Journal of dental hygiene science (치위생과학회지)

The Korean Society of Dental Hygiene Science (한국치위생과학회)
권호 표지

The Association between Environmental Tobacco Smoke and Periodontal Health: Finding from Korean National Health and Nutrition Examination Survey 2008~2009

간접흡연과 치주건강의 관련성: 2008~2009 국민건강영양조사 자료분석 결과

  • Kim, Jin Kyoung (Department of Dental Hygiene, Daegu Health College) ;
  • Baek, Hye-Jin (Department of Dental Hygiene, Taegu Science University) ;
  • Lee, Young-Eun (Department of Dental Hygiene, Daegu Health College) ;
  • Song, Keun-Bae (Department of Preventive Dentistry, Kyungpook National University School of Dentistry) ;
  • Choi, Youn-Hee (Department of Preventive Dentistry, Kyungpook National University School of Dentistry)
  • 김진경 (대구보건대학 치위생과) ;
  • 백혜진 (대구과학대학교 치위생과) ;
  • 이영은 (대구보건대학 치위생과) ;
  • 송근배 (경북대학교 치의학전문대학원 예방치과학교실) ;
  • 최연희 (경북대학교 치의학전문대학원 예방치과학교실)
  • Received : 2014.02.07
  • Accepted : 2014.05.12
  • Published : 2014.06.30
⟨ Previous Next ⟩

Abstract

Environmental tobacco smoke (ETS) or second hand smoke or passive smoking has become a well-known risk factor for various health hazards in nonsmoking adults as well as active smokers. In Korea, there have been few studies concerning about the impact of ETS on periodontal health. Therefore, the aim of this study was to investigate the association between exposure to passive smoking and prevalence of periodontitis using Korea National Health and Nutrition Examination Survey (KNHANES) in 2008 and 2009. The Fourth KNHANES data was employed from 2008~2009. The final sample size was 4,669 adults aged over 18 years, who were never-smoker and had the information about ETS both at home and in the workplace, urine analysis and periodontal examination by Community Periodontal Index (CPI). Periodontitis was defined as CPI codes ${\geq}3$. Data were analyzed using PASW Statistics 18.0. The sociodemographic and behavioral factors were adjusted as confounders. Overall, 17.1% (male 16.4%, female 83.6%) of the participants were exposed to ETS. The mean concentration of cotinine in those exposed ETS was significantly higher than that in unexposed people ($46.92{\mu}g/ml$ versus $19.34{\mu}g/ml$, p<0.001). Participants exposed to ETS were more likely to have periodontitis than those unexposed after adjusting for potential confounding variables. ETS is associated with the prevalence of periodontitis in Korean adults. This may suggest that patients with periodontitis or periodontal surgery should be protected from smokers or smoking places.

본 연구는 제4차 국민건강영양조사 자료를 바탕으로 직장 및 가정 내 간접흡연에 노출되는 자를 연구대상으로 하였다. 대상자들을 성별, CPI 및 간접흡연 노출여부를 기준으로 비교 분석하였으며, 다음과 같은 결론을 얻었다. 첫째, 간접흡연 노출자는 남성 380명, 여성 1,519명으로 조사되었으며, 간접흡연 노출여부에 따른 코티닌 농도는 노출군에서 유의한 차이를 보였다(p<0.001). 둘째, 치은염(CPI 1, 2)과 간접흡연의 관계는 남성은 치과방문횟수(p<0.001), 여성은 연령(p<0.001) 및 치과방문횟수(p<0.001)와 관계가 있었다. 셋째, 치주염(CPI 3, 4)와 간접흡연의 관계는 남성은 연령(p<0.001), 여성은 연령(p<0.001), 간접흡연 노출여부(p<0.001)와 관계가 있었다. 넷째, 치주상태에 따른 치주상태별(CPI 1~4) 코티닌 농도 차이는, 남성은 CPI 1, CPI 4에서, 여성은 모든 CPI 군에서 노출여부에 따른 큰 차이를 보였다. 이상의 결과를 종합하면 간접흡연 노출여부가 여성의 치주상태에 영향을 미치는 것으로 나타났다. 이로써 효과적인 치주치료는 물론 국민 구강건강증진을 위해 간접흡연 위해성을 확대 고취시키고 비흡연자를 보호할 수 있는 적극적인 금연정책이 실행되어야 할 것으로 고려된다.

Keywords

References

  1. Mathers CD, Loncar D: Projection of global mortality and burden of disease from 2002 to 2030. PLos Med 3: e442, 2006. https://doi.org/10.1371/journal.pmed.0030442
  2. Statistics Korea: Causes of mortality 2012. Retrieved March 14, 2014, from http://meta.narastat.kr/metasvc/index.do?confmNo=10154&inputYear=2012(2013, September 25).
  3. Yang JY, Park KS: The effects of smoking on oral environment. J Korean Soc Dent Hyg 1: 60-66, 2001.
  4. Park LS, Lee SH, Youn HJ: A comparative study on oral environment between smokers and non-smokers. J Korean Soc Dent Hyg 8: 139-146, 2008.
  5. Jang BJ, Nam LS: Relationship between smoking, drinking and periodontal pocket formation of patient was visited at College Scaling Center. J Korean Soc Dent Hyg 10: 117-122, 2010.
  6. Nelson E: The miseries of passive smoking. Hum Exp Toxicol 20: 61-83, 2001. https://doi.org/10.1191/096032701670538508
  7. Hayashino Y, Fukuhara S, Okamura T, et al.: A prospective study of passive smoking and risk is diabetes in a cohort of workers: the High-Risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study. Diabetes Care 31: 732-734, 2008. https://doi.org/10.2337/dc07-1905
  8. Ruiling L, David LB, Lara AG, Martha JH, Michael GA, Hammond SK: Assessment of risk for asthma initiation and cancer and heart disease deaths among patrons and servers due to secondhand smoke exposure in restaurants and bars. J tobacco control 0: 1-7, 2013.
  9. Lahmouzi J, Simain-Sato F, Defresne MP, et al.: Effect of nicotine on rat gingival fibroblast in vitro. Connect Tissue Res 41: 69-80, 2000. https://doi.org/10.3109/03008200009005643
  10. Arbes Jr SJ, Agustsdottir H, Slade GD: Environmental tobacco smoke and periodontal disease in the United States. Am J Public Health 91: 253-257, 2001. https://doi.org/10.2105/AJPH.91.2.253
  11. Erdemir EO, Sonmez IS, Oba AA, Bergstrom J, Caglayan O: Periodontal health in children exposed to passive smoking. J Clin Periodontol 37: 160-164, 2010. https://doi.org/10.1111/j.1600-051X.2009.01510.x
  12. Rylander E, Pershagen G, Ericsson M, Bermman G: Parental smoking, urinary cotinine, and wheezing bronchitis in children. Epidemiology 6: 289-293, 1995. https://doi.org/10.1097/00001648-199505000-00017
  13. Shelley D, Yerneni R, Hung D, Das D, Fahs M: The relative effect of household and workplace smoking restriction on health status among Chinese Americans living in New York City. J Urban Health 84: 360-371, 2007. https://doi.org/10.1007/s11524-007-9190-6
  14. Jee SH, Ohrr H, Kim IS: Effect of husbands' smoking on the incidence of lung cancer in Korean women. Int J Epidemiol 28: 824-828, 1999. https://doi.org/10.1093/ije/28.5.824
  15. Kim SJ, Kwon SM: Social cost analysis of smoking from 2006 data. J Policy Anal Eval 18: 119-140, 2008.
  16. Benowitz NL: Phamacology of nicotine: addition and therapeutics. Ann Rev Phamacol Toxicol 36: 597-600, 1986.
  17. Scott DA, Palmer RM, Stapleton JA: Validation of smoking status in clinical research into inflammatory periodontal disease. J Clin Periodontol 28: 715-722, 2001. https://doi.org/10.1034/j.1600-051X.2001.280801.x
  18. Benowitz NL: Cotinine as a biomarker of enviromental tobacco smoke exposure. Epidemiol Rev 18: 188-204, 1996. https://doi.org/10.1093/oxfordjournals.epirev.a017925
  19. Nogueira-Filho GR, Froes Neto EB, Casati MZ, et al.: Nicotine effects on alveolar bone changes induced by occlusal trauma: a histometric study in rats. J Periodontol 75: 348-352, 2004. https://doi.org/10.1902/jop.2004.75.3.348
  20. Ministry of Health and Welfare: Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey (KNHANES) raw data guideline the 4th 1st, 2009. Ministry Health and Welfare, Osong, 2009.
  21. Ministry of Health and Welfare: Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey (KNHANES) reports 4th 1st, 2009. Ministry Health and Welfare, Osong, 2009.
  22. Ministry of Health and Welfare: Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey (KNHANES) the 4th 1st, 2009. Medical Diagnostic Test (Clinical Test)-Neodine Medical Istitute, Seoul, 2009.
  23. Connolly GN, Alpert HR, Wayne GF, Koh H: Trends in nicotine yield in smoke and its relationship with design characteristics among popular US cigarette brands, 1997-2005. Tob Control 16: e5, 2007. https://doi.org/10.1136/tc.2006.019695
  24. Benowiz NL, Jacob P 3rd, Fong I, Gupta S: Nicotine metabolic profile in man: comparision of cigarette smoking and transdermal nicotine. J Pharmacol Exp Ther 268: 296-301, 1994.
  25. Liu KH, Hwang SJ: The change of nicotine and cotinine concentrations in the saliva of participants in the quitsmoking clinic in Daejeon. J Korean Acad of Oral Health 36: 228-237, 2012.
  26. Nakata A, Takahashi M, Haratani T, et al.: Association of active and passive smoking with sleep disturbances and short sleep duration among Japanese working population. Int J Behav Med 15: 81-91, 2008. https://doi.org/10.1080/10705500801929577
  27. Yamamoto Y, Nishida N, Tanaka M, et al.: Association between passive and acctive smoking evaluated bysalivary cotinine and periodontitis. J Clin Periodontal 32: 1041-1046, 2005. https://doi.org/10.1111/j.1600-051X.2005.00819.x
  28. Nishida N, Yamamoto Y, Tanaka M, et al.: Association between passive smoking and salivary markers related to periodontitis. J Clin Peridontol 33: 717-723, 2006. https://doi.org/10.1111/j.1600-051X.2006.00982.x
  29. Kang JM, Cha KS, Kim SJ, Bin JH: A study on urinary nicotine & cotinine levels of smokers, non-smokers. Rep Busan Inst Health and Environ 14: 63-74, 2004.
  30. Lee BE, Ha EH: Exposure to environmental tobacco smoke among South Korean adults: a cross sectional study of the 2005 Korea national health and nutrition examination survey. J Enviro Health 10: 1186-1195, 2011.
  31. Ministry of Health and Welfare: Smoking state survey [Internet]. Naver; [cited 2013 Nov 19]. Available from: http://academic.naver.com/openUrl.nhn?doc_id=39555729&linkType=doclink(2013, September 10).
  32. Gu D, Wu X, Reynolds K, et al.: Cigarette smoking and exposure to environmental tobacco smoke in China: The international collaborative study of cardiovascular disease in Asia. Am J Public Health 94: 1972-1976, 2004. https://doi.org/10.2105/AJPH.94.11.1972
  33. Jousilahti P, Helakorpi S: Prevalence of exposure to environmental tobacco smoke at work and at home-15 year trends in Finland. Scand J Work Environ Health 28: 16-20, 2002.