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1 AM..4adM..ww 1Y. r4h s ssr.r am j* .doad . .d *a.b r YK lW3ir'{t{ VGOBCCO6! Wtl "ridtY11 fK Aft1 (Mfl ` Ali/ }fB/om am HM1/ r.N{ AJ/4r•JiEYf 66CtT7 . a .d tLs losaxh .+d Gcfercnc. GMtl C.ftaaa.r .r tlK M .d;na7 r.aAe7 K•"Amb crvu Awe .+ 4110 Usi .aruh' .! H.nt lC.ut f.r fi.a+dal wrtwrc: hd .ror CJC Mok. Dn . MX. {ac. KX. La . M .7 w .i, v .C. Ckait. L Hou. tx tiw . C .w . Ckac id X.T . Tiua ad t'iur 1[. Asuinr Mr dtir .d•.is rd 1 .* 1tlr . C- Cir Ma . C . T.nt ..1 1i4. N, i.n f.r Ldt 1. Lu dl .criao .d au)7- ,it : r1 Ma . 0 . Lsn. Mta. T . Lr ad Hi A. Chow f« .asu,isl w1tw.« Rdtrssm.. l . Ch&n W .C . Ca)knan: M .1 . Funj S .C. Wo H . C- Imncdial mnter is Hon! Krn! 1f7b1117 . Ir. I . Cu,car, 3!: It2•!!2, 1979 . i pua W .C_ F=8 s.C_ Lvu rncn r re, eook .rr ie Honj Koag la. Gnismnann L. Itd .) . Catxa Camotitn . Voi . 7 . Cuetr toidemiolorY . trunjtrt/Nr. Y.rk: Gmru• F'ucAa V.rtaj . tl+. 241 . tit2. l. Man w .C . M .cLeaaata L : Lia nr+cer M Noat fCont Cau,.u .orulirt a+e kiiMtopu) tT" . tKStl12 . k . 1 . Catsa . ~! : ?212~) . 1f7l . • . Caotrr D .A . Cnru AJt.. >iwroc KA: h+• a .ry .Ucsaa . K de iamj i. ranr,otas. AreL In .iroe. Hni,A. 16 ; 3K4C0 . 1944 . f. Corr. F_ Picrle LiV . F.n"m 1L 1.ta Y . H.maal W . : Fuai .t seoY,iaj .ed hmj oanosr . Lans+s, Y : lf5Sl7• 1943, IL Don It., H)ll AA. Km" L : T1r rjnirr OtHCt hr ttu C/1rt {! R1ltion ID Mt rRi6)ofY .f ks+t •an=• tr . ( . G+rosr . Ii : il+t, am T . Do11 L. Frm R.: T1r r .u.. . .t .ncsr, tuair rt.uve .emur .f .aiLall. " rf sriea M *A Umied iur.o w.7 . I . Nu . Gac . taw_ i1 : 11i'1•)SOl, 1141 . http://legacy.library.ucsf.edu/tid/wyk81f00/pdf tsaivs t:aokiaW dkk ir Cklaw aasa? i. LdiaxiaL• hrivn tioktas: hersL Grf -d fibca . Lmsm k l4LS4f . 1oi2 . f . Garilnkd L Tbm uusd+ h Iri r+rr 6or WJr7 arosl Yoo-moktrf atrW iMtt • MO . jir. .eoklnt . I . Hac r...wr 1 .w ~f : !a,• eau . tos1 . ttf. Gmw I1, irntr7 t : Cr.h ... .f db iraj M .oatmotnj C2,ur. ...m 1vst . ( . itK .. 134 ; !!)•31+ . 1142 . 11 . Hiric...e LC_ f.tlko(t Lt . ltiriv. .mrr
e w http://legacy.library.ucsf.edu/tid/wyk81f00/pdf , Iru . J Cancer: 39, 1ti2-169 (1987) ~. . P 0 1987 Alan R . L.iss, Inc . MEASUREMENTS OF PASSIVE SMOKING AND ESTIMATES OF LUNG CANCER RISK AMONG NON-SMOKING CHINESE FEMALES Litsda C . Koot, John H-C . Ho~, Daisy SA'w3 and Ching-yet Hot il3ept of Communitv Medicirte, Univrrsirl of Ho+tg Kn+t ; . Hong Kong : 2Radiwhtrapy Drpr ., 6aprisr Hospiral, Kowloon, fa'ong Kong : and 3/ruriswe of Parholog) . Qurrn Efi ;ehrrh Hosptrcl, 14jlir Road, Kowloon . Hong Kong . . . . t.Hetime e :powrss to enviro~nm.ntat tobacco smoke from 28 .t}00 inhabitir,ts/km2, with tmly the home ac workptaci for tY "rsever-smoked" ferrule lung a{uce per person . eancer patienu and 137 "t+ev.rsrnoked " district contr-alt were S m2 of available living •stimated in Hong Kong to a .ueu the possibie causal rotationship of passive ,mokint to lung tincer risk . llelat}.e risks MATERlAL AlJll MET1fUDS based on the husband's unokint habits, or lifetime estimatas of total yean, total hours, maan hoursiday, or totsl ciraraest day unok .d by aach houuhold smoker did not show dosa rsponse rawta . Similarly, when such catetories as mean hours.~day, or earlier age of inicial eapowra, were combined with Ygan of expoture, there were no apparent Increases in From 1981-3, E8 never-smoked female lung cancer patients and 137 never-smoked female district controls were interviewed as pan of a larger retrospective study of femalc lung cancer in Hong Kong covering 200 cases :nd 200 controls In the orig nal study . pauents were matched with an equal numbtr relative risk . However, when the data were sepe=ated by of healthy controls by age (f S years), district of residence histological type and location of the primary tumor, it was (N-34), and housing type (pubGc or private housing), the asen t.hat peripheral tumon in the middle or bwer bbes, or, laner being in indication of soc)o-economic status Det3ils of fess strongly, squamous or smalt-cell tumors In the middle or }ower tob*s, had incrsuint ratauve ritkt that might lndicate some assotiatlon with pauive srt .ohin= eaposure . subject selection, lung cancer histological typing, and method of conducting the interviews have been discussed elsewhere (Koo et al ., 1983, 198A) . Never-srrwked subjects wrre defintxl as those who had smokeA less than 20 cigarenes ip the pasi . Epidemiologieal dsu linking passive smoking %kith lung All dau on ~assive smoking exposures were double-checked cancer among non-smokers have been controversial Six studies (Htnyama, 1981 ; Trichopouios ei al„ 1981 ; Correa ci al ., 1983 ; Knoth et al ., 1983 ; Miller, 1984 ; Garfinkel ri at ., 1985) found significantty elevated relative risks (RR) in the range of 2 .0 to 3 .5 based on the smoking tubits of the spouse . Five other studies (Garfsnkel, 1981 ; Kabat and Wynder, 1984, Chan and Fung, 1982 ; Koo ei af ., 1984 ; Wu cr al . 1985) two of which were conducted in Hong Kong, did not find significantly elevated RR from inhalation of sidestream tobacco smoke Four of these epidemiological studies (Hinyama, 1981 . Trichopoulos er al ., 1981 ; Garfinkel, 1981 ; Chan and Fung, 1982) defsned exposure solely by two questions : whether the spouse smoked (yestno), and the number of cigarenes smnked per day by the spouse . Five other studies (Correa er a1 ., 1983, irSiller, 1984 ; Garfinkel ei ol., 1985, Ksbat and Wynder, 1984 ; Wu er a1 ., 1985) aJso included questions about whether involuntary smoke exposure hnd occurred at work (yes/no), and/or whether the parents has smoked (yes/no) . Such data seem rather crude indices of exposure, providing only very indirect iaforrnafion on tbe 6KTrer add amount of exposurc . Funher• morc, altrtough spcntse(s), parents, or co-workers might have smoked, the actual degrte of contact of the non-smoker with tttese smokers could have been very low, or even nil (Friedsrun ei a1 ., 1983) . In our detailed sasdies (Koo ei at., 1983, 1984) of passive smoking exposures, smoking parents or spauses were sometimes rocalled as inflicting litnle or no exposure on the sub}'ut . In those cases where, for example, tfu husbard smoked but lived aepuated from the wife, then our study counted such wives as unexposed subjeru . Among our never-smoked subjects, this was found to be true for 3 cases a.ad 3 controls . In order to asseu the possible qusal relationship of passive smoking to lung eancer risk, dau from detailed life-hisrory exposures ttut were elicited in intensive 1 .5- to 2-hr taperncordad interviews of never-smoked female lung cancer cases and district controls havc been ana)yxed . Emphasis is placed on the eonsistetscy of the data, the strengths of tltc RR, and whether dose-tccponse relationships were present . with other data elicited in the ltfe-history interviews, espeeially residential pancrns since birth (i,ewhere she) liver :, type of housing . number of rooms, number of eo-habitants, etc ), occupatloru, and rnanul life to reduce errors in estitnating, exposure levels Among the txver-smoked subjects, the mean age of the patients was 57 .8 (so 10 .81) and that for the controls was 59 .3 (sD 9 .94) This umple included 60 who were widows usd 3 who had never mi .rried ; eone had rrtarried more ihan txsct . In the design of the interviews, separate data were eallectad to take into account that within the life-histories of the subjecu, sidestream tobarcro smoke could originate from : (a) different people who stnoked in the presence of the subjest ; (b) different places frequenud by the subject ; and (c) different types of tobacco . Persons who smoked included related and unrelated members of the household, and even co-habituns who shared an apartrrtent unit (if their tobacco smoke was tooticxd b) the subjea) . It was difficult to quantify expoi ;ilre levels from places that could have varying daily amounts of environmental tobacco smoke and were occasiorully visistti by the subject such as cinemu, while playing majong, or in t7anspon vthicles . This analysis will ottly take into account exposures that remained relatively regular during the lifetttnes of the subjects i .e . from exposures r.l borne and the workplace(s) . Among our subjects, tobacco srrsoke mosdv otiS'saued from cigarettes smoked by household members, ared from pipes (water and regular) smoked by parents or in-laws In addition to data based on the husband's smoking habits, 4 other measurements of passive smoking were evaluated : (a) Ioul ycars ot exposure, (b) total hours of exposure, (c) mun hours/day of exposure, and (d) total cigarettes per day snwked by each htwsehold member weighed by their years of exposure . These rrxasures should be a more accurate ref)ecuott t~ past lifetime expasures than simple ques :ions based on whtthc,r~ the spouse or pesenu sawked (yes/no), or whether envitvrt~ menul tobacco Ismoke was encatntered in the workplace (yen no) 'ihis srudy of thc effects of passive smoking is panicularly pettinent to Hong Kong because n is one of the most crowded . ~ urban ettvironrnents in the world . Its urban dertsity avetases Recoivad Jux. 24, t4a6 tad in ycvised fotm Sryternbar 19, t9iG la-A ~ ~ ~
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