Secondhand Smoke as a Potential Cause of Chronic Rhinosinusitis A Case-Control Study

Objective: To assess the role of secondhand smoke (Si-IS) in the etiology of chronic rhinosinusitis (CRS). Design: Matched case-control study. Associations between SHS and CRS were evaluated by conditional logistic regression odds ratios. Setting: Henry Ford Health System, Detroit, Michigan. Participants: A total of 306 nonsmoking patients diagnosed as having an incident case of CRS and 306 age-matched, sex-matched, and race/ethnicity-matched nonsmoking control patients. Main Outcome Measures: Exposure to SHS for the 5 years before diagnosis of CRS (case patients) and before study entry (controls) for 4 primary sources: home, work, public places, and private social functions outside the home, such as parties, dinners, and weddings. Results: Of controls and case patients, respectively, 28 (9.1%) and 41(13.4%) had SHS exposure at home, 21. (6.9%) and 57 (18.6%) at work, 258 (84.3%) and 276 (90.2%) in public places, and 85 (27.8%) and 157 (51.3%) at private social functions. Adjusted for potential con-founders (socioeconomic status and exposures to air pollution and chemicals or respiratory irritants from hobbies, work, or elsewhere), the odds ratios for CRS Were 1.69 (95% confidence interval, 0.92-3.10) for SHS exposure at home, 2.81 (1.42-5.57) for exposure at work, 1.48 (0.88-2.49) for exposure in public places, and 2.60 (1.74-3.89) for exposure at private functions. A strong, independent dose-response relationship existed between CRS and the number of venues where Si-IS exposure occurred (odds ratio per 1 of 4 levels, 2.03; 95% confidence interval,1.55-2.66). Approximately 40.0% of CRS appeared to be attributable to SHS. Conclusions: Exposure to SHS is common and significantly independently associated with CRS. These findings have important clinical and public health implications.