Environmental tobacco smoke and ischaemic heart disease : a case study in applying causal criteria.
Whether ischaemic heart disease (IHD) is caused by exposure to environmental tobacco smoke (ETS), commonly known as « passive smoking », has been debated from both epidemiological and biological perspectives.
Methods and results
In this paper we use Bradford Hill criteria to synthesize results from the biological and epidemiological literature in a formal assessment of the strength of support for such a relationship.
Although we find that these criteria, designed for clinical trials, do not give an ideal framework for assessment of epidemiological and biological studies, nevertheless they do provide systematic guidance for this assessment.
For the general population, of the nine tests proposed by Hill we find that one (biological plausibility) seems to be supported, though not unarguably ; three (strength, consistency, specificity) appear to fail by accepted standards ; and the remaining five have insufficient data for a clear evaluation (biological gradient, experimental evidence, temporality, coherence, analogy).
Overall, this provides at best weak support for a causal association between ETS and IHD across the general community.
Conversely, there appears to be more support, especially in the biology studies, for an association between ETS and IHD for those with pre-existing disease, although epidemiological studies are limited in this area. (...)
Mots-clés Pascal : Toxicité, Tabagisme passif, Homme, Epidémiologie, Ischémie, Myocarde, Etiologie, Pathogénie, Facteur risque, Relation dose réponse, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Cardiopathie coronaire, Myocarde pathologie
Mots-clés Pascal anglais : Toxicity, Passive smoking, Human, Epidemiology, Ischemia, Myocardium, Etiology, Pathogenesis, Risk factor, Dose activity relation, Cardiovascular disease, Vascular disease, Coronary heart disease, Myocardial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0284753
Code Inist : 002B03E. Création : 16/11/1999.