The Burden of Diseases From Exposure to Environmental Cigarette Smoke: A Case Study of Municipal Staff in Qazvin, Iran

This study aimed to estimate the burden of diseases (BoD) from environmental cigarette smoke (ECS) exposure. More precisely, the study examined the prevalence of non-communicable diseases (NCDs) related to cigarette smoking in municipal staff based on a prospective cohort study. This cross-sectional study was designed among municipal employees, aged 25-55 years in Qazvin, Iran during 2019-2020. The data on cigarette smoking and environmental exposure were obtained using a standard questionnaire. Finally, systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting blood sugar (FBS), triglyceride (TG), high-density lipoprotein, and low-density lipoprotein were measured to assess the relation between active cigarette smoking and the prevalence of NCDs, including hypertension and diabetes in workers. The prevalence of cigarette smoking was 16.2%. In addition, 15% of staff were exposed to ECS. The prevalence of anemia and high TG levels in current cigarette smokers was 2.71 (P=0.024) and 1.4 times higher than among non-smokers (P=0.027). The total number of disability-adjusted life years (DALYs) caused by lung cancer, asthma, and ischemic heart disease (IHD) attributable to ECS was 0.65 per 1000 adults annually. Further, the number of 0.058 death was estimated per 1000 adults annually at the workplace. Most deaths were caused by IHD (79%), followed by lung cancer (12%) and asthma (9%). It was revealed that the number of DALYs and deaths attributable to secondhand smoke (SHS) was 0.34 and 0.3 vs. 0.028 and 0.029 per 1000 adults in men and women, respectively. The results demonstrated that exposure to ECS is an important factor in increasing the risk of the prevalence of NCDs and can increase the BoD attributable to cigarette smoking.