News Roundup

Childhood exposure to smoke may increase risk of back pain in later life

BMJ 2004; 329 doi: http://dx.doi.org/10.1136/bmj.329.7460.250 (Published 29 July 2004) Cite this as: BMJ 2004;329:250
  1. Roger Dobson
  1. Abergavenny

    Exposure to secondhand smoke during childhood may increase the risk of developing back and neck problems in later life, says a new study. The research showed that adults who were exposed to tobacco smoke as children were more likely to take long term sick leave because of spinal pain.

    One explanation, say the researchers, could be the effects of the smoke on the developing spine. “In several studies, smoking has been associated with the occurrence of spinal pain, mostly low back pain, but also neck pain and prolapsed cervical intervertebral discs,” says the report in the European Journal of Public Health (2004:14;296-300).

    The study, which was carried out at the University of Oslo and supported by the Norwegian Ministry of Health and Social Affairs, looked at a cohort of nurses' aides—the assistants who provide practical care to patients—to see whether exposure to environmental tobacco smoke at home during childhood led to a greater likelihood of long term sick leave.

    “No studies seem to have explored the extent to which exposure to environmental tobacco smoke during childhood is related to work disability during adulthood,” says the report.

    The study used a sample of 4744 aides who completed two questionnaires 15 months apart. The two main outcome measures were the incidence of sick leave lasting longer than 14 days and the incidence of sick leave longer than eight weeks in the period between the two questionnaires. Included were questions relating to childhood exposure to tobacco smoke.

    In the second questionnaire 1609 people (34%) reported that they had had one or several periods of sick leave lasting longer than 14 days. A total of 818 (17%) reported having had sick leave lasting longer than eight weeks.

    The results showed that the aides who had been exposed to environmental tobacco smoke during childhood were more likely than aides who had not been exposed to smoke to take sick leave exceeding 14 days for neck pain (odds ratio 1.34 (95% confidence interval 1.04 to 1.73)), high back pain (1.49 (1.07 to 2.06)), and any illness (1.23 (1.07 to 1.42)), after demographic and family characteristics, former smoking status, current smoking status, physical leisure time activities, nature of work before neck injury, and affective symptoms were adjusted for. The difference in the number of aides who took leave exceeding 14 days for low back pain was not significant. Aides who had been exposed to environmental tobacco smoke were also more likely to take sick leave exceeding eight weeks (odds ratio 1.29 (1.08 to 1.55)).

    “The study supports the hypothesis that nurses' aides who were exposed to environmental tobacco smoke at home during childhood have an increased risk of long-term sickness absence,” concludes the report.

    “In the present study, reported exposure … during childhood was associated with an increased risk of long-term sick leave attributed to spinal pain, such as neck pain and back pain. One explanation may be that harmful effects of environmental tobacco smoke during childhood cause work disability during adulthood.”

    It adds, “Whether these associations represent causal effects remains unclear, but they could be due to effects of environmental tobacco smoke on the developing spine.”