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Dtsch Med Wochenschr 2004; 129(4): 157-162
DOI: 10.1055/s-2004-817603
Übersichten
Toxikologie / Umweltmedizin
© Georg Thieme Verlag Stuttgart · New York

Passivrauchen - aktueller Stand des Wissens

Environmental tobacco smoke exposure - current reviewK. Radon1 , D. Nowak1
  • 1Institut und Poliklinik für Arbeits- und Umweltmedizin (Direktor: Prof. Dr. med. D. Nowak), Ludwig-Maximilians-Universität München
Further Information

Publication History

eingereicht: 7.5.2003

akzeptiert: 19.8.2003

Publication Date:
15 January 2004 (online)

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Zusammenfassung

Passivrauch ist vermutlich die quantitativ bedeutsamste inhalative Noxe der Innenraumluft. In bevölkerungsbezogenen Untersuchungen geben 30-60 % aller Befragten an, regelmäßig gegenüber Passivrauch exponiert zu sein. Passivrauch ist durch die Senatskommission zur Bewertung gesundheitsgefährdender Arbeitstoffe der Deutschen Forschungsgemeinschaft als erwiesenermaßen humankanzerogener Arbeitsstoff eingestuft worden. Im Jahre 2002 wurde die Arbeitsstättenverordnung um einen Paragraphen „Nichtraucherschutz” ergänzt.

In international publizierten Metaanalysen einer Vielzahl epidemiologischer Studien zeigten sich für Bronchialkarzinome Relative Risiken (RR) von 1,1 bis 1,3. Das RR für koronare Herzkrankheiten lag bei 1,25 bis 1,35. Auch das RR für Atemwegssymptome, Asthma und chronische Bronchitis war konsistent erhöht. Dabei kann in den am höchsten exponierten Subgruppen das Relative Risiko auf den Faktor 2 erhöht sein.

Da bei ähnlich großen Relativen Risiken Herzerkrankungen wesentlich häufiger auftreten als Bronchialkarzinome, werden die Absolutzahlen der durch Passivrauchen verursachten Erkrankungen des Herz- und Gefäßsystems um den Faktor 5 - 10 höher eingeschätzt als die für das Bronchialkarzinom.

Summary

Among all indoor pollutants, environmental tobacco smoke (ETS) might be the most important. In population-based studies 30 to 60 % of the participants reported regular exposure to ETS. ETS has been classified as carcinogenic by several national and international agencies. In 2002, a paragraph on restriction of smoking at the workplace has been added to the German Workplaces Ordinance.

International meta-analyses have been published on the potential health effects of ETS exposure. In these studies, the pooled relative risk (RR) for lung cancer has been estimated between 1.1 and 1.3. The pooled risk estimate for coronary heart disease (CHD) was slightly higher (1.25 - 1.35). The RR in the group with the highest exposure might be as high as 2. An increased risk has also be shown consistently for respiratory symptoms, asthma, and COPD. Because of the high incidence of CHD the public health impact of ETS exposure on CHD might be higher than the impact due to additional lung cancer cases.

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Priv.-Doz. Dr. Katja Radon

Arbeitsgruppe Arbeits- und Umweltepidemiologie & Net Teaching, Institut für Arbeits- und Umweltmedizin

Ziemssenstraße 1

80336 München

Phone: 089/51602400

Fax: 089/51603957

Email: kradon@arbeits.med.uni-muenchen.de

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