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Scandinavian Journal of Public Health, Vol. 34, No. 6, 609-615 (2006)
DOI: 10.1080/14034940600590523
© 2006 Associations of Public Health in the Nordic Countries Regions

COHb% as a marker of cardiovascular risk in never smokers: Results from a population-based cohort study

BO Hedblad

Department of Clinical Sciences in Malmö, Epidemiological Research Group, Lund University, Malmö University Hospital, Sweden, Bo.Hedblad{at}med.lu.se

Gunnar Engström

Department of Clinical Sciences in Malmö, Epidemiological Research Group, Lund University, Malmö University Hospital, Sweden

Ellis Janzon

Department of Clinical Sciences in Malmö, Epidemiological Research Group, Lund University, Malmö University Hospital, Sweden

Göran Berglund

Department of Clinical Sciences in Malmö, Epidemiological Research Group, Lund University, Malmö University Hospital, Sweden

Lars Janzon

Department of Clinical Sciences in Malmö, Epidemiological Research Group, Lund University, Malmö University Hospital, Sweden

Aim: Carbon monoxide (CO) in blood as assessed by the COHb% is a marker of the cardiovascular (CV) risk in smokers. Non-smokers exposed to tobacco smoke similarly inhale and absorb CO. The objective in this population-based cohort study has been to describe inter-individual differences in COHb% in never smokers and to estimate the associated cardiovascular risk. Methods: Of the 8,333 men, aged 34—49 years, from the city of Malmö, Sweden, 4,111 were smokers, 1,229 ex-smokers, and 2,893 were never smokers. Incidence of CV disease was monitored over 19 years of follow up. Results: COHb% in never smokers ranged from 0.13% to 5.47%. Never smokers with COHb% in the top quartile (above 0.67%) had a significantly higher incidence of cardiac events and deaths; relative risk 3.7 (95% CI 2.0—7.0) and 2.2 (1.4—3.5), respectively, compared with those with COHb% in the lowest quartile (below 0.50%). This risk remained after adjustment for confounding factors. Conclusion: COHb% varied widely between never-smoking men in this urban population. Incidence of CV disease and death in non-smokers was related to COHb%. It is suggested that measurement of COHb% could be part of the risk assessment in non-smoking patients considered at risk of cardiac disease. In random samples from the general population COHb% could be used to assess the size of the population exposed to second-hand smoke.

Key Words: Carbon monoxide • epidemiology • myocardial infarction • passive smoking


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