 2016

Purpose: The purpose of this study was to identify the assertive behavior of asking smokers not to smoke and investigate the factors related to assertive behavior in patients with vascular diseases. Methods: Participants were 203 adult Korean patients with vascular diseases such as cerebral infarction and myocardial infarction. Data were collected using questionnaires that included the characteristics of secondhand smoke (SHS), secondhand smoke-related variables (Health belief model factors, health promotion model factors) and level of assertive behavior. Descriptive statistics, t-test, ANOVA and multiple regression using SPSS/WIN 18.0 were performed. Results: Participants who never ask smokers not to smoke was 39.9%, whereas participants who always ask was 7.4%. There was a weak positive relationship between assertive behavior and susceptibility to disease (r=.18), severity of disease (r=.19), benefit of assertive behavior to SHS exposure (r=.10), barrier of assertive behavior to SHS exposure (r=.24), and self-rated health (r=.21) respectively. There was a moderate positive relationship between assertive behavior and self-efficacy of assertive behavior to SHS exposure (r=.49). Health belief model factors explained 15.7% variance and health promotion model factors explained 27.0% of assertive behavior. Conclusion: The findings of this study suggest that self-efficacy of assertive behavior to SHS exposure is a very important factor. Therefore the development of a program to foster self-efficacy of assertive behavior regarding SHS exposure in patients with vascular diseases is needed.