Effect of exposure to secondhand smoke on markers of inflammation: the ATTICA study

PURPOSE: We sought to investigate the effect of secondhand smoke exposure on inflammatory markers related to cardiovascular disease. METHODS: During 2001 to 2002, we randomly selected a stratified (age-sex) sample of adults without clinical evidence of cardiovascular disease. Exposure to secondhand smoke (>30 minutes per day and greater than or equal to1 day per week) was recorded. Multivariate regression analysis was used to evaluate the effects of exposure to secondhand smoke on levels of C-reactive protein, fibrinogen, homocysteine, and oxidized low-density lipoprotein (LDL) cholesterol, and on white blood cell count. RESULTS: One hundred and thirty-seven (38%) of the 357 men who had never smoked and 211 (33%) of the 638 never-smoking women reported current exposure to secondhand smoke. Compared with those who were not exposed to secondhand smoke, those exposed more than 3 days per week had higher white blood cell counts (by 600 cells per muL; P = 0.02), as well as higher levels of C-reactive protein (by 0.08 mg/dL; P = 0.03); homocysteine (by 0.4 mumol/L; P = 0.002), fibrinogen (by 5.2 mg/dL; P = 0.4), and oxidized LDL cholesterol (by 3.3 mg/dL; P = 0.03), after adjusting for several potential confounders. CONCLUSION: Our findings suggest another pathophysiological mechanism by which exposure to secondhand smoke is associated with the development of atherosclerosis. (C) 2004 by Excerpta Medica Inc.