People who are exposed to the smoke of other smokers – secondhand smoke – in private or public settings appear to have a higher-than-normal risk of developing chronic rhinosinusitis (chronic sinus disease), , according to a study published in the April issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.

As background information, the report states that passive smoke (also known as second-hand smoke) contains over 4,000 substances, of which over 50 are either known or suspected to cause cancer. Evidence appears to indicate that passive smoking is linked to a wide range of diseases in children as well as adults, including SID (sudden infant death syndrome), acute respiratory infections, middle ear disease, asthma, coronary heart disease and lung and sinus cancers. It is estimated that 126 million non-smokers, or 60 percent of all U.S. non-smokers, are exposed to secondhand smoke, making it a major public health problem.

C. Martin Tammemagi, D.V.M., M.Sc., Ph.D., of Brock University, St. Catharine’s, Ontario, Canada, and team studied 306 non-smoking patients who had been diagnosed as having chronic rhinosinusitis (inflammation of the nose or sinuses lasting 12 weeks or longer). Their exposure to secondhand smoke at home, work, in public places and at private social functions during the five years before diagnosis was compared with that of 306 individuals who were the same age, sex and race but did not have rhinosinusitis.

Patients with chronic rhinosinusitis were more likely than control patients to have exposure to secondhand smoke at home (13.4% vs. 9.1%), at work (18.6% vs. 6.9%), in public places (90.2% vs. 84.3%) and at private social functions (51.3% vs. 27.8%). A dose-response relationship was observed, in which individuals who were exposed to secondhand smoke in more of the four venues had an increased risk of chronic rhinosinusitis.

In general, about 40% of chronic rhinosinusitis cases seemed to be attributable to passive smoking.

Mechanisms explaining the connection are not certain, but several possibilities exist, the authors note. Secondhand smoke exposure may increase susceptibility to or worsen respiratory infections, inhibit immune responses and increase the permeability of cells lining the respiratory tract.

The authors conclude “Even though more evidence is needed to validate the secondhand smoke-chronic rhinosinusitis association, secondhand smoke is already known to cause many other diseases. Thus, there is already ample reason for taking action to eliminate exposure to secondhand smoke. The U.S. Surgeon General recommends that physicians routinely ask their patients about secondhand smoke exposure.”

“On the basis of our findings, physicians should recommend that patients who are susceptible to chronic rhinosinusitis or who have chronic rhinosinusitis avoid exposure to secondhand smoke. The dose-response relationship between secondhand smoke and chronic rhinosinusitis indicates that even modest levels of exposure carry some risk.”

“Secondhand Smoke as a Potential Cause of Chronic Rhinosinusitis – A Case-Control Study”
C. Martin Tammemagi, DVM, MSc, PhD; Ronald M. Davis, MD; Michael S. Benninger, MD; Amanda L. Holm, MPH; Richard Krajenta, BSc
Arch Otolaryngol Head Neck Surg. 2010;136(4):327-334.
Link to article online

Written by Christian Nordqvist