Secondhand smoke as a potential cause of chronic rhinosinusitis: a case-control study.

OBJECTIVE To assess the role of secondhand smoke (SHS) in the etiology of chronic rhinosinusitis (CRS). DESIGN Matched case-control study. Associations between SHS and CRS were evaluated by conditional logistic regression odds ratios. SETTING Henry Ford Health System, Detroit, Michigan. PARTICIPANTS A total of 306 nonsmoking patients diagnosed as having an incident case of CRS and 306 age-matched, sex-matched, and race/ethnicity-matched nonsmoking control patients. MAIN OUTCOME MEASURES Exposure to SHS for the 5 years before diagnosis of CRS (case patients) and before study entry (controls) for 4 primary sources: home, work, public places, and private social functions outside the home, such as parties, dinners, and weddings. RESULTS Of controls and case patients, respectively, 28 (9.1%) and 41 (13.4%) had SHS exposure at home, 21 (6.9%) and 57 (18.6%) at work, 258 (84.3%) and 276 (90.2%) in public places, and 85 (27.8%) and 157 (51.3%) at private social functions. Adjusted for potential confounders (socioeconomic status and exposures to air pollution and chemicals or respiratory irritants from hobbies, work, or elsewhere), the odds ratios for CRS were 1.69 (95% confidence interval, 0.92-3.10) for SHS exposure at home, 2.81 (1.42-5.57) for exposure at work, 1.48 (0.88-2.49) for exposure in public places, and 2.60 (1.74-3.89) for exposure at private functions. A strong, independent dose-response relationship existed between CRS and the number of venues where SHS exposure occurred (odds ratio per 1 of 4 levels, 2.03; 95% confidence interval, 1.55-2.66). Approximately 40.0% of CRS appeared to be attributable to SHS. CONCLUSIONS Exposure to SHS is common and significantly independently associated with CRS. These findings have important clinical and public health implications.