J Korean Med Sci.  2013 Aug;28(8):1122-1128. 10.3346/jkms.2013.28.8.1122.

Associations between Cigarette Smoking and Total Mortality Differ Depending on Serum Concentrations of Persistent Organic Pollutants among the Elderly

• Lee YM
• Bae SG
• Lee SH
• Jacobs DR
• Lee DH

• KMID: 1793014
• DOI: http://doi.org/10.3346/jkms.2013.28.8.1122

Abstract

There are substantial variations of relative risks (RR) in smoking-related mortality by country and time. We hypothesized the RRs in smoking-related mortality might differ depending on serum concentrations of persistent organic pollutants (POPs). We evaluated the associations of cigarette smoking with total mortality in 610 elderly (aged > or = 70 yr) (702 elderly for organochlorine pesticides [OCPs]) after stratification by serum concentration of POPs, in the National Health and Nutrition Examination Survey (NHANES) 1999-2004 followed through 2006. Summary measures of POPs subclasses showed significant or marginally significant interaction with cigarette smoking on the risk of total mortality. P values for interaction were 0.069 for polychlorinated dibenzo-p-dioxins (PCDDs), 0.008 for polychlorinated biphenyls (PCBs), and 0.024 for OCPs. The effect of smoking on total mortality showed different patterns according to the serum concentration of some POPs. Former or current smokers had 1.4 to 2.9 times higher mortality rates compared with never smokers among participants with higher serum concentrations of POPs (2nd or 3rd tertiles). However, when the level of PCBs or OCPs were low (1st tertile), there were little positive associations between smoking and mortality. Our study suggests that the background exposure to several POPs may be related to variability in smoking-related total mortality.

Keyword

Smoking; Mortality; Persistent Organic Pollutants; Polychlorinated Biphenyls; Organochlorine Pesticides

MeSH Terms

Aged
Aged, 80 and over
Environmental Exposure
Environmental Pollutants/*blood
Female
Humans
Hydrocarbons, Chlorinated/blood
Male
Nutrition Surveys
Pesticides/blood
Polychlorinated Biphenyls/blood
Proportional Hazards Models
Risk
Smoking/*mortality
Tetrachlorodibenzodioxin/analogs & derivatives/blood
Environmental Pollutants
Hydrocarbons, Chlorinated
Pesticides
Polychlorinated Biphenyls
Tetrachlorodibenzodioxin

Figure

• 

  Fig. 1 Interactions of cigarette smoking with polychlorinated dibenzo-p-dioxins (PCDDs, A), polychlorinated dibenzofurans (PCDFs, B), polychlorinated biphenyls (PCBs, C), and organochlorines pesticides (OCPs, D) on mortality. Hazard ratios (HRs) adjusted for age, gender, race/ethnicity, physical activity and BMI. T1, first tertile; T2, second tertile; T3, third tertile. Values of individual POPs with statistically significant (P for interaction < 0.05) or marginally significant (P for interaction < 0.15) in each subclass were individually ranked and the rank orders of the individual POPs were summed and divided by tertiles to calculate summary measures of POPs subclass. Second tertile and third tertile were combined to a single group. *P value < 0.05; †P value < 0.01.

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