Philip Morris
Environmental Tobacco Smoke and Heart Disease
Fields
- Author
- S, W.L.
- Named Person
- Adena, M.A.
- Alderson, M.R.
- Alexander, H.M.
- Armitage, A.
- Arnold, J.
- Aronow
- Aronow, W.S.
- Aviado, D.
- Bansal, A.K.
- Barrettconnor, E.
- Bernheim, J.
- Bertanelli, F.
- Bodurtha, J.N.
- Bossano, R.
- Buerger
- Burghuber, O.C.
- Butler
- Butler, T.
- Caldwell, Ads
- Casper, M.
- Chamberlain, J.
- Chee, E.
- Chopra, C.
- Clarke, W.
- Comstock, G.W.
- Correa, P.
- Crepat, J.
- Criqui, M.
- Criqui, M.H.
- Croft, J.
- Davis
- Davis, J.W.
- Dobson, A.J.
- Donnan, G.A.
- Doyle, A.E.
- Eckfeldt, J.
- Etzel, R.A.
- Evans, G.
- Fabiano, P.
- Feldman, J.
- Filippelli, M.
- Fortmann, S.P.
- Froeb, H.F.
- Garland, C.
- Gerber, A.
- Gillis, C.R.
- Glantz, S.A.
- Green
- Green, J.
- Green, M.S.
- Haber, P.
- Hames, C.G.
- Harari, G.
- Hawthorne, V.M.
- He, Y.
- Heiss, G.
- Heller, R.F.
- Helsing, K.J.
- Hewitt, J.K.
- Hicks, L.L.
- Hirayama, T.
- Hole, D.J.
- Hollarbush, J.
- Howard, G.
- Humble
- Humble, C.
- Hunt, S.C.
- Isenberg, W.M.
- Jacobson, M.S.
- Kawachi
- Kefalides, A.
- Khalfen, E.S.
- Klochkov, V.A.
- Kristensen
- Kulik, J.A.
- Kuller, L.H.
- Lauer, R.
- Lee, P.N.
- Leone
- Leone, A.
- Lilienfield, D.E.
- Lloyd, D.M.
- Martin
- Martin, M.J.
- Matsumoto, T.
- Matsushita
- Matsushita, M.
- Mcmurray
- Mcmurray, R.G.
- Mcneil, J.J.
- Mennear, J.
- Mizell, M.
- Mori, L.
- Moskowitz, W.B.
- Mosteller, M.
- Munby, J.
- Neill, G.C.
- Nussbaum, M.
- Ockene, J.K.
- Omalley, H.M.
- Palmer
- Palmer, J.R.
- Parmley, W.W.
- Pomrehn, P.
- Punzengruber, C.
- Rosenberg, L.
- Sandler, D.P.
- Schieken, R.M.
- Segrest, J.P.
- Shaham, J.
- Shapiro, S.
- Shelton, L.
- Shenkder, I.R.
- Shionoya, S.
- Sievers, R.E.
- Silberbauer, K.
- Singh, C.B.
- Sinsheimer, P.J.
- Sinzinger, H.
- Soni, G.L.
- Spierto, F.W.
- Steenland, K.
- Suarez, L.
- Sun, Y.P.
- Surgeon General
- Svendsen
- Svendsen, K.H.
- Szklo, M.
- Taylor
- Tell, G.
- Thompson, D.L.
- Tribble, D.L.
- Tyroler, H.A.
- Virgolini, I.
- Watanabe, I.S.
- Weetman, D.F.
- Wells, A.J.
- Wexler, L.
- Whig, J.
- White, J.R.
- Williams, R.R.
- Wingard, D.L.
- Zhu
- Zhu, B.Q.
- Alderson, M.R.
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- REPT, REPORT, OTHER
- BIBL, BIBLIOGRAPHY
- Site
- R529
- Document File
- 2023511660/2023512308/Ets: Heart Disease 930900
- Characteristic
- PARE, PARENT
- Master ID
- 2023511661/2307
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- Date Loaded
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Document Images
Environmental Tobacco Smoke
and
Heart Disease
~ Literature Review
2o2351i6s5
THIS ISSUE BINDER IS INTENDED TO PROVIDE A BASIC,
COMPREHENSIVE REVIEW OF THE SCIENTIFIC LITERATURE
REGARDING A SPECIFIC TOPIC ON ETS AND THE HEALTH OF
NONSMOKER.S.
PRIMARY STUDIES AND REVIEWS HAVE BEEN HIGHLIGHTED
TO IDENTIFY (I) USEFUL OR HELPFUL INFORMATION (YELLOW
HIGHLIGHT) AND (2) ADVERSE RESULTS OR OPINIONS (BLUE
HIGHLIGHT).
TABLE OF
CONTENTS
2423511663
performance, potential effects in heart disease patients or in
relation to biochemical and cellular processes, including
atherosclerosis.
3
ETS and Heart Disease
TABLE OF CONTENTS
PAGEhTOS .
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 1
Provides a description of the scope and organization of
the notebook.
Epid'emiolocric Reports and Reviews . . . . . . . . . . . . . . 4
Reports with oricrinal data . . . . . . . . . . . . . . . 4
Summarizes the 12 epidemiological studies with~ data on
ETS exposure in relation to heart disease incidence or
mortality. Includes an~ epidemiological study on stroke
and one on Buerger's disease. For more detailed
discussions and criticisms of these reports, see Appendix
A.
Reviews claiming ETS-associated risk . . . . . . . . . .. 8
Discusses articles which have reviewed the epidemiological
literature and concluded that ETS exposure is causally
related to heart disease in nonsmokers. The focus is on
the meta-analyses and' risk assessments by Wells (1988),
Glantz and' Parmley (1991) and Steenland (1992). Copies
of these articles are in Appendix B.
Reviews emphasizing inconclusiveness of the data. . . . . 14
Sets forth the conclusions from several major literature
reviews that have judged that the data are inadequate to
support a conclusi~on that ETS is related~ to heart disease
in nonsmokers. Copies of these publications are provided
in Appendix C.
Laboratory and Biochemical Studies . . . . . . . . . . . . .. . 21
Identifies and summarizes laboratory studies of exercise
performance, biochemical studies involving such issues
as platelet activity, cholesterol levels and leukocyte
levels and studies of atherosclerosis. Copies of these
articles are in Appendix D.
Epid'emiologic Reports and Reviews
Reports with original data
There are currently 12 studies presenting epidemiological
data on~ a possible statistical association between ETS and heart
disease incidence and mortality.
The ETS associated risks reported in the 12
epidemiological studies are summarized in the following table.
- 4 -
ETS and Heart Disease 8/5/93
Introduction
This notebook discusses and provides copies of the public
literature bearing on the claim that environmental tobacco smoke
(ETS) is related to heart disease. The current notebook is an
update, following its initial preparation in 1991.
Currently, there is a total of 12 epidemiological studies
presenting data on a possible statistical~ association between ETS
and heart disease incidence or mortality. These epidemiological
reports are the primary basis for claims of an elevated~ heart
disease risk in~nonsmokers exposed to ETS. However,, the literature
also contains several laboratory and statistical reports dealing
with ETS and exercise performance (particularly in angina patients),
with biochemical factors suggested as involved in the development
of heart disease or with atherosclerosis. These reports are also
discussed and~ includ'ed in this notebook.
Each of the articles included in this notebook has been
highlighted in blue and yellow. The blue highlighting identifies
t1:
"adverse" comments -- that is, comments supporting a relationship Q
of ETS with heart disease, or that otherwise express unfavorable (,c
data or opinions regarding tobacco. The yellow, highlighting ~
identifies "helpful" comments -- that is, comments that challenge, t~
~
or at least that are concessionary concerning, the potential ~
involvement of ETS or tobacco in disease causation. Letters to
the editor or other editorial comments are included with several
of the articles in this notebook.
The initial section of this notebook contains an overview
and discussion of the literature. The literature itself is grouped
into four appendices..
Appendix A (Tabs 1-14) contains the 12 epidemiological
reports with data on~a potential association between ETS and! heart
disease (Tabs 1-12). Appendix A also contains two epidemiological
reports with: data on~other cardiovascular diseases -- namely stroke
(Tab 13) and Buerger's disease (Tab 14). A summary and discussion
of major criticisms is provided for each of the 12 ETS/heart disease
studies.
Appendix B (Tabs 15-20) contains major meta-analyses and
reviews concluding that ETS is associated with an elevated heart
disease risk.
Appendix C (Tabs 21-34) contains opinions that the data
-3_C.2 inadequate to conclude that ETS is related to heart disease.
Appendix D (Tabs 35-51) contains a mixed group of
articles which provide data concerning ETS in relation
2
to exercise
Epidemiolosy
ETS/Heart Disease Relative Risks
Sex Relative
Risk
Butler (1990)1 F 1.4
Dobson et al.
~ M .97 (Home)~
(1991) F 2.46*
M .95 (Work)
F .66
Garland, et al. F 2.7
(1985)3
He, et al. F 1.5*
(1989)4
Helsing, et al. M 1.3*
(1988) F 1.2*
Hirayama (1984)6 F 1.3
H'olie, et al. M+F 2.0*
(1989)7
Humble et al. F 1.6
(1990)A
Lee, et al. M+F 1.0
(198b)'9
Martin et al. F 3'.4*
(1986) i0
Palmer et al. F 1.2
(1988) il
Svendsen, et al. M 2.2 N
(1987)12
N
*Reported
to be statistically significant at
the 95% level of Li
CA
confidence.
N
- 5 -
